Chinese guidelines on the management of ascites and its related complications in cirrhosis

Hepatol Int. 2019 Jan;13(1):1-21. doi: 10.1007/s12072-018-09923-2. Epub 2019 Jan 18.

Abstract

The Chinese Society of Hepatology developed the current guidelines for the Management of Ascites and Its Related Complications in Cirrhosis based on the published evidences and the panelists' consensus. The guidelines provided recommendations for the diagnosis and management of cirrhotic ascites emphasizing a step-wise approach with the first-, second-, and third-line therapy. For refractory ascites, vasoconstrictors and albumin are recommended for splanchnic vasodilation and selective vasopressin (V2) receptor antagonists for moderate-to-severe hyponatremia. For spontaneous bacterial peritonitis, empirical anti-infection treatment was recommended based on the local microbiological examination of community- or hospital-acquired infections. For hepatorenal syndrome, the administration of vasopressor terlipressin and albumin is recommended.

Keywords: Ascites; Diagnosis; Guidelines; Hepatorenal syndrome; Liver cirrhosis; SBP; Therapy.

Publication types

  • Practice Guideline

MeSH terms

  • Anti-Infective Agents / therapeutic use
  • Ascites* / complications
  • Ascites* / diagnosis
  • Ascites* / therapy
  • Bacterial Infections / etiology
  • Diagnosis, Differential
  • Diet, Sodium-Restricted
  • Forecasting
  • Hepatorenal Syndrome / diagnosis
  • Hepatorenal Syndrome / etiology
  • Hepatorenal Syndrome / therapy
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / therapy
  • Nutritional Support
  • Paracentesis / methods
  • Peritonitis / etiology
  • Sodium Potassium Chloride Symporter Inhibitors / therapeutic use
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Anti-Infective Agents
  • Sodium Potassium Chloride Symporter Inhibitors
  • Vasoconstrictor Agents