Cirrhotic Ascites: An Etiologic Approach to Management

When loss of ascites fluid is achieved by dietary salt restriction, a lasting physiologic readjustment occurs, with the kidneys regaining ability to excrete salt normally. In contrast, evacuation of fluid by paracentesis or pharmacologic diuresis alone is rapidly followed by reconstitution of the ascites and, especially in patients without edema, is likely to be accompanied by diminished plasma volume and electrolyte abnormalities.