Ascites and renal failure in primary liver cell carcinoma.

Ascites and Renal Failure in Primary Liver Cell CarcinomaAscites appears in 50-75% of patients with primary liver cell carcinoma (P.L.C.C.)' but there have been few investigations of its cause.We studied 25 patients with P.L.C.C. and ascites to assess any renal disturbances present. Patients, Methods, and ResultsDiagnosis was based on histological data, and all except one patient had P.L.C.C. associated with cirrhosis.None received specific treatment for the P.L.C.C. and all died.Liver function was evaluated and renal function studied by determining the creatinine clearance as an index of the glomerular filtration rate (G.F.R.), the sodium, potassium, and urea concentrations in plasma and urine, and plasma and urine osmolality.Ascites was treated by bed rest and a low-salt diet for seven days after admission.Patients who did not lose ascites and body weight were started on distal diuretics (triamterene 300 mg/day or spironolactone 150 mg/day), and if the response was un- satisfactory frusemide (80 mg/day) was added.Renal failure was defined as a G.F.R. of below 50 ml/min, and we divided