Managing Ascites, Spontaneous Bacterial Peritonitis, and Hepatorenal Syndrome

Background

This practice guidance updates the 2012 AASLD practice guideline on this topic (Hepatology 2013; 57:1651). AASLD defines “practice guidance” as a synthesis of expert opinion, rather than the more traditional systematic review that is typical of practice guidelines. Here are a few key statements for each of these complications.

Key Points

Ascites:

• Diagnostic paracentesis should be performed in all patients with new-onset ascites and in all patients with cirrhosis and pre-existing ascites who are admitted to the hospital.

• Recommended initial peritoneal fluid tests are cell count and differential total protein, and albumin (to enable calculation of the s…