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This is a transudate ascites with a protein content that is rarely greater than 2g per litre. The main aetiological factor is portal hypertension
Features associated with cirrhotic ascites include:
- ascites is associated with sodium retention (reduced urinary sodium excretion)
- serum sodium is usually slightly low but there is an increase in total body sodium
- sodium retention is due to:
- secondary aldosteronism (with increased renin and aldosterone levels)
- a 'third factor' is postulated and thought to act via the proximal tubule
- may be a pleural effusion (usually right-sided) in up to two-thirds of cases
- bacteriological investigation is important - gram- negative infection may occur spontaneously or complicate paracentesis. Many cirrhotic patients have associated alcoholism and are prone to develop tuberculosis - tuberculous peritonitis may occur.
Last reviewed 01/2018