Abstract
temic vasoconstriction, decreased renal blood flow and granular filtration fraction, and sodium and water reabsorption due to an over-active renin–angiotensin– aldosterone system. Thus, patients are locked in a vicious cycle of hyponatraemia and ascites. Deleterious effects on ECV and other adverse effects of vaptans may restrict the use of these agents in patient with advanced cirrhosis. However, short-term use of vaptan with colloid oncotic pressure extenders would be more beneficial than other diuretics in the treatment of acute exacerbation of ascites.
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