Gastroenterology
AGA update provides advice for managing ascites, hyponatremia in cirrhosis
Highlights from the AGA expert review:
- Initiate sodium restriction and diuretics at the lowest effective dose; escalate based on symptoms and monitoring.
- Prompt diagnostic paracentesis for new or hospitalized ascites cases.
- Refer refractory ascites or hydrothorax for liver transplant evaluation, regardless of MELD score.
- Use albumin infusion when >5L ascites is removed, or in cases of hypotension/renal dysfunction.
- Manage hyponatremia with sodium/water restriction, diuretic adjustment, and multidisciplinary care for refractory cases.
Clinical takeaway: Early, individualized intervention and multidisciplinary management are key to improving outcomes in cirrhotic patients with ascites, volume overload, and hyponatremia.
Source:
Orman ES, et al. (2025, December). Gastroenterology. AGA Clinical Practice Update on the Management of Ascites, Volume Overload, and Hyponatremia in Cirrhosis: Expert Review. https://pubmed.ncbi.nlm.nih.gov/41114681/