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Management and Complications of Cirrhosis and Ascites

Ascites Workup Algorithm
Ascites Management
Refractory Ascites
Hyponatremia
Spontaneous Bacterial Peritonitis (SBP)
Hepatic Hydrothorax
AKI in
Ascites Workup Algorithm ... Refractory Ascites Hyponatremia ... Hepatic Hydrothorax AKI ... in Cirrhosis, HRS-AKI ... diagnosis #management #gastroenterology
AKI in Cirrhosis - Hepatorenal Syndrome Management Algorithm

DOI: 10.1136/bmj.m2687

#AKI #Cirrhosis #Hepatorenal #Syndrome #HRS #Management #Algorithm #nephrology
AKI in Cirrhosis ... - Hepatorenal Syndrome ... Management Algorithm ... #Syndrome #HRS ... #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Syndrome of Inappropriate ... heart failure • Cirrhosis ... • Reduced GFR, AKI ... #Nephrology #Differential
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Syndrome of Inappropriate ... heart failure • Cirrhosis ... • Reduced GFR, AKI ... #Nephrology #Differential
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Heart failure, Cirrhosis ... , Nephrotic syndrome ... #Algorithm #diagnosis ... #sodium #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... Renal Losses (AKI ... Heart failure, Cirrhosis ... , Nephrotic syndrome ... table #sodium #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... , Cirrhosis, Cardiac ... failure #Hyponatremia ... #Causes #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Heart failure, Cirrhosis ... #differential #algorithm ... #causes #nephrology
Hyponatremia Treatment Algorithm

CHF, Cirrhosis - Fluid restriction
SIADH - Fluid restriction
 - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... , Cirrhosis - Fluid ... DrEricStrong #Hyponatremia ... #Treatment #Algorithm
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... underlying cause (CHF, cirrhosis ... , nephrotic syndrome ... #diagnosis #nephrology