"Etilefrine Could Improve Response to Standard Medical Therapy in Chronic Hepatitis C Egyptian Patients with Cirrhotic Refractory Ascites: A Randomized Pilot Study"

Ascites is the most common of the three major complications of cirrhosis; the other complications are hepatic encephalopathy and variceal hemorrhage [1]. Approximately 50% of patients with “compensated” cirrhosis develop ascites during 10 years of observation. Ascites is the most common complication of cirrhosis that leads to hospital admission [2]. Development of fluid retention in the setting of cirrhosis is an important landmark in the natural history of chronic liver disease: approximately 15% of patients with ascites succumb in 1 year and 44% succumb in 5 years [3]. Many patients are referred for liver transplantation after development of ascites. Refractory ascites develops in approximately 5-10% of all cases of cirrhosisrelated ascites and carries a high mortality rate [4]. The available therapies for patients with refractory ascites are repeated large volume paracentesis, transjugular intra hepatic portosystemic shunts, peritoneovenous shunts, and liver transplantation [5,6]. The mechanism by which refractory ascites develops in cirrhosis