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Increase in ascites white blood cell and protein concentrations during diuresis in patients with chronic liver disease
Author(s) -
Hoefs John C.
Publication year - 1981
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840010310
Subject(s) - ascites , diuresis , white blood cell , medicine , endocrinology , chronic liver disease , chemistry , cirrhosis , renal function
Serum and ascites protein concentration and ascites cell concentration alterations were determined serially during diuresis in 27 patients with uncomplicated liver disease. The total protein concentration in ascites increased from 1.38 ± 0.96 gm% to 2.86 ± 1.28 gm% (p < 0.001); the serum protein concentration from 6.26 ± 0.81 gm% to 7.24 ± 0.93 gm% (p < 0.001), and the ascites to serum ratio of the total protein concentration from 0.21 ± 0.13 to 0.38 ± 0.14 (p < 0.001). The white blood cell (WBC) concentration in ascites increased from 289 ± 179 cells per mm 3 to 1,108 ± 924 cells per mm 3 (p < 0.001). Despite the increase in WBC concentration, the polymorphonuclear cell concentration remained constant (42 ± 52 cells per mm 3 to 68 ± 96 cells per mm 3 ). Protein concentration of the ascitic fluid greater than 3.0 gm% was demonstrated in 12 patients before completion of diuresis and ascitic fluid WBC concentration was greater than 750 cells per mm 3 in 17 patients. Ten of 27 patients eventually developed ascites which had a combination of more than 3.0 gm% total protein concentration and greater than 750 cells per mm 3 . Ascitic fluid protein and WBC concentrations are not „fixed” at a low level in chronic liver disease since each rose during diuresis. Thus, the interpretation of these parameters must be made with caution in patients following significant diuresis.