Refractory ascites
seen in 5–10% of Pts; 2-y survival 25%
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Defined as diuretic-resistant if on 2-g Na diet w/ minimal weight loss on max diuretics, or diuretic-induced complications (AKI, Na <125, ↑ K, encephalopathy) Conflicting evid. for d/c’ing βB (Hep 2016;63:1968; J Hepatol 2016;64:574).
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Discontinue if SBP <90 or MAP ≤82 mmHg, serum Na <120 mEq/L, AKI, HRS, SBP, sepsis, severe alcohol-assoc hepatitis, or poor follow-up. If limited by HoTN, can add midodrine.