Esophageal Varix - Bleeding (14 of 15)

Pathogenesis of ascites in cirrhosis

Renal function abnormalities

Sodium Retention

The impairment in the renal ability to excrete sodium is the
earliest renal dysfunction in cirrhosis. Before the
development of ascites, when patients are still
compensated (compensated cirrhosis is a term commonly
used to define patients prior to the development of any of
the major complications of the disease: i.e. ascites,
hemorrhage or hepatic encephalopathy), they present
subtle abnormalities in renal sodium metabolism. For
example they may not escape to the sodium retaining
effect of mineralcorticoids or may be unable to excrete a
sodium overload. However, as the disease progresses,
patients became unable to excrete their regular sodium
intake and develop sodium retention.