الفهرس 
List of abbreviationsOnly 14 pages are availabe for public view
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Abstract
Summary br Most ascitic patients respond to dietary sodium restriction and diuretic therapy. About 10% of patients with ascites do not respond to such medical treatment and require something more invasive like large volume paracentesis, serial therapeutic paracentesis, transjugular intrahepatic portosystemic stents and Peritoneovenous shunts. Without adjunctive treatment large volume paracentesis is associated with the risk of post paracentesis circulatory dysfunction. The most effective method to preventing circulatory dysfunction after LVP is the administration of albumin. However, the high cost of albumin is a financial concern. The occurrence of hepatic encephalopathy, high cost and lacks of availability in some centers limit the use of transjugular intrahepatic portosystemic stents. br The present study was included 96 patients with cirrhosis and marked ascites at the period between (November-2016 up to July- 2017). br We report here the results of a study designed to compare large volume paracentesis with dialytic ultrafiltration in cirrhotic with massive ascites recording the complication during each procedure or shortly after (48 hours); in terms of renal disturbance (renal functions), hemodynamic changes, hepatic encephalopathy, albumin level, abdominal pain, fever, local infection, cost and time of the procedures. The studied patients were divided into 2 groups one for dialytic peritoneal ultrafiltration include 48 patients, the other was further subdivided into 2 groups one include 31 patients for large volume paracentecis and second one include 17 patients for large volume paracentecis plus albumin infusion. br We have reported that dialytic ultrafiltration using a haemofilter to treat marked ascites in cirrhotic patients was not associated with clinically significant haemodynamic, renal or neurological complications. Improvement in albumin level and serum creatinine was noted within the first 48 hours after Dialytic ultrafiltration. Also the hospitalization time and cost was reduced. Dialytic ultrafiltration is an effective and relatively safe alternative to large-volume paracentesis with intravenous albumin infusion. br Conclusion br Dialytic ultrafiltration is an effective and relatively safe alternative to large-volume paracentesis plus intravenous albumin infusion in the treatment of marked ascites in cirrhotic patients. Blood pressure is well maintained, kidney functions is preserved. Dialytic ultrafiltration has the advantages of cost and time saving and avoidance of the side effects associated with intravenous transfusion of blood products such as albumin. However further larger studies are needed to clarify the role of dialytic ultrafiltration in treatment of patients with marked ascites.