Review in DepthAscites and hepatorenal syndromeGentilini, Paolo; Vizzutti, Francesco; Gentilini, Alessandra; La Villa, Giorgio Author Information Department of Internal Medicine, University of Florence, School of Medicine, Florence, Italy Correspondence to Dr Paolo Gentilini, Department of Internal Medicine, University of Florence, School of Medicine, Viale Morgagni, 85, 50134 Florence, Italy Tel: +39 055 4296451; fax: +39 055 417123; e-mail: [email protected] European Journal of Gastroenterology & Hepatology 13(4):p 313-316, April 2001. Buy Abstract Ascites is a frequent complication of chronic liver disease with severe portal hypertension. Moreover, in the presence of tense ascites, renal dysfunction and hepatorenal syndrome may occur. Unfortunately, there is no explanation that thoroughly describes the complex relationship between the liver and kidney in either physiological or pathological conditions. Nevertheless, available evidence indicates that early sodium and water retention precedes decompensation, characterized by hyperdynamic circulation. The best approach to the treatment of these patients should be aimed at the prevention of ascites formation. An accurate sequential treatment is indicated in patients with ascites. In the case of hepatorenal syndrome, the only definitive approach is liver transplantation. © 2001 Lippincott Williams & Wilkins, Inc.