title: [Water immersion for adjuvant treatment of refractory ascites in patients with liver cirrhosis].
abstract: BACKGROUND
  Head-out water immersion has been proposed as an adjuvant treatment in refractory ascites and hepatorenal syndrome. We undertook this study to present the results of management of patients with refractory ascites.
  
  
  METHODS
  We included 10 patients with diagnosis of hepatic cirrhosis and refractory ascites. Variables were measured in four stages: stage I (basal); II (at the end of water immersion); III (72 h after water immersion); IV (1 week after water immersion concludes). Clinical and laboratory variables were measured and included general exams and renal function tests. Friedman test was used for statistics to establish differences between variables at the end of stage IV. We considered statistical significance when p<0.05.
  
  
  RESULTS
  Median age was 53.8 years, corresponding to seven men and three women with a Child's classification of B or C. Statistically significant variables were weight (p=0.02) and abdominal circumference (p=0.003), as a result of an increased urine output (p=0.03) and glomerular filtration rate (p<0.002). Renal plasma rate increased until stage III, returning to basal level in stage IV. Serum potassium levels decreased but the difference was marginal (p=0.052). During follow-up, two patients died as a consequence of liver insufficiency.
  
  
  CONCLUSIONS
  Head-out water immersion showed a decrease in weight and abdominal circumference, which means reduction of ascites. There was a transitory improvement in renal function. No collateral events were reported. Water immersion could be proposed as an adjuvant treatment in patients with refractory ascites and liver cirrhosis.
authors.affiliation: Departamento de Gastroenterología, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco.
authors.forename: María-Elena
authors.initials: ME
authors.lastname: López-Ortega
authors.forename: Ernesto
authors.initials: E
authors.lastname: Santiago-Luna
authors.forename: Mario
authors.initials: M
authors.lastname: Salazar-Páramo
authors.forename: José Luis
authors.initials: JL
authors.lastname: Montañez-Fernández
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Osuna-Rubio
authors.forename: Alejandro
authors.initials: A
authors.lastname: González-Ojeda
mesh_terms: D000328:Adult; D000368:Aged; D001201:Ascites / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D006875:Hydrotherapy; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies