title: Value of the extracellular water ratio for assessment of cirrhotic patients with and without ascites.
abstract: OBJECTIVE
  Ascites, which often complicates liver cirrhosis, is reported to be a factor that worsens the outcome. The aims of this study were to quantify body water compartment changes in cirrhotic patients, with and without ascites, and to elucidate the value of body water analysis for predicting the development of ascites.
  
  
  METHODS
  A total of 109 cirrhotic patients, with and without ascites, and 65 controls were studied. Intra- and extracellular water (ECW) in the whole body and in the arm, leg and trunk were measured using the recently developed 8-electrodes multiple-frequency bioelectrical impedance analyzer. Furthermore, patients without ascites were followed to an episode of ascites or death.
  
  
  RESULTS
  Patients with liver cirrhosis had significantly higher ECW ratios than controls. ECW ratios were increased in cirrhotic patients with moderate and severe disease. The ECW ratio of the trunk showed highly significant changes in cirrhotic patients with ascites. The ECW ratio correlated with age, serum albumin, and prothrombin time. A relative expansion of ECW and low albumin were predictive of further episodes of ascites (log-rank 6.94, P < 0.01). In multivariate analysis, the ECW ratio was independently associated with the development of ascites.
  
  
  CONCLUSIONS
  Liver cirrhosis was characterized by a redistribution of body water. The ECW ratio is a reliable tool for quantification of redistribution of body water and can predict the development of ascites.
authors.affiliation: Department of Gastroenterology and Hepatology, Division of Clinical Medicine and Biomedical Sciences, Institute of Medical Science, Mie University Graduate School of Medicine, and.
authors.forename: Nagisa
authors.initials: N
authors.lastname: Hara
authors.forename: Motoh
authors.initials: M
authors.lastname: Iwasa
authors.forename: Kazuko
authors.initials: K
authors.lastname: Iwata
authors.forename: Hirohide
authors.initials: H
authors.lastname: Miyachi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Masaki
authors.initials: M
authors.lastname: Takeo
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujita
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei