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Spironolactone is the best initial choice in cirrhosis: it increases sodium excretion and potassium reabsorption in the distal tubules. 100 mg/day can gradually be increased to 400 mg as necessary. Serum potassium levels need monitoring, as hyperkalaemia frequently limits spironolactone's use.

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Case Studies (ascites)

By Reem Ayyad

Ascites patient