Mobilization of malignant ascites with diuretics is dependent on ascitic fluid characteristics

Abstract Serial ascites and plasma volumes were measured during diuresis in nine patients with ascites caused by peritoneal carcinomatosis, four patients with chylous malignant ascites, and three patients with portal hypertension-related ascites caused by massive hepatic metastases. Oral diuretics were given to achieve an adequate natriuresis on a sodium-restricted diet. During the study period (7.8 ± 3.2 days), patients with peritoneal carcinomatosis and chylous ascites lost 0.49 ± 0.31 and 0.51 ± 0.42 kg/ day in weight, respectively, with negligible change in ascites volumes (−0.03 ± 0.11 and 0.02 ± 0.09 L/day). Patients with ascites caused by massive hepatic metastasis lost 1.06 ± 0.15 kg/day in weight ( P = 0.01 for massive hepatic metastasis vs. peritoneal carcinomatosis) and 0.23 ± 0.13 L/day of ascites ( P