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Previous Volume 354:2733-2734 June 22, 2006 Number 25 Next

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Second edition. Edited by Pere Ginès, Vicente Arroyo, Juan Rodés, and Robert W. Schrier. 450 pp., illustrated. Malden, Mass., Blackwell, 2005. $174.95. ISBN 1-405-11804-0.

The onset of ascites in a patient with cirrhosis signals the beginning of compromised quality and expectancy of life. This common complication of end-stage liver disease results from a complex pathogenesis that leads to marked renal sodium and water retention. The hepatorenal syndrome is characterized by progression of the renal dysfunction of cirrhotic ascites to a more advanced level of functional renal failure. The evolution of our understanding of the pathogenesis of cirrhosis has been beset by chicken-and-egg conundrums, including dueling theories of circulatory "overflow" as compared with "underfill." The almost metaphysical (but ingenious) concept of reduced "effective blood volume," . . . [Full Text of this Article]

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