Background: Paracentesis is a common procedure for patients with decompensated cirrhosis. In patients with cirrhosis and superimposed renal impairment, clinicians may hesitate to perform a large volume paracentesis, given concerns of intraabdominal fluid shifts resulting in further renal dysfunction. In this study, we aimed to answer whether greater ascites fluid removal was associated with 48-hour [...]

Case Presentation: A 77-year-old male with history of hypertension, hyperlipidemia, type 2 diabetes mellitus, and chronic kidney disease (stage 3a) presented with generalized weakness and fatigue. He denied other symptoms, including myalgias, cold intolerance, or oliguria. Laboratory evaluation revealed blood urea nitrogen (BUN) of 56.9 mg/dL, serum creatinine (SCr) of 5.93 mg/dL, and glomerular filtration [...]