Refractory ascites was defined according to the International Ascites Club criteria 1 as either: (a) diuretic-resistant refractory ascites: <1.5kg ⁄week weight loss while being treated with furosemide (160mg⁄day) and spironolactone (400mg⁄day) or an equivalent dose of a loop-acting and distal-acting diuretic; or (b) diuretic-intractable refractory ascites: <1.5kg⁄week weight loss as a result of the inability to use an effective dose of diuretic because of development of diuretic-induced hyponatremia (sodium level <125mEq⁄ L), hyperkalemia (potassium level >5.5mEq⁄L), renal failure (doubling of serum creatinine or values >2.5g⁄dL) or encephalopathy; (c) previous dietary restriction of sodium between 50-66mEq ⁄day.