Significance Vasoconstrictors like midodrine have been shown to be beneficial, with improvement of circulatory dysfunction in various groups of patients including patients with HRS type 1, type 2, non azotemic patients and in patients requiring hemodialysis. There are suggestions of decreased body weight in some of these patients. In patients with hydrothorax, addition of vasoconstrictors has helped in relieving the symptoms. The investigators suggest that midodrine could also benefit patients with refractory ascites. By decreasing the rate of ascitic fluid accumulation, it may be possible to decrease the volume of ascites drained or lengthen the interval between paracentesis, giving comfort to the patients. The beneficial effect on portal pressures and ascites could be due to other mechanisms (such as autonomic function) rather than their effect on renal hemodynamics as they are not sustained. There are no studies where this has been systematically analyzed.