Failure to recruit.

To determine the relationship between degree of sodium restriction and dietary compliance with clinical outcome of diuresis of portal hypertensive ascites in cirrhotic patients from a county hospital population.

Primary objective: Demonstrate that, when accompanied by the appropriate diuretic regimen, a No Added Salt diet (4 grams sodium per day) is as effective as a Low Sodium diet (2 grams sodium per day) in the management of cirrhotic ascites.

Secondary objectives:

1. Demonstrate that patient acceptance is greater and diuresis faster with a No Added Salt diet compared with a Low Sodium diet
2. Demonstrate that side-effects of diuretic therapy are the same or less when patients are on a No Added Salt diet
3. Determine if glomerular filtration rate estimated from the modified diet in renal disease equation differs from that obtained by a 24 hour urinary creatinine in patients with cirrhotic ascites

Inclusion Criteria:

• Cirrhotic patients of any etiology with ascites from portal hypertension diagnosed by paracentesis,
• Age 18-75
• Clinical or radiographic (abdominal CT or ultrasound) estimate of moderate - severe ascites
• Spanish-speaking subjects will be eligible for participation

Exclusion Criteria:

• Active drug or alcohol abuse,
• Active complications of SBP, hepatic encephalopathy, or GI bleed within 2 weeks,
• Hemorrhagic ascites, malignant ascites,
• Creatinine >2 mg/dL or CCl < 30 mL/min,
• K > 5.5 mmol/L,
• Diuretic refractory ascites
• Allergy to or intolerance of either spironolactone or furosemide
• Homelessness, incarceration, inability to follow up in clinic, or comply with diet.