Yosry A, et al. - In patients receiving albumin vs midodrine, an oral α1-adrenergic agonist, researchers evaluated whether or not morbidity in terms of renal dysfunction, hyponatremia, systemic, or portal hemodynamics derangement or mortality differed. After therapeutic large volume paracentesis (LVP), 75 patients with cirrhosis and refractory ascites were randomized to receive albumin infusion, oral midodrine for 2 days, or oral midodrine for 30 days. In patients with refractory ascites undergoing LVP, midodrine is as effective as albumin in decreasing morbidity and mortality at significantly lower costs. In terms of improvement of renal perfusion and sodium excretion, long-duration midodrine intake can be more useful than shorter duration intake.