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During the last 6 months, a cirrhotic patient was hospitalized three times for recurrent episodes of tense ascites. Which of the following statements is regarded as most helpful to define refractory ascites?

Which of the following statements is correct?

A. Maximal medical therapy achieves mean weight loss of <0.8 kg over four days

B. Need to remove at least 5 liters of ascitic fluid every two weeks

C. Need to use high doses intravenous diuretics to manage ascites

D. Unsatisfactory response to maximal medical therapy (400mg/day of spironolactone and 160mg/day of furosemide) followed for at least 4 weeks

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