<s>[INST] I am a 44 year old male with cirrhosis.  I was diagnosed three years ago.  As you can imagine I have a number of problems.  Recently, I was hospitalized for a GI bleed and it was discovered that my creatinine level was 31 and potassium level was high.  The reduced my fluid medication, I was taking 100 mg of spriolactone they cut it to 50 mg.  They kept my Lasix the same 40 mg a day.  Now my fluid retention is bad legs (calf's and thighs) and stomach are swollen.  I am having a hard time bending down to tie my shoes and breathing is difficult.  I may need to have stomach drained, a procedure I hate but will endure if need be.  Any ideas? [/INST] Dear Friend,You had cirrhosis and when you had upper gi bleed , you developed a kidney involvement too. Seems to be a part of Hepato-renal syndrome , i am assuming that your previous kidney functions were normal.You have a ascitis ,it requires diagnostic evaluation to see for any infection in fluid.You should be cautious about using spironolactone as it can cause hyperkalemia.Your increased edema can be because of your deteriorating renal functions, i hope you have a good urine output.You need to build up protein in your blood (provided you don't have albuminuria) , if you should never be constipated.You need to get re-evaluation of your kidney functions , and diuretic dose adjustment is required.Stay Healthy </s>