Empagliflozin in Diuretic Refractory Ascites

Inclusion Criteria: * Decompensated liver cirrhosis with ascites * Diuretic-resistant ascites defined as one of the following: a) An inability to mobilize ascites despite adherence to dietary sodium restriction (2000 mg per day) and administration of maximum tolerable doses of oral diuretics; b) Rapid reaccumulation of fluid after therapeutic paracentesis despite adherence to a sodium-restricted diet. c) Development of diuretic-related complications such as progressive azotemia, hepatic encephalopathy, or progressive electrolyte imbalances * Ability to understand and willingness to sign a written informed consent document Exclusion Criteria: * Hypersensitivity to any SGLT2 inhibitor * Pregnant or breastfeeding women * eGFR below 45mL/min/1.73m2 or decrease in eGFR by \>30% between screening * Recurrent urinary tract infections or recurrent genitourinary fungal infections, defined as \> 2 infections in six months or \>3 infections in one year * Hypotension requiring oral vasopressor therapy * Patients with particular risk for ketoacidosis including active moderate or severe alcohol use disorder, pancreatitis, pancreatic insulin deficiency from any cause, or episode of ketoacidosis in the past * History of skin or soft tissue infection requiring IV antibiotics including Fornier's gangrene or prior limb amputation * Chronic alcohol or drug abuse or any condition that, in the investigator's opinion, makes them an unreliable trial subject or unlikely to complete the trial