Inclusion Criteria:  - Cirrhosis with refractory ascites  Exclusion Criteria:  - Recent Gastrointestinal bleeding within 7 days  Systemic arterial hypertension (>160/90mmhg) Presence of hepatocellular carcinoma or portal vein thrombosis, Budd-chiari syndrome. Pregnancy No use of drugs affecting systemic hemodynamics 7 days prior to enrolment Patients with Cardiovascular disease (NYHA > II) or chronic obstructive pulmonary disease Refusal to participate Known or suspected hypersensitivity to albumin Prior TIPS Post liver or kidney transplantation Patients enrolled in other clinical trials Extrahepatic malignancy Patients on cardiac glycosides like digoxin, phenylephrine, ephedrine, thyroid hormones, ergot derivatives, salt retaining steroids like fludrocortisone, MAO inhibitors, alpha blockers metformin and ranitidine (known to have interactions with midodrine) Patients with intrinsic kidney disease, organ nephropathy and CKD stage 4 and MELD > 30 and extremely moribend patient