Conclusions:
Ascites recirculation with dialysis is a safe and effective therapy for patients with refractory ascites
and severe renal failure, which can be carried out in routine inpatient and outpatient settings.
Does dialysis help with fluid overload?
After a diagnosis of kidney failure, dialysis treatments
replace some kidney function
to help to remove excess fluid from your body and get you as close to your “dry weight” as possible.
Can you do peritoneal dialysis with ascites?
Peritoneal dialysis (PD) can be an
ideal treatment
in cirrhotic patients with ascites and chronic kidney disease stage 5 (CKD 5D) who require dialysis.
Cirrhosis
is the most common cause of ascites. Other conditions that can cause it include heart failure, kidney failure, infection or cancer.
How does dialysis cause ascites?
The major causes of ascites (the accumulation of fluid within the abdomen) in patients on dialysis are
heart failure, liver failure, and malnutrition
. Nephrotic syndrome (excess protein losses in the urine) can also cause ascites. Cancer, blockage of the lymphatic system, and portal hypertension also cause ascites.
Is ascites a contraindication to peritoneal dialysis?
The cirrhotic patient with ascites presents unique challenges to the renal caregiver. This patient population has relative contraindications both to hemodialysis (HD) and to peritoneal dialysis (PD). Challenging hemodynamics and the bleeding risk from acquired coagulopathy make HD problematic.
What is refractory ascites?
Refractory ascites, that is ascites which
cannot be mobilized by low sodium diet
and maximal doses of diuretics (up to 400 mg spironolactone or potassium canrenoate and 160 mg furosemide per day), occurs in 5% of cirrhotic patients with ascites.
Does drinking water help ascites?
Options to help relieve ascites include: Eating
less salt and drinking less water and other liquids
. However, many people find this unpleasant and hard to follow. Taking diuretics, which help reduce the amount of water in the body.
Can ascites be cured completely?
Ascites can’t be cured
. But lifestyle changes and treatments may decrease complications.
How long can you survive with ascites?
In general, the prognosis of malignant ascites is poor. Most cases have a mean survival time
between 20 to 58 weeks
, depending on the type of malignancy as shown by a group of investigators. Ascites due to cirrhosis usually is a sign of advanced liver disease and it usually has a fair prognosis.
How does ascites cause renal failure?
Ascites is a frequent complication in patients with liver cirrhosis. The accumulation of fluid in the abdominal cavity is associated with
disturbances of systemic and splanchnic haemodynamics and of kidney function
, which contribute to the poor prognosis of these patients.
How is urinary ascites diagnosed?
The clue to the diagnosis of urinary ascites is
markedly elevated ascitic fluid urea and creatinine levels
despite near normal serum urea and creatinine level. Improvement of ascites and ascitic fluid creatinine level after urinary catheterization also give clue for diagnosis of urinary ascites.
What is the most common complication of peritoneal dialysis?
The most frequent and important complication of peritoneal dialysis (PD) catheters is
infection
, which may result in catheter loss and discontinuation of PD [1,2].
Who is a good candidate for peritoneal dialysis?
These include patient age, cause of end-stage renal disease (diabetes, polycystic kidney disease, scleroderma), co-morbid conditions (previous cardiovascular disease), surgical history (previous abdominal surgery, aortic prosthetic grafts in patients with abdominal aortic aneurysm), body habitus, presence or absence of …
What is the best PD catheter?
Several kinds of PD catheters are available for chronic Peritoneal Dialysis (PD) as shown in the figure 1 below.
The double-cuff straight Tenckhoff catheter
, a silicone catheter with a straight intra-abdominal portion, is the most used [1].
