Wednesday, 06 June 2012
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I'm a nephrology resident  and have a patient  in dialysis with nephrogenic ascitis. Even with 4 times a week dialysis, we can't improve her ascitis. Her albumin levels are very low, and she's also malnurished. No kidney diseases associated. How do you deal with it?
Hello,

Nephrogenic ascites is a diagnosis of exclusion. I presume this is a hemodialysis patient. Has s/he ever been on PD? Has the fluid been analyzed?

Regards,

Jordan
Hello,

I didn't hear back from you to update the missing information.

Assuming that all other causes of ascites have been eliminated (which is imperative), then one could call this nephrogenic ascites, or ascites that occurs in patients on dialysis - since to imply the kidneys generate it when they are not functioning, does not seem appropriate. Unfortunately, there are no good treatments for it. Aggressive dry weight reduction may actually only serve to cause hypotension, particularly if the patient has low albumin.

Sorry I cannot be of greater help.

Jordan
9 years ago
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#214
Hello. All other causes were eliminated. We did 3 paracenthecis and daily dialysis for one week, she got better, but we know its not a treatment that lasts long.

Thanks a lot
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