Reinfusion of ascites during hemodialysis as a treatment of massive refractory ascites and acute renal failure

Ta-Wei Hsu¹, Yi-Chuan Chen², Meei-Ju Wu², Anna Fen-Yau Li³, Wu-Chang Yang², Yee-Yung Ng^2
1Department of Medicine, I-Lan Hospital, ²Division of Nephrology, Department of Medicine, ³Department of Pathology, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan

Abstract: Refractory ascites can occur in patients with various conditions. Although several procedures based on the reinfusion of ascitic fluid have been reported after the failure of bed rest, salt and water restriction, diuretics, intravenous administration of albumin, and repeated paracentesis, these procedures are performed for ascitic fluid removal without dialytic effect. In this study, a flow control reinfusion of ascites during hemodialysis (HD) was performed to demonstrate the efficacy of this method in a lupus patient with massive refractory ascites and respiratory and acute renal failure (ARF). The alleviation of ascites and ARF attests to the success of the flow control reinfusion of ascites during HD. This procedure can control the rate of ascites and body fluid removal simultaneously during HD using the roller pump. In conclusion, with a normal coagulation profile, the procedure of flow control reinfusion of ascites during HD is an effective alternative treatment for the alleviation of refractory ascites with renal failure.

Keywords: ascites, lupus, renal failure, reinfusion