Cell-Free and Concentrated Ascites Reinfusion Therapy during Hemodialysis for Intradialytic Hypotension and Intractable Ascites

Hideyuki Hayasaka; Kiyonori Ito; Susumu Ookawara; Masaya Kofuji; Takayuki Uchida; Shunto Kawamura; Ayumi Gomyo; Haruhisa Miyazawa; Yuichiro Ueda; Keiji Hirai; Shun-Ichi Kimura; Naoki Momose; Shinichi Kako; Yoshiyuki Morishita

doi:10.1155/2022/7099227

Cell-Free and Concentrated Ascites Reinfusion Therapy during Hemodialysis for Intradialytic Hypotension and Intractable Ascites

Case Rep Nephrol. 2022 Oct 15:2022:7099227. doi: 10.1155/2022/7099227. eCollection 2022.

Affiliations

¹ Department of Clinical Engineering, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
² Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
³ Division of Hematology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.

Abstract

A 60-year-old woman with POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome and intractable ascites presented with acute renal failure and received hemodialysis (HD) therapy. Due to frequent intradialytic hypotension, ultrafiltration with cell-free and concentrated ascites reinfusion therapy (CART) was performed to adequately manage the body fluid status and massive ascites. During HD with CART, her blood pressure was maintained compared with that during HD without CART, and an ultrafiltration volume of 3.7 L was achieved after HD with CART. In HD patients with intradialytic hypotension and massive ascites, the combination of CART and ultrafiltration during HD may be an effective therapeutic option for body-fluid management.

Publication types

Case Reports