Nephrogenic ascites, or ascites associated with renal failure, is most commonly observed in patients with end-stage renal disease undergoing hemodialysis, though it can occur less frequently in earlier stages of renal failure. While its exact cause is likely multifactorial, several contributing mechanisms are commonly recognized. These include delayed diagnosis of chronic kidney disease, reduced peritoneal lymphatic reabsorption, malnutrition, increased permeability of the peritoneal membrane, and the effects of dialysis and ultrafiltration in uremia. Nephrogenic ascites typically affects cachectic, under-dialyzed, and malnourished patients and carries a poor long-term prognosis. This paper presents a series of eight cases involving patients with refractory ascites subsequently diagnosed as being of renal origin and provides a review of this condition.
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http://dx.doi.org/10.1111/hdi.13216 | DOI Listing |
Hemodial Int
February 2025
Department of Nephrology, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India.
Nephrogenic ascites, or ascites associated with renal failure, is most commonly observed in patients with end-stage renal disease undergoing hemodialysis, though it can occur less frequently in earlier stages of renal failure. While its exact cause is likely multifactorial, several contributing mechanisms are commonly recognized. These include delayed diagnosis of chronic kidney disease, reduced peritoneal lymphatic reabsorption, malnutrition, increased permeability of the peritoneal membrane, and the effects of dialysis and ultrafiltration in uremia.
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July 2024
General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND.
Introduction Nephrogenic ascites is an uncommon disorder associated with grave prognosis. Studies on etiopathogenesis and outcomes are scarce. This study aimed to identify the etiologies of ascites in patients with chronic kidney disease (CKD) and estimate the proportion of nephrogenic ascites and the 90-day mortality.
View Article and Find Full Text PDFBackground: Diagnosis and management of dengue hemorrhagic fever (DHF) can be challenging in the presence of confounding comorbidities. Important confounders are conditions that alter hematological parameters and intra/extra vascular fluid distribution. We report the case of a patient with active lupus nephritis, who developed DHF with subsequent bleeding and fluid overload.
View Article and Find Full Text PDFCase Rep Nephrol
April 2023
Division of Hospital Medicine, Emory University School of Medicine, Atlanta, GA, USA.
A middle-aged immigrant male from a region with endemic tuberculosis who had a history of end-stage kidney disease presented to the emergency room for routine hemodialysis and abdominal swelling. He was admitted to the medicine service for suggested daily dialysis to improve his volume overload, which was attributed to nephrogenic ascites. He was found to have several findings concerning for systemic illness, including fevers, night sweats, hypercalcemia, lymphadenopathy, omental thickening, ascitic fluid with a serum ascites albumin gradient of less than 1.
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October 2022
Internal Medicine, Ascension Saint Francis Hospital, Evanston, USA.
Nephrogenic ascites or dialysis-associated ascites is a rare condition that develops in patients with end-stage renal disease (ESRD) who have been on long-term hemodialysis. It is characterized by rapidly accumulating ascites that is often recurrent and resistant to standard treatment. The diagnosis typically requires the exclusion of common causes of ascites including possible hepatic, cardiac, malignant, and infectious etiologies.
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