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A Real Neglected Problem With a Grave Prognosis: Nephrogenic Ascites
Nephrogenic ascites is described as a clinical condition of refractory ascites in patients with end-stage renal disease (ESRD) on renal replacement therapy. This entity was first described in 1970. Many nephrologists do not believe in nephrogenic ascites. The underlying etiologies can be multifactor...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383680/ https://www.ncbi.nlm.nih.gov/pubmed/34434332 http://dx.doi.org/10.14740/jmc3413 |
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author | Al-zakhari, Rana Alataby, Harith Freg, George Moussa, Joseph Mossayebi, Elaheh Ebrahimi, Farhang |
author_facet | Al-zakhari, Rana Alataby, Harith Freg, George Moussa, Joseph Mossayebi, Elaheh Ebrahimi, Farhang |
author_sort | Al-zakhari, Rana |
collection | PubMed |
description | Nephrogenic ascites is described as a clinical condition of refractory ascites in patients with end-stage renal disease (ESRD) on renal replacement therapy. This entity was first described in 1970. Many nephrologists do not believe in nephrogenic ascites. The underlying etiologies can be multifactorial including a combination of poor nutrition, inadequate dialysis and ultrafiltration, increased peritoneal membrane permeability, and overall uremia. The nephrogenic ascites is a rare syndrome and is often associated with a grave prognosis especially if it is not diagnosed early and treated. In the present study, we report a 27-year-old woman with past medical history of diabetes type 1 (diagnosed at age 11), ESRD secondary to diabetic nephropathy on hemodialysis (diagnosis in December 2017), bilateral diabetic retinopathy, ovarian cyst, hypertension, and anxiety who presented to the emergency department for evaluation of intractable abdominal pain, nausea and vomiting for 2-day duration. She was found to have large ascites. Diagnostic paracentesis was done and found to be exudative with serum ascites albumin gradient (SAAG) of 0.7. After detailed workup, hepatic, cardiac, infectious and malignant causes for ascites were ruled out. The diagnosis of ascites of nephrogenic origin was made. Given the patient’s situation and her inability of self-care, she is not a good candidate for intra-abdominal dialysis. The patient has been treated conservatively with salt/fluid restriction and intensive hemodialysis with ultrafiltration. |
format | Online Article Text |
id | pubmed-8383680 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-83836802021-08-24 A Real Neglected Problem With a Grave Prognosis: Nephrogenic Ascites Al-zakhari, Rana Alataby, Harith Freg, George Moussa, Joseph Mossayebi, Elaheh Ebrahimi, Farhang J Med Cases Case Report Nephrogenic ascites is described as a clinical condition of refractory ascites in patients with end-stage renal disease (ESRD) on renal replacement therapy. This entity was first described in 1970. Many nephrologists do not believe in nephrogenic ascites. The underlying etiologies can be multifactorial including a combination of poor nutrition, inadequate dialysis and ultrafiltration, increased peritoneal membrane permeability, and overall uremia. The nephrogenic ascites is a rare syndrome and is often associated with a grave prognosis especially if it is not diagnosed early and treated. In the present study, we report a 27-year-old woman with past medical history of diabetes type 1 (diagnosed at age 11), ESRD secondary to diabetic nephropathy on hemodialysis (diagnosis in December 2017), bilateral diabetic retinopathy, ovarian cyst, hypertension, and anxiety who presented to the emergency department for evaluation of intractable abdominal pain, nausea and vomiting for 2-day duration. She was found to have large ascites. Diagnostic paracentesis was done and found to be exudative with serum ascites albumin gradient (SAAG) of 0.7. After detailed workup, hepatic, cardiac, infectious and malignant causes for ascites were ruled out. The diagnosis of ascites of nephrogenic origin was made. Given the patient’s situation and her inability of self-care, she is not a good candidate for intra-abdominal dialysis. The patient has been treated conservatively with salt/fluid restriction and intensive hemodialysis with ultrafiltration. Elmer Press 2020-01 2020-01-31 /pmc/articles/PMC8383680/ /pubmed/34434332 http://dx.doi.org/10.14740/jmc3413 Text en Copyright 2020, Al-zakhari et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Al-zakhari, Rana Alataby, Harith Freg, George Moussa, Joseph Mossayebi, Elaheh Ebrahimi, Farhang A Real Neglected Problem With a Grave Prognosis: Nephrogenic Ascites |
title | A Real Neglected Problem With a Grave Prognosis: Nephrogenic Ascites |
title_full | A Real Neglected Problem With a Grave Prognosis: Nephrogenic Ascites |
title_fullStr | A Real Neglected Problem With a Grave Prognosis: Nephrogenic Ascites |
title_full_unstemmed | A Real Neglected Problem With a Grave Prognosis: Nephrogenic Ascites |
title_short | A Real Neglected Problem With a Grave Prognosis: Nephrogenic Ascites |
title_sort | real neglected problem with a grave prognosis: nephrogenic ascites |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383680/ https://www.ncbi.nlm.nih.gov/pubmed/34434332 http://dx.doi.org/10.14740/jmc3413 |
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