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

Hideyuki Hayasaka, K. Ito, S. Ookawara, Masaya Kofuji, Takayuki Uchida, S. Kawamura, Ayumi Gomyo, Haruhisa Miyazawa, Yuichiro Ueda, Keiji Hirai, S. Kimura, N. Momose, S. Kako, Yoshiyuki Morishita
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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.
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无细胞和浓缩腹水回输治疗透析期间的低血压和顽固性腹水
一位60岁女性,患有POEMS(多神经病变、器官肿大、内分泌病变、单克隆γ病变和皮肤改变)综合征和顽固性腹水,表现为急性肾功能衰竭,接受血液透析(HD)治疗。由于频繁出现溶栓性低血压,我们采用超滤+无细胞浓缩腹水再输注治疗(CART)来充分控制体液状态和大量腹水。合并CART的HD患者与未合并CART的HD患者相比血压维持正常,合并CART的HD患者超滤体积达到3.7 L。对于伴有溶性低血压和大量腹水的HD患者,在HD期间联合CART和超滤可能是体液管理的有效治疗选择。
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来源期刊
Case Reports in Nephrology
Case Reports in Nephrology Medicine-Nephrology
CiteScore
1.70
自引率
0.00%
发文量
32
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