Division of Nephrology and Division of Occupational Medicine, Department of Medicine, Taipei City Hospital, Zhongxiao Campus, Taipei City, Taiwan, ROC.
Ren Fail. 2012;34(8):1033-6. doi: 10.3109/0886022X.2012.705206.
In this report, the clinical characteristics of a 65-year-old female patient with tricuspid regurgitation, ischemic cardiomyopathy, congestive heart failure, and chronic renal failure were retrospectively evaluated. Laboratory studies revealed cardiogenic ascites coincided with nephrogenic ascites and subclinical amiodarone-induced hypothyroidism. The ascites of the patient was responsive to management of congestive heart failure and therapeutic paracentesis during the first episode, add-on therapy with intensified hemodialysis during the second episode, and add-on therapy with low-dose eltroxin during the third episode. When nephrogenic ascites and cardiogenic ascites of maintenance hemodialysis patients become refractory, hypothyroidism should be examined in these patients.
本报告回顾性评估了一位 65 岁女性患者的临床特征，该患者患有三尖瓣反流、缺血性心肌病、充血性心力衰竭和慢性肾衰竭。实验室研究显示心源性腹水合并肾源性腹水和亚临床胺碘酮诱导的甲状腺功能减退。该患者的腹水对充血性心力衰竭的管理和第一次发作时的治疗性腹腔穿刺术有反应，第二次发作时添加强化血液透析治疗，第三次发作时添加小剂量左旋甲状腺素治疗。当维持性血液透析患者的肾源性腹水和心源性腹水变得难治时，应在这些患者中检查甲状腺功能减退症。
