Hayasaka Hideyuki, Ito Kiyonori, Ookawara Susumu, Kofuji Masaya, Uchida Takayuki, Kawamura Shunto, Gomyo Ayumi, Miyazawa Haruhisa, Ueda Yuichiro, Hirai Keiji, Kimura Shun-Ichi, Momose Naoki, Kako Shinichi, Morishita Yoshiyuki
Department of Clinical Engineering, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Case Rep Nephrol. 2022 Oct 15;2022:7099227. doi: 10.1155/2022/7099227. eCollection 2022.
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.
一名患有POEMS（多发性神经病、脏器肿大、内分泌病、单克隆丙种球蛋白病和皮肤改变）综合征且伴有顽固性腹水的60岁女性出现急性肾衰竭并接受了血液透析（HD）治疗。由于透析期间频繁发生低血压，遂采用无细胞浓缩腹水回输疗法（CART）进行超滤，以充分控制体液状态和大量腹水。在采用CART进行HD期间，与未采用CART进行HD时相比，她的血压得以维持，且采用CART进行HD后超滤量达到了3.7升。对于透析期间出现低血压和大量腹水的HD患者，HD期间CART与超滤相结合可能是控制体液的一种有效治疗选择。
