Melero M, Rodriguez M, Araque A, Alamo C, Andrés A, Praga M
Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain.
Am J Kidney Dis. 1995 Oct;26(4):668-70. doi: 10.1016/0272-6386(95)90607-x.
The incidence of idiopathic dialysis ascites seems to have decreased since the introduction of more effective techniques for control of fluid overload and uremia in chronic hemodialysis patients. Most of the patients reported so far had some predisposing factor, such as malnutrition or sustained fluid overload. We report a case of idiopathic dialysis ascites in a young well-nourished woman with an excellent control of fluid overload and in whom biocompatible dialyzer membranes and volumetric controlled ultrafiltration had been used since her onset of chronic dialysis. Extensive studies excluded the existence of an underlying cause for ascites. Ascitic fluid had the characteristics of an exudate, and a peritoneal biopsy specimen showed chronic nonspecific inflammatory changes. Massive ascites persisted for 6 months, requiring repeated paracentesis, until the performance of a successful renal transplantation. Coinciding with the recovery of renal function, a dramatic disappearance of ascites was observed.
自从对慢性血液透析患者采用更有效的控制液体超负荷和尿毒症的技术以来，特发性透析性腹水的发病率似乎有所下降。迄今为止报道的大多数患者都有一些诱发因素，如营养不良或持续性液体超负荷。我们报告一例年轻营养良好的女性特发性透析性腹水病例，该患者液体超负荷控制良好，自慢性透析开始以来一直使用生物相容性透析器膜和容量控制超滤。广泛的检查排除了腹水的潜在病因。腹水具有渗出液的特征，腹膜活检标本显示慢性非特异性炎症改变。大量腹水持续了6个月，需要反复进行腹腔穿刺术，直到成功进行肾移植。随着肾功能的恢复，腹水戏剧性地消失了。
