Recurrent ascites secondary to endometriosis in a dialysis patient

Ahmad Shaadi Mat Saad, Saad AS, VuiHeng Chong, AhmadShaadi-Mat Saad, Chong CL, Chean Leung Chong, LiewYin Ping, Liew Yin Ping, Ping LY, Tan J, Jackson Tan, Chong VH, Vui Heng Chong, CheanLeung Chong
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia · 2015 · vol. 26(5) , pp. 1013 · doi:10.4103/1319-2442.164594 · PMID:26354581 · W2259485259
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This prospective observational study evaluated the feasibility and clinical outcomes of peritoneal dialysis in 51 patients with end-stage renal disease, chronic liver disease, and ascites.

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This prospective observational study evaluated the feasibility and clinical outcomes of peritoneal dialysis in patients with end-stage renal disease complicated by chronic liver disease and ascites. The research included 51 such patients compared to 55 controls without liver disease, all of whom underwent automated peritoneal dialysis at a tertiary hospital in Saudi Arabia. Results indicated that catheter insertion was successful for all participants, with comparable rates of peritonitis and early dialysate leakage between the two groups, although mortality occurred in both cohorts. The authors concluded that while peritoneal dialysis is feasible in this specific population, the descriptive findings do not establish safety or effectiveness equivalence. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Objectives

Patients with chronic liver disease (CLD) complicated by ascites may develop end-stage renal disease (ESRD), making selection of renal replacement therapy challenging. This study described the feasibility and clinical outcomes of peritoneal dialysis (PD) in selected patients with ESRD, CLD, and ascites. Patients and Methods: This prospective observational study included 51 selected patients with ESRD, CLD, and ascites and 55 patients with ESRD without CLD who underwent PD at a tertiary university hospital in Saudi Arabia. All underwent percutaneous insertion of a three-cuff PD catheter and received automated peritoneal dialysis (APD). Clinical outcomes recorded during observed follow-up are presented descriptively.

Results

Percutaneous catheter insertion was successful in all patients without bowel perforation, catheter migration, or major hemorrhage. Thirteen peritonitis episodes were recorded in the CLD group and 12 in the non-CLD group. The overall peritonitis rate was 0.10 episodes per patient-year; group-specific rates were 0.11 and 0.09 episodes per patient-year, respectively. None required catheter removal. A transient serum albumin decline of at least 0.5 g/dL was recorded in 5 and 4 patients, respectively. Early dialysate leakage occurred in 7/51 and 3/55 patients and was managed by temporary reduction of fill volume. During observed follow-up, 12/51 patients with CLD and 9/55 patients without CLD died.

Conclusions

Peritoneal dialysis was feasible in this selected cohort of patients with ESRD, chronic liver disease, and ascites. The observed adequacy values, complication counts, and crude mortality are reported descriptively. The findings should not be interpreted as establishing safety, effectiveness, equivalence, or superiority.

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Condition tags

endometriosis

MeSH descriptors

Ascites Endometriosis Kidney Failure, Chronic Peritoneal Diseases Renal Dialysis Renal Dialysis Adult Adult Ascites Ascites Ascites Ascites Endometriosis Endometriosis Endometriosis Endometriosis Female Female Humans Humans

Citation neighborhood (sparse)

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Cites (4)

References (6)

Source provenance

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License: CC0 · commercial use OK