NEPHROGENIC ASCITES

Nephrogenic ascites is a clinical diagnosis defined as persistent asci tes in an uremic patient without evidence for a causative (specific) u nderlying disease. The incidence is not known. Contributing mechanisms may include peritoneal membrane changes, fluid overload, hyperparathy roidism, reduced lymphatic drainage, heart failure and hypoproteinemia . Rigid fluid control, intensive hemodialysis, high-protein diet, intr avenous albumin infusion, intraperitoneal steroid injections and parac enteses as well as implantation of a peritoneatrial pump have all been found ineffective as treatment. Peritoneal dialysis has been shown to resolve ascites, however, the only effective treatment is so far rena l transplantation. The development of nephrogenic ascites is associate d with a poor prognosis. Thus, one year after the development of nephr ogenic ascites 1/3 had died.