Nephrogenic Ascites : An Exceptional Diagnosis. About One Case

##plugins.themes.academic_pro.article.sidebar##

Published May 31, 2010
Download
pdf
Vol. 88 No. 6 (2010): Issue Jun 2010

##plugins.themes.academic_pro.article.main##

Radhouan Debbeche
Mohamed Salem
Leila Mouelhi
Yosra Said
Senda Trabelsi
Slim Bouzaidi
Amel Moussa
Fatma Houissa
Haifa Mekki
Taoufik Najjar

Abstract

Background : Nephrogenic ascites is a clinical entity that manifests as refractory and exsudative ascites with unknown etiology in patients with end stage renal disease and often undergoing hemodialysis. This entity presents in practice many diagnostic and therapeutic difficulties.
Aim : The aim of this study is to focus on these difficulties through a new observation
Case report : We report one case of nephrogenic ascites in chronic renal failure related to an idiopathic neurologic bladder. It’s a 38 years old patient on hemodialysis for three years who consulted for exsudative ascites with a low rate of leucocytes
Conclusion : We conclude that nephrogenic ascites is rare. Its diagnosis is an exclusion diagnosis based on exclusion of other causes of ascites, particularly exsudative forms with low leucocytes rate. Its management is based essentially on renal transplantation and its prognosis is very poor.

Keywords:

Refractory ascites, Chronic renal failure, Hemodialysis

##plugins.themes.academic_pro.article.details##

References

  1. Han, Steven Huy B. MD, Reynolds, Telfer B. MD, Fong, Tsc-Ling MD Nephrogenic ascites : Analysis of 16 cases and review of the literature. Ovid. Han. Medicine (Baltimore). 1998 ; 77 : 233-45
  2. Cinque TJ, Letteri J. Idiopatic ascites : complication of extra corporeal dialysis. Am.Soc.Nephrol.1970 ; 4 :16
  3. Mahony JF. , Guth CF., Holmes JH. Intractables ascites in chronic dialysis patients. Am. Soc - Nephrol. 1970 ; 4 : 51
  4. Anonymous. Nephrogenic asictes. Lancet 1988 ; 2 : 1232-3
  5. Morgan AG., Torry SI. Impaired peritoneal fluid drainage in nephrogenic ascites. Clin. Nephrol. 1981 ; 15 : 61-5
  6. Hela Elloumi, Dalenda Arfaoui, Ahlem Zayane, Salem Ajmi. Ascite néphrogénique. A propos d'une observation. Ann. Med. Interne. 2002 ; 153 : 478-80
  7. Mank PM, Shwartz JT. Lowe JE, Smith JL, Graham DY. Diagnosis and course of nephrogenic ascites. Arch. Intern. Med. 1998 ; 148 : 1577-9
  8. Gluck Z, Nolph KD. Ascites associated with end stage renal disease. Am. J. Kidney Dis. 1987 ; 10 : 9-18
  9. Terry C. hammoud and Marwan A. Taki yyuddin. Nephrogenic ascites. A poorly understood Syndrome. J. Am. Soc. Nephrol. 1994 ; 5 : 1173-7
  10. Olivero. J.L. Ascites and malnutrition in a chronic dialysis patient. Hosp Pract. 1993 ; 28 : 61-2
  11. Feingold LN, Gutman RA., Walch Fx, Gunelles C. Control of cachexia and ascites in hemodialysis patients by binephrectomy. Arch. Intern. Med. 1974 ; 134 : 989-97.
  12. Jones BF., Trevillian PR., Nanra RS. Idiopathic ascites of hemodialysis. Reponse to treatment (abstract). Br. Med. J. 1976 ; 1 : 877.
  13. Touam M., Orozoo R., Fumeron C., Ganea A., Drueke T., Grunfeld J.P. Refractory ascites in hemodialysis. Treatment by Paracentesis-reinjection during dialysis (abstract). Nephrologie. 2001; 22 : 25 - 8.
  14. Ing TS., Dangirdas JT, Popli S., Kheirbek AO., Hmayin HM., Gandhi VC., Chapa SM. Treatment of refractory hemodialysis ascites with maintenance peritoneal dialysis. Clin. Nephrol. 1981 ; 15 : 198 - 202.
  15. Popli S., Chen WT., Nakamoto S., Dangirdas JT., Cespedes LE., Ing TS. Hemodialysis ascites in anephric patients. Clin. Nephrol. 1981 ; 15 : 203-5