The Evaluation of Ascites Filtration and Reinfusion with Hemodialysis (AF On-Line HD) in 2 Cases with Renal Insufficiency Complicated with Hepatic Cirrhosis

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  • Higashiyama,Chikako
    Hemodialysis Unit, Kagawa University Hospital, Faculty of Medicine, Kagawa University
  • Kiyomoto,Hideyasu
    Second Department of Internal Medicine, Faculty of Medicine, Kagawa University
  • Moriwaki,Kumiko
    Second Department of Internal Medicine, Faculty of Medicine, Kagawa University
  • Hara,Taiga
    Second Department of Internal Medicine, Faculty of Medicine, Kagawa University
  • Matsubara,Keisuke
    Second Department of Internal Medicine, Faculty of Medicine, Kagawa University
  • Hitomi,Hirofumi
    Second Department of Internal Medicine, Faculty of Medicine, Kagawa University
  • Shokoji,Takatomi
    Second Department of Internal Medicine, Faculty of Medicine, Kagawa University
  • Kondo,Naoki
    Second Department of Internal Medicine, Faculty of Medicine, Kagawa University
  • Matsumoto,Keiko
    Hemodialysis Unit, Kagawa University Hospital, Faculty of Medicine, Kagawa University
  • Yokoyama,Rumiko
    Hemodialysis Unit, Kagawa University Hospital, Faculty of Medicine, Kagawa University
  • Kohno,Masakazu
    Hemodialysis Unit, Kagawa University Hospital, Faculty of Medicine, Kagawa University:Second Department of Internal Medicine, Faculty of Medicine, Kagawa University

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Other Title
  • 慢性腎不全に非代償性肝硬変症を合併した難治性腹水に対する腹水濾過還元on-line血液透析療法の有用性の検討(<特集>白血球系細胞除去療法の最近の展開)

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We evaluated the new technique of ascites filtration and re-infusion with hemodialysis (HD), called AF on-line HD therapy, for the treatment of massive or refractory ascites in 2 cases with renal insufficiency complicated with hepatic cirrhosis. In both cases, the ascites was caused by renal insufficiency and cirrhosis; one case showed with the severe pneumonia accompanied severe inflammatory response. We first tried to decrease the ascites using HD; however, the blood pressure dropped during dialysis. Then, we attempted AF on-line HD for both patients. In order to prevent the contaminations of endotoxins and cytokines, the reverse filtration was used for purification of ascites. Purified ascites were directly infused into HD circulation prior to HD pump. No fever was observed in either case, and their severe abdominal fluids diminished by a couple of AF on-line HD treatments. It is concluded therefore that AF on-line HD therapy is an effective and safe method for the patients having renal insufficiency complicated with massive or refractory ascites from hepatic cirrhosis.

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