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Osmotic disequilibrium causing ascites during chronic hemodialysis
B Fajardo1, G Gonzalez, A M Tannenberg
1Renal Section, Metropolitan Hospital, New York, NY 10029.
ASAIO Transactions
|July 1, 1988
Summary
Chronic hemodialysis (CHD) can cause ascites. This study found that osmotic gradients during hemodialysis (HD) may explain ascites formation in patients undergoing HD.
Area of Science:
- Nephrology
- Internal Medicine
- Clinical Research
Background:
- Ascites formation is a known complication of chronic hemodialysis (CHD).
- The etiology of ascites in the absence of other common causes remains unclear.
- This study investigated osmotic disequilibrium during hemodialysis (HD) as a potential cause.
Observation:
- A patient on CHD developed intractable ascites.
- Serum and ascites osmolality (Sosm and Aosm) were measured before and after a 4-hour HD session.
- Osmolality levels were re-evaluated two days later.
Findings:
- At the end of HD, a significant osmotic gradient (16 mosm/L) was observed, with higher osmolality in the ascites.
- Serum osmolality decreased significantly post-HD, while ascites osmolality remained elevated.
- Osmolality normalized two days after the HD session.
Implications:
- The osmotic gradient at the conclusion of HD sessions may drive fluid movement into the peritoneal cavity, leading to ascites.
- Understanding this mechanism could inform management strategies for ascites in patients undergoing chronic hemodialysis.
- Further research is warranted to confirm these findings in a larger cohort.