Ascites associated with end-stage renal disease

Area of Science:

• Nephrology
• Gastroenterology

Background:

• Ascites is a common complication in patients with end-stage renal disease (ESRD).
• Understanding the underlying mechanisms of ascites in ESRD is crucial for effective management.

Purpose of the Study:

• To review patient characteristics, clinical outcomes, and proposed pathophysiologic mechanisms of ascites in ESRD.
• To identify potential contributing factors and effective therapeutic strategies.

Main Methods:

• Literature review of 138 reported cases of ascites associated with ESRD.
• Analysis of patient data, clinical outcomes, and proposed pathophysiologic mechanisms.

Main Results:

• Identified contributing mechanisms including fluid overload, peritoneal membrane changes, hypoproteinemia, and lymphatic drainage disturbances.
• An underlying disease was identified in 15% of cases following extensive evaluation.
• Kidney transplantation emerged as the most effective therapeutic option.

Conclusions:

• Ascites in ESRD is multifactorial, involving various physiological disturbances.
• While often complex, identifying underlying causes can guide treatment.
• Kidney transplantation offers the most promising outcome for patients with ESRD-associated ascites.