Treatment of cirrhotic ascites by dialytic ultrafiltration with a hemofilter system

Dialytic ultrafiltration with a hemofilter was performed in 21 cirrhotic patients with intractable ascites refractory to sodium restriction and diuretic therapy. A continuous flow of ascitic fluid at a rate of 300-400 ml/min through a hemofilter was maintained by the use of a single-head blood pump. The protein-rich ascitic fluid was reinfused into the peritoneal cavity, whereas sodium and water were filtered and removed. An average of 6.8 liters of filtrate was removed over an averaged period of 4.4 h. The new technique is simple, safe, and cost-effective as compared with conventional treatment of paracentesis. Rapid relief of symptom related to intractable ascites could readily be achieved. These patients remained hemodynamically stable, and no major complications such as hepatic encephalopathy, hepatorenal syndrome, and variceal bleeding were experienced.