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Nephrogenic ascites in the emergency department
Samuel Hampton1, Sara Hollis2, Kevin Beier1
1University of Tennessee Health Science Center, College of Medicine Nashville - Emergency Medicine Residency, 1840 Medical Center Parkway, Suite 403, Murfreesboro, TN 37129, United States of America.
The American Journal of Emergency Medicine
|November 16, 2021
Summary
Nephrogenic ascites, a rare complication of end-stage renal disease, is often misdiagnosed. Early diagnosis in the emergency department using imaging can significantly reduce patient morbidity and mortality.
Area of Science:
- Nephrology
- Emergency Medicine
- Radiology
Background:
- Nephrogenic ascites is a rare but serious complication in patients with end-stage renal disease (ESRD).
- Its low incidence and non-specific presentation contribute to frequent misdiagnosis by emergency physicians and nephrologists.
- Delayed diagnosis of nephrogenic ascites is associated with increased morbidity and mortality.
Observation:
- This case report details the diagnosis of nephrogenic ascites in an emergency department setting.
- Diagnostic confirmation involved excluding alternative causes of ascites and utilizing point-of-care ultrasound (POCUS) and CT imaging.
- The patient's presentation highlighted the challenges in recognizing this rare condition.
Findings:
- Accurate diagnosis of nephrogenic ascites was achieved through a combination of clinical assessment and advanced imaging.
- Exclusion of other potential causes of ascites was crucial for identifying nephrogenic ascites.
- Point-of-care ultrasound and CT scans were instrumental in the diagnostic process.
Implications:
- Increased awareness among emergency physicians regarding nephrogenic ascites is critical for timely diagnosis.
- Early recognition and management of nephrogenic ascites can substantially improve patient outcomes.
- This case underscores the importance of considering rare complications of ESRD in the differential diagnosis.
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