Water immersion in an anuric cirrhotic patient

An anuric ESRD patient on chronic hemodialysis with liver cirrhosis and refractory ascites was treated with ultrafiltration followed by head-out water immersion (HWI) and a new period of ultrafiltration. Despite anuria and the absence of peripheral edema, 4 h of HWI significantly raised the central venous pressure, diminished the abdominal girth by 5%, and successfully transfered at least 2.4 liters of ascitic fluid to the intravascular space made available to ultrafiltration. Dialysis or ultrafiltration alone were not effective in removing this amount of fluid or in reducing ascites.