Impact of Cell-Free and Concentrated Ascites Reinfusion Therapy on eGFR

Whether cell-free and concentrated ascites reinfusion therapy (CART) improves renal function remains unclear. We investigated the effects of CART on renal function.

We retrospectively analyzed changes in renal function after CART in 157 patients (264 sessions) with or without chronic kidney disease (CKD) who underwent the treatment between June 1, 2010, and March 31, 2022.

The most common underlying disease was malignant ascites (93.6%), most frequently caused by breast (n = 49, 31.2%) and ovarian (n = 31, 19.7%) cancers. The mean patient age was 61.6 ± 12.2 years (women, 82.1%). The median processed ascites volume was 4.26 [3.40-6.43] L, and the mean number of CART sessions per patient was 1.66 ± 1.38. No severe adverse events were observed. The estimated glomerular filtration rate (eGFR) significantly increased after CART (from 64.5 [47.5-82.9] to 65.1 [50.5-85.6] mL/min/1.73 m²; p = 0.004), particularly in patients with CKD stage G3b and G4 (G3b: from 35.4 [33.0-38.6] to 45.9 [36.1-52.5] mL/min/1.73 m²; p = 0.005, G4: from 25.1 [21.0-26.8] to 27.3 [21.1-35.3] mL/min/1.73 m²; p = 0.045).

CART may be associated with an increase in eGFR, particularly in patients with CKD.