Use of Extracorporeal Ascites Dialysis in Combined Hepatic and Renal Failure

Abstract

Dialytic therapy was performed in 2 patients with combined hepatic and renal failure by dialyzing ascitic fluid extracorporeally through an artificial kidney and returning it to the peritoneal cavity. Efficient removal of urea (12.2–25.7 g) and creatinine (0.5–1.2 g) was achieved during each of 4 treatments without the attendant hypotensive and hemorrhagic complications often encountered in these patients when hemodialysis is attempted. Blood urea nitrogen and serum creatinine fell gradually following treatments due to diffusion into the reservoir of dialyzed ascitic fluid. Extracorporeal ascites dialysis thus offers a safe and effective alternative to hemodialysis in patients with ascites and hepatorenal failure.