[TIPS in patients with therapy refractory ascites and kidney dysfunction].
BACKGROUND
A transjugular intrahepatic portosystemic shunt (TIPS) is increasingly being used for treatment of patients with refractory ascites and renal failure. The aim of this study was to investigate the effects of TIPS in patients with refractory ascites and organic or functional renal impairment.


METHODS
A TIPS was placed for refractory or intractable ascites in 10 consecutive patients with liver cirrhosis and impaired renal function (serum creatinine > 1.5 mg/100 ml). Four of them had organic kidney disorders. The other six patients had functional renal impairment due to the underlying liver disease.


RESULTS
TIPS was effective in reducing ascites in 8 of 10 patients, including all patients with organic renal disease. Furthermore, after TIPS the renal function improved in all patients. Serum creatinine and serum urea levels decreased significantly from 1.8 to 1.5 mg/100 ml (p < 0.05) and from 107 to 78 mg/100 ml respectively.


CONCLUSIONS
TIPS may be useful in patients with functional and in patients with organic renal disease, resulting in improvement of ascites and renal function.
Waggershauser
T
T
Institut für Klinische Radiologie, Klinikum der Universität München, Grosshadern, Marchioninistr. 15, 81377 München.
Müller-Schunk
S
S
Holl
J
J
Reiser
M
M
D000368:Aged; D001201:Ascites / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D007677:Kidney Function Tests; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D016896:Treatment Outcome