title: The role of peritoneal dialysis in the treatment of ascites.
abstract: Cirrhosis represents a late stage of hepatic fibrosis and leads to high morbidity and mortality, and the most frequent complication is ascites. Only a few patients with advanced cirrhosis have 'refractory ascites' and do not respond to conventional treatment. Repeated paracentesis for evacuation is considered the treatment of choice in these cases. A large proportion of these patients have associated chronic kidney disease (CKD), which may require renal replacement therapy (RRT). Due to the complications associated with liver disease with coagulation disorders and tendencies towards spontaneous hypotension, there are significant problems associated to RRT, especially haemodialysis (HD). On the contrary, peritoneal dialysis (PD) offers several advantages over HD in cirrhotic patients (with or without ascites) thanks to better haemodynamic tolerance, as it is a continuous and slow technique. Furthermore, PD has a low rate of infection and bleeding.
authors: Unidad de Nefrología, Hospital Regional Carlos Haya, Playa Park 2, Málaga, Spain. sirosru@yahoo.es
authors: S
authors: S
authors: Ros Ruiz
authors: E
authors: E
authors: Gutiérrez Vilchez
authors: T P
authors: TP
authors: García Frías
authors: T M
authors: TM
authors: Martín Velázquez
authors: L
authors: L
authors: Blanca Martos
authors: T
authors: T
authors: Jiménez Salcedo
authors: D
authors: D
authors: Hernández Marrero
mesh_terms: D001201:Ascites / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001778:Blood Coagulation Disorders / Q000209:etiology; D002908:Chronic Disease; D006439:Hemodynamics; D006525:Hepatitis, Viral, Human / Q000453:epidemiology / Q000209:etiology / Q000635:transmission; D006801:Humans; D007019:Hypoproteinemia / Q000209:etiology; D007022:Hypotension / Q000209:etiology; D007674:Kidney Diseases / Q000150:complications / Q000628:therapy; D008103:Liver Cirrhosis / Q000150:complications; D044342:Malnutrition / Q000209:etiology; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods; D010538:Peritonitis / Q000209:etiology; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects; D012306:Risk; D016019:Survival Analysis