Dialytic peritoneal ultrafiltration versus large-volume paracentesis in the treatment of marked ascites in cirrhotic patients

Document Type : Original Article

Authors

1 Department of Internal medicine, Faculty of Medicine, Sohag University.

2 Department of Internal Medicine, Faculty of Medicine, Sohag University.

3 Department of Internal medicine, Faculty of Midicine, Sohag University.

Abstract

Background and aim: Ascites in liver cirrhosis is associated with a poor prognosis and impairment of the quality of life. The clinical efficacy and safety of large-volume paracentesis in comparison to dialytic peritoneal ultrafiltration in the treatment of marked ascites were evaluated.
Patients and methods: A total of 96 cirrhotic patients with marked ascites were divided into two groups: group I 48 patients treated with dialytic ultrafiltration group IIa 31 patients treated with LVP without albumin and IIb 17 patients treated with LVP plus albumin infusion.
Results: Mean arterial pressure of patients in the studied groups show significant decrease immediately after the different procedures and start to rise within 24 hours and reach readings similar to those before ascites drainage especially with peritoneal ultrafiltration. Improvement in plasma albumin concentration has been reported after dialytic ultrafiltration. There is statistically significant decrease in serum creatinine after 48 hours of the different treatments. The average volume of ascites removed was (9.04 ± .04) in the dialytic ultrafiltration group versus (4.45 ± 0.51) in large volume paracentesis without albumin group and (6.06 ± 0.83) in large-volume paracentesis plus albumin infusion. After treatment all patients experienced a relief of ascites which is better with larger amounts of fluids removed as occurred in dialytic ultrafiltration group.
Conclusion: Dialytic ultrafiltration is an effective and relatively safe alternative to large-volume paracentesis in the treatment of marked ascites in cirrhotic patients. Blood pressure is well maintained, kidney functions are preserved. Dialytic ultrafiltration has the advantages of cost and time saving and avoidance of blood-borne infection associated with intravenous transfusion of blood products such as albumin. 

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References

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