Dialytic ultrafiltration by hemofilter in treatment of patients with refractory ascites and renal insufficiency

Six cirrhotic patients with intractable ascites had coexisting renal insufficiency. Dialytic ultrafiltration of ascitic fluid by hemofilter was attempted in these patients for symptomatic relief. The hemofilter removes fluid and substances with a molecular weight less than 50,000 daltons and the concentrated ascitic fluid was reinfused into the peritoneal cavity after ultrafiltration. A transient increase in urine output (p<0.01), urinary sodium excretion (p<0.01), and endogenous creatinine clearance (p<0.02) was noted and the plasma creatinine levels had remained stable for more than 4 months after the procedure. Our study suggests that dialytic ultrafiltration of ascites by hemofilter is a safe method in the management of patients with refractory ascites and renal insufficiency.