Journal of the American Society of Nephrology : JASN
-
J. Am. Soc. Nephrol. · Nov 1994
Case ReportsHepatic venous outflow obstruction in autosomal dominant polycystic kidney disease.
To discuss the clinical presentation, diagnosis, and treatment of hepatic venous outflow obstruction as a complication of polycystic liver disease, four cases diagnosed and treated at our institution have been reviewed and the information from six previously published case reports has been summarized. Eight of the 10 patients were women. All presented with severe ascites. ⋯ On the other hand, five of the six patients without thrombosis recovered after alcohol sclerosis of a large dominant cyst (one patient) or after hepatic resection and cyst fenestration (four patients). Hepatic venous outflow obstruction probably has been underrecognized as a cause of portal hypertension, ascites, and liver dysfunction in polycystic liver disease. The diagnosis can be reliably established with current imaging techniques, especially magnetic resonance imaging.(ABSTRACT TRUNCATED AT 250 WORDS)
-
J. Am. Soc. Nephrol. · Nov 1994
Review Case ReportsNephrogenic ascites: a poorly understood syndrome.
Nephrogenic ascites is a condition characterized by the presence of massive ascites in a patient with ESRD. Neither the exact cause nor the pathogenesis of ascites formation is clearly understood. Patients frequently present with hypertension, moderate to massive ascites, minimal extremity edema, cachexia, and a history of dialysis-associated hypotension. ⋯ Although treatment options are limited, continuous ambulatory peritoneal dialysis, peritoneovenous shunt placement, and renal transplantation appear to be effective in controlling ascites formation. Nephrogenic ascites is associated with a grave prognosis, especially if treatment is not instituted. One patient with nephrogenic ascites is described here.