Biomaterial Database

Successful use of the Denver peritoneovenous shunt in patients with nephrogenic ascites. 1987

P C Hobar, and W W Turner, and R J Valentine

Tense ascites in patients who require hemodialysis for renal failure (nephrogenic ascites) is a rare but ominous complication. Its appearance is often followed by a rapid physical deterioration. Nonsurgical attempts to control the ascites are often unsuccessful. Four patients with refractory ascites were treated with Denver peritoneovenous shunts (DPVS). These patients suffered from ventilatory failure, anorexia with malnutrition, and hypotension during hemodialysis. Patients were followed for as long as 18 months after DPVS, and all experienced clinical resolution of the ascites. Ventilatory failure, malnutrition, and hypotension either improved or resolved after shunting. Shunt-related morbidity occurred in all patients and consisted of mechanical complications in four patients and bacteremia in one patient. These problems were resolved by either revision or removal of the DPVS. No deaths were directly related to shunting. Peritoneovenous shunting successfully treats nephrogenic ascites and reverses the morbid sequelae usually associated with this syndrome.

UI	MeSH Term	Description	Entries
D007022	Hypotension	Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs. Common symptom is DIZZINESS but greater negative impacts on the body occur when there is prolonged depravation of oxygen and nutrients.	Blood Pressure, Low,Hypotension, Vascular,Low Blood Pressure,Vascular Hypotension
D007676	Kidney Failure, Chronic	The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.	ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010536	Peritoneovenous Shunt	An operation for the continuous emptying of ascitic fluid into the venous system. Fluid removal is based on intraperitoneal and intrathoracic superior vena cava pressure differentials and is performed via a pressure-sensitive one-way valve connected to a tube traversing the subcutaneous tissue of the chest wall to the neck where it enters the internal jugular vein and terminates in the superior vena cava. It is used in the treatment of intractable ascites.	Ascites Shunt, Peritoneovenous,LeVeen Shunt,Peritoneo-Venous Shunt,Ascites Shunts, Peritoneovenous,Peritoneo Venous Shunt,Peritoneo-Venous Shunts,Peritoneovenous Ascites Shunt,Peritoneovenous Ascites Shunts,Peritoneovenous Shunts,Shunt, LeVeen,Shunt, Peritoneo-Venous,Shunt, Peritoneovenous,Shunt, Peritoneovenous Ascites,Shunts, Peritoneo-Venous,Shunts, Peritoneovenous,Shunts, Peritoneovenous Ascites
D012131	Respiratory Insufficiency	Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed)	Acute Hypercapnic Respiratory Failure,Acute Hypoxemic Respiratory Failure,Hypercapnic Acute Respiratory Failure,Hypercapnic Respiratory Failure,Hypoxemic Acute Respiratory Failure,Hypoxemic Respiratory Failure,Respiratory Depression,Respiratory Failure,Ventilatory Depression,Depressions, Ventilatory,Failure, Hypercapnic Respiratory,Failure, Hypoxemic Respiratory,Failure, Respiratory,Hypercapnic Respiratory Failures,Hypoxemic Respiratory Failures,Respiratory Failure, Hypercapnic,Respiratory Failure, Hypoxemic,Respiratory Failures
D005260	Female		Females
D006435	Renal Dialysis	Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION.	Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults