| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
IN-DEPTH REVIEW |
Division of Nephrology,1 University of Missouri Health Center; Harry S. Truman VA Hospital,2 Columbia, Missouri, USA
Correspondence to: K. Chaudhary, Harry S. Truman VA Hospital, 800 Hospital Drive, Columbia, Missouri 65203 USA. Chaudharyk{at}health.missouri.edu
Chronic liver disease and cirrhosis account for several thousand deaths
in the United States and often these patients have renal disease that
progresses to end-stage renal disease (ESRD), necessitating renal replacement
therapy. These patients provide significant challenges to their physicians,
especially in the management of their ESRD with dialysis. ESRD patients with
chronic liver disease and ascites are more difficult to manage on hemodialysis
(HD) due to their hemodynamic status and risk of bleeding. Peritoneal dialysis
(PD) offers them a viable alternative, along with a stable hemodynamic status
and a lower risk of bleeding. The overall morbidity and mortality as well as
the risk of peritonitis appear to be almost similar between cirrhotic and
non-cirrhotic PD patients. In the absence of clinical trials comparing HD
versus PD in such a population, and despite the limited clinical observations,
the authors support PD as a viable and effective form of renal replacement
therapy for patients with ESRD and associated chronic liver disease with
cirrhosis and ascites.
KEY WORDS: Liver disease; ascites; hemodialysis; cirrhosis.
Received 11 June 2007; accepted 14 November 2007.
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
 |
