Journal of the Formosan Medical Association = Taiwan yi zhi · 2025
Paracentesis exceeding three liters increases risks of acute kidney injury even in cirrhotic patients with albumin infused refractory ascites.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wu Pei-Shan, Lee Kuei-Chuan, Li Chih-Yu, Hsieh Yun-Cheng, Huo Teh-Ia, Lin Han-Chieh, Hou Ming-Chih
Аннотация
BACKGROUND: Cirrhotic patients with refractory ascites exhibit severe portal hypertension and hemodynamic disturbances. The risks associated modest-volume paracentesis (<5 L) for refractory ascites remains unclear. We aimed to explore the impact of modest-volume paracentesis in refractory ascites.
METHODS: Cirrhotic patients with refractory ascites undergoing paracentesis <5 L with albumin infusion were retrospectively enrolled. Patients were categorized into two groups based on the volume of paracentesis: ≥3 L and <3 L. Logistic regression analyses were used to determine risk factors for post-paracentesis complications, while Kaplan-Meier analysis was used to assess 28-day survival rates.
RESULTS: Among 116 patients, 40 (34.5%) experienced post-paracentesis complications within one week, predominantly acute kidney injury (AKI) (19.8%). Twenty patients had paracentesis ≥3 L and 96 patients had <3 L. Overall complications were comparable between two groups (50% vs. 31.3%, p = 0.109), but ≥3 L group had more AKI (40% vs. 15.6%, p = 0.013). Additionally, paracentesis ≥3 L is an independent risk factor for AKI [Odds ratio (OR) = 4.15, p = 0.012], while higher MELD scores (OR = 1.14, p = 0.001) and older age (OR = 1.03, p = 0.047) are risk factors for overall complications. Furthermore, patients with post-paracentesis complications had significantly poorer 28-day survival.
CONCLUSION: Cirrhotic patients with refractory ascites face a high risk of complications from modest-volume paracentesis, even with albumin infusion. Paracentesis ≥3 L increases AKI risks, while higher MELD scores are linked to greater overall complications, leading to poor short-term survival.
METHODS: Cirrhotic patients with refractory ascites undergoing paracentesis <5 L with albumin infusion were retrospectively enrolled. Patients were categorized into two groups based on the volume of paracentesis: ≥3 L and <3 L. Logistic regression analyses were used to determine risk factors for post-paracentesis complications, while Kaplan-Meier analysis was used to assess 28-day survival rates.
RESULTS: Among 116 patients, 40 (34.5%) experienced post-paracentesis complications within one week, predominantly acute kidney injury (AKI) (19.8%). Twenty patients had paracentesis ≥3 L and 96 patients had <3 L. Overall complications were comparable between two groups (50% vs. 31.3%, p = 0.109), but ≥3 L group had more AKI (40% vs. 15.6%, p = 0.013). Additionally, paracentesis ≥3 L is an independent risk factor for AKI [Odds ratio (OR) = 4.15, p = 0.012], while higher MELD scores (OR = 1.14, p = 0.001) and older age (OR = 1.03, p = 0.047) are risk factors for overall complications. Furthermore, patients with post-paracentesis complications had significantly poorer 28-day survival.
CONCLUSION: Cirrhotic patients with refractory ascites face a high risk of complications from modest-volume paracentesis, even with albumin infusion. Paracentesis ≥3 L increases AKI risks, while higher MELD scores are linked to greater overall complications, leading to poor short-term survival.