In vivo (Athens, Greece) · 2025
Marked Increase in Zinc Concentration of Ascitic Fluid After Cell-free and Concentrated Ascites Reinfusion Therapy in Patients With Cirrhotic Refractory Ascites: A Retrospective Observational Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Namisaki Tadashi, Shibamoto Akihiko, Iwai Satoshi, Takami Masayoshi, Masuda Hiroyuki, Tsuji Yuki, Fujinaga Yukihisa, Takaya Hiroaki, Inoue Takashi, Sato Shinya, Kitagawa Koh, Nishimura Norihisa, Kaji Kosuke, Mitoro Akira, Asada Kiyoshi, Yoshiji Hitoshi
Аннотация
BACKGROUND/AIM: Zinc (Zn) deficiency is common among patients with cirrhosis and is associated with hepatic encephalopathy, immune dysfunction, and sarcopenia. In Japan, cell-free and concentrated ascites reinfusion therapy (CART) is widely employed for refractory ascites, effectively restoring albumin (ALB) and coagulation factors. However, its effect on trace elements has not been investigated. This retrospective study aimed to assess Zn concentration changes in ascitic fluid before and after CART in patients with cirrhotic refractory ascites.
PATIENTS AND METHODS: Data from 24 patients with decompensated cirrhosis who underwent CART at Nara Medical University Hospital between June 2022 and May 2024 were analyzed. The concentrations of Zn and ALB in original and processed ascitic fluid were measured.
RESULTS: Among the cohort (mean age, 66.3±13.7 years, 69.6% men), 75.0% had Child-Pugh class C cirrhosis. The mean volume of drained ascitic fluid was 5,947.2±2,345.9 ml, whereas that of processed ascitic fluid was 350.6±167.6 ml. Positive correlations were observed between serum Zn and serum albumin (ALB) levels as well as ascitic Zn and ascitic ALB levels. The Zn concentration significantly increased from 12 μg/dl in the original ascitic fluid to 119 μg/dl in the processed ascitic fluid (p<0.001). The calculated recovery rates for Zn and ALB, based on the ratio of total Zn and ALB content in processed versus original fluid, were approximately 70% and 80%, respectively.
CONCLUSION: CART markedly increases Zn concentration in ascitic fluid, which may contribute to the restoration of micronutrient levels in patients with cirrhosis. Further studies should determine whether reinfusion of Zn-rich processed ascitic fluid increases serum Zn levels and enhances clinical outcomes.
PATIENTS AND METHODS: Data from 24 patients with decompensated cirrhosis who underwent CART at Nara Medical University Hospital between June 2022 and May 2024 were analyzed. The concentrations of Zn and ALB in original and processed ascitic fluid were measured.
RESULTS: Among the cohort (mean age, 66.3±13.7 years, 69.6% men), 75.0% had Child-Pugh class C cirrhosis. The mean volume of drained ascitic fluid was 5,947.2±2,345.9 ml, whereas that of processed ascitic fluid was 350.6±167.6 ml. Positive correlations were observed between serum Zn and serum albumin (ALB) levels as well as ascitic Zn and ascitic ALB levels. The Zn concentration significantly increased from 12 μg/dl in the original ascitic fluid to 119 μg/dl in the processed ascitic fluid (p<0.001). The calculated recovery rates for Zn and ALB, based on the ratio of total Zn and ALB content in processed versus original fluid, were approximately 70% and 80%, respectively.
CONCLUSION: CART markedly increases Zn concentration in ascitic fluid, which may contribute to the restoration of micronutrient levels in patients with cirrhosis. Further studies should determine whether reinfusion of Zn-rich processed ascitic fluid increases serum Zn levels and enhances clinical outcomes.