モリモト　サトシ   Morimoto Satoshi   森本　聡    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	A patient with refractory nephrotic syndrome withdrawn from peritoneal dialysis.
掲載誌名	正式名：Clinical and experimental nephrology 略　 称：Clin Exp Nephrol ISSNコード：14377799/13421751
掲載区分	国外
巻・号・頁	14(4),pp.363-6
著者・共著者	Morimoto Satoshi†*, Takahashi Nobuyuki, Someya Kazunori, Morita Tatsuyori, Jo Fusakazu, Toyoda Nagaoki, Kosaki Atsushi, Nishikawa Mitsushige, Iwasaka Toshiji
担当区分	筆頭著者,責任著者
発行年月	2010/08
概要	A 67-year-old woman was admitted to our hospital because of anasarca due to refractory nephrotic syndrome and chronic renal insufficiency. Laboratory data indicated serum total protein of 4.8 g/dl, albumin of 1.5 g/dl, creatinine of 1.9 mg/dl and BUN of 17 mg/dl. Urinary protein excretion was 7.8 g/day. Because of severe atrophy of both kidneys, neither renal biopsy nor immunosuppressive treatment was performed. Since conservative management including bed rest, diet therapy, limitation of water intake and administration of diuretics was not effective, peritoneal dialysis therapy using icodextrin only at night was started. The amount of water removal was steadily secured without progressing renal dysfunction or decreasing urine volume. From day 290 onward, the urinary protein excretion was decreased to show complete remission and urine volume increased. On day 528, peritoneal dialysis was discontinued, and thereafter only peritoneal lavage was performed. On day 858, the catheter was removed from the abdominal cavity, and thereafter diuretics could be discontinued. The reason for the dramatic reduction of urinary protein in this patient is unclear. However, it is possible that the primary disease such as membranous nephritis showed remission while the patient was undergoing icodextrin peritoneal dialysis, which preserves renal function but not extracorporeal ultrafiltration or hemodialysis. Icodextrin peritoneal dialysis may be an alternative to hemodialysis for refractory fluid overload in patients with nephrotic syndrome and may have the advantage of preserving renal function.
DOI	10.1007/s10157-010-0271-6
PMID	20186457