CENTRAL ASIAN JOURNAL OF NEPHROLOGY
Case Report
Sep 02, 2025 47 30

A Case Report of a Diabetic Nephropathy Patient with Cirrhotic Ascites and HIV Recommended for Peritoneal Dialysis

Zhanna Kozybayeva 1 * ,
Nazia Islam 1 * ,
Baknur Absattar 1,
Raushan Bigaliyeva 1,
Aigerim Khabayeva 2,
Meruyert Madikenova 2,
Aruzhan Meirmankulova 2,
Lazzat Toleuova 2,
Venera Altynova 2
1 Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan2 Department of Nephrology, University Medical Center, Astana, Kazakhstan* Corresponding Author
Central Asian Journal of Nephrology, 1(1), 2025, cajn003, https://doi.org/10.63946/cajn/16851
Publication date: Sep 02, 2025
Full Text (PDF)

ABSTRACT

A 46-year old male was admitted to the University Medical Center (UMC) hospital with the following symptoms of anuria, abdominal fullness, hypotension, exertional dyspnea, and peripheral edema. The purpose of his visit was the insertion of a peritoneal dialysis catheter. He had chronic kidney disease stage 5 as a consequence of diabetic nephropathy, liver cirrhosis due to hepatitis C infection, and HIV. His disease course was further complicated by the presence of a urinary tract infection. As a result of his multiple comorbidities, he underwent a complex treatment regimen which included renal replacement therapy with ultrafiltration, blood transfusions for his anemia, platelet transfusions for his thrombocytopenia, albumin infusion for his hypoalbuminemia, and antibiotic treatment for his concurrent infection. Additionally, he received diuretic treatment for his hypervolemia and anti-hypertensives to control his blood pressure. After peritoneal dialysis (PD) insertion, the patient successfully underwent PD and was discharged home.

KEYWORDS

Diabetic Nephropathy Cirrhotic Ascites HIV Infection Case Report Renal Complica-tions Comorbidities Chronic Kidney Disease Liver Cirrhosis Infectious Disease Nephrology

CITATION (Vancouver)

Kozybayeva Z, Islam N, Absattar B, Bigaliyeva R, Khabayeva A, Madikenova M, et al. A Case Report of a Diabetic Nephropathy Patient with Cirrhotic Ascites and HIV Recommended for Peritoneal Dialysis. Central Asian Journal of Nephrology. 2025;1(1):cajn003. https://doi.org/10.63946/cajn/16851
APA
Kozybayeva, Z., Islam, N., Absattar, B., Bigaliyeva, R., Khabayeva, A., Madikenova, M., Meirmankulova, A., Toleuova, L., & Altynova, V. (2025). A Case Report of a Diabetic Nephropathy Patient with Cirrhotic Ascites and HIV Recommended for Peritoneal Dialysis. Central Asian Journal of Nephrology, 1(1), cajn003. https://doi.org/10.63946/cajn/16851
Harvard
Kozybayeva, Z., Islam, N., Absattar, B., Bigaliyeva, R., Khabayeva, A., Madikenova, M., . . . Altynova, V. (2025). A Case Report of a Diabetic Nephropathy Patient with Cirrhotic Ascites and HIV Recommended for Peritoneal Dialysis. Central Asian Journal of Nephrology, 1(1), cajn003. https://doi.org/10.63946/cajn/16851
AMA
Kozybayeva Z, Islam N, Absattar B, et al. A Case Report of a Diabetic Nephropathy Patient with Cirrhotic Ascites and HIV Recommended for Peritoneal Dialysis. Central Asian Journal of Nephrology. 2025;1(1), cajn003. https://doi.org/10.63946/cajn/16851
Chicago
Kozybayeva, Zhanna, Nazia Islam, Baknur Absattar, Raushan Bigaliyeva, Aigerim Khabayeva, Meruyert Madikenova, Aruzhan Meirmankulova, Lazzat Toleuova, and Venera Altynova. "A Case Report of a Diabetic Nephropathy Patient with Cirrhotic Ascites and HIV Recommended for Peritoneal Dialysis". Central Asian Journal of Nephrology 2025 1 no. 1 (2025): cajn003. https://doi.org/10.63946/cajn/16851
MLA
Kozybayeva, Zhanna et al. "A Case Report of a Diabetic Nephropathy Patient with Cirrhotic Ascites and HIV Recommended for Peritoneal Dialysis". Central Asian Journal of Nephrology, vol. 1, no. 1, 2025, cajn003. https://doi.org/10.63946/cajn/16851

REFERENCES

  1. Sridhar VS, Limonte CP, Groop PH, Heerspink HJ, Pratley RE, et al. Chronic kidney disease in type 1 diabetes: translation of novel type 2 diabetes therapeutics to individuals with type 1 diabetes. Diabetologia. 2024;67(1):3-18. DOI: 10.1007/s00125-023-06015-1
  2. Papadopoulou-Marketou N, Chrousos GP, Kanaka-Gantenbein C. Diabetic nephropathy in type 1 diabetes: a review of early natural history, pathogenesis, and diagnosis. Diabetes Metab Res Rev. 2017;33(2):e2841. DOI: 10.1002/dmrr.2841
  3. Hovind P, Rossing P, Tarnow L, Smidt UM, Parving HH. Progression of diabetic nephropathy. Kidney Int. 2001;59(2):702-709. DOI: 10.1046/j.1523-1755.2001.059002702.x
  4. Herman ES, Klotman PE. HIV-associated nephropathy: Epidemiology, pathogenesis, and treatment. Semin Nephrol. 2003;23(2):200-208. DOI: 10.1053/snep.2003.50018
  5. Barsoum RS, William EA, Khalil SS. Hepatitis C and kidney disease: A narrative review. J Adv Res. 2016;8(2):113. DOI: 10.1016/j.jare.2016.07.004
  6. Mogensen CE, Christensen CK, Vittinghus E. The Stages in Diabetic Renal Disease: With Emphasis on the Stage of Incipient Diabetic Nephropathy. Diabetes. 1983;32(Supplement_2):64-78. DOI: 10.2337/diab.32.2.s64
  7. Flandre P, Pugliese P, Cuzin L, Bagnis CI, Tack I, et al. Risk factors of chronic kidney disease in HIV-infected patients. Clinical Journal of the American Society of Nephrology. 2011;6(7):1700-1707. DOI: 10.2215/CJN.09191010
  8. Swanepoel CR, Atta MG, D’Agati VD, Estrella MM, Fogo AB, et al. Kidney disease in the setting of HIV infection: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International. 2018;93(3):545-559. DOI: 10.1016/j.kint.2017.11.007
  9. Barsoum RS, William EA, Khalil SS. Hepatitis C and kidney disease: A narrative review. Journal of Advanced Research. 2016;8(2):113-130. DOI: 10.1016/j.jare.2016.07.004
  10. Rajora N, De Gregorio L, Saxena R. Peritoneal Dialysis Use in Patients With Ascites: A Review. Am J Kidney Dis. 2021;78(5):728-735. DOI: 10.1053/j.ajkd.2021.04.010
  11. Selgas R, Bajo MA, Del Peso G, Sánchez-Villanueva R, Gonzalez E, et al. Peritoneal Dialysis in the Comprehensive Management of End-Stage Renal Disease Patients with Liver Cirrhosis and Ascites: Practical Aspects and Review of the Literature. Perit Dial Int. 2008;28(2):118-22.
  12. Nader MA, Aguilar R, Sharma P, Krishnamoorthy P, Serban D, et al. In-Hospital Mortality in Cirrhotic Patients with End-Stage Renal Disease Treated with Hemodialysis versus Peritoneal Dialysis: A Nationwide Study. Perit Dial Int. 2017;37(4):464-471. DOI: 10.3747/pdi.2016.00131
  13. Chou CY, Wang SM, Liang CC, Chang CT, Liu JH, et al. Peritoneal dialysis is associated with a better survival in cirrhotic patients with chronic kidney disease. Medicine (United States). 2016;95(4). DOI: 10.1097/MD.0000000000002465
  14. De Vecchi AF, Colucci P, Salerno F, Scalamogna A, Ponticelli C. Outcome of peritoneal dialysis in cirrhotic patients with chronic renal failure. American Journal of Kidney Diseases. 2002;40(1):161-168. DOI: 10.1053/ajkd.2002.33925
  15. Evaluating patients for chronic peritoneal dialysis and selection of modality - UpToDate. Accessed February 13, 2025. https://www.uptodate.com/contents/evaluating-patients-for-chronic-peritoneal-dialysis-and-selection-of-modality?search=peritoneal%20dialysis&source=search_result&selectedTitle=1%7E150&usage_type=default&display_rank=1#H769822640
  16. Fathima N, Kashif T, Janapala RN, Jayaraj JS, Qaseem A. Single-best Choice Between Intermittent Versus Continuous Renal Replacement Therapy: A Review. Cureus. 2019;11(9):e5558. DOI: 10.7759/cureus.5558
  17. Puri P, Kotwal N. An Approach to the Management of Diabetes Mellitus in Cirrhosis: A Primer for the Hepatologist. J Clin Exp Hepatol. 2022;12(2):560-574. DOI: 10.1016/j.jceh.2021.09.010
  18. Biggins SW, Angeli P, Garcia-Tsao G, Ginès P, Ling SC, et al. Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021;74(2):1014-1048. DOI: 10.1002/hep.31884
  19. Overview of the management of chronic kidney disease in adults - UpToDate. Accessed February 12, 2025. https://www.uptodate.com/contents/overview-of-the-management-of-chronic-kidney-disease-in-adults?search=management%20of%20hypervolemia%20in%20patients%20on%20dialysis%20&source=search_result&selectedTitle=11%7E150&usage_type=default&display_rank=11#H13
  20. Kumar R, Priyadarshi RN, Anand U. Chronic renal dysfunction in cirrhosis: A new frontier in hepatology. World J Gastroenterol. 2021;27(11):990. DOI: 10.3748/wjg.v27.i11.990

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