Successful induction of peritoneal dialysis in  a patient with massive hydrothorax due to pleuroperitoneal communication
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Successful induction of peritoneal dialysis in a patient with massive hydrothorax due to pleuroperitoneal communication
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Clin Nephrol. 2017 Jan 19;:
Authors: Uchida T, Yamada Y, Imakiire T, Oshima N, Kumagai H
Abstract
A 74-year-old woman with liver cirrhosis and chronic kidney disease (CKD) who had complained of chronic abdominal distension due to prominent ascites presented with sudden dyspnea. Chest radiography showed massive right pleural effusion that shifted the mediastinum. Peritoneal scintigraphy using 99mTc-macroaggregated albumin revealed pleuroperitoneal communication (PPC). As her hydrothorax was refractory and frequent thoracentesis did not improve her respiratory distress, thoracoscopic surgery was performed for repair of the diaphragm defect. Continuous ambulatory peritoneal dialysis (CAPD) was started soon after surgery because her renal function was progressively worsening, and there was no recurrence of hydrothorax. The chronic abdominal distension resolved as her ascites decreased. In addition, peritoneal protein loss decreased after initiation of peritoneal dialysis (PD). PPC is an uncommon but serious complication of PD, and PD patients with PPC are often forced to discontinue PD. To our knowledge, no report has presented successful PD induction in a patient with evident PPC. We believe that further accumulation of such cases will expand the treatment options for CKD.
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PMID: 28102814 [PubMed - as...

Source: Clinical Nephrology - January 18, 2017 Category: Urology & Nephrology Authors: Uchida T, Yamada Y, Imakiire T, Oshima N, Kumagai H Tags: Clin Nephrol Source Type: research