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Abstract: FR-PO569

Pleuroperitoneal Leak in Peritoneal Dialysis Patients: Experience of a Single Center

Session Information

Category: Trainee Case Report

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Nava, Marcos Garcia, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de Mexico, Mexico
  • Leal, Gabriela, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de Mexico, Mexico
  • Cano Escobar, Karla Bernice, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de Mexico, Mexico
Introduction

Pleuroperitoneal leak (PPL) is a rare complication, incidence reported between 1.6-10%.Etiology include congenital and acquired defects in the diaphragmatic muscle fibres, favored by increase intraabdominal pressure due to peritoneal dialysis solutions. The objective is to report the incidence,diagnosis,treatment and evolution of PPL.

Case Description

Descriptive,retrospective study. We analyzed all cases of PPL in the last 3 years.

Discussion

We found 5 patients with the diagnostic of PPL (Table 1). The male gender predominated, vintage of peritoneal dialysis (5-22 months) Diagnosis was suspected with clinical presentation, chest x –ray, difference between plasmatic and pleural effusion glucose (the pleural higher than plasmatic), and confirmed with scintigraphy. All patients required endopleural tube and peritoneal cavity rest with change of modality to hemodialysis. In 4 of the 5 patients an attempt was made to return to peritoneal dialysis (PD), but PPL recurred in all.The prognosis is discouraging due to the high recurrence rate.We included biompedance data, none of the patients had sarcopenia, ruling out this condition as a risk factor to develop diafragmatic defect, the only biochemical association was with hypoalbuminemia.

Characteristics of all patients
 Case 1Case 2Case 3Case 4Case 5
ModalityCAPDAPDCAPDCAPDAPD
Time in peritoneal dialysis until diagnosis (months)5221055
Albumin (g/dL)2.743.283.032.353.32
Appendicular lean body mass index (kg/m2)8.826.77.27.58.4
Sarcopenia (Reference Values Healthy Mexican Population)NoNoNoNoNo
LocationBilateralRightBilateralRightRight
Peritoneal Scintigraphy ReportPositiveNegativePositivePositivePositive
Initial TreatmentEndopleural TubeEndopleural TubeEndopleural TubeEndopleural tube + PleurodesisEndopleural Tube
Cavity Rest (weeks)648732
Final Renal Replacement TherapyHDHDHDHDHD + Kidney Transplant