Abstract: FR-OR078
Pleuroperitoneal Leaks: Diagnosis, Management, and Outcomes in the North American Peritoneal Dialysis Catheter Registry
Session Information
- What's New at Home (Dialysis)?
November 07, 2025 | Location: Room 351D, Convention Center
Abstract Time: 05:20 PM - 05:30 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Li, Vincent, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Oliver, Matthew J., Department of Medicine, Division of Nephrology, University of Toronto, Toronto, Ontario, Canada
- Quinn, Robert R., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
Background
Pleuroperitoneal leaks are an uncommon but well-known complication of peritoneal dialysis (PD) that often lead to discontinuation of therapy. This study aims to describe the incidence, clinical presentation, diagnosis, management, and outcomes of patients who developed pleuroperitoneal leaks in a contemporary cohort of PD patients registered in the International Society for Peritoneal Dialysis (ISPD) North American PD Catheter Registry.
Methods
Data from the ISPD PD Catheter Registry were used for the analysis. Adult patients 18 years of age and older who underwent PD catheter insertion at 12 participating sites between November 18, 2015 and December 29, 2022 were captured. Cases that developed a pleuroperitoneal leak at any point during follow-up were identified and descriptive statistics were used to report the incidence, clinical presentation, diagnostic tests used, management strategies, and patient outcomes.
Results
Forty-seven cases of pleuroperitoneal leaks were identified among 2,300 patients, corresponding to an incidence rate of 2%. Forty-two patients (89%) presented with a unilateral right-sided pleural effusion. Diagnosis was made based on thoracentesis in 47% of cases, clinical history alone in 26% of cases, and CT peritoneography in 23% of cases. The remaining cases were diagnosed using nuclear medicine scans or at the time of surgery. Once a leak was identified, 32 patients (68%) were transitioned to hemodialysis permanently, 8 patients (17%) underwent chemical or surgical pleurodesis, 5 patients (11%) temporarily transferred to HD, and 2 patients (4%) had their PD prescription modified. A total of 12 patients reattempted PD and 7 (58%) had no recurrence of the leak. All 5 patients who underwent pleurodesis and attempted PD again were successful.
Conclusion
Pleuroperitoneal leaks remain a rare complication of PD. The majority were transferred to HD and never returned to PD. However, more than half of patients who re-attempted PD had no recurrence of their leaks and all patients who underwent pleurodesis and re-attempted PD were successful.