Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2020; 8(24): 6437-6443
Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6437
Novel conservative treatment for peritoneal dialysis-related hydrothorax: Two case reports
Bin-Bin Dai, Bei-Duo Lin, Li-Yan Yang, Jian-Xin Wan, Yang-Bin Pan
Bin-Bin Dai, Bei-Duo Lin, Li-Yan Yang, Jian-Xin Wan, Yang-Bin Pan, Department of Nephrology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
Yang-Bin Pan, Department of Nephrology, Shanghai Pudong Hospital, Shanghai 201399, China
Author contributions: Dai BB and Lin BD contributed equally to this study; Wan JX and Pan YB designed the report; Dai BB, Lin BD and Yang LY collected the patient’s clinical data, analyzed the data and wrote the paper; all authors read and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yang-Bin Pan, MD, PhD, Chief Doctor, Department of Nephrology, Shanghai Pudong Hospital, No. 2800 Gongwei Road, Pudong District, Shanghai 201399, China. panyb9999@126.com
Received: August 12, 2020
Peer-review started: August 12, 2020
First decision: September 13, 2020
Revised: September 23, 2020
Accepted: October 13, 2020
Article in press: October 13, 2020
Published online: December 26, 2020
Processing time: 129 Days and 14.7 Hours
Abstract
BACKGROUND

Peritoneal dialysis (PD) is an important renal replacement therapy for patients with end-stage renal disease. PD-related hydrothorax is a rare but serious complication in PD patients, produced by the movement of peritoneal dialysate through pleuroperitoneal fistulas. In previous reports, patients with hydrothorax secondary to PD were usually recommended to discontinue PD and transfer to hemodialysis (HD). Herein, we describe another method of managing this complication—with an adjusted PD prescription and continuous drainage of pleural effusion, patients could continue PD without recurrence of hydrothorax.

CASE SUMMARY

In this report, we present the medical records of 2 patients with hydrothorax secondary to PD. We recommended intermittent PD with continuous drainage of pleural effusion. A type 18Ga soft catheter was placed to drain pleural effusion. Ultrasound-guided thoracentesis was performed, and the soft catheter was placed in the pleural cavity for a long period (3 mo and 2 mo, respectively). The pleural catheter was removed when no fluid was drained from the pleural cavity. After several months, pleuroperitoneal fistulas were closed in both patients and PD was continued. These patients did not transfer to HD, had no recurrence of hydrothorax and were still treated with PD after 1 year.

CONCLUSION

These 2 case reports show that continuous drainage of pleural effusion with an 18Ga soft catheter is a useful method for hydrothorax secondary to PD.

Keywords: Peritoneal dialysis, End-stage renal disease, Hydrothorax, Treatment, Conservative, Case report

Core Tip: In previous reports, patients with hydrothorax secondary to peritoneal dialysis (PD) were usually recommended to discontinue PD and transfer to hemodialysis. We demonstrate another method of managing this complication—with an adjusted PD prescription and continuous drainage of pleural effusion, patients can continue PD without recurrence of hydrothorax.