Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6437
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
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.
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.
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.
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.