Pleuroperitoneal communication in a patient on automated peritoneal dialysis: A rare but important complication

Abstract Despite its rare frequency, a pleuroperitoneal communication is a well‐documented complication for patients on peritoneal dialysis. It occurs in ~2% of continuous ambulatory peritoneal dialysis, with uncertain incidence for those on automated peritoneal dialysis. We report a case of a 30‐ye...

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Published in:Nephrology (Carlton, Vic.) Vic.), 2023-12, Vol.28 (12), p.682-683
Main Authors: Motta Guimarães, Maria Gabriela, Tapioca, Fernanda Pinheiro Martin, Peixoto, Leonardo Matos, Teixeira, Sheila Nunes Freitas, Passos, Luiz Carlos Santana
Format: Article
Language:English
Subjects:
Automation
Case reports
Communication
Computed tomography
Contrast media
Diagnosis
Dyspnea
Glucose
Hemodialysis
Kidney diseases
Peritoneal dialysis
Peritoneum
Pleural effusion
Respiration
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Summary:Abstract Despite its rare frequency, a pleuroperitoneal communication is a well‐documented complication for patients on peritoneal dialysis. It occurs in ~2% of continuous ambulatory peritoneal dialysis, with uncertain incidence for those on automated peritoneal dialysis. We report a case of a 30‐year‐old female patient with end‐stage kidney disease with sudden dyspnea 2 days after starting automated peritoneal dialysis. Her chest x‐ray revealed a significant pleural effusion on the right side. A thoracocentesis was performed, with a pleural glucose/plasma glucose of 1.08. Additionally, a computed tomography scan revealed a pleuroperitoneal communication upon dialysate infusion added with media contrast. A pleural‐to‐serum glucose gradient of greater than 50 mg/dL may indicate the diagnosis of a pleuroperitoneal communication in patients on peritoneal dialysis. Current literature also indicates that a pleural‐to‐serum glucose ratio above 1.0 may provide a more sensitive analysis. This case highlights the diagnosis process for this complication, with both laboratory and image findings corroborating the clinical hypotheses of a pleuroperitoneal communication in a patient on automated peritoneal dialysis.
ISSN:1320-5358
1440-1797
DOI:10.1111/nep.14241