Retroperitoneal leakage as a cause of ultrafiltration failure.
We report 3 patients on continuous ambulatory peritoneal dialysis (CAPD) who developed reversible ultrafiltration failure secondary to retroperitoneal leakage. The patients presented with pulmonary edema and fluid overload following a sudden onset of ultrafiltration failure on maintenance CAPD. There was no localized edema, suggesting peritoneal leakage in the abdominal wall or the perineum. Radiological examination showed no migration of the Tenckhoff catheter. Leakage of dialysate into the retroperitoneal space was only revealed by computed tomographic (CT) peritoneography. These patients were then treated with intermittent peritoneal dialysis twice weekly. After repeated CT peritoneography showing complete resolution of the leakage, they successfully resumed CAPD treatment 2 months later, without ultrafiltration problems. Our finding suggests that retroperitoneal leakage could be one of the uncommon, yet reversible, causes of acute ultrafiltration failure that can be diagnosed with CT peritoneography.
Lam
Man-Fai
MF
Nephrology Division, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Lo
Wai-Kei
WK
Chu
Ferdinand S K
FS
Li
Fu-Keung
FK
Yip
Terence P S
TP
Tse
Kai-Chung
KC
Chan
Tak-Mao
TM
Lai
Kar-Neng
KN
D000328:Adult; D000368:Aged; D003663:Decision Trees; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010537:Peritoneum / Q000000981:diagnostic imaging; D012187:Retroperitoneal Space; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure