title: Hepatorenal syndrome treated for eight months with continuous-flow peritoneal dialysis.
abstract: The case documented here represents the longest course of continuous-flow peritoneal dialysis (PD) reported in the literature. A 61-year-old man with hepatorenal syndrome type 1 and ascites presented with hypotension and bright red blood per rectum and was found to be in acute renal failure with severe anemia. Continuous-flow PD was initiated, and the patient improved clinically. The patient died of a jejunal bleed 8 months later, before discharge. Acute PD or continuous-flow PD is a viable alternative in the setting of hemodynamic instability and ascites, can be used as a chronic modality, and addresses many of the weaknesses of continuous ambulatory and automated PD.
authors.affiliation: Division of Nephrology and Hypertension, Beth Israel Medical Center, New York, NY, USA. echaren@chpnet.org
authors.forename: Elliot
authors.initials: E
authors.lastname: Charen
authors.affiliation: Division of Nephrology and Hypertension, Beth Israel Medical Center, New York, NY, USA.
authors.forename: Kobena
authors.initials: K
authors.lastname: Dadzie
authors.affiliation: Division of Nephrology and Hypertension, Beth Israel Medical Center, New York, NY, USA.
authors.forename: Nijal
authors.initials: N
authors.lastname: Sheth
authors.affiliation: Division of Nephrology and Hypertension, Beth Israel Medical Center, New York, NY, USA.
authors.forename: Hira
authors.initials: H
authors.lastname: Siktel
authors.affiliation: Division of Nephrology and Hypertension, Beth Israel Medical Center, New York, NY, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Dubrow
authors.affiliation: Division of Nephrology and Hypertension, Beth Israel Medical Center, New York, NY, USA.
authors.forename: Nikolas
authors.initials: N
authors.lastname: Harbord
authors.affiliation: Division of Nephrology and Hypertension, Beth Israel Medical Center, New York, NY, USA.
authors.forename: James
authors.initials: J
authors.lastname: Winchester
authors.affiliation: Nephrology Division, San Bortolo Hospital, Vicenza, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.affiliation: Division of Nephrology and Hypertension, Beth Israel Medical Center, New York, NY, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Amerling
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy; D001201:Ascites / Q000628:therapy; D017809:Fatal Outcome; D006530:Hepatorenal Syndrome / Q000188:drug therapy*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*