Peritoneal Dialysis Complicated by Pleuroperitoneal Communication and Hydrothorax.
BACKGROUND
Hydrothorax is an uncommon but well-recognized complication of peritoneal dialysis. It is a potentially serious condition that frequently requires cessation of peritoneal dialysis and permanent transition to hemodialysis. Hydrothorax is produced by movement of peritoneal dialysate through pleuroperitoneal fistulas. Pleural fluid analysis typically detects a high glucose concentration, and contrast imaging reveals tracer uptake transgressing the diaphragm. Experience with the treatment of hydrothorax related to peritoneal dialysis is limited.


METHODS
We describe the case of a 54-year-old female on peritoneal dialysis for end-stage renal failure who developed a hydrothorax soon after beginning treatment.


CONCLUSIONS
This case describes a classical presentation of hydrothorax in the context of peritoneal dialysis. Treatment is frequently unsuccessful. All clinicians prescribing peritoneal dialysis should be aware of this complication.
Department of Internal Medicine, Redcliffe Hospital, Redcliffe, Queensland, Australia.
Julian
J
Yaxley
Department of Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
Kevin
K
Twomey
Ascitic fluid; hernias–diaphragmatic–congenital; hydrothorax; peritoneal dialysis