A previously healthy 2-year-old female patient was admitted to the intensive care unit with a diagnosis of AKI secondary to HUS, with no other complications.
Her admission tests revealed a decrease in hematocrit from 46 to 24%, thrombocytopenia of 37,000/μl, urea nitrogen of 51 mg/dl and creatininemia 3.2 mg/dl. The rest of the blood tests were acceptable.
PD was indicated for anuria and a tunneled Tenckhoff catheter was installed by median approach, checking by plain abdominal X-ray its location in the periumbilical region and starting PD-2 ml immediately.
In the first 24 h, the patient developed severe respiratory distress, and an important chest X-ray showed right pleural effusion, which subsequently extended to the left and required two 50 ml evacuating punctures 220 ml to the right in 48 h.
Concomitantly, the volume of the PD baths had decreased to 10 ml/kg and to optimize the extraction of fluid from the peritoneal cavity its frequency and the concentration of DS increased from 2.5 to 4.5%.
However, due to the recurrence of AMH with progressive respiratory compromise (which required mechanical ventilation for three days), hypertension and volume overload, PD had to be suspended on the third day and the Tenckhoff catheter was closed.
Continuous venous catheter was installed in the femoral vein and maintained for 8 days.
Subsequently, PD was resumed, with SD volumes of 10 ml/kg, without new hydrothorax.
Four days later, PD was suspended.
After 26 days of hospitalization, the patient was discharged without complications.
