A 41-year-old male with stage V CRE of interstitial profile that after receiving education on treatment options for CAPD.
In September 2014, a double-cuffed Swan-neck silicone catheter was implanted and two inguinal and umbilical hernias were repaired.
Her body surface was 2.06 m2 and her Body Mass Index was 26.1.
Education for learning the technique was performed and in November 2014 began treatment at home with four exchanges of Biera at 1.5% glucose and 2000 ml volume, without complications.
UF volumes were 500-700 ml/ 24 hours and residual diuresis was 1700 ml.
In December 2014 a peritoneal function test was performed and classified as high carrier with a residual volume of 411.39 ml and intraperitoneal pressure (IPP) of 16.05 cm H2O.
On February 2, 2015 she came to the emergency department due to difficulty in drainage, her intestinal pattern was normal without constipation or diarrhea and the abdominal X-ray showed migration of the catheter, treated with laxatives improved drainage 4 kg.
Treatment regimen was changed to two 2.3 % exchanges and two 1.5% glucose lowering 800 gr.
The next day in the telephone consultation, dyspnea was noticed when speaking and coughing, so it was recommended to urgently attend the hospital consultation.
The chest X-ray showed a large right pleural effusion that did not exist in chest X-rays after the onset of PD.
1.
Toracentesis was performed, showing the biochemistry of the liquid a concentration of glucose in pleural fluid higher than that presented in plasma and compatible with dialysis fluid.
peritoneal dialysis was suspended due to suspicion of fluid leakage into the pleural cavity.
Scintigraphy was performed administering 117 MBq albumin nanocolloid TC 99 m.
The administration of the radiopharmaceutical required the collaboration of PD nursing and Nuclear Medicine (MN).
The PD nurse performed manual exchange and the MN exchange rated and injected the radiopharmaceutical into the dialysis solution, according to the medication administration protocol in dialysis fluid, before infusing it into the peritoneal cavity.
At 10-15 minutes, the first reading was made and after 3-4 hours the late images were taken.
At the end, a new manual exchange was performed to completely drain the abdomen, discarding the liquid drained in the specific container according to the MN protocol.
The study was indicative of peritoneal-pleural communication, so the PD was definitively suspended.
Patholysis (HD) was transferred and hydrothorax was resolved.
The patient is currently receiving this therapy.
