Chemical Pleurodesis as a Treatment for Hydrothorax Complicating Peritoneal Dialysis.
- Author:
Su Ah SUNG
1
;
Gang Jee KO
;
Myung Kyu KIM
;
Jeong Yup KIM
;
Sang Kyung JO
;
Won Young CHO
;
Hyoung Kyu KIM
Author Information
1. Department of Internal Medicine, Institute of Kidney Disease, College of Medicine, Korea University, Seoul, Korea. wonyoung@korea.ac.kr
- Publication Type:Case Report
- Keywords:
Pleurodesis;
Pleural effusion;
Continuous ambulatory peritoneal dialysis
- MeSH:
Dialysis;
Humans;
Hydrothorax*;
Korea;
Peritoneal Dialysis*;
Peritoneal Dialysis, Continuous Ambulatory;
Pleural Effusion;
Pleurodesis*;
Sclerosing Solutions;
Thoracostomy;
Thumb
- From:Korean Journal of Nephrology
2005;24(1):162-166
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hydrothorax complicating continuous ambulatory peritoneal dialysis (CAPD) occurs approximately 2% of continuous ambulatory peritoneal dialysis. Management might begin with interruption of peritoneal dialysis for 2-6 weeks. But, approximately half of the patients failed to respond to the conservative approach, as thus some authors advocated the combined use of intrapleural sclerosing agents and discontinuation of CAPD. As a rule of thumb, a 10-day wait is recommended after pleurodesis before resuming CAPD. As opposed to closed pleurodesis, the diaphragmatic defects can be identified and repaired under direct vision with surgical approach. But, limited eligibility of dialysis patients for open thoracostomy or video-assisted thoracostomy has been a major impediment for this definitive treatment of choice. From 1999 to 2003, among patients undergoing CAPD in Korea University Hospital, hydrothorax developed in four patients. Discontinuation of CAPD and conventional pleurodesis were performed. Three patients were treated successfully. A patient who interrupted peritoneal dialysis only for four days recurred after resuming CAPD. In conclusion, when pleural effusion complicates in a CAPD patient, chemical pleurodesis and cessation of CAPD during at least 10 days might be an initial tratement of choice.
