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- Title
Peritoneal–mediastinal communication complication in peritoneal dialysis.
- Authors
Sy‐Go, Janina Paula T.; Androga, Lagu A.; Saini, Jaskaran S.; Qureshi, Fawad; Kattah, Andrea G.
- Abstract
Peritoneal–mediastinal communication is a rare complication of peritoneal dialysis (PD). We report the first case of peritoneal–mediastinal communication complication in a 36‐year‐old Caucasian man on continuous cycler peritoneal dialysis (CCPD) after undergoing cardiac surgery. He developed end‐stage kidney disease (ESKD) due to calcineurin inhibitor nephrotoxicity and BK virus nephropathy in the setting of prior heart transplantation. He was initially started on intermittent hemodialysis (iHD) and was switched to CCPD 1 year later. He presented with increased drainage from his sternal incision site and reduced ultrafiltration. A contrast‐enhanced chest computed tomography scan revealed an anterior chest wall subcutaneous fluid collection. He was found to have a peritoneal–mediastinal communication intraoperatively. He was successfully managed with "low‐volume" PD by using reduced fill volumes for all his exchanges and did not require transition to iHD. He also had no vascular access options because of multiple prior thromboses, which would have made transitioning to iHD not feasible. This case further highlights the complex management of an ESKD patient who cannot do iHD and only do low‐volume PD because of a surgical complication and the need for a multidisciplinary approach to ensure appropriate patient care.
- Subjects
CHRONIC kidney failure; ARTERIAL catheterization; HEART transplantation; SURGICAL complications; CARDIAC surgery; BK virus; PERITONEAL dialysis
- Publication
Seminars in Dialysis, 2021, Vol 34, Issue 5, p384
- ISSN
0894-0959
- Publication type
Article
- DOI
10.1111/sdi.13008