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Perit Dial Int 27(Supplement_3): 14- 2007
© 2007 International Society for Peritoneal Dialysis
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Clinical Experience

Subtle Peritoneal Dialysate Leak: a Not So Unusual Presentation of Transient Loss of Ultrafiltration in Peritoneal Dialysis Patients

J. De Arteaga, E.F. Ledesma, H.E. Romero and P. Massari

Department of Nephrology, Hospital Privado, Post Graduate School of Medicine Catholic University, Córdoba, Córdoba, Argentina

Objective: To present our cases of transient loss of ultrafiltration (TLOUF) in our chronic peritoneal dialysis (PD) patients due to subtle peritoneal leak. Methods: Since 1998, 31 consecutive patients comprising our total chronic PD population were analyzed. 4.25% dextrose peritoneal equilibration tests (PET) were performed each 6 months, and any time of an event that caused problems with ultrafiltration. In cases of TLOUF, a peritoneal leak was investigated with a CAT scan. Data from PETs were recorded on Adequest 2.0 Baxter. Results:

Patients with subtle peritoneal leak Case 1 Case 2 Case 3 Sex F F F Age 61 62 46 Time on PD (months) 12 14 3 BMI 34 28 39 CAT scan Positive Positive Positive PET test* D/P creat High average High average High UF (mL) 1500 240 *** 900 UF (mL)** 0 0 0 *Not done during the episode of subtle peritoneal leak; **done during the episode of subtle peritoneal leak; ***TLOUF over UFF.

Conclusions: Subtle peritoneal leak presented as TLOUF in 3 patients with few or no local clinical symptoms. Subtle peritoneal leak was confirmed by a CAT scan. All 3 cases were females with a high BMI (>28). Chronic PD could be resumed 1 month later. TLOUF due to subtle peritoneal leak is not always associated with a high transport state. Case 2 had TLOUF over chronic UFF.






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