BACKGROUND. Transudative pleural effusion due to pleuroperitoneal communication (PPC) is an uncommon complication of peritoneal dialysis (PD). PPC prevalence ranges from 1.6 to 10% in PD patients. PPC is more frequent on the right side and in females. PD is often not proposed to patients with polycistic kidney disease (PKD-pts) due to either possible complications for increased intra-abdominal pressure or infectious risk due to diverticula. This study tries to analyse the outcome of PD in PKD-pts. METHODS. between July 1979 and May 2017, 1026 patients started PD in our centre: 46 (4.5%) patients had PKD and 980 (95.8%) other nephropathy. RESULTS. Not significant difference was found between PKD-pts and and non-PKD patients (nPKD-pts) for age at PD initiation. Fifteen (1.5%) cases of PPC occurred overall (Female/Male:12/3): 6/45 (13.3%) in PKD-pts and 9/980 (0.9%) in nPKD-pts. In eight patients, the diagnosis of PPC occurred within two months of start of PD, in four patients between three and seven months of PD and in three patients between two and five years before PPC diagnosis (p = NS). In 13 patients, the interval between the placement of the catheter and start of the PD (break-in time) was less than 45 days; in a patient it was about three months and in another of about three years (Median 22 days, QI-QIII: 13-30). Break-in in PKD and nPKD-pts was not significant for the appearance of PPC. Final outcome in 46 PKD-pts: 21 patients had died, 19 received a kidney transplant and 6 shifted to HD. CONCLUSIONS. In our experience, PKD does not appear to be a contraindication for PD. PPC is more frequent in this population, but its prevalence does not preclude PD as a valid replacement therapy.
TRANSUDATIVE PLEURAL EFFUSION DUE TO PLEUROPERITONEAL COMMUNICATION IN PERITONEAL DIALYSIS PATIENTS WITH POLYCISTIC KIDNEY DISEASE
Vizzardi ValerioWriting – Original Draft Preparation
;Sandrini MassimoWriting – Review & Editing
;Facchini AnnalisaData Curation
;Cancarini GiovanniWriting – Review & Editing
2018-01-01
Abstract
BACKGROUND. Transudative pleural effusion due to pleuroperitoneal communication (PPC) is an uncommon complication of peritoneal dialysis (PD). PPC prevalence ranges from 1.6 to 10% in PD patients. PPC is more frequent on the right side and in females. PD is often not proposed to patients with polycistic kidney disease (PKD-pts) due to either possible complications for increased intra-abdominal pressure or infectious risk due to diverticula. This study tries to analyse the outcome of PD in PKD-pts. METHODS. between July 1979 and May 2017, 1026 patients started PD in our centre: 46 (4.5%) patients had PKD and 980 (95.8%) other nephropathy. RESULTS. Not significant difference was found between PKD-pts and and non-PKD patients (nPKD-pts) for age at PD initiation. Fifteen (1.5%) cases of PPC occurred overall (Female/Male:12/3): 6/45 (13.3%) in PKD-pts and 9/980 (0.9%) in nPKD-pts. In eight patients, the diagnosis of PPC occurred within two months of start of PD, in four patients between three and seven months of PD and in three patients between two and five years before PPC diagnosis (p = NS). In 13 patients, the interval between the placement of the catheter and start of the PD (break-in time) was less than 45 days; in a patient it was about three months and in another of about three years (Median 22 days, QI-QIII: 13-30). Break-in in PKD and nPKD-pts was not significant for the appearance of PPC. Final outcome in 46 PKD-pts: 21 patients had died, 19 received a kidney transplant and 6 shifted to HD. CONCLUSIONS. In our experience, PKD does not appear to be a contraindication for PD. PPC is more frequent in this population, but its prevalence does not preclude PD as a valid replacement therapy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
