Late pericatheter leakage in continuous ambulatory peritoneal dialysis patient– a case report

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Author: 
Balamukunthan, K., Ram Prasad, E. and Soundararajan, P.
Abstract: 

Introduction: Continuous ambulatory peritoneal dialysis (CAPD) is one of the treatment modalities for end-stage renal disease. The most important advantage of CAPD over hemodialysis is that it endows patients the liberty to perform daily activities and also is technically simpler. However, there is only limited long-term effectiveness of CAPD because of various complications. Dialysate leakage is a major noninfectious complication of peritoneal dialysis. This paper presents a peritoneal dialysis patient with late pericatheter leak.
Case Presentation: A 60 year old male, a known case of chronic kidney disease, basic kidney disease - Diabetic nephropathy was on peritoneal dialysis for past 2 years came with complains of abdominal pain during outflow, localized swelling over the abdomen and scrotal edema. Peritoneal fluid was cloudy and subsequent peritoneal dialysis fluid analysis showed, White blood cell count of 4000 cells with 80% neutrophils. No fungal elements were found. Fungal and bacterial cultures were negative. There was also associated pericatheter leak and peritonitis.
Discussion: The number of noninfectious complications in peritoneal dialysis is steadily increasing which may be due to the fall in the incidence of infectious peritonitis. The incidence of dialysate leakage is more than 5% in CAPD patients. The importance of prevention, early identification and adequate management of pericatheter leak is important because of associated patient morbidity and technique failure. Early dialysate leakage usually presents with pericatheter leakage but we present here a case of late pericatheter leakage.

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