Pleuroperitoneal communication in a patient on automated peritoneal dialysis: A rare but important complication

• DOI: 10.1111/nep.14241
• Publication Date: 2023-09-20T23:25:40Z
• Authors: Maria Gabriela Mo...; Fernanda Pinheiro...; Leonardo Matos Pe...; Sheila Nunes Frei...; Luiz Carlos Santa...
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

AbstractDespite its rare frequency, a pleuroperitoneal communication is a well‐documented complication for patients on peritoneal dialysis. It occurs in ~2% of continuous ambulatory peritoneal dialysis, with uncertain incidence for those on automated peritoneal dialysis. We report a case of a 30‐year‐old female patient with end‐stage kidney disease with sudden dyspnea 2 days after starting automated peritoneal dialysis. Her chest x‐ray revealed a significant pleural effusion on the right side. A thoracocentesis was performed, with a pleural glucose/plasma glucose of 1.08. Additionally, a computed tomography scan revealed a pleuroperitoneal communication upon dialysate infusion added with media contrast. A pleural‐to‐serum glucose gradient of greater than 50 mg/dL may indicate the diagnosis of a pleuroperitoneal communication in patients on peritoneal dialysis. Current literature also indicates that a pleural‐to‐serum glucose ratio above 1.0 may provide a more sensitive analysis. This case highlights the diagnosis process for this complication, with both laboratory and image findings corroborating the clinical hypotheses of a pleuroperitoneal communication in a patient on automated peritoneal dialysis.