An Alternative Approach to Surgical Treatment of Acute Hydrothorax in Peritoneal Dialysis Patients

Abstract

A 58-year-old man, on Continuous Ambulatory Peritoneal Dialysis (CAPD) since six months, was admitted to the emergency department for sudden onset of dyspnea. The chest X-ray showed basal-medium right pleural effusion. Peritoneal dialysis was temporarily stopped, evacuative thoracentesis and then chemical pleurodesis were performed, with clinical improvement. Peritoneal dialysis was restarted. Two months later, the patient was readmitted to the emergency unit for severe dyspnea from hydrothorax. Evacuative thoracentesis was performed, dialysis was temporarily stopped without performing chemical pleurodesis. Three months later, dialysis was restarted with a new schedule: 2 daily exchanges with empty peritoneal cavity overnight. The patient has not experienced new episodes of respiratory distress due to hydrothorax for the last 3 years.