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Modalities of Diagnosis and Management of Peritoneal Dialysis-related Hydrothorax Including Videothoracoscopy-assisted Repair: A Single-center Experience
Continuous ambulatory peritoneal dialysis (PD)-related hydrothorax (PDRH) is uncommon; however, it is associated with a high discontinuation rate and morbidity. We report clinical characteristics, pleural fluid chemistry patterns, diagnostic modality, management options, and outcomes in 12 patients...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722551/ https://www.ncbi.nlm.nih.gov/pubmed/35068768 http://dx.doi.org/10.4103/ijn.IJN_101_20 |
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author | Prasad, Narayan Patel, Manas Ranjan Kushwaha, Ravi Behera, Manas Ranjan Yachcha, Monika Kaul, Anupama Bhadauria, Dharmendra Kumar, Suresh Gupta, Amit |
author_facet | Prasad, Narayan Patel, Manas Ranjan Kushwaha, Ravi Behera, Manas Ranjan Yachcha, Monika Kaul, Anupama Bhadauria, Dharmendra Kumar, Suresh Gupta, Amit |
author_sort | Prasad, Narayan |
collection | PubMed |
description | Continuous ambulatory peritoneal dialysis (PD)-related hydrothorax (PDRH) is uncommon; however, it is associated with a high discontinuation rate and morbidity. We report clinical characteristics, pleural fluid chemistry patterns, diagnostic modality, management options, and outcomes in 12 patients who have confirmed pleuroperitoneal communication after the inception of the PD program at our institute. The incidence of PDRH in our study was 0.64%. The interval between initiation of PD and hydrothorax ranged from 7 weeks to 40 weeks (average 20.6 weeks). Ten (83.3%) had right-sided, one (8.3%) left-sided, and one (8.3%) bilateral hydrothorax. Most patients (83.3%) had dyspnea with chest symptoms, but two (16.6%) patients were asymptomatic. All patients had confirmed communication either by peritoneal scintigraphy or computed topography peritoneography. PD had to be stopped in two patients and patients were shifted back to hemodialysis. Pleurodesis, through thoracostomy with tetracycline or betadine, was used for four patients. Three patients underwent video-assisted thoracoscopy (VATS) with surgical repair of the diaphragmatic defect, and one underwent VATS assisted talc pleurodesis. All four patients who underwent VATS repair of the defect had successful outcomes. With availability and experience with VATS, most patients had successfully returned to PD with no recurrence and with minimal morbidity. |
format | Online Article Text |
id | pubmed-8722551 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-87225512022-01-20 Modalities of Diagnosis and Management of Peritoneal Dialysis-related Hydrothorax Including Videothoracoscopy-assisted Repair: A Single-center Experience Prasad, Narayan Patel, Manas Ranjan Kushwaha, Ravi Behera, Manas Ranjan Yachcha, Monika Kaul, Anupama Bhadauria, Dharmendra Kumar, Suresh Gupta, Amit Indian J Nephrol Case Report Continuous ambulatory peritoneal dialysis (PD)-related hydrothorax (PDRH) is uncommon; however, it is associated with a high discontinuation rate and morbidity. We report clinical characteristics, pleural fluid chemistry patterns, diagnostic modality, management options, and outcomes in 12 patients who have confirmed pleuroperitoneal communication after the inception of the PD program at our institute. The incidence of PDRH in our study was 0.64%. The interval between initiation of PD and hydrothorax ranged from 7 weeks to 40 weeks (average 20.6 weeks). Ten (83.3%) had right-sided, one (8.3%) left-sided, and one (8.3%) bilateral hydrothorax. Most patients (83.3%) had dyspnea with chest symptoms, but two (16.6%) patients were asymptomatic. All patients had confirmed communication either by peritoneal scintigraphy or computed topography peritoneography. PD had to be stopped in two patients and patients were shifted back to hemodialysis. Pleurodesis, through thoracostomy with tetracycline or betadine, was used for four patients. Three patients underwent video-assisted thoracoscopy (VATS) with surgical repair of the diaphragmatic defect, and one underwent VATS assisted talc pleurodesis. All four patients who underwent VATS repair of the defect had successful outcomes. With availability and experience with VATS, most patients had successfully returned to PD with no recurrence and with minimal morbidity. Wolters Kluwer - Medknow 2021 2021-11-13 /pmc/articles/PMC8722551/ /pubmed/35068768 http://dx.doi.org/10.4103/ijn.IJN_101_20 Text en Copyright: © 2021 Indian Journal of Nephrology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Prasad, Narayan Patel, Manas Ranjan Kushwaha, Ravi Behera, Manas Ranjan Yachcha, Monika Kaul, Anupama Bhadauria, Dharmendra Kumar, Suresh Gupta, Amit Modalities of Diagnosis and Management of Peritoneal Dialysis-related Hydrothorax Including Videothoracoscopy-assisted Repair: A Single-center Experience |
title | Modalities of Diagnosis and Management of Peritoneal Dialysis-related Hydrothorax Including Videothoracoscopy-assisted Repair: A Single-center Experience |
title_full | Modalities of Diagnosis and Management of Peritoneal Dialysis-related Hydrothorax Including Videothoracoscopy-assisted Repair: A Single-center Experience |
title_fullStr | Modalities of Diagnosis and Management of Peritoneal Dialysis-related Hydrothorax Including Videothoracoscopy-assisted Repair: A Single-center Experience |
title_full_unstemmed | Modalities of Diagnosis and Management of Peritoneal Dialysis-related Hydrothorax Including Videothoracoscopy-assisted Repair: A Single-center Experience |
title_short | Modalities of Diagnosis and Management of Peritoneal Dialysis-related Hydrothorax Including Videothoracoscopy-assisted Repair: A Single-center Experience |
title_sort | modalities of diagnosis and management of peritoneal dialysis-related hydrothorax including videothoracoscopy-assisted repair: a single-center experience |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722551/ https://www.ncbi.nlm.nih.gov/pubmed/35068768 http://dx.doi.org/10.4103/ijn.IJN_101_20 |
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