A 70-year-old woman with end-stage kidney disease from IgA nephropathy commenced peritoneal dialysis 20 days after catheter insertion. At the first exchange, 2 L of dialysate was instilled; after 40 minutes, she developed chest tightness and dyspnea with diminished breath sounds on the right side.
Only 0.5 L of dialysate drained from the peritoneal cavity. Ultrasonography revealed a new right-sided hydrothorax, and thoracentesis drained 1.4 L.
An elevated effusion–blood glucose concentration gradient (12.4 mmol/L in the pleural fluid and 5.3 mmol/L in the serum) supported a diagnosis of peritoneal dialysis–associated pleuroperitoneal communication.
Kidney International published a clinical update in Research Highlights on 13 Mar 2026.
The item focuses on Diffuse diaphragmatic leaks localized by fluorescence thoracoscopy.
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