Atypical Pleural Effusions in Patients on Peritoneal Dialysis

Rarely, peritoneal dialysis (PD) is complicated by a hydrothorax, often referred to as a pleural effusion, that commonly occurs early after starting PD and is usually right-sided. We illustrate three cases of atypical hydrothorax presenting in PD patients. Case 1 is a 72-year-old lady with left-sided pleuroperitoneal communication confirmed on nuclear imaging. Case 2 is a 50-year-old lady who presented with right-sided pleuroperitoneal leak which occurred 11 months after commencement of PD. The last case is a 64-year-old man with congestive cardiac failure secondary to ischemic heart disease who had recurrent right-sided pleural effusion despite multiple pleural drainage. He continued on PD with no drainage problems. Pleuroperitoneal leaks need to be excluded even in patients presenting with left-sided effusion and in those who present late after commencement of PD. World J Nephrol Urol. 2015;4(4):256-259 doi: http://dx.doi.org/10.14740/wjnu227w