Hepatorenal syndrome treated for eight months with continuous-flow peritoneal dialysis

The case documented here represents the longest course of continuous-flow peritoneal dialysis (PD) reported in the literature. A 61-year-old man with hepatorenal syndrome type 1 and ascites presented with hypotension and bright red blood per rectum and was found to be in acute renal failure with severe anemia. Continuous-flow PD was initiated, and the patient improved clinically. The patient died of a jejunal bleed 8 months later, before discharge. Acute PD or continuous-flow PD is a viable alternative in the setting of hemodynamic instability and ascites, can be used as a chronic modality, and addresses many of the weaknesses of continuous ambulatory and automated PD.