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Challenges Faced in a CAPD Patient with Hemoperitoneum.

Divya Sundar¹, Georgi Abraham², Cherin Josi³

¹Registrar, Department of Nephrology, MGM Healthcare, Chennai, Tamil Nadu, India.

The Journal of the Association of Physicians of India

|February 10, 2025

Summary

A kidney transplant patient on continuous ambulatory peritoneal dialysis (CAPD) experienced reddish dialysis effluent. This case highlights the importance of investigating unusual symptoms in CAPD patients to ensure graft and patient well-being.

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Area of Science:

Nephrology
Transplantation
Dialysis

Background:

A 54-year-old male underwent ABO-incompatible spousal kidney transplantation in May 2023.
The graft was subsequently removed due to dysfunction, leading to hemodialysis (HD) and later continuous ambulatory peritoneal dialysis (CAPD).

Purpose of the Study:

To report a case of intermittent reddish dialysis effluent in a CAPD patient.
To discuss potential causes and diagnostic considerations for this unusual finding.

Main Methods:

Clinical case presentation.
Review of patient's medical history, laboratory results, and dialysis parameters.
Physical examination of the dialysis effluent.

Main Results:

The patient presented with intermittent reddish effluent in his CAPD drainage bag.
Laboratory investigations revealed anemia (Hb 7.8 g/dL) and elevated creatinine (10.01 mg/dL).
Coagulation profile, liver function tests, and viral markers (HBsAg, anti-HCV Ab) were within normal limits.

Conclusions:

Reddish dialysis effluent in CAPD patients warrants thorough investigation.
Potential causes include intradialytic bleeding, although other etiologies should be considered.
Prompt evaluation is crucial for appropriate management and patient outcomes.