Chronic peritoneal dialysis in a patient with primary amyloidosis, renal failure, and factor X deficiency

Chronic peritoneal dialysis was used in a patient with renal failure due to primary amyloidosis. Paraprotein was demonstrated in serum and urine, and was removed in peritoneal dialysate. The patient objectively improved as long as he was receiving peritoneal dialysis. When dietary indiscretion necessitated hemodialysis for fluid removal, he died shortly thereafter of subdural hematomas, possibly aggravated by factor X deficiency. Reasons for selecting chronic peritoneal dialysis as the treatment of choice in patients with renal failure associated with overproduction of paraprotein are discussed.