Hydrothorax and Peritoneal Dialysis

Introduction

Peritoneal dialysis (PD) hydrothorax is a well-described, albeit uncommon, complication of PD. It results from movement of PD fluid from the peritoneal cavity to the pleural space across the diaphragm. It was first reported in 1967 by Edwards and Unger in a 69-year-old patient who developed acute severe respiratory distress with radiographic evidence of right-sided hydrothorax soon after the commencement of PD.

It is reported in 1.6%–10% of PD patients. Observational studies have documented it to occur almost exclusively on the right side ( Fig. 30.1 ). Several risk factors have been associated with the development of hydrothorax, including female sex, polycystic kidney disease (PKD), previous surgery, and peritonitis.