Abstract: FR-PO493
Peritoneal Dialysis Uncovers an Unusual Medical Condition
Session Information
- Home Dialysis - 1
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Odeh, Emad Azzam, Al-Basheer hospital, Amman, Jordan
- Yousef, Jehad, Al-Basheer hospital, Amman, Jordan
Introduction
PD is used to treat individuals with end-stage kidney disease(ESKD),by introducing dialysate into the peritoneal cavity using the peritoneum as a filter to remove an excess fluids and waste products from the body
We present a case of a patient who started on PD,which later uncovered an unusual disease
Case Description
A17-year-old female was diagnosed at the age of 16 with ESKD of unknown etiology,investigations revealed only positive ANA,kidney biopsy not done.At that time she underwent urgent hemodialysis(HD),found to have hypertension which was controlled with amlodipin5mg/day,and discharged on PD
After APD initiation she started suffering from reccurent episodes of abdominal pain,headach,and BP-elevation during PD-treatment.These symptoms persist despite several changes in PD settings.Later she presented with cough,hemoptysis,severe HTN and found to have acute pulmonary hemorrhage confirmed by imaging and bronchoscopy.Treated as vasculitis with PLEX and steroid.
One month after discharge she again suffered from the same symptoms during PD,followed by a second attack of pulmonary hemorrhage associated with resistant HTN,panic attack and headach that prompted us to exclude secondary HTN.Renal doppler study was normal.Aldosterone renin ratio and serum cortisone were normal.At that time she was anuric so 24hrs urine collection for metanephrine not done.Adrenal MRI without contrast was not informative.
MIBIG scan done and confirmed left adrenal pheochromocytoma
The patient shifted permanently to HD,BP controlled with doxazocine,lecardipine.Carvidolol was added3weeks later.plan for left adrenalectomy
Discussion
Take-home messages:
several well-known causes of PD failure exist,but occasionally you may encounter an uncommon cause
Dialysate instillation during PD can increase intra-abdminal pressure and may lead to catecholamine release from a masked adrenal tumour