Utility of Peritoneal Scintigraphy in Peritoneal Dialysis Patients: One Center Experience

Background: Peritoneal dialysis (PD) is the renal replacement therapy of choice in 15% of patients with chronic kidney disease (CKD), having multiple advantages over haemodialysis. PD leaks can prompt technique failure and dropout. Peritoneal scintigraphy (PS) use in its diagnosis has declined in favour of more complex and expensive tests. We analysed the utility of PS for PD leak diagnosis in our center. Methods: We retrospectively analysed all PS done in our center from January 2000 until December 2018, both included, in all PD patients with a suspected dialysate leak. Results: Thirty nine PS procedures were done in 36 PD patients in the study period. Of those, 80.5% were male and 11.1% had CKD due to polycystic kidney disease. During this period 23 leaks were diagnosed, showing an incidence of 6.3% (3 episodes per patient/year). In all cases with negative PS other tests did not confirm a peritoneal dialysate leak. Conclusion: PS is a safe, inexpensive, reproducible and highly effective diagnostic tool for peritoneal dialysate leaks, allowing nephrologists to tailor or stop PD therapy if required. In our opinion, it should be the first line imaging test to diagnose PD leaks with minimum exposure to radiation, contrast or other substances that could irritate the peritoneal membrane. We believe PS should be considered as initial test of choice to diagnose this PD complication as soon as possible, minimising technique failure and dropout due to leaks.