Successful treatment of pleuroperitoneal communication with pleurodesis using autologous blood in a patient with severe heart failure undergoing peritoneal dialysis: a case report and brief literature review

Pleuroperitoneal communication is a potential complication of peritoneal dialysis (PD). Of the various treatment strategies for pleuroperitoneal communication, successful treatment with pleurodesis using autologous blood has rarely been reported. A 58-year-old man with end-stage kidney disease secondary to diabetic nephropathy and severe heart failure was placed on PD. He developed right-sided hydrothorax after the commencement of PD. Technetium-99m macro-aggregated human serum albumin peritoneal scintigraphy revealed pleuroperitoneal communication. PD was temporarily discontinued and substituted with hemodialysis. Subsequently, the levels of pleural fluid decreased. However, the resumption of PD exacerbated the hydrothorax. After thoracentesis, 50 mL of autologous blood was instilled into the right pleural cavity. There were no complications related to the procedure. PD was reinitiated 5 days after pleurodesis. Repeated chest X-rays did not depict any evidence of recurrent hydrothorax over the subsequent 10 months. Pleurodesis using autologous blood was effective for pleuroperitoneal communication and was evidently safe in our patient. It should be considered in patients with severe heart failure since it is minimally invasive.