Peritoneal Dialysis (PD) Terminal: A Rescue Treatment for Uremic Patients with Massive Ascites Related to Malignancies

DOI 28 References
  • Maeda Yoshitaka
    Nephrology Section, Department of Internal Medicine, Toride Kyodo General Hospital
  • Shiigai Tatsuo
    Nephrology Section, Department of Internal Medicine, Toride Kyodo General Hospital

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Abstract

  Dialysis therapies are generally considered to be contraindications in cases with non-curative malignancies. Here we report two cases in which peritoneal dialysis was undertaken to reduce malignancy-related symptoms like abdominal full sensation and anorexia as well as to eliminate uremic toxins. The first case was a 61year-old male with peritonitis carcinomatosa and its related ascites disseminated from pancreas tail cancer. His renal function deteriorated after initiating chemotherapy using 1,000mg/m² of gemcitabine (GEM), and dialysis was required to improve his uremic symptoms. The second case was an 81year-old male who had been receiving maintenance HD therapy for 8years at another clinic. He had been complaining of abdominal distension derived from ascites and had multiple liver tumors of unknown origin. Since the main complaint in these two cases was unbearable abdominal full sensation, continuous ambulatory peritoneal dialysis (CAPD) was initiated to simultaneously control uremia and to relieve the abdominal distension. CAPD was successful in reducing ascites and in controlling the uremia as well as general symptoms. Consequently, we propose “PD terminal” as the rescue treatment for uremic patients with massively retained ascites related to malignancies.

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