HEMOPERITONEUM: BLOODY PERITONEAL DIALYSATE IN ESRD PATIENTS RECEIVING PERITONEAL DIALYSIS

Hemoperitoneum is seen in patients receiving peritoneal dialysis (PD) because the PD catheter provides a window to the peritoneum. Gynecological associated phenomena ac-count for the majority of cases. Intra-abdominal pathology of solid organs such as the kidney, liver, and spleen as well as the gastrointestinal tract is recognized. Unique to PD pa-tients, hemoperitoneum may be associated with the cath-eter itself, uremic bleeding, or peritonitis. A successful PD program requires nephrologists, PD nurses, and patients as-sess and manage hemoperitoneum in a systematic fashion. This paper reviews hemoperitoneum in adult PD patients. Perit Dial Int 2007; 27:226–233 www.PDIConnect.com KEY WORDS: Hemoperitoneum; blood; end-stage renal disease (ESRD); peritoneum. A40-year-old woman with polycystic kidney diseasewas receiving peritoneal dialysis (PD) for renal fail-ure. Her kinetics were adequate, with weekly Kt/V urea 2.1 and weekly creatinine clearance 61 L. She had never experienced peritonitis. She was taking several antihy-pertensive medications, a phosphate binder, a vitamin D supplement, a multivitamin, and erythropoietin. Approximately 15 months after starting PD, she no-ticed during an exchange that her PD effluent was bloody. Immediately at the end of the exchange she called the PD nurse. The nurse determined that this pa-tient had never had this happen previously. The patien