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Peritoneal Dialysis As Salvage Therapy in a High-Risk Patient With Failed Hemodialysis Access: A Case Report

Year: 2025

Type: article

Abstract: Peritoneal dialysis (PD) is often contraindicated in patients with extensive prior abdominal surgeries due to the risk of adhesions, catheter malposition, and poor dialysis efficacy. We present a complex case of a 64-year-old male with end-stage kidney disease (ESKD) who experienced repeated arteriovenous fistula (AVF) thromboses and multiple catheter-related bloodstream infections, ultimately exhausting all viable vascular access sites for hemodialysis (HD). Despite prior abdominal surgeries, the patient underwent successful PD catheter insertion following femoral catheter-related sepsis and fungemia. Although initial PD catheter malposition was observed, it was corrected surgically, and PD was initiated, leading to full clinical recovery. This case highlights the potential role of PD as a rescue therapy, even in patients with relative contraindications and no remaining HD access options. It underscores the importance of reconsidering the feasibility of PD in high-risk patients when vascular access is no longer available.

Source: Cureus

DOI: 10.7759/cureus.86681

Authors: Selena Gajić, Marko Baralic, Ana Bontic, Aleksandar Sic, Aleksandra Kezic

Institutions: Univerzitetski Klinički Centar Srbije, University of Belgrade

Language: English

Topic: Dialysis and Renal Disease Management

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4411586669