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

• Published in: Kidney360 Vol. 1; no. 5; pp. 354 - 358
• Main Authors: Sosa Barrios, R Haridian, Rioja Martín, María Eugenia, Burguera Vion, Víctor, Santos Carreño, Astrid Lucía, Fernández Lucas, Milagros, Rivera Gorrín, Maite E
• Format: Journal Article
• Language: English
• Published: United States American Society of Nephrology 28-05-2020
• Subjects: Dialysis Solutions; Humans; Male; Original Investigations; Peritoneal Dialysis - adverse effects; Peritoneum; Radionuclide Imaging; Retrospective Studies; dialysate leak; renal replacement therapy; peritoneal dialysis; imaging test; clinical nephrology; scintigraphy
• ISSN: 2641-7650; 2641-7650
• DOI: 10.34067/KID.0000302020

Peritoneal dialysis (PD) is the RRT of choice in 15% of patients with CKD and has multiple advantages over hemodialysis. PD leaks can prompt technique failure and dropout. Use of peritoneal scintigraphy (PS) for diagnosis of PD leaks has declined in favor of more complex and expensive tests. We analyzed the utility of PS for PD leak diagnosis in our center.
We retrospectively analyzed all PS done in our center from January 2000 until December 2018, inclusive, in all patients on PD with a suspected dialysate leak.
A total of 39 PS procedures were done in 36 patients on PD in the study period. Of those, 81% were male and 11% had CKD due to polycystic kidney disease. During this period, 23 leaks were diagnosed, showing an incidence of 6% (three episodes per patient per year). In all cases with negative PS, other tests did not confirm a peritoneal dialysate leak.
PS is a safe, inexpensive, reproducible, and highly effective diagnostic tool for peritoneal dialysate leaks that allows 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 the initial test of choice to diagnose this PD complication as soon as possible, minimizing technique failure and dropout due to leaks.