MANAGEMENT
Dialysis therapy:
- Initiate PD or APD in supine position, using low volume exchanges (500 to 1500 mL) until leak has resolved. Keep abdomen dry when not in supine position
- If required, use HD backup for 1 to 2 weeks
In new patients in whom dialysis is not urgently required:
- Delay use of PD for up to 3 weeks if necessary until leakage subsides1
- Cautious reintroduction of PD after rest period with frequent monitoring for recurrence
Invasive steps:
- Persistent leak may require surgical repair1
- Provide HD backup if needed during healing in patients with no residual renal function if low volume APD is not feasible or does not adequately control azotemia
- Recurrent pericatheter leaks may require catheter replacement1
