81 Peritoneal Dialysis in a Cystic Fibrosis Patient

Abstract

PERITONEAL DIALYSIS IN A CYSTIC FIBROSIS PATIENT Susmitha Dhanyamraju, Austine Mengnjo, Guillermo Carnero, William Difilippo Geisinger Medical Center, Danville, Pennsylvania Cystic fibrosis (CF) is an autosomal recessive disease caused by a mutation in the CFTR gene. While CF is primarily a pulmonary disease, renal disease is beginning to emerge as a cause of morbidity and mortality in this patient population. The spectrum of renal diseases commonly associated with CF includes nephronopthisis, nephrolithiasis, medullary cystic disease as well as aminoglycoside related renal toxicity and interstitial nephritis. Management of end stage renal disease (ESRD) in the CF patient is an area which is not well studied, with minimal data regarding dialysis modalities. This case discusses the successful use of peritoneal dialysis in a CF patient with ESRD. A 24 yo Caucasian female with a history of CF, gastric feeding tube, and underlying renal insufficiency due to MCD presented with worsening renal failure. Her renal insufficiency progressed as a result of multiple courses of aminoglycosides used to treat her CF exacerbations. Due to progression to ESRD by age 23, hemodialysis was initiated via a tunneled catheter. The concern of potential catheter related infection led to a change in dialysis modality to PD. Despite the existing gastric tube placement a PD catheter was placed laparoscopically. Low volume CCPD was used effectively in this patient achieving a Kt/v of 2.37. Literature review reveals only 2 other cases of peritoneal dialysis in patients with cystic fibrosis. In both of these cases the patient outcome was poor within the first month of treatment. Our patient is without PD complications for the last 4 months. We conclude PD should be considered a promising dialysis option for CF patients with ESRD.