Investigation and treatment of poor drains of dialysate fluid associated with anterior abdominal wall leaks in patients on chronic ambulatory peritoneal dialysis.

Reduced dialysate fluid volume and genital and abdominal-wall oedema occurring many months after initiation of continuous ambulatory peritoneal dialysis (CAPD) has been investigated in 20 patients using computed tomographic peritoneography. Leaks into the anterior abdominal wall at the site of insertion of the Tenckhoff catheter have been demonstrated in a series of 14 patients. Nocturnal peritoneal dialysis alone led to resolution of leaks in four of the nine patients who underwent this mode of treatment. Four of the failures plus a further four patients successfully underwent either resuture of the peritoneum or replacement of the catheter. A policy for management of proven anterior abdominal-wall leaks in CAPD patients is described, consisting of nocturnal peritoneal dialysis for 2 weeks followed by surgical intervention if the former is unsuccessful.