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Low BP, shortness of breath. Hemodialysis, peritoneal dialysis, had catheter moved. Done CAT scan. Is there a leak from catheter?

My husband was on hemodialysis for about a year. Last December we began with peritoneal dialysis at home and have been doing this for almost a year. He had his catheter moved last June as it was much too low. Since then he has been retaining fluid in his abdomen. He recently had a CAT scan and a ecocardiogram which showed a heart problem which his doctor said could be controlled with medication. While in the hospital, his blood pressure dropped so low he was given a bag of saline solution which raised it but he was taken off this medication for his heart. Now he is at home and has a physical therapist come to our home twice a week and he is doing light exercises but his biggest problem, which has been with him for about three months, is shortness of breath. It is from all of the fluid in his abdomen pressing on his diaphram, etc. He has increased his trouser size by two inches. I called this to the attention of his nephrologist as his stomach is like a big bowl of jelly. Nothing is being done to take care of this fluid except the doctor has put him back on hemodialysis with no reduction of fluid. Is there a possibility that there is a leak inside from his catheter or could it be a buildup of fluids from the peritoneal dialysis which I understand does not always completely flush all the fluids out of his body? Sorry about this being such a long messge but we are at a wits end as to finding out what is causing this problem. Could you possibly help us by offering your guideance about the fluid. Thank you in advance.
Asked On : Wed, 16 Oct 2013
Answers:  1 Views:  51
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Nephrologist 's  Response
Thanks for your query.
If there is no active peritonral dialysis going on, then the abdominal fluid collection is unlikely to be related to the Peritoneal dialysis catheter.
Ascites or fluid in the peritoneal cavity can be due to a weak heart or liver problems.
I would recommend a 2D Echocardiogram, Ultrasound of the abdomen and a diagnostic ascitic fluid tap.
Based on the results we could make further recommendations.
Hope this helps
Good luck.
Answered: Wed, 16 Oct 2013
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