Kai-Ming CHOW, Cheuk-Chun SZETO
Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
A 54-year-old man with chronic glomerulonephritis and end-stage renal failure on peritoneal dialysis presented with abdominal discomfort and slow dialysis drainage. After a few cycles of attempted rapid dialysis exchange, a giant fibrin clot was drained into the dialysis effluent (Panel A, white arrows). His symptoms immediately resolved, and dialysis drainage returned to normal. A culture of the dialysis effluent was negative. He received 3 days of intraperitoneal heparin and the problem did not recur. Fibrin in dialysis effluent is a common problem in peritoneal dialysis patients. However, it is distinctly uncommon to have a fibrin clot of the size in our patient squeeze its way through the Tenckhoff catheter. (Hong Kong J Nephrol 2002;4(2):115)
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