Suzuki Yasuhiro, Mizuno Masashi, Sakata Fumiko, Kojima Hiroshi, Sato Yuka, Kishimoto Mayuko, Suzuki Nobuaki, Kinashi Hiroshi, Saito Shoji, Katsuno Takayuki, Kosugi Tomoki, Maruyama Shoichi, Murata Makoto, Kiyoi Hitoshi, Ito Yasuhiko
Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Japan.
Division of Nephrology, Nagoya University Graduate School of Medicine, Japan.
Intern Med. 2020;59(5):683-687. doi: 10.2169/internalmedicine.3775-19. Epub 2020 Mar 1.
A 45-year-old man with idiopathic aplastic anemia required renal replacement therapy (RRT) due to end-stage renal disease (ESRD). We succeeded in inserting the peritoneal dialysis (PD) catheter under cover of frequent red blood cell and platelet infusions because of severe pancytopenia. During the one-year period after starting PD using an ultraviolet-ray sterilization device, he developed severe leukopenia but no PD-related peritonitis or exit site/tunnel infection until he died of pneumonia. This case suggests that PD might be a suitable choice as RRT in ESRD patients with aplastic anemia, even in those with severe pancytopenia.
一名45岁的特发性再生障碍性贫血男性患者因终末期肾病(ESRD)需要肾脏替代治疗(RRT)。由于严重全血细胞减少,在频繁输注红细胞和血小板的掩护下,我们成功插入了腹膜透析(PD)导管。在使用紫外线消毒装置开始腹膜透析后的一年时间里,他出现了严重的白细胞减少,但在死于肺炎之前未发生与腹膜透析相关的腹膜炎或出口处/隧道感染。该病例表明,对于再生障碍性贫血的ESRD患者,即使是严重全血细胞减少的患者,腹膜透析也可能是肾脏替代治疗的合适选择。