A 60 year old man, who is a known case of CKD due to diabetes, and heart failure with triple vessel disease and not willing for CABG, presented with worsening breathlessness. His BP was not recordable at admission and his creatinine was found to be 8mg/dl. Due to poor financial status, he was admitted in general ward, initiated on inotropic support and BP maintained around 80mmHg. He had pulmonary edema, was started on BiPAP and needed urgent dialysis. We inserted bedside CAPD peritoneal dialysis catheter and initiated on urgent start PD. He underwent daily exchanges, following which patient’s dyspnea improved, was maintaining without oxygen support, BP improved and was discharged on CAPD. This case highlights the importance of PD, which is especially the modality of choice of dialysis for patients with heart failure and heart disease, and also best mode of maintenance dialysis in children.
Figure 1: bedside insertion of peritoneal dialysis catheter
Figure 2: patient doing well on CAPD