Successful Peritoneal Dialysis Catheter Placement in a New End-Stage Renal Disease Patient with Combined Antiphospholipid Syndrome and Factor XI Deficiency.

We present the case of a 68-year-old woman with combined antiphospholipid syndrome and factor XI deficiency, with chronic prolongation of activated partial thromboplastin time that was not correctable with fresh-frozen plasma (FFP).The patient had a history of stroke, but was not on antiplatelet therapy because of mucocutaneous bleeding events. She had progressive renal failure attributed to her autoimmune disease, and a decision was made to pursue peritoneal dialysis (PD) when she reached end-stage kidney disease. She was admitted to the hospital the day before her planned PD catheter placement and was transfused with FFP and platelets before placement of a temporary hemodialysis catheter. One session of hemodialysis was performed to minimize uremic platelet dysfunction. The patient was given additional FFP and platelets at the time of PD catheter placement; desmopressin was not used. No thrombotic or bleeding complications occurred, and at 8 months out, the patient has been doing well on PD.In summary, careful perioperative planning led to successful PD initiation in a patient with combined bleeding and clotting disorders. PMID: 29668426 [PubMed - in process]
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research