ABSTRACT
Background: Peritoneal dialysis (PD) is the RRT of choice in 15% of patients with CKD and has multiple advantages over hemodialysis. PD leaks can prompt technique failure and dropout. Use of peritoneal scintigraphy (PS) for diagnosis of PD leaks has declined in favor of more complex and expensive tests. We analyzed the utility of PS for PD leak diagnosis in our center. Methods: We retrospectively analyzed all PS done in our center from January 2000 until December 2018, inclusive, in all patients on PD with a suspected dialysate leak. Results: A total of 39 PS procedures were done in 36 patients on PD in the study period. Of those, 81% were male and 11% had CKD due to polycystic kidney disease. During this period, 23 leaks were diagnosed, showing an incidence of 6% (three episodes per patient per year). In all cases with negative PS, other tests did not confirm a peritoneal dialysate leak. Conclusions: PS is a safe, inexpensive, reproducible, and highly effective diagnostic tool for peritoneal dialysate leaks that allows nephrologists to tailor or stop PD therapy if required. In our opinion, it should be the first-line imaging test to diagnose PD leaks with minimum exposure to radiation, contrast, or other substances that could irritate the peritoneal membrane. We believe PS should be considered as the initial test of choice to diagnose this PD complication as soon as possible, minimizing technique failure and dropout due to leaks.
Subject(s)
Peritoneal Dialysis , Dialysis Solutions , Humans , Male , Peritoneal Dialysis/adverse effects , Peritoneum , Radionuclide Imaging , Retrospective StudiesABSTRACT
La sarcoidosis y la tuberculosis son 2 enfermedades granulomatosas frecuentes que comparten presentaciones clínicas y radiológicas. Entre los signos radiológicos característicos de sarcoidosis pulmonar descritos recientemente en la tomografía computarizada de tórax destaca el signo de la «galaxia». Presentamos un caso de sarcoidosis que inicialmente fue confundido con una tuberculosis en el que este signo radiológico fue útil para indicar el diagnóstico correcto
Sarcoidosis and tuberculosis are two common granulomatous conditions that may share clinical and radiological presentations. The galaxy sign (sarcoid galaxy sign) is a characteristic radiological sign of pulmonary sarcoidosis on thoracic computed tomography (CT). We present the case of a patient with sarcoidosis that was initially misdiagnosed as tuberculosis, in whom the galaxy sign on CT was useful as it suggested the correct diagnosis
Subject(s)
Humans , Female , Adult , Sarcoidosis, Pulmonary/diagnostic imaging , Tomography, X-Ray Computed , Tuberculosis, Pulmonary/diagnostic imaging , Diagnosis, DifferentialABSTRACT
Sarcoidosis and tuberculosis are two common granulomatous conditions that may share clinical and radiological presentations. The galaxy sign (sarcoid galaxy sign) is a characteristic radiological sign of pulmonary sarcoidosis on thoracic computed tomography (CT). We present the case of a patient with sarcoidosis that was initially misdiagnosed as tuberculosis, in whom the galaxy sign on CT was useful as it suggested the correct diagnosis.
Subject(s)
Sarcoidosis, Pulmonary/diagnostic imaging , Tomography, X-Ray Computed , Tuberculosis, Pulmonary/diagnostic imaging , Adult , Diagnosis, Differential , Female , HumansABSTRACT
No disponible
