Board question of the week: PD-1

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A 55-year-old woman with ESRD secondary to lupus nephritis presents to the PD clinic with volume overload. She reports decreased UF volume, despite the use of 4.25% dextrose exchanges over the last few weeks. She has been on PD for the last 12 years. Historically, she has been able to maintain her weight, despite being a rapid transporter. She denies any abdominal pain or cloudy fluid. An abdominal film shows proper placement of the PD catheter in the lower pelvis. A catheter assessment shows no flow obstruction. A 4 hour PET using 4.25% dextrose solution results in the ultrafiltration of 350cc on a 2L dwell. The D/P Cr level is reduced from her previous studies.
What is the most likely explanation for these results? Possible answers are listed in the poll on the upper right hand column.

The answer and explanation will be posted on Friday July 16th

Michael Lattanzio DO

*RFN board questions are meant to help introduce concepts about nephrololgy related diseases and do not represent actual questions seen on the ABIM exam.

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