Efficacy and safety of pleural infusion of elemene in the treatment of peritoneal dialysis complicated with pleuroperitoneal communication.

PURPOSE: To evaluate the efficacy and safety of elemene pleural instillation in peritoneal dialysis (PD) patients with pleuroperitoneal communication (PPC).

METHODS

This single-center retrospective study enrolled PD patients with PPC who received elemene between October 2020 and January 2022. The diagnosis was confirmed by computed tomography peritoneography (CTP), demonstrating contrast medium in the pleural cavity. Patients received intrapleural elemene (200-400 mg/m2) once or twice weekly. Primary outcomes included treatment efficacy, changes in laboratory parameters, recurrence and safety.

RESULTS

In this study 12 patients were included. After elemene instillation (median follow-up 14.1 months), 10 patients (83.3%) successfully resumed continuous ambulatory peritoneal dialysis. Drug-related adverse events occurred in 9 patients (75.0%): chest pain alone (5, 41.7%) and chest pain with fever (4, 33.3%). All events were CTCAE grade 1 (7, 58.3%) or 2 (2, 16.7%). No significant pretreatment to post-treatment changes were observed in renal function (eGFR), coagulation parameters (PLT, PT, TT, APTT) or dialysis adequacy (Kt/V, Ccr) (all P > 0.05).

CONCLUSION

Elemene pleural instillation appears safe and effective for PD patients with PPC, facilitating resumption of continuous ambulatory peritoneal dialysis.