The patient is a male in his 60s with morbid obesity and end-stage renal disease secondary to hypertension and diabetes. After a lifelong struggle with weight management, he was approved for bariatric surgery. Following completion of the bariatric clinic courses, he underwent laparoscopic Roux-en-Y gastric bypass. There were no intraoperative complications nor divergences from our routine practice. Postoperatively, the patient resumed peritoneal dialysis (PD) on postoperative day zero. He tolerated the operation and dialysis well, noting that the drained abdominal fluid remained serosanguinous for 5 days after surgery. While the traditional practice after intra-abdominal surgery is to temporarily transition to haemodialysis in patients who require dialysis, we demonstrate that immediate resumption of PD may be safe and efficacious. However, patients should be educated regarding the temporary change in colour of the drained intra-abdominal fluid. More robust data is required for further research and future practice guideline development.
Zhang et al. (Wed,) studied this question.