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Referred Shoulder Pain in Patients Undergoing Peritoneal Dialysis

Mohammad R. Ardalan, R. Shane Tubbs, Jalal Etemadi, Mohammadali M. Shoja


Peritoneal dialysis is a popular mode of renal replacement therapy worldwide. Infusion of peritoneal dialysate fluid in the peritoneal cavity may be associated with pain. We prospectively evaluated the occurrence of the infusion of pain in incident patients on peritoneal dialysis. The clinical course and factors associated with this manifestation are presented. Four out of 87 end-stage renal disease patients (5%) who started peritoneal dialysis in our center developed shoulder pain. Beginning immediately after the initiation of dialysate infusion, the shoulder pain was more severe on the left side, and radiated to the chest, then went posterolaterally down the upper extremities, up the lateral side of the hand and digits. No severe underlying clinical problem or catheter malposition was discovered. The referred pain gradually relieved by 3 weeks to 4 months. In conclusion, radiating shoulder, chest, and upper limb pains are transient and seemingly benign complications of peritoneal dialysis.

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