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All Journal Cermin Dunia Kedokteran
Shian, Davis
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Health Professions

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Hypokalemia and Hemoperitoneum from Retrograde Menstruation in a Woman with Peritoneal Dialysis – A Case Report: Case Report Sanjaya, Winston; Halim, Hendry; Wibisono, Raden Sony Yusuf; Shian, Davis; Ekaputra, Anthony
Cermin Dunia Kedokteran Vol 53 No 09 (2026): September 2026 - CDK 356
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i09.2123

Abstract

Introduction: Hypokalemia in peritoneal dialysis (PD) can be caused by dialysate potassium loss, low intake of potassium-rich foods, or gastroenteritis. Hemoperitoneum is a non-mechanical complication of peritoneal dialysis, common in menstruating women. Case: A 52-yearold woman with end stage renal disease (ESRD) on PD was admitted to the emergency department with persistent vomiting and bloody dialysate. The patient had a history of type 2 diabetes, controlled with antidiabetic drugs. Her serum potassium was 2.0 mEq/L. Ultrasound showed simple ovarian cysts and uterine myomas. She was diagnosed with severe hypokalemia, hemoperitoneum, type 2 diabetes, and ESRD. The treatment included oral and intravenous potassium chloride, tranexamic acid, and frequent dialysate changes. After a one-month follow-up, no complications were reported. Discussion: The hypokalemia was likely associated with gastrointestinal potassium loss and inadequate intake of potassium-rich foods. The temporal relationship between menstruation and bloody dialysate, together with the absence of cyst rupture or peritonitis, supported retrograde menstruation as the probable cause of hemoperitoneum. Conclusion: Hypokalemia may result from gastrointestinal losses, inadequate potassium intake, while menstruation might cause bloody dialysate in PD.
Co-Authors Ekaputra, Anthony Hendry Halim Sanjaya, Winston Wibisono, Raden Sony Yusuf