A case in which peritoneal dialysis was initiated in an American woman in Japan with scleroderma renal crisis

Abstract

The patient was a 26-year-old female American, who had come to Japan one year earlier as an assistant language teacher. She visited a nearby hospital with a headache and vomiting. She was diagnosed with acute renal failure, hypertension, and thrombocytopenia and was admitted to the hospital. Her renal function gradually worsened, and she was transferred to our hospital. She was diagnosed with scleroderma, as skin sclerosis and symptoms of Raynaud’s disease were seen on her forearm. The cause of the acute renal failure was diagnosed as scleroderma renal crisis, and the patient was treated with ACE inhibitors and other antihypertensive therapies. However, she eventually developed end-stage renal failure. We suggested that she return to the United States and undergo renal replacement therapy, but she strongly preferred to continue working in Japan. Therefore, she was started on peritoneal dialysis in Japan. After her work contract ended, she returned to the United States. This was a rare case, and we report its course from the initiation of peritoneal dialysis to the patient’s return to the United States.