Free nephrology board questions: Peritoneal Dialysis

A nephrology fellow is reviewing peritoneal membrane physiology before starting a patient on peritoneal dialysis. Which of the following statements about the peritoneal membrane and fluid transport is correct?

A 57-year-old woman on CAPD develops a new right-sided transudative pleural effusion after several weeks of increasingly difficult ultrafiltration. The pleural fluid is clear, and its glucose concentration is higher than the serum glucose. What is the most likely diagnosis?

A 38-year-old man with ESKD from type 1 diabetes has been on peritoneal dialysis for 4 years and, apart from two early peritonitis episodes, has done well. He is on automated PD with five short overnight dwells (2.5% dextrose) and a long daytime dwell (1.5% dextrose). His home records show declining ultrafiltration, especially on the daytime drain, and his weight has risen from 190 to 207 lb with a blood pressure of 174/96 mmHg and 2+ peripheral edema; lungs are clear, the abdomen is soft with no hernia, and the catheter exit site is clean. A repeat peritoneal equilibration test shows the 4-hour dialysate-to-plasma creatinine ratio has risen from 0.75 to 0.90. Which of the following is the MOST appropriate management?