{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:59:44Z","timestamp":1790132384442,"version":"4.0.1"},"reference-count":11,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>We report a 23\u2010year\u2010old male with kidney failure secondary to childhood Focal Segmental Glomerulosclerosis who presented with sepsis, severe lactic acidosis, and encephalopathy. Following stabilization of the acute condition with Continuous Veno\u2010Venous Hemofiltration, a diagnosis of Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke\u2010like episodes (MELAS) was confirmed by muscle biopsy and the identification of the m.3243A&gt;G mutation. This case highlights the diagnostic difficulties of this rare disease and the challenges in selecting a long\u2010term renal replacement therapy. Specifically, the use of lactate\u2010buffered peritoneal dialysis fluids in these patients remains controversial. In our case, the patient demonstrated poor tolerance to intermittent haemodialysis due to MELAS\u2010associated cardiomyopathy. However, despite theoretical concerns regarding lactate load, steady\u2010state serum lactate remained stable on Continuous Ambulatory Peritoneal Dialysis (CAPD), and the patient achieved good functional recovery. We conclude that while acute decompensation requires aggressive management, CAPD is a feasible long\u2010term dialysis modality for patients with kidney failure secondary to MELAS.<\/jats:p>","DOI":"10.1111\/nep.70283","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T01:17:20Z","timestamp":1789435040000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Peritoneal Dialysis for End\u2010Stage Kidney Disease due to Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke\u2010Like Episodes (\n                    <scp>MELAS<\/scp>\n                    ): A Case Report"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9606-3388","authenticated-orcid":false,"given":"Zi","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Medicine United Christian Hospital  Hong Kong HKSAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka Lok","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine United Christian Hospital  Hong Kong HKSAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Kwan","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Medicine United Christian Hospital  Hong Kong HKSAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Ping","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Medicine United Christian Hospital  Hong Kong HKSAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Lun Will","family":"Pak","sequence":"additional","affiliation":[{"name":"Department of Medicine United Christian Hospital  Hong Kong HKSAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5200-6672","authenticated-orcid":false,"given":"Yick Hei","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine United Christian Hospital  Hong Kong HKSAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3136-0941","authenticated-orcid":false,"given":"Sunny Sze Ho","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine United Christian Hospital  Hong Kong HKSAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2015.06.004"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.5414\/cn107063"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.82a.14098"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfh546"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8030303"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1590\/0004\u2010282x20150154"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2017.00169"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467\u2010025\u201006679\u20104"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2017.09.022"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1986.62"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytae690"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70283","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.70283","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70283","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:03:46Z","timestamp":1790129026000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.70283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":11,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/nep.70283"],"URL":"https:\/\/doi.org\/10.1111\/nep.70283","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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