The patient and spouse were able to successfully complete their CAPD training program and meet established parameters. The diaphragmatic leak precluded the patient from maintaining fluid volume status within our guidelines. Through the efforts and intervention by our nursing staff and renal social worker, the patient was able to demonstrate positive coping strategies when dealing with this difficult situation. Maintaining fluid and electrolyte balance was eventually achieved though hemodialysis. The patient did not agree to having pleural sclerotherapy and, therefore, she remains on chronic hemodialysis.