透析液渗漏是腹膜透析(peritoneal dialysis，PD）主要非感染性并发症之一。晚期渗漏多发生于导管置入30 d以后，表现为皮下水肿、生殖器水肿、疝气等。治疗手段包括手术修补、临时转血液透析（hemodialysis，HD）及缩减透析液灌入量等。既往多数文献提出保守治疗无效后需尽早手术以减少并发症，但手术后复发率较高。部分患者因基础疾病或个人意愿无法接受手术或转为HD，给临床带来挑战。本文纳入武汉大学中南医院腹膜透析中心3例晚期腹膜透析液渗漏患者，分别表现为阴囊水肿、皮下渗漏及腹股沟疝，全部采用低容量夜间自动腹膜透析(automated peritoneal dialysis，APD)的方式治疗，2～3个月渗漏完全消失，逐步过渡至持续不卧床腹膜透析(continuous ambulatory peritoneal dialysis，CAPD)治疗，避免了转为HD。经5年以上随访，3例患者渗漏均未复发。综上所述，针对无法手术、不适合转为HD的晚期腹膜透析液渗漏患者，低容量夜间APD是一种有效的治疗选择。

Dialysate leakage is one of the major non-infectious complications of peritoneal dialysis. Late leakage is defined as occurring more than 30 days after catheter placement and may present as subcutaneous edema, genital edema, or hernia. Treatment options include surgical repair, temporary conversion to hemodialysis, and reduction of dialysate volume. Previous literature generally recommends early surgical repair when conservative measures fail, in order to reduce complications; however, the postoperative recurrence rate is high. Some patients are unable to undergo surgery or transition to hemodialysis due to underlying comorbidities or personal preference, making management challenging. This article reports three cases of late dialysate leakage from the Peritoneal Dialysis Center of Zhongnan Hospital of Wuhan University, presenting as scrotal edema, subcutaneous leakage, and inguinal hernia, respectively. All three patients were managed with low‑volume nocturnal automated peritoneal dialysis (APD) to continue peritoneal dialysis. The leakage resolved within 2～3 months, and they were gradually transitioned back to continuous ambulatory peritoneal dialysis (CAPD), successfully avoiding conversion to hemodialysis. After more than 5 years of follow-up, no recurrence of leakage occurred in any of the three patients. Therefore, low-volume nocturnal APD represents an effective alternative treatment option for patients with late dialysate leakage who are intolerant to surgery or unable to switch to hemodialysis.