A 56‒year‒old male with diabetic nephropathy was started on continuous ambulatory peritoneal dialysis （CAPD） in May 2018. Approximately 2 months later, he was admitted to our hospital because of weariness. A chest X‒ray showed right‒sided hydrothorax. The CAPD was interrupted, and the hydrothorax disappeared. However, the hydrothorax recurred when the CAPD was restarted. Thoracentesis was performed, and transudative pleural effusion was noted. Thus, we diagnosed the patient with pleuroperitoneal communication. Video‒assisted thoracoscopic surgery was carried out. After dialysis solution containing indigo carmine dye was passed through a CAPD catheter, it was shown to flow through a fistula near the right central tendon of the diaphragm. The fistula was directly closed with an automatic anastomotic device. CAPD was restarted 14 days after the surgery. A few days later, the right‒sided hydrothorax recurred. We suspected recurrent pleuroperitoneal communication. Thoracentesis was performed by passing dialysis solution containing indigo carmine dye through a CAPD catheter. The pleural effusion was not colored with indigo carmine dye and appeared hemorrhagic and exudative. These findings excluded tuberculous and cancerous pleural effusion. We diagnosed the patient with uremic pleuritis and initiated hemodialysis. No recurrence of the hydrothorax has been detected since the treatment.