[Effect of peritonitis frequency on the effectiveness of peritoneal dialysis and effect of peritoneal dialysis effectiveness on the frequency of peritonitis].
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Peritonitis is the most serious complication of peritoneal dialysis treatment for ESRD. There is no unanimous attitude yet concerning the influence of PD adequacy on the frequency of peritonitis.The paper reports on a study of interrelation of peritonitis frequency and PD adequacy in 61 patients (27 women, 34 men) during a 5-year period. The group included 88% of all PD patients (61 of totally 69).The patients experienced a total of 71 peritonitis episodes over a total of 1615 months of PD treatment. There was one peritonitis episode per 23 months of treatment on an average. When a patient who experienced 11 peritonitis episodes was excluded, the average frequency of peritonitis turned to one in 26 months. Peritonitis frequency and PD adequacy showed a significant negative correlation (r = 0.25, p < 0.05). PD adequacy expressed as total weekly Kt/V did not differ between the patients with and those without a history of peritonitis (Kt/V+ = 1.87 +/- 0.21, Kt/V- = 1.88 +/- 0.24; t = 0.17, p > 0.05). The frequency of peritonitis in men was twofold that in women, i.e. one peritonitis in every 17.24 +/- 11.67 months of treatment in men, and one peritonitis in every 37.81 +/- 13.11 months in women. The difference was statistically significant (t = 6.39, p < 0.01). However, PD adequacy did not differ between men and women (Kt/V = 1.84 +/- 0.21: 1.92 +/- 0.23, t = 1.40, p > 0.05). Patients with more adequate dialysis (n = 51) (Kt/V = 1.70) had one peritonitis in every 23.16 +/- 20.07 months on an average, and those with less adequate dialysis one peritonitis in 21.82 +/- 18.12 months of treatment. The difference was not statistically significant (t = 0.21, p > 0.05). The patients in whom PD was the first method of ESRD treatment (n = 55) experienced one peritonitis in every 24.04 +/- 12.51 months of treatment on an average, and those in whom PD was the second method of ESRD treatment (n = 6) had one peritonitis in 15.68 +/- 13.54 months of treatment. The difference was not significant (t = 1.45, p > 0.05). The difference in dialysis adequacy between these two groups was not significant either, even though the patients with PD as the first method had more adequate dialysis (1.88 +/- 0.22: 1.83 +/- 0.27; t = 0.44, p > 0.05).Peritonitis frequency and PD adequacy are significantly negatively correlated. The patients with higher peritonitis frequency had less adequate dialysis, while the patients with less adequate dialysis had peritonitis more frequently. However, the patients with a history of peritonitis had not significantly less adequate dialysis, nor the patients with less adequate dialysis had a significantly higher frequency of peritonitis.Cite
Twenty patients presenting with renal failure were treated with peritoneal dialysis in a private hospital in Nigeria. Of the nine patients with acute renal failure, six survived. Four patients with chronic failure was maintained on Intermittent Peritoneal Dialysis and were sustained for variable periods. There were some complications, especially peritonitis and catheter obstruction. It is suggested that a chronic peritoneal dialysis programme should be encouraged in a developing country like Nigeria. This is an alternative to haemodialysis. Our suggestions are based on its proven efficacy, comparatively lower cost, easy maintenance and convenience to patients.
Chronic renal failure
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Bowel perforation
Perforation
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Port (circuit theory)
Abdominal cavity
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One hundred-and-ten consecutive surgically implanted one-cuff straight peritoneal dialysis catheters in 103 adult patients over a 7 year period have been reviewed. All catheters were placed for chronic dialysis (CAPD). There were no early failures. Early complications consisted of one leak, 14 migrations, and two wound infections. In the long term 15 patients required transfer to haemodialysis (5 recurrent peritonitis, 7 unable to cope, 3 inadequacy of dialysis). Overall probability of catheter survival was 92.4% at 1 year and 82.4% at 2 years. The surgical implantation technique described provides a safe, reliable access for peritoneal dialysis with a low complication rate.
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The authors percutaneously placed 45 catheters for peritoneal dialysis in 32 patients, aged 31-83 years, in a radiology department. In all patients, the procedure was modified by use of the Hawkins needle, and in response to the high frequency of extrusion of the proximal cuff, the deep cuff of the 16th and each subsequent catheter was sutured to the rectus muscle or fascia. After 17 catheters were placed, the catheter was modified with a permanent bend, or "U" neck, between the two cuffs, which were then thickened. All procedures were performed with use of local anesthesia, and all catheters were successfully placed. Acute complications included bowel perforation associated with peritonitis in one patient (2%). Delayed complications included cuff extrusion in nine patients (20%), obstruction in nine patients (20%), and peritonitis requiring removal of the catheter in three patients (7%). This study shows the feasibility of percutaneous placement of peritoneal dialysis catheters by radiologists despite the need for improved technique and equipment.
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Objectives To summarize the complications of peritoneal dialysis in postoperative infants with congenital heart disease(CHD).Methods Clinical data of infants with CHD who received cardiac surgery from June 2010 to June 2012 in The People's Hospital of Gaozhou were retrospectively analyzed.There were 41 cases who had acute kidney injury or acute cardiac insufficiency after surgery.Peritoneal dialysis was performed and related complications were analyzed.Results Renal function in most infants were recovered gradually and duration of peritoneal dialysis was(5.92±4.74) days.Related complications of peritoneal dialysis occurred in 12 cases and the most common complication was pulmonary complications..All complications were cured without fatal complications..Conclusions Related complications of peritoneal dialysis are few and not serious.Early use of peritoneal dialysis is safe and effective when acute renal injury or cardiac insufficiency occurrs in postoperative infants with CHD.
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The hospital records of 56 patients (25M, 31F) with acute or chronic renal failure treated by peritoneal dialysis were retrospectively reviewed. Mean dialysis time was 13 +/- 15 days in acute renal failure and 32 +/- 23 months in chronic renal failure. The incidence of infectious (exit site infections and peritonitis) and non-infectious dialysis-related complication was assessed. Exit site infections were significantly more frequent in children aged 5 or less than in older patients (1/9.6 patient-month and 1/26.5 patient-month, respectively, p < 0.001). Such relationship was not found with regard to the incidence of peritonitis. There was a tendency of peritonitis rate to decrease in consecutive years was noted. This can be probably related to an increase in the number of patients, introduction of automated peritoneal dialysis, increasing experience of medical staff and patients themselves.
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Acute (stab) peritoneal dialysis is commonly practised in Malaysia. This study is designed to improve the management of peritoneal dialysis (PD) in Hospital University Science Malaysia (HUSM). Consecutive peritoneal dialysis (PD) on adult inpatients from May 1992 to September 1992 were reviewed prospectively. There were 40 episodes of peritoneal dialysis on 27 patients during this period given at the rate of 2 PD per week. The mean age of patients were 53 +/- 15 years. Uraemia was the main indication for dialysis, while hyperkalaemia and pulmonary oedema were indications for urgent dialysis. Complications occurred in 14 episodes of dialysis (35%). The most common complication was bleeding in the peritoneal cavity while peritonitis was the second most common complication. Dialysis episodes complicated by peritonitis were done by less experienced performers compared to uncomplicated dialysis episodes. Overall mean time spent on each dialysis and time per cycle were longer than recommended (59 +/- 24 hours and 77 +/- 14 minutes). In conclusion, acute PD performed on patients admitted in Hospital University Malaysia was safe and had complication rates comparable to other established centres. However, improvements are possible through closer supervision of new doctors and tighter nursing precautions.
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