Peritoneal dialysis

2015 ◽  
Author(s):  
Sara Dunsmore ◽  
Joanne M. Bargman
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Infectious Complications ◽  
Abdominal Pressure ◽  
Metabolic Complications ◽  
Mechanical Complications ◽  
Potential Problems ◽  
Dialysate Solution

Many patients tolerate peritoneal dialysis well and experience little difficulty with the process. There are, however, a number of unique complications that can arise in a patient undergoing peritoneal dialysis. While infection remains a significant concern, there are also many non-infectious problems that can occur. Many mechanical complications occur as a result of the increased intra-abdominal pressure associated with the instillation of fluid into the peritoneal cavity. The dialysate solution itself may also play a role in some of the metabolic complications seen. An awareness of the potential problems that can occur will help the clinician in properly caring for a patient on this therapy and this chapter describes a range of non-infectious complications that may arise.

scholarly journals Efficiency and safety of using a peritoneal dialysis catheter weighted with a stainless steel ballast : the Limousin experience

2019 ◽  
Vol 2 (4) ◽  
pp. 193-200
Author(s):  
Bénédicte Larivière-Durgueil ◽  
Rémi Boudet ◽  
Marie Essig ◽  
Stéphane Bouvier ◽  
Ali Abdeh ◽  
...  
Keyword(s):  
Stainless Steel ◽  
Peritoneal Dialysis ◽  
Infectious Complications ◽  
Control Group ◽  
Peritoneal Dialysis Catheter ◽  
Causal Factors ◽  
Catheter Migration ◽  
Mechanical Complications ◽  
Increased Risk ◽  
One Year

Objective: To assess the recurrence of PD catheter migration after the introduction of a walnut ballast. Materials and Methods: Retrospective study from 1999 to 2014 of PD patients followed in Limousin. Were compared two groups: ballast group (patients who benefited from the establishment of stainless steel ballast at the intraperitoneal catheter extremity) with 26 patients and control group with 204 patients. The primary endpoint was the occurrence of an episode catheter’s migration after ballast’s establishment. Secondary objectives were (i) to determine the causal factors leading to the catheter weighting, (ii) to ensure the safety of the procedure on the following criteria: infectious complications, mechanicals complications, epurations criteria, and catheter’s survival. Results: More than one year after the implementation of the ballast, no recurrent migration was observed in 86.6% of cases. It wasn’t found an increased risk of infections (OR = 0.5, 95% CI [0.22, 1.13]) or mechanical complications (OR = 1.77- 95% CI [0.77, 4.05]) between the two groups. The adequation criteria were similar: KT / V total : 2.37 in the control group and 2.28 in the ballast group (p = 0.63). The survival of the ballast catheter was comparable among the two groups (p = 0.983). Three causal factors that led to the ballast were identified: automated peritoneal dialysis (APD) (OR = 0.38, 95% CI [0.16, 0.9]), the failure from the first use of the catheter (OR = 19.48, CI 95 % [7.67, 49.48]) and the incarceration of the omentum (OR = 15.84, 95% CI [5.81, 43.21]). Conclusion: The ballast used in these study appears to prevent recurrence of migration, without any impact in terms of infectious or mechanical complications, or on the dialysis criteria or on catheter’s survival. However this catheter does currently not have an EC authorization

Survival of 138 Surgically Placed Straight Double-Cuff Tenckhoff Catheters in Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (3) ◽  
pp. 224-227 ◽  
Author(s):  
Jochen Weber ◽  
Thomas Mettang ◽  
Eugen Hübel ◽  
Thomas Kiefer ◽  
Ulrich Kuhlmann
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Infectious Complications ◽  
Catheter Survival ◽  
Tenckhoff Catheter ◽  
Mechanical Complications ◽  
Unselected Patient ◽  
Kaplan Meier ◽  
History Of ◽  
The Difference

Objective To determine the natural history of a surgically placed Tenckhoff catheter in patients on continuous ambulatory peritoneal dialysis (CAPD). Design Prospective 7–year study analyzing catheter survival of all catheters using the Kaplan-Meier life table methodology. Setting Teaching hospital, department of nephrology. Patients One hundred and fifteen unselected patients beginning CAPD. Interventions Removal of the catheter required for the following complications: exit-site or tunnel infections or relapsing peritonitis, outflow obstruction, pericatheter leak, and development of hernias. Main Outcome Measures Period between insertion and removal of the catheter. Results The cumulative survival of all catheters after 1,2, and 3 years of CAPD was 87%, 69% and 65%. Catheter survival of the first versus the second catheter after 1 year was significantly longer (p=0.03). The difference was not significant in relation to diabetes, age, and sex. Infectious complications caused 61% (n=19) of all 31 catheter failures, mainly due to tunnel infections caused by Staphylococcus aureus (n=12). “Mechanical” complications accounted for 49% (n=12) of catheter failures. Eight of 12 mechanical complications were outflow failures. Seven patients had to be transferred to hemodialysis. Conclusions The straight Tenckhoff catheter is a reliable peritoneal access device for CAPD in an unselected patient population.

Comparison of Outcomes between Percutaneous and Surgical Placement of Peritoneal Dialysis Catheters in Uremic Patients: A Meta-Analysis

2021 ◽  
pp. 1-17
Author(s):  
Linxi Huang ◽  
Cheng Xue ◽  
Sixiu Chen ◽  
Shoulian Zhou ◽  
Bo Yang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Open Surgery ◽  
Meta Analysis ◽  
Infectious Complications ◽  
Current Evidence ◽  
Catheter Survival ◽  
Mechanical Complications ◽  
Surgical Methods ◽  
Lower Infection ◽  
Uremic Patients

<b><i>Background:</i></b> The optimal technique for inserting peritoneal dialysis catheters in uremic patients remains debated. This meta-analysis aimed to summarize the current evidence evaluating the efficacy and safety of percutaneous insertion methods compared to surgical methods. <b><i>Method:</i></b> A literature search was performed in the PubMed, EMBASE, Cochrane, and Web of Science databases. The primary outcome was defined as catheter survival. The secondary outcomes were mechanical and infectious complications related to catheter insertion. <b><i>Results:</i></b> Twenty studies were finally identified, including 2 randomized controlled trials. The pooled results of catheter survival, overall mechanical complications, and infectious complications were not significant (odds ratio [OR] = 1.10, 95% confidence interval (CI) = 0.76–1.57, <i>p</i> = 0.62; OR = 0.73, 95% CI = 0.48–1.11, <i>p</i> = 0.14; and OR = 0.64, 95% CI = 0.37–1.09, <i>p</i> = 0.14, respectively). Comparison stratified by the blind percutaneous method versus open surgery indicated a lower overall number of mechanical complications (OR = 0.54, 95% CI = 0.31–0.93, <i>I</i><sup>2</sup> = 72%) and malposition rate (OR = 0.56, 95% CI = 0.34–0.90, <i>I</i><sup>2</sup> = 0%). The leakage rate was higher in the blind percutaneous group than in the open surgery group (OR = 2.55, 95% CI = 1.72–3.79, <i>I</i><sup>2</sup> = 0%); the guided percutaneous method achieved a similar leakage risk to the surgical methods. <b><i>Conclusions:</i></b> The blind percutaneous method performed better with fewer overall mechanical complications and less malposition than open surgery. The leakage risk was higher in the blind percutaneous group, while the guided percutaneous placement group showed similar outcomes to the surgical method groups. Percutaneous methods also had a lower infection risk, which needs further evidence to be confirmed.

Klebsiella pneumoniae Renal Abscess and Peritonitis in a Peritoneal Dialysis Patient: A Novel Route of Infection

2017 ◽  
Vol 37 (6) ◽  
pp. 654-656
Author(s):  
Miten J. Dhruve ◽  
Joanne M. Bargman
Keyword(s):  
Peritoneal Dialysis ◽  
Klebsiella Pneumoniae ◽  
Renal Biopsy ◽  
Peritoneal Cavity ◽  
Successful Treatment ◽  
Dialysis Patient ◽  
Peritoneal Dialysis Patient ◽  
Renal Abscess ◽  
Biopsy Site ◽  
Route Of Infection

We present a peritoneal dialysis (PD) patient who had a renal biopsy performed during an episode of urosepsis and subsequently presented with a renal abscess at the biopsy site along with concurrent peritonitis. Microbiology from the PD effluent and from the renal abscess were both positive for Klebsiella pneumoniae. We propose that the PD peritonitis was the result of seeding of the peritoneal cavity with bacteria from the renal abscess. Successful treatment was achieved through drainage of the abscess and intraperitoneal antibiotics.

Peritoneal Dialysis

2019 ◽  
Author(s):  
Karlien François ◽  
Joanne M. Bargman
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Dialysis Fluid ◽  
Keywords Peritoneal Dialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Developed World

In peritoneal dialysis (PD), the peritoneum serves as a biological dialyzing membrane. The endothelium of the vast capillary network perfusing the peritoneum functions as a semipermeable membrane and allows bidirectional solute and water transfer between the intravascular space and dialysate fluid dwelling in the peritoneal cavity. PD is a renal replacement strategy for patients presenting with end-stage renal disease. It can also be offered for ultrafiltration in patients with diuretic-resistant fluid overload even in those without advanced renal failure. PD can also be used for patients with acute kidney injury, although in the developed world this occurs rarely compared to the use of extracorporeal therapies. This review contains 9 videos,  8 figures, 4 tables, and 73 references.  Keywords: peritoneal dialysis, peritoneal cavity, catheter, dialysis fluid, ultrafiltration, tunnel infection, osmotic pressure, renal failure

scholarly journals MECHANICAL COMPLICATIONS AND LOSS OF CORRECTION IN OSTEOTOMIES OF THE THREE COLUMNS

2017 ◽  
Vol 16 (4) ◽  
pp. 318-322
Author(s):  
Marcelo Simoni Simões ◽  
Ernani Vianna de Abreu ◽  
Samuel Bamberg Pydd
Keyword(s):  
Infectious Complications ◽  
Significant Loss ◽  
Categorical Variables ◽  
Sagittal Imbalance ◽  
Exact Test ◽  
Loss Of Correction ◽  
Mechanical Complications ◽  
Significant Difference ◽  
One Year

ABSTRACT Objectives: To observe the degree of correction and postoperative evolution of the spinopelvic parameters in patients with sagittal imbalance submitted to 3-column osteotomies. Methods: Retrospective analysis of 20 cases of 3-column osteotomies in patients with evident sagittal imbalance and minimum follow-up of one year, computing evolution of radiological data as a function of time, complications and reinterventions, and classification into subgroups by preoperative spinopelvic measures and complications. The variation of measures, quantitative and categorical variables, and differences between groups were evaluated using the Wilcoxon, Spearman, Fischer’s exact test, Kruskal-Wallis and Mann-Whitney tests. Results: There was improvement of all the sagittal parameters, ideal correction in 55% of the cases and maintained until the end of the follow-up in 40% of the cases. No correlation was found between obtaining optimal correction and data or preoperative measurements. Clinical and infectious complications did not affect the maintenance of the correction. The most common mechanical complications were pseudoarthrosis-related rod fracture at osteotomy (30%) and failures at the lower fixation level (15%). There was no significant difference in the maintenance of the correction between the groups with and without mechanical complications treated. In the untreated mechanical complications there was a significantly higher radiological worsening (p<0.05) in the maintenance parameters of the curve correction (loss of 27.5 ± 14.39o vs. 3.69 ± 3.68o) and increased pelvic tilt (PT) (increase of 12.25 ± 7.27o vs. 1.13 ± 1.93o). Conclusion: The perfect correction was obtained in 55% of cases and the significant loss of correction occurred only in cases of untreated mechanical complications.

scholarly journals Catheter-Related Mechanical Complications in Children on Chronic Peritoneal Dialysis: Ten-Year Experience

2006 ◽  
Vol 16 (2) ◽  
pp. 55-61
Author(s):  
Orhan Kara ◽  
Önder Yavaşcan ◽  
Hakan Erdoğan ◽  
Murat Anıl ◽  
Özlem Parlak ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Chronic Peritoneal Dialysis ◽  
Mechanical Complications

scholarly journals Peritoneal dialysis - associated peritonitis during treatment with continuous ambulatory peritoneal dialysis

2019 ◽  
pp. 47-52
Author(s):  
M. Malasaiev ◽  
I. Dudar ◽  
A. Shymova
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Infectious Complications ◽  
First Year ◽  
Significant Progress ◽  
Main Risk Factor ◽  
Common Cause ◽  
Hemodialysis Treatment ◽  
Methodological Approaches ◽  
Peritoneal Function

 Infections associated with peritoneal dialysis (infection of the catheter, tunnel infection and peritonitis) are the most common complications of this method. Despite significant progress in the methodological approaches to the prevention, diagnosis and treatment of PD associated infections, peritonitis remains the main risk factor for mortality in PD patients (up to 6%) and plays a significant role in more than 1/6 of the deaths associated with non-infectious complications such as cardiovascular and / or cerebrovascular disease. Besides, PD-associated infections are the most common cause of loss of peritoneal function and the patients’ transition to hemodialysis treatment. About 5% of PD patients are converted to hemodialysis treatment in the first year after postponed peritonitis.

scholarly journals Peritoneal Dialysis at Ibn Sina Hospital in Rabat: 10 years’ experience

2020 ◽  
Vol 3 (1) ◽  
pp. 27-35
Author(s):  
Meryem Benbella ◽  
Aziza Guennoun ◽  
Mohamed Belrhiti ◽  
Tarik Bouattar ◽  
Rabia Bayahia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Retrospective Study ◽  
Infectious Complications ◽  
Dialysis Modality ◽  
Ibn Sina ◽  
End Stage Renal Failure ◽  
End Stage

Introduction:  The choice of dialysis modality has become an important decision that affects not only the country's health policy in the management of chronic end stage renal failure, but also the quality of life of patients and their survival. Peritoneal dialysis is an alternative for the treatment of these patients. The objective of our work is to report the epidemiological, clinical and biological results in the unit of PD, UHC of Rabat and to clarify the obstacles to the development of PD in Morocco.  Material and Methods:  We conducted a descriptive retrospective study in our PD unit from July 2006 to July 2017, including all patients who were in PD by choice or necessity and enrolled in the French Peritoneal Dialysis Registry (RDPLF).  Results: In 10 years, 159 patients were placed in PD, with an average age of 50.44 +/- 17.42 years and a sex ratio of 1.36. The indication for placement of setting in PD was by choice in 34% of the cases, social in 52% and medical in 14% of cases. Mechanical complications were dominated by catheter migrations. Infectious complications were represented by peritonitis, caused by poor of hygiene in 42% of cases. Conclusion: The obstacles to the development of PD are the lack of knowledge of the technique by the patients, as well as the prejudices or myths about the technique.

scholarly journals IR-Photometry Method for Measuring Glucose Concentration in Peritoneal Dialysis Fluid

2021 ◽  
Vol 24 (4) ◽  
pp. 68-78
Author(s):  
N. M. Zhilo ◽  
M. O. Mikhailov ◽  
E. L. Litinskaia ◽  
K. V. Pozhar
Keyword(s):  
Peritoneal Dialysis ◽  
Optical System ◽  
Glucose Concentration ◽  
Experimental Studies ◽  
The Body ◽  
Artificial Kidney ◽  
Dialysis Fluid ◽  
Glucose Content ◽  
Peritoneal Dialysis Fluid ◽  
Dialysate Solution

Introduction. The transition of glucose into the blood during automated peritoneal dialysis with regeneration of the dialysis fluid leads to a decreased removal of excess fluid from the body and corresponding violations of the water-salt balance.Aim. To consider a system for automatically maintaining the concentration of glucose in the dialysate solution, which provides effective ultrafiltration, as well as to propose a non-contact photometric feedback sensor.Materials and methods. The sensor is an optical system of an IR laser diode with a power of 30 mW and a wavelength of 1600 nm, a photodiode and a quartz tube, through which the test solution circulates. The sensor measures the attenuation of the radiation passing through the solution in a pulsed mode and calculates the glucose concentration. The selected combination of digital filters provides compensation for the noise of the optical system. Experimental studies of the efficiency of the sensor were carried out on peritoneal dialysis solutions with various concentrations of urea, creatinine, uric acid and glucose. At the beginning of the experiments, the sensor was calibrated in a pure solution.Results. It was shown that the developed sensor makes it possible to measure the concentration of glucose in a solution for peritoneal dialysis in the range of 42…220 mmol / l with a relative error of about 15%. The time of one measurement is about 1 minute, which makes it possible to obtain up-to-date information on the current concentration of the solution.Conclusion. This combination of characteristics will allow the sensor to be used in artificial kidney wearable devices for assessing the glucose content in the solution, calculating the time to change the solution and as a feedback sensor in a system for maintaining the concentration of the osmotic agent.

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