Retroperitoneal Leakage as a Cause of Ultrafiltration Failure

2004 ◽  
Vol 24 (5) ◽  
pp. 466-470 ◽  
Author(s):  
Man-Fai Lam ◽  
Wai-Kei Lo ◽  
Ferdinand S.K. Chu ◽  
Fu-Keung Li ◽  
Terence P.S. Yip ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Pulmonary Edema ◽  
Abdominal Wall ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Complete Resolution ◽  
Fluid Overload ◽  
Sudden Onset ◽  
Tenckhoff Catheter ◽  
Computed Tomographic ◽  
Ultrafiltration Failure

We report 3 patients on continuous ambulatory peritoneal dialysis (CAPD) who developed reversible ultrafiltration failure secondary to retroperitoneal leakage. The patients presented with pulmonary edema and fluid overload following a sudden onset of ultrafiltration failure on maintenance CAPD. There was no localized edema, suggesting peritoneal leakage in the abdominal wall or the perineum. Radiological examination showed no migration of the Tenckhoff catheter. Leakage of dialysate into the retroperitoneal space was only revealed by computed tomographic (CT) peritoneography. These patients were then treated with intermittent peritoneal dialysis twice weekly. After repeated CT peritoneography showing complete resolution of the leakage, they successfully resumed CAPD treatment 2 months later, without ultrafiltration problems. Our finding suggests that retroperitoneal leakage could be one of the uncommon, yet reversible, causes of acute ultrafiltration failure that can be diagnosed with CT peritoneography.

Rupture of the Spleen: A Complication of Continuous Ambulatory Peritoneal Dialysis

1986 ◽  
Vol 6 (4) ◽  
pp. 203-204 ◽  
Author(s):  
C. Abaete De Los Santos ◽  
Osvaldo Von Eye ◽  
Domingos d’ A Vila ◽  
Claudio Cora Mottin
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Wall ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Chronic Peritoneal Dialysis ◽  
Abdominal Organ ◽  
X Ray ◽  
Tenckhoff Catheter ◽  
Direct Trauma ◽  
Intraperitoneal Bleeding ◽  
Rupture Of The Spleen

A 44-year-old woman on CAPD for 20 months presented with severe intraperitoneal bleeding secondary to rupture of the spleen. On the day of the accident displacement of the Tenckhoff catheter to the left upper quadrant of the abdomen was detected by X-ray. We believe this dislodgement caused the rupture either by direct trauma or erosion of the organ. This complication of CAPD has not been described before. There are no previous reports of rupture of an abdominal organ during chronic peritoneal dialysis. However massive intraperitoneal hemorrhage in CAPD has been described secondary to abdominal wall erosion by the Tenckhoff catheter. We believe that rupture of the spleen in the present case was due to trauma and/or erosion induced by a displaced Tenckhoff catheter.

Tuberculous Peritonitis in a Cohort of Continuous Ambulatory Peritoneal Dialysis Patients

2001 ◽  
Vol 21 (3_suppl) ◽  
pp. 202-204 ◽  
Author(s):  
Georgi Abraham ◽  
Milly Mathews ◽  
Lena Sekar ◽  
Aparajitha Srikanth ◽  
Uma Sekar ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Membrane Integrity ◽  
Tuberculous Peritonitis ◽  
Mantoux Test ◽  
Men 2 ◽  
Caseating Granuloma ◽  
Ultrafiltration Failure

Among 155 patients who were initiated on continuous ambulatory peritoneal dialysis (CAPD), 4 patients (2 men, 2 women) developed tuberculous peritonitis. They had been on PD for between 2 months and 84 months when they developed the peritonitis. The Mantoux test was negative in all of them. The diagnosis was made by a variety of means in the various cases: demonstration of Mycobacterium tuberculosis in the peritoneal cavity; presence of caseating granuloma in a peritoneal biopsy; Mycobacterium tuberculosis in a cold abscess adjacent to the peritoneal cavity; and demonstration of IS6110 and MPB64 genes of Mycobacterium tuberculosis by polymerase chain reaction (PCR) technique. Two of the patients developed ultrafiltration failure. Among 3 patients who were switched to hemodialysis, 2 died and 1 continues on maintenance dialysis. The last patient, whose catheter was removed, was reimplanted with a new catheter and continues on PD without ultrafiltration failure. Any patient with peritonitis unresponsive to conventional therapy should be investigated for tuberculous peritonitis. Institution of chemotherapy without delay will preserve peritoneal membrane integrity.

National Comparisons: Optimal Peritoneal Dialysis Outcomes among Japanese Patients

1999 ◽  
Vol 19 (3_suppl) ◽  
pp. 9-16 ◽  
Author(s):  
Yoshindo Kawaguchi
Keyword(s):  
Peritoneal Dialysis ◽  
Positive Selection ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Therapeutic Intervention ◽  
Scoring System ◽  
Japanese Patients ◽  
Current Status ◽  
Technique Survival ◽  
Ultrafiltration Failure ◽  
Dialysis Outcomes

This paper describes the current status of chronic dialysis in Japan and the guidelines used to initiate dialysis (scoring system), and reports the outcome of continuous ambulatory peritoneal dialysis (CAPD), focusing upon our center's experience. Fifty percent of CAPD technique survival was 6.9 ± 1.3 years among those patients classified as “positive selection.” The major causes of withdrawal from CAPD were ultrafiltration failure, the patients’ inability to continue on CAPD by themselves, and peritonitis. The clinical issues that most concern nephrologists in CAPD management are prevention and management of ultrafiltration failure, prevention/therapeutic intervention in encapsulating peritoneal sclerosis, catheter-related infections, and prevention of underdialysis.

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.

Is peritoneal rest a treatment for ultrafiltration failure during continuous ambulatory peritoneal dialysis?

1992 ◽  
Vol 52 (1) ◽  
pp. 202-212 ◽  
Author(s):  
Tosiharu Ikutaka ◽  
Motoyuki Ishiguro ◽  
Seiichi Shimabukuro ◽  
Takahiro Hirano ◽  
Michio Arakawa
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Ultrafiltration Failure

Peritonitis Caused by Monilia sitophila in a Patient Undergoing Peritoneal Dialysis

1996 ◽  
Vol 19 (4) ◽  
pp. 218-220 ◽  
Author(s):  
A.E. Radix ◽  
V.M. Bieluch ◽  
C.W. Graeber
Keyword(s):  
Peritoneal Dialysis ◽  
Amphotericin B ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Fungal Peritonitis ◽  
Common Cause ◽  
Tenckhoff Catheter ◽  
First Case ◽  
Etiologic Agents ◽  
Oral Itraconazole

Fungi have become an increasingly important cause of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. The most common cause of fungal peritonitis is Candida. However, in recent years unusual and “nonpathogenic” fungi have been reported as etiologic agents of CAPD-associated peritonitis. We are reporting the first case of CAPD-associated peritonitis caused by Monilia sitophila. This organism had previously been considered to be non-pathogenic, and a troublesome laboratory contaminant. Our patient was successfully managed with intravenous and intraperitoneal amphotericin B, followed by oral itraconazole, without removal of her Tenckhoff catheter.

scholarly journals A Simple Tenckhoff Catheter Placement Technique for Continuous Ambulatory Peritoneal Dialysis (CAPD) Using the Bandung Method

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jonny ◽  
Rudi Supriyadi ◽  
Rully Roesli ◽  
Goh Bak Leong ◽  
Lydia Permata Hilman ◽  
...  
Keyword(s):  
Developing Countries ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Cost Effective ◽  
Catheter Insertion ◽  
Catheter Removal ◽  
Seldinger Technique ◽  
Invasive Technique ◽  
Tenckhoff Catheter ◽  
Stage Renal Disease

Insertion of Tenckhoff catheters for continuous ambulatory peritoneal dialysis by nephrologists remains uncommon in most developing countries, including Indonesia. The aim of this study is to describe our experience on a simple technique of Tenckhoff catheter insertion by a nephrologist called the Bandung method. We conducted a retrospective observational study from May 2012 until December 2018 in 230 patients with end-stage renal disease using the Bandung method, a blind percutaneous insertion approach modified from the Seldinger technique. Early complications after insertion were assessed. The mean age of patients was 47.28 years (range 14–84 years). Within 1 month after insertion, complications occurred in 34 patients: 13 (5.7%) malposition, 8 (3.5%) omental trapping, 6 (2.6%) outlow failure, 3 (1.3%) peritonitis, 1 (0.4%) catheter infections, 1 (0.4%) bleeding, 1 (0.4%) kinking, and 1 (0.4%) hernia. None of these complications led to catheter removal. One patient experienced a late (>1 month) post-insertion complication of malposition that could not be repositioned and led to catheter removal. The Bandung method is a simple, cost effective, and minimally invasive technique for Tenckhoff catheter insertion that is associated with the same rate of complications compared to other techniques. This technique may useful for application in developing countries.

Overnight Mesothelial Cell Exfoliation: A Magic Tool for Predicting Future Ultrafiltration Failure in Patients on Continuous Ambulatory Peritoneal Dialysis

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 107-113
Author(s):  
Talerngsak Kanjanabuch ◽  
Monchai Siribamrungwong ◽  
Rungrote Khunprakant ◽  
Sirigul Kanjanabuch ◽  
Piyathida Jeungsmarn ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Mesothelial Cell ◽  
Mesothelial Cells ◽  
Nutrition Status ◽  
Continuous Exposure ◽  
Peritoneal Membrane ◽  
Dialysis Solution ◽  
Ultrafiltration Failure

⋄ Background Continuous exposure of the peritoneal membrane to dialysis solutions during long-term dialysis results in mesothelial cell loss, peritoneal membrane damage, and thereby, ultrafiltration (UF) failure, a major determinant of mortality in patients on continuous ambulatory peritoneal dialysis (CAPD). Unfortunately, none of tests available today can predict long-term UF decline. Here, we propose a new tool to predict such a change. ⋄ Mesothelial cells from 8-hour overnight effluents (1.36% glucose dialysis solution) were harvested, co-stained with cytokeratin (a mesothelial marker) and TUNEL (an apoptotic marker), and were counted using flow cytometry in 48 patients recently started on CAPD. Adequacy of dialysis, UF, nutrition status, dialysate cancer antigen 125 (CA125), and a peritoneal equilibration test (3.86% glucose peritoneal dialysis solution) were simultaneously assessed and were reevaluated 1 year later. ⋄ Results The numbers of total and apoptotic mesothelial cells were 0.19 ± 0.19 million and 0.08 ± 0.12 million cells per bag, respectively. Both numbers correlated well with the levels of end dialysate–to–initial dialysate (D/D0) glucose, dialysate-to-plasma (D/P) creatinine, and sodium dipping. Notably, the counts of cells of both types in patients with diabetes or with high or high-average transport were significantly greater than the equivalent counts in nondiabetic patients or those with low or low-average transport. A cutoff of 0.06 million total mesothelial cells per bag had sensitivity of 1 and a specificity of 0.75 in predicting a further decline in D/D0 glucose and a sensitivity of 0.86 and a specificity of 0.63 to predict a further decline in UF over a 1-year period. In contrast, dialysate CA125 and other measured parameters had low predictive values. ⋄ Conclusions The greater the loss of exfoliated cells, the worse the expected decline in UF. The ability of a count of mesothelial cells to predict a future decline in UF warrants further investigation in clinical practice.

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