Current guidelines in peritoneal dialysis – Part I

Ferreira, Ana Carina; Santos, Joana; Amoedo, Manuel; Oliveira, Ana Carolina Mascarenhas; Silva, Rui; Guedes, Anabela Malho

doi:10.32932/pjnh.2019.04.007

Cited by 2 publications

(3 citation statements)

References 52 publications

(92 reference statements)

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“…Some authors recommend concomitant cholecystectomy only in symptomatic biliary tract disease; however, our national renal transplant program insists on performing cholecystectomy even in patients with asymptomatic gallbladder disease prior to being listed for renal transplantation. 16 , 18 – 21 And with a concomitant procedure, it is not needed to be performed later. Also, asymptomatic biliary tract disease can become symptomatic after the patient has already had the PD catheter inserted requiring cholecystectomy, which would unnecessarily threaten the catheter’s survival.…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal wall hernias should be repaired prior to or at the time of PD catheter insertion, because otherwise the dialysate fluid is sequestered in the hernia sac causing unpredictable dialysis clearance and ultrafiltration. 18 , 19 Furthermore, peritoneal dialysis was found to increase the risk of abdominal hernia formation and can cause progressive enlargement of already existing hernia sacs. 22 For all those reasons, early surgical repair has been advocated.…”

Section: Discussionmentioning

confidence: 99%

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Minimally invasive peritoneal dialysis catheter insertions with concomitant cholecystectomy or hernioplasty: Surgical technique and our experiences

Janež

Škapin

2021

J Vasc Access

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Introduction: Peritoneal dialysis is a well-accepted replacement therapy in patients with end-stage renal disease. There are many different options adopted on how to insert a peritoneal dialysis catheter. In our institution, a laparoscopic insertion has become the method of choice for providing peritoneal dialysis access in adult patients. The aim of this study was to analyze surgical outcomes of patients after laparoscopically assisted placement of a PD catheter some of them after concomitant cholecystectomy or hernioplasty. Methods: We have evaluated 70 consecutive patients from 1st of October 2015 to 30th of April 2020 who underwent laparoscopic insertion of a peritoneal dialysis catheter. Demographic data, details about surgery and about peri- and postoperative complications were gathered. Results: Out of 70 enrolled patients, 15 had gallstones (21%) and underwent concomitant laparoscopic cholecystectomy. Three patients (4%) had abdominal wall hernia and underwent concomitant hernioplasty. We observed no perioperative complications connected with any of the performed procedures. There was one early postoperative complication: an early leak of dialysate fluid. Late complications were observed in nine patients (13%): mechanical catheter problems (two patients), peritonitis (three patients), skin exit-site infections (two patients), peri-catheter leak (one patient), and port-site hernia (one patient). Conclusions: For all patients with concomitant gallbladder disease or abdominal wall hernias we suggest to perform synchronous surgeries, due to finding no more complications after concomitant procedures in comparison to patients in whom only a PD catheter was inserted. Concomitant procedures are done to spare patients two separate procedures and to avoid possible complications. We also suggest using the cholecystectomy first, PD catheter insertion second approach for having excellent peri- and postoperative results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Minimally invasive peritoneal dialysis catheter insertions with concomitant cholecystectomy or hernioplasty: Surgical technique and our experiences

Janež

Škapin

2021

J Vasc Access

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“…In the second questionnaire (Google Forms), we asked about five selected ISPD guidelines (for reducing infections) [15], and we investigated the local protocols related to those. The five guidelines were (1) monitoring catheter-related infection on a yearly basis (yes or no answer); this monitoring is made as an incident rate of number of episodes/months at risk; (2) screening nasal carriage of Staphylococcus aureus (yes or no answer; in case of an affirmative answer, it was asked about screening periodicity and type of microorganism screened -MRSA, MSSA, or both); (3) treatment of nasal carriage of Staphylococcus aureus (yes or no answer; in case of an affirmative answer, antibiotic name and posology); (4) antibiotic prophylaxis at the time of catheter placement (yes or no answer; in case of an affirmative answer, antibiotic name and posology); (5) daily topical antibiotic cream at the ES (yes or no answer; in case of an affirmative answer, antibiotic name).…”

Section: Surveysmentioning

confidence: 99%

Peritoneal Dialysis Exit-Site Care Protocols in Portugal and Its Association with Catheter-Related Infections

et al. 2023

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Introduction: Exit-site infection (ESi) prevention is a key factor in lowering the risk of peritonitis. This study aimed to evaluate the associations between exit-site (ES) care protocols and the annual incidence rates of ESi and peritonitis in Portugal. Methods: We performed a national survey using two questionnaires: one about the incidence of catheter-related infections and the other characterizing patients’ education and ES care protocols. Results: In 2017 and 2018, 14 Portuguese units followed 764 and 689 patients. ESi incidence rate was 0.41 episodes/year, and the peritonitis incidence rate was 0.37. All units monitor catheter-related infections on a yearly basis, use antibiotic prophylaxis at the time of catheter placement, and treat nasal carriage of S. aureus, although with different approaches. Screening for nasal carriage of S. aureus is performed by 12 units, and daily topical antibiotic cream is recommended by 6 out of 14 of the units. We did not find statistical differences in ESi/peritonitis, comparing these practices. The rate of ESis was lower with nonocclusive dressing immediately after catheter insertion, bathing without ES dressing, with the use of colostomy bags in beach baths and was higher with the use of bath sponge. The peritonitis rate was lower with bathing without ES dressing and if shaving of the external cuff was performed in the presence of chronic ESi. Conclusions: We found potential proceedings associated with ESi and peritonitis. A regular national audit of peritoneal dialysis units is an important tool for clarifying the best procedures for reduction of catheter-related infections.

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Current guidelines in peritoneal dialysis – Part I

Cited by 2 publications

References 52 publications

Minimally invasive peritoneal dialysis catheter insertions with concomitant cholecystectomy or hernioplasty: Surgical technique and our experiences

Minimally invasive peritoneal dialysis catheter insertions with concomitant cholecystectomy or hernioplasty: Surgical technique and our experiences

Peritoneal Dialysis Exit-Site Care Protocols in Portugal and Its Association with Catheter-Related Infections

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