Mechanical Complications of Peritoneal Dialysis

Abstract

Introduction: The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. The mechanical complications of peritoneal dialysis (MCPD) are a major cause of the failure of the technique. The aim of the study was to define the prevalence of peritoneal dialysis (PD) mechanical catheter complications, to determine the time and the factors associated with their occurring. Materials and Methods: A retrospective study was conducted between January 2009 and January 2014 at the nephrology, dialysis and renal transplants department of Ibn Sina university hospital in Rabat. We included all patients who were on peritoneal dialysis and presented mechanical complications. These mechanical catheter complications are represented by catheter migration or obstruction, inguinal or umbilical hernias, early and late peritoneal dialysate leakage, subcutaneous cuff extrusion and hemoperitoneum. Results: MCPD were noted in 23 of the 62 patients (37% of cases). Onset time of complications was 24.8 ± 18.9 months [3 -60 months]. Among these complications, we noted a catheter migration (65.2%), postoperative hematoma (21.7%), cracking or perforation of catheter (17.4%), epiploic aspiration (17.4%), sleeve externalization (17.4%), catheter obstruction (13%), hemoperitoneum (13%), hernia (22%; 13% umbilical and 8.7% inguinal), early dialysate leakage (13%), and pleuroperitoneal leakage (8.7%). The average age of our patients was 54.9 ± 15.5 years [21 -81 years old], with a male predominance and a sex ratio of 2.28. The average body mass index (BMI) was 25.4 kg/m². Diabetic patients represent 48.7% of our series. In our study, MCPD represent 13% of causes of transfer to hemodialysis (HD). Conclusion: Prevention of MCPD remains crucial. It is based on good patient education on hygiene and handling errors but also periodic retraining of patients and caregivers.

Non-Infectious Complications of Peritoneal Dialysis in Senegal

“…The prevalence of mechanical complications in our study (45.3%) was slightly higher than that of the Moroccan and Pakistani studies, where the prevalence was 37% and 40%, respectively [5] [6]. Open Journal of Nephrology [8] found an even higher prevalence of obstruction (25% of cases).…”

“…Miftah et al [5] found a slightly lower prevalence at 6.5% after a long average delay (25.6 months). Flayou et al [7] and Raina et al in India [11] found a much lower prevalence of 3.4% and 2.47%, respectively.…”

“…The prevalence of hernia in our study was 5.3%, with a predominance of umbilical localization in 75% of cases. Miftah et al [5], Flayou et al [7], Villemain et Open Journal of Nephrology al. in France [9] and Huraib et al [8] found a higher prevalence at 21.7%, 12.2%, 11.8% and 10%, respectively.…”

“…These results are corroborated by Miftah et al [4], as well as Flayou et al in Morocco [7], who noted a respective prevalence of 24.2% (or 65.2% of complications) and 23.6% (or 36.8% of complications).Blockage of the catheter was noted in 10.7% of our patients. Miftah et al[5] reported a higher prevalence at 13%. Huraib et al in Saudi Arabia…”

Klinikinis Atvejis: Dviguba Mechaninė Peritoninės Dializės Komplikacija

“…Anot šaltinio, analizuojančio 5 metų PD komplikacijų dažnį [1], vidutinis bambos išvaržos atsiradimo laikas nuo PD pradžios buvo 20 mėnesių (12-36 mėnesiai). Mūsų atveju ši komplikacija nustatyta daug anksčiau -5 mėnesiai po CAPD pradžios.…”