Hernia in Esrd Patients Receiving Peritoneal Dialysis
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چکیده
Peritoneal dialysis (PD) is a well-established treatment modality for end-stage renal disease (ESRD) and is gaining popularity as a home dialysis therapy. Hernia, a mechanical complication, is not uncommon in patients on PD. This retrospective study was designed to investigate the prevalence of different types of hernias and related outcomes in all ESRD patients on peritoneal dialysis (PD) at our institution. Between January, 1992 and August, 2002, a total of 235 ESRD patients (84 male, 151 female) at our center were treated with PD at our center over 5266 patient-months. The clinical and laboratory parameters of 14 patients who developed hernias were compared with that of 221 patients who did not develop hernias. Fourteen patients (6%), 7 male and 7 female, developed 14 hernias, of which 5 were umbilical, 7 inguinal, 2 ventral. Half of the hernias in our cohort developed within the first seven months following catheter implantation. Seven patients received surgical repair as hernia developed, of which six patients resumed PD and only one shifted to hemodialysis. The remaining hernias were managed with volume reduction, conversion from CAPD to automated PD and mechanical support with corset. None of the patients with hernia developed incarceration after careful management. Risk factors including age, sex, types of catheter, fill-volumes and co-morbidities as DM, and previous operations were statistically analyzed. However, none of them seemed to have a predisposing factor for hernia formation in our cohort. With early detection and careful management including non-surgical methods, patients with hernias may be maintained on peritoneal dialysis. (Acta Nephrologica 2002; 16: 57-61)
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تاریخ انتشار 2004