Surgical aspects of peritoneal dialysis: prevention, diagnosis and treatment of complications

July 4, 2018
989
Specialities :
Resume

Aim — to analyze the complications that arise during peritoneal dialysis and to study the results of their prevention and treatment. Object and methods of research. The results of treatment of 54 patients with chronic kidney disease, which was carried out by renal replacement therapy by the method of peritoneal dialysis, were analyzed. Prevention of complications included preoperative preparation, careful observance of the rules for the catheter implantation, postoperative care of the cathe­ter. Results. Complications developed in 18 (33.3%) people. In 10 (18.5%) patients, they were infectious (catheter exit site infection, the tunnel infection, peritonitis). Staphylococcus aureus, Pseudomonas aeruginosa and Staphylococcus epidermidis were the main causes of complications. Non-infectious complications (pericateretric leakage of dialysis, catheter migration) were observed in 8 (14.8%) cases. The integrated differentiated approach was applied in treatment. Before the removal of the cathe­ter had to resort to 3 cases. There were no deaths associated with complications of peritoneal dialysis. Conclusions. The effectiveness of peritoneal dialysis depends on the correct catheter implantation, the implementation of preventive measures to prevent infectious complications and disruption of the functioning of the catheter, timely diagnosis and pathogenetically substantiated treatment.

O.V. Kravets, I.A. Myslovskyі, V.M. Popadynets

Key words: chronic kidney disease, peritoneal dialysis, catheter exit site infection, tunnel infection, peritonitis, pericateretric outflow of dialyzate, catheter migration.

Published: 05.07.2018

References:

  • Hetalo O.V. (2015) Monitorynh vartosti zastosuvannia zasobiv dlia perytonealnoho dializu u khvorykh na khronichnu khvorobu nyrok. Sots. farmatsiia v okhor. zdorovia, 1(2): 82–87.
  • Kolesnyk M.O. (red.) (2015) Natsionalnyi reiestr khvorykh na khronichnu khvorobu nyrok: 2014 rik. DUIN NAMN Ukrainy, Kyiv, 202 s.
  • Kolesnyk M.O. (red.) (2017) Natsionalnyi reiestr khvorykh na khronichnu khvorobu nyrok ta patsiientiv z hostrym poshkodzhenniam nyrok: 2016 rik. DUIN NAMN Ukrainy, Kyiv, 201 s.
  • Lesovoy V.N., Andoneva N.M., Guts E.A. i dr. (2011) Primenenie peritonealnogo dializa kak metoda korrektsii uremicheskogo sindroma u patsientov s hronicheskoy boleznyu pochek. Mezhdunar. med. zhurn., 3: 95–100.
  • Mishalov V.H., Zavodovskyi Ye.S., Markulan L.Iu. ta in. (2015) Faktory ryzyku dializnoho perytonitu (tryrichne prospektyvne doslidzhennia). Klin. khir., 9: 23–25.
  • Tolstanov O.K. (2013) Suchasnyi pidkhid do rozvytku nyrkovozamisnoi terapii metodom perytonealnoho dializu. Suchasni medychni tekhnolohii, 4: 5–8.
  • Brück K. (2016) Epidemiology of chronic kidney disease in Europe. University of Amsterdam, 291 р.
  • Centers for Disease Control and Prevention (2017) National сhronic кidney disease fact sheet. US Department of Health and Human Services, Atlanta, GA.
  • Gonçalves F.A., Dalosso I.F., Camargo Borba J.M. et al. (2015) Quality of life in chronic renal patients on hemodialysis or peritoneal dialysis: a comparative study in a referral service of Curitiba — PR. J. Bras. Nefrol., 37(4): 467–474.
  • Honeycutt А.А., Segel J.E., Zhuo X. et al. (2013) Costs of CKD in the Medicare Population. JASN, 24(9): 1478–1483.
  • Mangione F., Dal Canton A. (2011) Chronic kidney disease epidemic: myth and reality. Intern. Emerg. Med., 6 (1): 69–76.
  • Miftah M., Asseban M., Bezzaz A. et al. (2014) Mechanical complications of peritoneal dialysis. Open J. Nephrol., 4(3): 103–109.
  • Sinangil A., Koc Y., Unsal A. et al. (2013) Effects of infectious complications on patients’ survival in peritoneal dialysis. Eur. Rev. Med. Pharmacol. Sci., 17: 1064–1072.
  • Turchetti G., Bellelli S., Amato M. et al. (2017) The social cost of chronic kidney disease in Italy. Eur. J. Health Econ., 18(7): 847–858.
  • Xueqing Y., Xiao Y. (2015) Peritoneal dialysis in China: meeting the challenge of chronic kidney failure. Am. J. Kidney Dis., 65(1): 147–151.