Impact of Hernias on Peritoneal Dialysis Technique Survival and Residual Renal Function

Balda, Sagrario; Power, Albert; Papalois, Vassilios; Brown, Edwina A.

doi:10.3747/pdi.2012.00255

Cited by 55 publications

(46 citation statements)

References 19 publications

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“…Strong associations of abdominal hernias with aging, male sex, chronic cough [4], polycystic kidney disease [19], and PD vintage [5] have been reported. In our study, PD and male sex were risk factors for the development of inguinal hernia.…”

Section: Discussionmentioning

confidence: 99%

Inguinal hernia in hemodialysis versus peritoneal dialysis patients: a case-control study

et al. 2016

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Background: Inguinal hernia is common in dialysis patients, especially peritoneal dialysis (PD) patients; however, no previous reports have assessed the incidence, type, treatments, and risk factors of inguinal hernia in hemodialysis (HD) patients. We retrospectively evaluated the differences in these factors between HD and PD patients. Methods: A total of 2287 HD and 410 PD patients treated between March 2006 and December 2013 were enrolled. The incidence, type (indirect, direct, or combined), and hernioplasty of inguinal hernia as well as demographic characteristics of HD and PD patients were compared. Results: The incidence of inguinal hernia was lower in HD (0.7 %) than in PD patients (5.9 %) (P < 0.001), and these incidences were higher among men (P = 0.007 and P < 0.001, respectively). Of the 16 HD and 24 PD patients with inguinal hernia, 14 and 21 (both 88 %) underwent hernioplasty. Among them, PD patients demonstrated a higher proportion of indirect hernia (91 %) than HD (47 %) patients (P = 0.003). No recurrence was observed in either group. In a multivariate logistic regression model, PD and male sex were risk factors for inguinal hernia (both P < 0.001). Conclusions: In this study, indirect inguinal hernia was more frequent in PD patients than in HD patients. Male sex and PD are risk factors for inguinal hernia in dialysis patients. Tension-free hernioplasty for inguinal hernia was effective in both HD and PD patients. Our findings can help inform clinicians when selecting the dialysis modality (HD or PD) prior to the initiation of dialysis therapy and guide clinical management practices for inguinal hernias in dialysis patients.

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Section: Discussionmentioning

confidence: 99%

Inguinal hernia in hemodialysis versus peritoneal dialysis patients: a case-control study

et al. 2016

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“…La corrección del defecto dependerá del tamaño: si es mayor de 2 cm se suele usar malla extendiéndola hasta 5 cm del borde del defecto, siempre teniendo la precaución de no abrir el peritoneo. Las recurrencias aumentan significativamente en los pacientes que tienen corrección del defecto con sutura simple, por lo que el uso de malla es el manejo indicado en estos pacientes (9,12,19).…”

Section: Discussionunclassified

Corrección por laparoscopia de hernia incisional en paciente con diálisis peritonal

et al. 2017

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Comparte ResumenLa hernia incisional es un problema común en pacientes que son llevados a procedimientos quirúrgicos abdominales y predomina en pacientes con laparotomía mediana, en quienes tiene gran impacto en cuanto a la morbilidad y complicaciones, particularmente en pacientes con diálisis peritoneal. El manejo laparoscópico con colocación de malla ha sido la opción recomendada en el caso de las hernias incisionales, por lo que su implementación en pacientes dializados es determinante para reducir la morbilidad y las futuras complicaciones. AbstractIncisional hernia is a common problem in patients who are carried abdominal surgical procedures, predominantly in patients with median laparotomy where have an increased incidence, having a major impact in terms of morbidity and complications, especially in patients with peritoneal dialysis. Laparoscopic management with mesh placement has been the gold standard in its handling so that its implementation in this special population will be crucial to improve morbidity and future complications.Keywords: Peritoneal dialyisis, Incisional hernia, Surgical mesh, Abdominal wall. IntroducciónLos defectos de la pared abdominal hacen parte de las enfermedades con mayor afectación de la morbilidad y la calidad de vida en los pacientes que son llevados a cirugía abdominal; su incidencia es baja y su formación depende tanto de eventos propios de la técnica quirúrgica como de eventos fisiopatológicos del paciente (1).De otro lado, los pacientes que son llevados a diálisis peritoneal que consecuentemente presentan defectos de la pared abdominal, presentan mayor tasas de complicaciones, siendo necesario en ocasiones el retiro del catéter, reparos emergentes o tardíos de la pared abdominal con complicaciones a largo plazo (2).

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“…The other patients were managed with intermittent peritoneal dialysis or low volume automated peritoneal dialysis. Only, 14% of their PD patients required temporary transfer to HD as they did not have space for intermittent PD or lacked training in automated PD …”

Section: Intra‐abdominal Pressure In Pdmentioning

confidence: 99%

Reducing intra‐abdominal pressure in peritoneal dialysis patients to avoid transient hemodialysis

Jegatheswaran

Warren

Zimmerman

2018

Seminars in Dialysis

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Patients treated with peritoneal dialysis (PD) are often required to switch to hemodialysis (HD) temporarily when they develop abdominal wall hernias and dialysate leaks, peritonitis or undergo thoracic or abdominal surgeries. There are significant risks associated with incident hemodialysis including possible central venous catheter infections, thrombosis, and need for invasive procedures. Therefore, strategies to avoid temporary transfer to hemodialysis are desirable. The increased intra-abdominal pressure associated with PD is largely responsible for the issues requiring withholding PD. However, the high intra-abdominal pressure, due to dialysate and body position, can be minimized by making changes to the peritoneal dialysis prescription. The lower intra-abdominal pressure may allow dialysate leaks, hernia repairs, and abdominal incisions time to heal as well as to facilitate earlier resumption of PD after catheter replacement. These strategies help to decrease morbidity and minimize cost to the health care system associated with modality switches and its complications.

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Impact of Hernias on Peritoneal Dialysis Technique Survival and Residual Renal Function

Abstract: The incidence of abdominal hernia and hernia management in patients on PD do not significantly influence residual renal function or PD technique survival. Timely management of hernias is advisable and does not preclude continuation with PD as a dialysis modality.

Cited by 55 publications

References 19 publications

Inguinal hernia in hemodialysis versus peritoneal dialysis patients: a case-control study

Inguinal hernia in hemodialysis versus peritoneal dialysis patients: a case-control study

Corrección por laparoscopia de hernia incisional en paciente con diálisis peritonal

Reducing intra‐abdominal pressure in peritoneal dialysis patients to avoid transient hemodialysis

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