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

Abstract

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.

The risk factors of the occurrence of inguinal hernia in ESRD patients receiving dialysis treatment: An observational study using national health insurance research database

“…The current study showed that male gender and PD were the risk factors for inguinal hernia development in patients with ESRD. Furthermore, the current findings are comparable with previous reports [8,14] although others observed no complications. [12,15] Abdominal wall hernia, especially inguinal hernia, which accounts for 83.08% of all hernia in the present study, is a common mechanical PD complication.…”

“…The current study showed that male gender and PD were the risk factors for inguinal hernia development in patients with ESRD. Furthermore, the current findings are comparable with previous reports [8,14] although others observed no complications. [12,15]…”

“…Male gender was also a risk factor for hernia occurrence. [7–9] According to several previous studies, a higher incidence of inguinal hernia was observed to be 10 times more common in men than in women. [1,3,7,10] The inguinal canal, where the spermatic cord enters the scrotum, is supposed to act as a pathway from the abdomen wall to the genitalia.…”

“…Several previous articles illustrated that BMI is associated with the incidence of inguinal hernia occurrence. [ 3 , 7 , 8 , 21 ] Some that indicated higher BMI is a protective factor for inguinal hernia compared to patients with lower BMI, and the temporarily hypothetical explanation was the strengthened abdominal adipose tissue or musculature proved to have a stronger barrier against herniation, while others thought patients with higher BMI are more likely to suffer from inguinal hernia than low BMI. [ 3 , 7 , 8 , 14 , 22 , 23 ] However, limited data were collected in the current study, and more studies are needed to determine whether the association between inguinal hernia and obesity is true and the effect of body fat and abdominal muscle distribution needs to be evaluated further as well.…”

“…Increasing age, the male gender, smoking, physical exertion, chronic obstructive pulmonary disease (COPD) and peritoneal dialysis (PD) have been reported as risk factors of inguinal hernia. [1,5–11] The cause of inguinal hernia is multifactorial and is, however, mainly due to intraabdominal pressure increase. [12]…”