Intraabdominal Pressures during Natural Activities in Patients Treated with Continuous Ambulatory Peritoneal Dialysis

Abstract

Intraabdominal pressures were measured during natural activities in 6 men, age 24–62 years, treated with continuous ambulatory peritoneal dialysis. The pressures were measured with a pressure transducer secured at the level of the umbilicus in the supine, sitting, and upright positions with 0–3 liters intraperitoneal fluid during talking, coughing, straining, changing position, walking, jogging, exercycling, jumping and weight lifting. Coughing and straining generated the highest intraabdominal pressures in every position. The pressures with weight lifting were proportional to the magnitude of the weight lifted up to 50 lbs, but were lower than those during coughing and straining. The pressures were generally higher with greater intraabdominal fluid volumes, especially with jumping and coughing. Exercycling was associated with lower intraabdominal pressure than was jogging, and the pressures were only minimally influenced by intraperitoneal fluid volumes. The results of this study can be used as a guide in establishing preventive measures in patients with intraperitoneal fluid to decrease complication rates related to raised intraabdominal pressures such as dialysate leaks, hernias and hemorrhoids.

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

“…In a previous report, low body weight was associated with abdominal hernia formation in PD patients [18]. In another report, BMI was not a risk factor for hernia development in PD patients [6].…”

Non-Peritonitis Complications of Continuous Ambulatory Peritoneal Dialysis in Saudi Arabia

“…22 Changes in posture, coughing and straining in the sitting and upright positions generate higher intraperitoneal pressure for a given activity. 23,24 All types of hernias are described. Six (10%) of our patients developed hernias, which is comparable to 11.5% reported in some studies.…”

Is There a Difference in the Prevalence of Gastroesophageal Reflux Disease between Peritoneal Dialysis and Hemodialysis Patients?

“…11 The effect of intraperitoneal pressure (IPP) on GERD in per- itoneal dialysis, which can be explained by decreased basal tone of the lower esophageal sphincter. 11,12 In contrast, a manometric study showed no effect of dialysate infusion on lower esophageal sphincter pressures due to transient relaxation of lower esophageal sphincter function. 13 The aim of this study was to determine the differences in the prevalence of erosive reflux esophagitis (ERD) and nonerosive reflux esophagitis (NERD) between CKD patients undergoing peritoneal dialysis and those undergoing hemodialysis.…”