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

Abstract

Although peritonitis is the major complication and leading cause of morbidity in patients undergoing continuous ambulatory peritoneal dialysis (CAPD), there are other complications of this long-term renal replacement therapy (RRT) modality. In order to evaluate the non-peritonitis complications, we retrospectively studied 60 new patients who were accepted in our CAPD program over a period of eight years from 1984 to 1993. Out of the 60 patients, 31 were females and 29 were males, with a mean age of 37.0 ± 18 years. Tenckhoff s catheter was implanted by surgeons under direct vision in the operating theater through a midline incision. Nine of ourpatients had previous abdominal surgery and 11 females had pregnancies before CAPD, ranging from one to 10 with a mean of four. A total of 49 episodes of complications were observed, 32 early and 17 late. Early complications were defined if they occurred within three months from starting the procedure and late complications were defined as occurring after this period. There were 15 catheter blocks (25%), nine dialysate leaks (15%) and five hemoperitoneums (8.3%). Two serious and unusual complications were observed. In one of our patients, a mesenteric blood vessel injury occurred during catheter insertion, which necessitated massive blood transfusions and laparotomy. The other patient developed intestinal obstruction due to obstruction of intestinal loops around the catheter; this was corrected by removal of the catheter without the need for laparotomy. The late complications included six hernias, three hydroceles, three exit site infections, three tunnel infections and one case of loss of ultrafiltration. Ann Saudi Med 1995;15(5):458-461

Non-Infectious Complications of Peritoneal Dialysis in Senegal

“…The prevalence of mechanical complications in our study (45.3%) was slightly higher than that of the Moroccan and Pakistani studies, where the prevalence was 37% and 40%, respectively [5] [6]. Open Journal of Nephrology [8] found an even higher prevalence of obstruction (25% of cases).…”

“…Miftah et al [5], Flayou et al [7], Villemain et Open Journal of Nephrology al. in France [9] and Huraib et al [8] found a higher prevalence at 21.7%, 12.2%, 11.8% and 10%, respectively. In PD this complication generally constitutes the recurrence of a pre-existing hernia and the number increases with age [9] [10].…”