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Impact of Intra-Abdominal Adhesion on Dialysis Outcome in Peritoneal Dialysis Patients

BACKGROUND: Peritoneal dialysis (PD) is an increasingly popular therapeutic option for patients with advanced renal failure. However, intra-abdominal adhesions (IAA) represent a major unsolved problem in adequate PD performance. In this study, we investigated the role of previous abdominal surgery o...

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Autores principales: Cheng, Ben-Chung, Tsai, Nai-Wen, Lai, Yun-Ru, Huang, Chin-Cheng, Lu, Cheng-Hsien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176331/
https://www.ncbi.nlm.nih.gov/pubmed/30356377
http://dx.doi.org/10.1155/2018/1978765
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author Cheng, Ben-Chung
Tsai, Nai-Wen
Lai, Yun-Ru
Huang, Chin-Cheng
Lu, Cheng-Hsien
author_facet Cheng, Ben-Chung
Tsai, Nai-Wen
Lai, Yun-Ru
Huang, Chin-Cheng
Lu, Cheng-Hsien
author_sort Cheng, Ben-Chung
collection PubMed
description BACKGROUND: Peritoneal dialysis (PD) is an increasingly popular therapeutic option for patients with advanced renal failure. However, intra-abdominal adhesions (IAA) represent a major unsolved problem in adequate PD performance. In this study, we investigated the role of previous abdominal surgery on the presence of subsequent IAA as well as outcomes in those patients with PD who had subsequent IAA. METHODS: Two hundred and two patients who received continuous ambulatory peritoneal dialysis were prospectively enrolled in this study. We compared the PD adequacy indices and outcomes for technical failure in patients with and without subsequent IAA at presentation and a minimum of 2 years of follow-up. RESULTS: Subsequent IAA accounted for 19% (38/202) of patients. Patients who had previous abdominal surgery had higher risks of subsequent IAA especially those patients who had higher mean ages (P=0.023). PD adequacy indices including both 24-hour dialysate volume and peritoneal WCcr L/week/1.73 m(2) were significantly lower in patients who had, as compared to those who did not have subsequent IAA (P=0.003 and 0.018, respectively). Although patients who had subsequent IAA had decreased PD adequacy, the development of technical failures during PD maintenance did not show significant differences at the 2-year minimum follow-up study. CONCLUSIONS: Subsequent IAA is not rare, especially in high-risk patients including those with previous abdominal surgery and higher mean ages. Although decreased PD adequacy after IAA was found, the development of technical failures was not significantly different at the 2-year minimum follow-up study.
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spelling pubmed-61763312018-10-23 Impact of Intra-Abdominal Adhesion on Dialysis Outcome in Peritoneal Dialysis Patients Cheng, Ben-Chung Tsai, Nai-Wen Lai, Yun-Ru Huang, Chin-Cheng Lu, Cheng-Hsien Biomed Res Int Research Article BACKGROUND: Peritoneal dialysis (PD) is an increasingly popular therapeutic option for patients with advanced renal failure. However, intra-abdominal adhesions (IAA) represent a major unsolved problem in adequate PD performance. In this study, we investigated the role of previous abdominal surgery on the presence of subsequent IAA as well as outcomes in those patients with PD who had subsequent IAA. METHODS: Two hundred and two patients who received continuous ambulatory peritoneal dialysis were prospectively enrolled in this study. We compared the PD adequacy indices and outcomes for technical failure in patients with and without subsequent IAA at presentation and a minimum of 2 years of follow-up. RESULTS: Subsequent IAA accounted for 19% (38/202) of patients. Patients who had previous abdominal surgery had higher risks of subsequent IAA especially those patients who had higher mean ages (P=0.023). PD adequacy indices including both 24-hour dialysate volume and peritoneal WCcr L/week/1.73 m(2) were significantly lower in patients who had, as compared to those who did not have subsequent IAA (P=0.003 and 0.018, respectively). Although patients who had subsequent IAA had decreased PD adequacy, the development of technical failures during PD maintenance did not show significant differences at the 2-year minimum follow-up study. CONCLUSIONS: Subsequent IAA is not rare, especially in high-risk patients including those with previous abdominal surgery and higher mean ages. Although decreased PD adequacy after IAA was found, the development of technical failures was not significantly different at the 2-year minimum follow-up study. Hindawi 2018-09-25 /pmc/articles/PMC6176331/ /pubmed/30356377 http://dx.doi.org/10.1155/2018/1978765 Text en Copyright © 2018 Ben-Chung Cheng et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Cheng, Ben-Chung
Tsai, Nai-Wen
Lai, Yun-Ru
Huang, Chin-Cheng
Lu, Cheng-Hsien
Impact of Intra-Abdominal Adhesion on Dialysis Outcome in Peritoneal Dialysis Patients
title Impact of Intra-Abdominal Adhesion on Dialysis Outcome in Peritoneal Dialysis Patients
title_full Impact of Intra-Abdominal Adhesion on Dialysis Outcome in Peritoneal Dialysis Patients
title_fullStr Impact of Intra-Abdominal Adhesion on Dialysis Outcome in Peritoneal Dialysis Patients
title_full_unstemmed Impact of Intra-Abdominal Adhesion on Dialysis Outcome in Peritoneal Dialysis Patients
title_short Impact of Intra-Abdominal Adhesion on Dialysis Outcome in Peritoneal Dialysis Patients
title_sort impact of intra-abdominal adhesion on dialysis outcome in peritoneal dialysis patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176331/
https://www.ncbi.nlm.nih.gov/pubmed/30356377
http://dx.doi.org/10.1155/2018/1978765
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