Complications of continuous ambulatory peritoneal dialysis: An early experience in tertiary hospital of Western region of Nepal

A. Maskey, N. Dhakal, Chirayu Regmi
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Abstract

Background and Aims: Chronic ambulatory peritoneal dialysis (CAPD) has been established form of therapy in adults patients with end stage kidney diseases and has emerged as a feasible modality of renal replacement therapy. The aim of the study was to evaluate the complications of CAPD and its contributing factor in order to improve the patient survival and reduce morbidity and mortality. Methods: A hospital based retrospective study of 35 patients who opted for CAPD at Manipal teaching hospital, Pokhara from 1st June 2015 to 31st May 2016 was carried out. Results: Total 35 CAPD patients were included in study. The mean age of the patients was 45.78±16.34 years. Nineteen (54%) patients were male. The total follow up was 533 patients months with mean follow up of 15.22 ±5.02 months. There were 41 episodes of different complications that occurred during the study period with rate of 0.9 episodes/patient years. There were 18 (43%) episodes of peritonitis including 5 recurrence of peritonitis in 5 patients, 6 (15%) exit site infections, 6 (15%) failure of drainage, 2 (5%) pericatheter leakage, 2 (5%) catheter displacement , 2 (5%) omental wrapping, 2 (5%) catheter removal, 2 (5%) mortality. The commonest pathogen for peritonitis was staphylococcus aureus in 5 (22%) episodes. Conclusion: Overall complications rate was comparable to other studies . Peritonitis rate has been declined in our study. The majority of non-infectious complications are treatable and do not interfere with the catheter survival. CAPD is a safe and viable mode of renal replacement therapy alternative to hemodialysis. Journal of Advances in Internal Medicine Vol.5(2) 2016: 34-37
尼泊尔西部地区三级医院持续性非卧床腹膜透析并发症的早期经验
背景和目的:慢性非卧床腹膜透析(CAPD)已成为晚期肾脏疾病成年患者的一种治疗形式,并已成为一种可行的肾脏替代治疗方式。本研究的目的是评估CAPD的并发症及其影响因素,以提高患者的生存率,降低发病率和死亡率。方法:对2015年6月1日至2016年5月31日在博卡拉马尼帕尔教学医院选择CAPD的35名患者进行医院回顾性研究。结果:共有35名CAPD患者被纳入研究。患者的平均年龄为45.78±16.34岁。19名(54%)患者为男性。总随访533个月,平均随访15.22±5.02个月。研究期间共发生41次不同并发症,发生率为0.9次/患者年。腹膜炎发作18次(43%),其中5例腹膜炎复发,6例(15%)出口感染,6例引流失败,2例(5%)鞘管渗漏,2例导管移位,2例网膜包裹,2例移除导管,2例死亡。腹膜炎最常见的病原体是金黄色葡萄球菌,发病率为5例(22%)。结论:总体并发症发生率与其他研究相当。在我们的研究中,腹膜炎的发生率有所下降。大多数非感染性并发症是可以治疗的,不会影响导管的生存。CAPD是一种安全可行的替代血液透析的肾脏替代疗法。《内科学进展》2016年第5卷(2):34-37
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