Does prior abdominal surgery influence peritoneal transport characteristics or technique survival of peritoneal dialysis patients?
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Does prior abdominal surgery influence peritoneal transport characteristics or technique survival of peritoneal dialysis patients?Autor(es)
Fecha
2020-10-22Cita bibliográfica
Dias da Silva A, García Gago L, Rodríguez Magariños C, Astudillo Jarrín D, Rodríguez-Carmona A, García Falcón T, et al. Does prior abdominal surgery influence peritoneal transport characteristics or technique survival of peritoneal dialysis patients?. Blood Purif. 2021;50(3):328-335
Resumen
[Abstract] Introduction: Prior abdominal surgery may result in peritoneal membrane adhesions and fibrosis, compromising the success of peritoneal dialysis (PD). The impact of this factor on peritoneal membrane function and PD technique survival has not been adequately investigated. Methods: Following an observational, retrospective design, we studied 171 incident PD patients, with the main objective of analyzing the influence of prior abdominal surgical procedures (main study variable) on baseline and evolutionary peritoneal transport characteristics (main outcome) and PD patient and technique survival (secondary outcomes). Abdominal surgeries were categorized according to the degree of presumed injury to the peritoneal membrane. We also considered the additive effect of aggressions to the membrane during the first year on PD therapy. Results: All patients had a baseline peritoneal equilibration test with complete drainage at 60′, and 113 patients had a second study at the end of the first year. Sixty-one patients (35.7%) had a record of prior abdominal surgery, including 29 patients with at least one major intraperitoneal surgery, 22 having undergone minor intraperitoneal procedures, and 21 with a background of major abdominopelvic extraperitoneal surgery. We did not observe differences, at baseline or after 1 year, among patients with or without previous abdominal procedures regarding small solute transport, overall capacity of ultrafiltration, free water transport, small pore ultrafiltration, or peritoneal protein excretion. Stratified analysis, considering prior and first-year-on-PD peritoneal aggressions, did not reveal any differences, although in this case our analysis was hampered by a limited statistical power. Abdominal surgical events did not influence patient or PD technique survival. Conclusion: Prior abdominal surgical procedures do not appear to compromise peritoneal membrane function or technique survival in patients successfully started on PD.
Palabras clave
Peritoneal dialysis
Peritoneal transport
Peritoneal equilibration test
Abdominal surgery
Ultrafiltration
Peritoneal transport
Peritoneal equilibration test
Abdominal surgery
Ultrafiltration
Versión del editor
Derechos
This is the accepted manuscript version of an article published by Karger Publishers in "Blood Purification" and available on karger.com
ISSN
0253-5068
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