BACKGROUND: Peritonitis is a life-threatening complication of peritoneal dialysis. Peritoneal sclerosis is associated with long-term peritoneal dialysis. The aim of this study was to assess the effect of peritoneal sclerosis on outcomes following laparotomy for peritoneal dialysis peritonitis. METHODS: A series of 63 consecutive patients underwent laparotomy for peritoneal dialysis peritonitis. Patients were divided into two groups, those with and those without simple peritoneal sclerosis identified at laparotomy. Medical, anaesthetic, and surgical notes were used for data collection. Patients with known encapsulating peritoneal sclerosis were excluded from the study. RESULTS: Patients with simple peritoneal sclerosis had a statistically significant longer duration of peritoneal dialysis. They also had a significantly higher risk of major complications postoperatively and a greater relative risk for mortality. CONCLUSIONS: There is an increased prevalence of simple peritoneal sclerosis with long-term peritoneal dialysis. Patients with simple peritoneal sclerosis have higher incidence of postlaparotomy complications. Patients on long-term peritoneal dialysis should be treated aggressively for peritoneal dialysis peritonitis to reduce complication/mortality rates. Evidence of simple peritoneal sclerosis at laparotomy should preclude further peritoneal dialysis.
BACKGROUND:Peritonitis is a life-threatening complication of peritoneal dialysis. Peritoneal sclerosis is associated with long-term peritoneal dialysis. The aim of this study was to assess the effect of peritoneal sclerosis on outcomes following laparotomy for peritoneal dialysis peritonitis. METHODS: A series of 63 consecutive patients underwent laparotomy for peritoneal dialysis peritonitis. Patients were divided into two groups, those with and those without simple peritoneal sclerosis identified at laparotomy. Medical, anaesthetic, and surgical notes were used for data collection. Patients with known encapsulating peritoneal sclerosis were excluded from the study. RESULTS:Patients with simple peritoneal sclerosis had a statistically significant longer duration of peritoneal dialysis. They also had a significantly higher risk of major complications postoperatively and a greater relative risk for mortality. CONCLUSIONS: There is an increased prevalence of simple peritoneal sclerosis with long-term peritoneal dialysis. Patients with simple peritoneal sclerosis have higher incidence of postlaparotomy complications. Patients on long-term peritoneal dialysis should be treated aggressively for peritoneal dialysis peritonitis to reduce complication/mortality rates. Evidence of simple peritoneal sclerosis at laparotomy should preclude further peritoneal dialysis.
Authors: W F Keane; G R Bailie; E Boeschoten; R Gokal; T A Golper; C J Holmes; Y Kawaguchi; B Piraino; M Riella; S Vas Journal: Perit Dial Int Date: 2000 Jul-Aug Impact factor: 1.756
Authors: Angela M Summers; Marc J Clancy; Fysal Syed; Nicola Harwood; Paul E C Brenchley; Titus Augustine; Hany Riad; Alastair J Hutchison; Paul Taylor; Robert Pearson; Ram Gokal Journal: Kidney Int Date: 2005-11 Impact factor: 10.612
Authors: Miguel Pérez Fontan; Ana Rodríguez-Carmona; Rafael García-Naveiro; Miguel Rosales; Pedro Villaverde; Francisco Valdés Journal: Perit Dial Int Date: 2005 May-Jun Impact factor: 1.756