终末期肾病腹膜透析患者腹壁疝的患病率和结局。

Prevalence and outcome of abdominal wall hernia in patients with end-stage renal disease on peritoneal dialysis.

机构信息

Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupathi, Andhra Pradesh, India.

Department of Gastroenterology, Sri Venkateswara Institute of Medical Sciences, Tirupathi, Andhra Pradesh, India.

出版信息

Ther Apher Dial. 2023 Apr;27(2):320-327. doi: 10.1111/1744-9987.13917. Epub 2022 Aug 16.

DOI:10.1111/1744-9987.13917

PMID:36858048

Abstract

INTRODUCTION

We aimed to study the prevalence, risk factors, management, and outcome of hernias in end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) from India.

METHODS

This was a retrospective study of ESRD-PD patients who developed hernias over 11 years.

RESULTS

Of 470 PD patients, 21 developed hernias (4.2%). Mean age of patients was 49.9 ± 15.36 years; 15 (66.66%) were males; 18 (85.71%) patients had umbilical hernia, 3 (14.28%) had inguinal hernia. Continuous ambulatory PD (CAPD) versus automated PD (APD) (OR: 11.623, 95% CI: 2.060-65.581, p = 0.005) was the independent risk factor identified. Incarcerated umbilical/inguinal hernia was managed surgically (6 [28.57%]); uncomplicated umbilical hernia (15 [71.42%]) managed conservatively (shift to (APD) [33.33%]; switch to low-volume APD [20%], switch to low-volume CAPD [46.66%]). None had postoperative hernia recurrences; 4 (19%) had PD technique failure; median PD survival was 36 (IQR 17-55) months.

CONCLUSION

Although complicated hernias in PD require surgical repair, uncomplicated umbilical hernias can be managed conservatively by switching to APD/low-volume CAPD, with good long-term PD technique survival.

摘要

简介

我们旨在研究来自印度的腹膜透析（PD）终末期肾病（ESRD）患者中疝的流行率、危险因素、治疗方法和结局。

方法

这是一项对 11 年间发生疝的 ESRD-PD 患者进行的回顾性研究。

结果

在 470 名 PD 患者中，有 21 名（4.2%）发生疝。患者的平均年龄为 49.9±15.36 岁；15 名（66.66%）为男性；18 名（85.71%）患者为脐疝，3 名（14.28%）为腹股沟疝。持续非卧床腹膜透析（CAPD）与自动化腹膜透析（APD）（OR：11.623，95%CI：2.060-65.581，p=0.005）是确定的独立危险因素。嵌顿性脐疝/腹股沟疝通过手术治疗（6[28.57%]）；非复杂性脐疝（15[71.42%]）通过保守治疗（转换为 APD[33.33%]；转换为低容量 APD[20%]，转换为低容量 CAPD[46.66%]）。术后疝无复发；4 名（19%）出现 PD 技术失败；中位 PD 生存时间为 36（IQR 17-55）个月。