Document Detail


Persistent symptomatic intra-abdominal collection after catheter removal for PD-related peritonitis.
MedLine Citation:
PMID:  20448239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Peritoneal dialysis (PD) patients with severe peritonitis require catheter removal. It is often assumed that this approach, together with antibiotics, would eradicate the infection; however, some patients continue to have problems despite catheter removal.
METHOD: We reviewed 30 consecutive PD patients in our center from 1997 to 2008 with recurrent loculated peritoneal collection after catheter removal for severe peritonitis.
RESULTS: Of the 1928 episodes of peritonitis that occurred in 702 patients during the study period, 11.1% required catheter removal and 1.6% developed recurrent peritoneal collection that required percutaneous drainage. Median time to diagnosis of intra-abdominal collection was 12 days after catheter removal (interquartile range 7 - 61 days). In 25 patients (83.3%), aspirate of the abdominal collection was culture negative. In 17 patients (56.7%), the abdominal collection was recurrent and required repeated percutaneous aspiration. Only 3 patients had successful reinsertion of the peritoneal catheter but all had reduced small solute clearance after returning to PD.
CONCLUSION: A small but not negligible proportion of patients with PD-related peritonitis develop recurrent intra-abdominal collection that requires percutaneous drainage after catheter removal. The chance of a successful return to PD is very low in this group of patients. Direct conversion to long-term hemodialysis may avoid unnecessary attempts at peritoneal catheter reinsertion.
Authors:
Cheuk-Chun Szeto; Bonnie Ching-Ha Kwan; Kai-Ming Chow; Wing-Fai Pang; Vickie Wai-Ki Kwong; Chi-Bon Leung; Philip Kam-Tao Li
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-06
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  31     ISSN:  1718-4304     ISO Abbreviation:  Perit Dial Int     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-02-01     Completed Date:  2011-12-30     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  34-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Abdomen
Body Fluids
Catheters, Indwelling*
Device Removal*
Female
Humans
Male
Middle Aged
Peritoneal Dialysis / instrumentation*
Peritonitis / surgery*
Severity of Illness Index
Treatment Failure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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