Afthentopoulos IE, Rao P, Bhaskaran S, Oreopoulos DG
Does a large dialysate volume (2.5 liters) increase hernia formation in CAPD?
17th Annual CAPD Conference
Perit Dial Int Suppl 1 (Feb) 17:S55 1997

To achieve adequate dialysis in PD, it may be necessary to use a high-dose prescription; e.g. 2.5 litres per exchange. The risk of this treatment consists mainly of inducing hernia. To address this issue, a retrospective study in 404 CAPD patients on 2 litre exchanges, and 50 patients on 2.5 litre exchanges was performed. 16.8% of the first group developed a hernia after an average CAPD treatment time of 9.9 months. For the 2.5 litre exchange group this was separately calculated for patients that went immediately on 2.5 litre (n=23), and for those who were initially using 2 litre bags before switching to 2.5 litres (n=27). In the latter group 18% had had a repaired hernia. The whole group of patients using 2.5 litre exchanges showed only 1 case of hernia over a treatment time of 12 months.

Comment: It is concluded that there are no arguments in disfavour of high-volume PD concerning the delopment of hernia. This is an interesting study, although the numbers of patients in the subgroups are low compared to the 2 litre exchange group. Although it is unlikely that the even lower risk of hernia in high-volume patients can be confirmed in larger and longer trials, it is worthy to study this phenomenon more in detail. (Johan Rosman M.D., The Hague, Netherlands)

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17th Annual CAPD Conference
Basic peritoneal dialysis : Complications of PD
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