Marriott J, Cartnel L, McQuie J, Williams P
Can an elevated intraperitoneal pressure predict PD
complications?
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S64 1997
High volume CAPD with 2.5 litre exchanges is becoming increasingly popular.
Known complications are poor tolerance and hernia formation. The authors
question whether there is a relationship between measured intraperitoneal
pressure -IPP- (as measured by the method of B. Mathieu, 1994) and the
occurrence of hernia or dialysate leaks.
From 33 patients with a mean CAPD treatment time of 27 months IPP was
measured and follow-up showed that 9 of them had an IPP > 17 cm water. 7
patients in this group developed hernias or dialysate leaks. From the 24
patients with IPP < 17 cm of water only 3 developed such problems. There
was a significant increase in IPP with increasing body weight. The authors
conclude that IPP may predict abdominal complications and that larger
patients have a paradoxically higher IPP than smaller patients. They state
that high volume CAPD should only be prescribed if IPP can be monitored.
Comment: This very interesting study, although performed in a small
subset of patients gives conflicting results, if compared to larger
clinical trials like the one by
Afthentopoulos I.E. et al, presented
at this same congress. Further study of this subject is warranted,
especially since these complications lead to an important technical failure
drop-out.
(Johan Rosman M.D., The Hague, Netherlands)
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17th Annual CAPD Conference
Basic peritoneal dialysis :
Complications of PD