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Background: The percutaneous placement of peritoneal dialysis (PD) catheters using conscious sedation with ultrasound and fluoroscopic guidance is underutilised and has several advantages over the open surgical and laparoscopic placement methods, especially in the resource-limited developing world. Objectives: To describe our patients’ demographics...
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Context 1
... entrance skin incision was approximated using the interrupted horizontal mattress suturing technique with Nylon 3/0 and covered with a sterile dressing. The catheter exit site was covered with sterile gauze and an Opsite dressing specifically not applied to the catheter (to prevent difficulty in subsequent removal). The exit site was not sutured to avoid seroma and potential infection (Figure 9). A control pelvic radiograph was taken to document and confirm the correct position of the catheter (Figure 10). Table 1 shows the demographic data and clinical characteristics of the group of 25 patients with 16 men (64%) and nine women (36%). Ages ranged from 18-60 years, with a median of 44 ...
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Introduction:
Data on impact of high body mass index (BMI) on mortality of patients on peritoneal dialysis (PD), especially among elderly, are inconsistent. Objective: To evaluate impact of BMI on cohort of incident elderly PD patients over time.
Methods:
Prospective multicenter cohort study (December / 2004-October/2007) with 674 patients. Socio-...
Citations
Worldwide, the number of end-stage renal disease (ESRD) patients has been rapidly increasing, with more than a million patients receiving dialysis therapy. Coverage of renal replacement therapy (RRT) is usually directly related to country-specific gross national income (GNI). In pediatrics, global data from the International Pediatric Peritoneal Dialysis Network (IPPN) showed that dialysis patient survival was associated with GNI status, being significantly higher in high-income economies (94.1% at 5 years), compared to middle- and low-income countries combined (88.7%). The provision of RRT, funding, dialysis modality, ESRD etiology, technical resources, and trained healthcare professionals also show important variation across regions around the world, most of the cases directly related to economic and cultural factors. The IPPN data also showed that these differences do have an impact on growth, nutrition, biochemical status, and dialysis-related complications such as peritonitis, especially in children with chronic kidney disease in the developing world. This chapter provides an analysis of the differences in RRT around the world, allowing a better understanding of the ways to improve dialysis programs for children and adolescents in developing regions.
Peritoneal dialysis (PD) is a means of renal replacement therapy (RRT) that can be performed in remote settings with limited resources, including regions that lack electrical power. PD is a mainstay of end-stage renal disease (ESRD) therapy worldwide, and the ease of initiation and maintenance has enabled it to flourish in both resource-limited and resource-abundant settings. In natural disaster scenarios, military conflicts, and other austere areas, PD may be the only available life-saving measure for acute kidney injury (AKI) or ESRD. PD in austere environments is not without challenges, including catheter placement, availability of dialysate, and medical complications related to the procedure itself. However, when hemodialysis is unavailable, PD can be performed using generally available medical supplies including sterile tubing and intravenous fluids. Amidst the ever-increasing global burden of ESRD and AKI, the ability to perform PD is essential for many medical facilities.
