Long-term clinical experience with continuous ambulatory peritoneal dialysis: access-related problems
| Autor: | Y.C.G.J. Paquay, John A. Jansen, R.J.A. Goris, A.J. Hoitsma |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Percutaneous
medicine.medical_treatment Abdominal cavity causes and effects (sepsis and inflammation) [Sepsis and non-bacterial generalized inflammation] Health Services Accessibility Peritoneal Dialysis Continuous Ambulatory Surgical Outpatients Medicine Prospective Studies Netherlands Anastomosis Surgical Hand Injuries Anti-Bacterial Agents Extracellular Matrix Catheter medicine.anatomical_structure Inflammation Mediators medicine.medical_specialty Invloed van dialysetechniek en dialysemembraan op klaring en stolling Free Radicals Anastomosis Multiple Organ Failure Peritonitis mogelijke oorzaken en gevolgen (sepsis en ontsteking) [Sepsis en niet-bacteriële gegeneraliseerde ontsteking] Gram-Positive Bacteria Autonomic Nervous System Peritoneal dialysis Foot Diseases Renal Dialysis Sepsis Gram-Negative Bacteria Humans Intensive care medicine Dialysis Retrospective Studies Inflammation Animal business.industry Multiple Trauma Continuous ambulatory peritoneal dialysis medicine.disease Discontinuation Surgery Disease Models Animal Disease Models Kidney Failure Chronic Wounds and Injuries business |
| Zdroj: | Journal of Investigative Surgery, 9, 81-93 Journal of Investigative Surgery, 9, pp. 81-93 |
| ISSN: | 0894-1939 |
| Popis: | Patients with end-stage renal failure can be treated with peritoneal dialysis, which is based on the capacity of the peritoneum to exchange fluid and metabolic products. To achieve this, dialysis fluid has to be instilled in the abdominal cavity through a permanent percutaneous access device. Apart from the advantages of peritoneal dialysis, severe problems are related to the access device. In this study, catheter-related morbidity and mortality are described, as found in the patient population from the University Hospital, Nijmegen, The Netherlands. The overall rates of exit-site infections and peritonitis are respectively 0.80 and 1.36 infection episodes per patient-year. Furthermore, it appeared that exit-site infections and peritonitis are the main reasons for discontinuation of dialysis and removal of the catheter. A correlation between the occurrence of peritonitis and exit-site infections was found. Also, the efficacy of the antibiotic treatment necessary to control these infectious complications is described. It is concluded that the design and the materials used to manufacture the currently used access device are the main reason for the existing morbidity in peritoneal dialysis. Therefore, more efforts should be undertaken to improve the access device, in which the design and the material used are critically considered. |
| Databáze: | OpenAIRE |
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