Surgical aspects of peritoneal dialysis: prevention, diagnosis and treatment of complications
Summary. Aim — to analyze the complications that arise during peritoneal dialysis and to study the results of their prevention and treatment. Object and methods of research. The results of treatment of 54 patients with chronic kidney disease, which was carried out by renal replacement therapy by the method of peritoneal dialysis, were analyzed. Prevention of complications included preoperative preparation, careful observance of the rules for the catheter implantation, postoperative care of the catheter. Results. Complications developed in 18 (33.3%) people. In 10 (18.5%) patients, they were infectious (catheter exit site infection, the tunnel infection, peritonitis). Staphylococcus aureus, Pseudomonas aeruginosa and Staphylococcus epidermidis were the main causes of complications. Non-infectious complications (pericateretric leakage of dialysis, catheter migration) were observed in 8 (14.8%) cases. The integrated differentiated approach was applied in treatment. Before the removal of the catheter had to resort to 3 cases. There were no deaths associated with complications of peritoneal dialysis. Conclusions. The effectiveness of peritoneal dialysis depends on the correct catheter implantation, the implementation of preventive measures to prevent infectious complications and disruption of the functioning of the catheter, timely diagnosis and pathogenetically substantiated treatment.
Key words: chronic kidney disease, peritoneal dialysis, catheter exit site infection, tunnel infection, peritonitis, pericateretric outflow of dialyzate, catheter migration.
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