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Hernias: a frequent complication in children treated with continuous peritoneal dialysis
T von Lilien1, I B Salusky, H K Yap
1Division of Pediatric Nephrology, UCLA School of Medicine.
Summary
Hernia development is a frequent complication in children undergoing peritoneal dialysis. This study found 40% of patients developed hernias, particularly early in treatment.
Area of Science:
- Pediatric Nephrology
- Gastroenterology
- Surgical Complications
Background:
- Peritoneal dialysis is a common renal replacement therapy for children.
- Hernias are a known potential complication of abdominal procedures and increased intra-abdominal pressure.
Purpose of the Study:
- To retrospectively evaluate the incidence and characteristics of hernia development in children treated with continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD).
Main Methods:
- Retrospective evaluation of 93 children over 1,819 months of CAPD/CCPD treatment.
- Analysis of hernia occurrence, type, timing, and associated factors.
- Review of management strategies and complications.
Main Results:
- 40% of patients (37/93) developed 60 hernias (36 ventral, 7 umbilical, 14 inguinal, 3 scrotal).
- Hernia incidence was inversely correlated with patient age and duration of dialysis; highest in the first 3 months.
- Dialysate inflow volume did not correlate with hernia development; one case of bowel incarceration occurred.
Conclusions:
- Hernia development is a frequent complication in pediatric patients undergoing CAPD/CCPD.
- Early detection and management are crucial, with surgical repair being the most common treatment.
- Further research into preventative strategies may be warranted.