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Continuous ambulatory peritoneal dialysis complicating with abdominal hernias in children
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Insights
Hernias are common in children undergoing continuous ambulatory peritoneal dialysis (CAPD). Early surgical repair is recommended to prevent complications in pediatric patients requiring CAPD.
Area of Science:
- Pediatric Nephrology
- Surgical Complications
- Renal Replacement Therapy
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for uremic children.
- Hernias can be a complication of abdominal procedures in children.
Purpose of the Study:
- To investigate the incidence and characteristics of hernias in pediatric patients undergoing CAPD.
- To assess the outcomes of surgical repair for hernias in this population.
Main Methods:
- Retrospective review of 10 uremic children (3.6-14.4 years) who received 13 CAPD catheters between May 1991 and December 1995.
- Analysis of hernia development, types, surgical repair, and patient outcomes.
Main Results:
- Eight abdominal hernias (38.5%) developed in four patients, associated with five catheters.
- Hernia types included inguinal, umbilical, epigastric, and at the catheter site; six were repaired.
- Two patients switched to night intermittent PD (NIPD) due to recurrent hernias.
Conclusions:
- Hernia development is a significant concern in young children on CAPD.
- Early surgical intervention for hernias is advised to mitigate potential complications.
Abstract:
From May 1991 through December 1995, 10 uremic children ranging in age from 3.6 years old to 14.4 years old underwent insertion of 13 peritoneal dialysis catheters for continuous ambulatory peritoneal dialysis (CAPD). Eight abdominal hernias developed, associated with five catheters (38.5%) in four of the patients. Three hernias were inguinal, three were umbilical, one was epigastric, and one occurred at the catheter insertion site. Six hernias, including one umbilical hernia developing incarceration, were repaired. After operations because of recurrent hernias, two patients were switched from standard CAPD to night intermittent PD (NIPD) using low volumes of dialysate. Male sex and age younger than six years were possible associated risk factors (P = 0.19). In conclusion, hernia in young children undergoing CAPD is not unusual, and early surgical repair is advisable to avoid complications.