Presentation
We present a case of aortic dissection with an atypical presentation in a peritoneal dialysis patient, and the challenges met with peritoneal dialysis. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
The most common symptom and signs are abdominal pain, acute appendicitis and palpable mass. Additionally, abdominal pain is common in patient on peritoneal dialysis, which may confound the diagnosis in such patient. [ncbi.nlm.nih.gov]
The patient may also experience pain or discomfort if the dialysate is too acidic, too cold or introduced too quickly, while diffuse pain with cloudy discharge may indicate an infection. [globaldialysis.com]
- Anemia
Fluctuation of symptoms Hemodialysis – Blood clots – Infection – Low blood pressure – Anemia – Pericarditis (inflammation of the membrane around the heart) – Sepsis – Access site complications such as infections, aneurysm or blockage Peritoneal dialysis [laminatemedical.com]
However, the results in this research indicated anemia in PD patients without cardiovascular events history should be timely treated. Instead, hemoglobin should be kept within a relatively low level in patients with history of cardiovascular events. [ncbi.nlm.nih.gov]
Outcomes of Importance ID’d for Peritoneal Dialysis Patients PD-related infection, mortality, fatigue are highest-ranked outcomes for patients, caregivers Anemia Severity Linked to LVH Risk in Pediatric Dialysis Time-averaged hemoglobin levels, not hemoglobin [renalandurologynews.com]
- Falling
Our patient's pregnancy is considered high risk as she has end stage renal failure and falls in the category of advance maternal age for pregnancy. [ncbi.nlm.nih.gov]
Residual function typically falls, although slowly, over the months or even years of treatment with PD. [niddk.nih.gov]
Patients who fall below a standard measurement of blood flow receive a fistulagram, a test that checks for the presence of stenosis or closing of a graft. [barnesjewish.org]
Treatment failure was variably measured by resolution of symptoms and signs, clearing of dialysate, fall in dialysate white cell count and microbiological eradication of the causative organism. [doi.org]
[…] concentration dependent bacterial killing meaning maximal bacterial killing requires high peak drug concentrations [ 21 ] and also have a prolonged post-antibiotic effect (PAE) where bacterial growth continues to be inhibited even when the drug concentrations fall [bmcnephrol.biomedcentral.com]
- Severe Pain
We report a 71- years- old woman on peritoneal dialysis that experienced several episodes of abdominal cramping pain and sterile peritonitis. She had one episode of severe pain and underwent an appendectomy for suspicion of appendicitis. [ncbi.nlm.nih.gov]
Severe pain in the rectum or perinium can be the result of an improperly placed catheter. [globaldialysis.com]
Severe pain in the rectum or perineum can be the result of an improperly placed catheter. [en.wikipedia.org]
Peritonitis may cause constant, sharp, severe pain throughout the abdomen, but sometimes causes little pain. Infection at the insertion site causes redness of the skin and pain at the insertion site. [msdmanuals.com]
- El Salvador
Countries included in the survey Albania Dominican Republic Kyrgyzstan Russia Algeria Ecuador Latvia Saudi Arabia Argentina Egypt Lebanon Senegal Armenia El Salvador Libya Serbia and Montenegro Australia Estonia Lithuania Singapore Austria Finland Luxembourg [doi.org]
Respiratoric
- Pleural Effusion
One patient was transferred to hemodialysis, which led to complete resolution of pleural effusion. The other patient was switched to automated peritoneal dialysis, using small dwell volumes with consequent reduction in size of the pleural effusion. [ncbi.nlm.nih.gov]
In addition, the clinical manifestations of systemic venous congestion, including accumulation of fluid outside the lungs (elevated jugular venous pressure, pleural effusions, hepatic enlargement, ascites and oedema) are leading reasons for hospital admission [karger.com]
Gastrointestinal
- Diarrhea
Based on our case, we recommend that intestine perforations should be considered as a cause of relapsing PD-related peritonitis with abdominal symptoms, particularly watery diarrhea. [ncbi.nlm.nih.gov]
Peritonitis Peritonitis is often the result of contamination with skin bacteria, but it may also be due to gram-negative bacteria associated with diarrhea or diverticulitis. [emedicine.medscape.com]
[…] vomiting Unusual color or cloudiness in used dialysis solution You are not able to pass gas or have a bowel movement Also call your provider if you experience any of the following symptoms severely, or they last more than 2 days: Itching Trouble sleeping Diarrhea [medlineplus.gov]
- Abdominal Distension
The chronic abdominal distension resolved as her ascites decreased. In addition, peritoneal protein loss decreased after initiation of peritoneal dialysis (PD). [ncbi.nlm.nih.gov]
In case of Overdose If you accidentally infuse a larger volume of Dianeal than prescribed by your Kidney Doctor, you may experience abdominal distension and pain. [mydr.com.au]
- Abdominal Fullness
What To Expect After Treatment Mild back pain or abdominal fullness may sometimes occur during peritoneal dialysis. Why It Is Done Peritoneal dialysis replaces the work of the kidneys after complications of kidney failure develop. [myhealth.alberta.ca]
What To Expect Mild back pain or abdominal fullness may sometimes occur during peritoneal dialysis. Why It Is Done Peritoneal dialysis replaces the work of the kidneys after complications of kidney failure develop. [northshore.org]
Cardiovascular
- Heart Disease
Abstract A 70-years of age, male patient with underlying type 2 diabetes mellitus, hypertension, dyslipidemia and ischemic heart disease had undergone continuous ambulatory peritoneal dialysis (CAPD)for 3 years without any episodes of peritonitis. [ncbi.nlm.nih.gov]
For example, peritoneal dialysis may be recommended for: children aged 2 or younger people who still have some limited kidney function adults who don't have other serious health conditions, such as heart disease or cancer Haemodialysis may be recommended [nhs.uk]
It can also be used for gentle fluid removal in patients with non-primary kidney disease, such as patients with congestive heart failure or cirrhosis of the liver. [nkti.gov.ph]
Abstract Maladaptive responses between a failing heart and the kidneys ultimately lead to permanent chronic kidney disease, referred to as cardiorenal syndrome type 2. [karger.com]
Musculoskeletal
- Back Pain
BACKGROUND Aortic dissection presents with acute chest or back pain and is associated with high mortality. [ncbi.nlm.nih.gov]
Other complications include hypotension (due to excess fluid exchange and sodium removal), low back pain and hernia or leaking fluid due to high pressure within the abdomen. [globaldialysis.com]
What To Expect After Treatment Mild back pain or abdominal fullness may sometimes occur during peritoneal dialysis. Why It Is Done Peritoneal dialysis replaces the work of the kidneys after complications of kidney failure develop. [myhealth.alberta.ca]
What To Expect Mild back pain or abdominal fullness may sometimes occur during peritoneal dialysis. Why It Is Done Peritoneal dialysis replaces the work of the kidneys after complications of kidney failure develop. [northshore.org]
The results suggested APD may have psychosocial advantages for younger patients and those who are employed or pursuing an education.Other complications include hypotension (due to excess fluid exchange and sodium removal), low back pain and hernia or [en.wikipedia.org]
- Low Back Pain
Other complications include hypotension (due to excess fluid exchange and sodium removal), low back pain and hernia or leaking fluid due to high pressure within the abdomen. [globaldialysis.com]
The results suggested APD may have psychosocial advantages for younger patients and those who are employed or pursuing an education.Other complications include hypotension (due to excess fluid exchange and sodium removal), low back pain and hernia or [en.wikipedia.org]
Skin
- Ulcer
The penile ulcers eventually resolved completely. There have been very few reports about calciphylaxis in patients on combined dialysis modalities. [ncbi.nlm.nih.gov]
Peritoneal dialysis is not recommended when any of the following conditions are present: Scarring of the lining of the abdominal wall ( peritoneal membrane ) Leaks in the lining of the abdominal wall Active inflammatory bowel disease (Crohn's disease, ulcerative [myhealth.alberta.ca]
It causes painful skin bumps and ulcers that often become infected. Severe infection can affect the entire body and be fatal. Treatment aims to relieve complications of calciphylaxis. [msdmanuals.com]
Psychiatrical
- Withdrawn
Because EPS occurs after withdrawal from PD in more than half of all cases, strict monitoring is necessary when a long-term PD patient is withdrawn from PD. [ncbi.nlm.nih.gov]
An exchange record is kept of the fluid that is introduced into and withdrawn from the peritoneal cavity. The amount withdrawn is expected to closely approximate or be slightly more than the amount introduced. [medical-dictionary.thefreedictionary.com]
Doctors such as a vascular surgeon and often an interventional radiologist prepare the blood vessels so that blood can be easily withdrawn from the body and cycled through the dialysis machine. [msdmanuals.com]
Neurologic
- Dizziness
It can cause you to feel weak, tired or dizzy. [dciinc.org]
[…] the abdomen membrane) – Scarring of the peritoneum – Abdominal muscle weakening – High blood sugar due to the dextrose in the dialysate – Hernia – Eventual ineffectively of procedure Possible Side effects Hemodialysis – Muscle cramps – Hypotension – Dizziness [laminatemedical.com]
Occasionally nausea, muscle cramps or dizziness can occur due to the fast removal of extra water from your body, which may cause your blood pressure to drop. [web.archive.org]
Note level of jugular pulsation Decreased BP, postural hypotension, and tachycardia are early signs of hypovolemia Note reports of dizziness, nausea, increasing thirst. May indicate hypovolemia and hyperosmolar syndrome. [nurseslabs.com]
Haemodialysis isn't painful, but some people feel a bit sick and dizzy, and may have muscle cramps during the procedure. This is caused by the rapid changes in blood fluid levels that occur during the treatment. [nhs.uk]
- Irritability
It is a thin, non-irritating, flexible tube. One end of this tube rests in the peritoneal cavity, while the other extends from the body by about 4 inches, so that it can be attached to the dialysis fluid. [kidneypatientguide.org.uk]
More patients reported adverse effects with the antibiotic treatments (headache, diarrhoea, nausea, vomiting, pruritus, nasal irritation/rhinitis) but the results did not achieve significance. Heterogeneity could not be determined ( Analysis 3.7 ). [doi.org]
Adhesions often develop as a result of local irritation to the surrounding tissues caused by the intraperitoneal catheter. [medical-dictionary.thefreedictionary.com]
Complications of Peritoneal Dialysis Complication Cause Low blood pressure Loss of too much fluid and salt during dialysis Bleeding Unintentional perforation of an internal organ during placement of the catheter Removal of the catheter from the body Irritation [msdmanuals.com]
- Headache
See discussion at peritoneal dialysis. dialysis dysequilibrium syndrome a condition occasionally seen following overly rapid hemodialysis, characterized by increased intracranial pressure that causes nausea, headache, vomiting, restlessness, and a decreased [medical-dictionary.thefreedictionary.com]
More patients reported adverse effects with the antibiotic treatments (headache, diarrhoea, nausea, vomiting, pruritus, nasal irritation/rhinitis) but the results did not achieve significance. Heterogeneity could not be determined ( Analysis 3.7 ). [doi.org]
People, particularly when starting hemodialysis, may have muscle cramps, itching, nausea and vomiting, headache, restless legs syndrome, and pain in the chest and back. [msdmanuals.com]
Please contact us if you think your child may have fluid overload or has any of the symptoms below: weight increase high blood pressure, which may show up as headaches puffiness, especially around the ankles and eyes breathlessness Dehydration Dehydration [gosh.nhs.uk]
Workup
Colonoscopy
- Colitis
[…] dialysis is not recommended when any of the following conditions are present: Scarring of the lining of the abdominal wall ( peritoneal membrane ) Leaks in the lining of the abdominal wall Active inflammatory bowel disease (Crohn's disease, ulcerative colitis [myhealth.alberta.ca]
PD may not be suitable for you if you: have had major surgery on your abdomen. have bowel disease such as diverticulitis, colitis or are very overweight. live alone and need significant support. do not have a permanent address. [mykidney.org]
[…] diaphragmatic hernia, bladder extrophy) Patient’s condition not amenable to dialysis Relative: Abdominal wall infection Frequent episodes of diverticulitis Inability to tolerate large volumes of peritoneal dialysate Inflammatory bowel disease Ischemic colitis [msdmanuals.com]
Pleura
- Pleural Effusion
One patient was transferred to hemodialysis, which led to complete resolution of pleural effusion. The other patient was switched to automated peritoneal dialysis, using small dwell volumes with consequent reduction in size of the pleural effusion. [ncbi.nlm.nih.gov]
In addition, the clinical manifestations of systemic venous congestion, including accumulation of fluid outside the lungs (elevated jugular venous pressure, pleural effusions, hepatic enlargement, ascites and oedema) are leading reasons for hospital admission [karger.com]
Treatment
Patients take charge their own treatment plan and advice given by the PD care team. [nkfs.org]
The treatment of PD peritonitis consists mainly of antibiotic therapy, surgical intervention not being usually required. [ncbi.nlm.nih.gov]
Antifungal versus placebo/no treatment [doi.org]
Prognosis
PURPOSE: To investigate the effect of hemoglobin fluctuations on cardiovascular prognosis of patients on peritoneal dialysis (PD). METHODS: Retrospective descriptive study, with sample composed of 333 patients treated with PD at the Renal Unit. [ncbi.nlm.nih.gov]
Two patients fully recovered, one died, and one patient with a poor prognosis was lost to follow-up. Conclusion: IPD can be delivered effectively using readily available materials in forward surgical units and level III combat support hospitals. [doi.org]
Etiology
We report 2 episodes of hemoperitoneum in a PD patient occurring more than 1.5 years apart, with different underlying etiologies. [ncbi.nlm.nih.gov]
Three recent case-control studies, one each from the United Kingdom, France, and Hong Kong, have shown no increased risk for infections in patients with PKD compared to patients with ESRD from other etiologies. [renalandurologynews.com]
Among 18 patients in which omental wrapping was observed to be the etiology for catheter malfunction, two failures were observed. [sages.org]
Epidemiology
We present a case of PDRP due to M. paraoxydans and review the epidemiology, clinical manifestations, and available evidence for treatment of this organism. [ncbi.nlm.nih.gov]
An increasing number of national and international renal registries have provided valuable demographic and epidemiologic information on renal patients since the first report of the European Dialysis and Transplant Association (EDTA) was published in 1965 [doi.org]
Pathophysiology
The results suggest that hepcidin may be involved in the pathophysiology of atherosclerosis. Prospective studies should be carried out in this patient population to determine whether hepcidin has an effect on atherosclerosis. [ncbi.nlm.nih.gov]
Jones & Bartlett Learning, 2009 - 786 Seiten An Introduction to Human Disease: Pathology and Pathophysiology Correlations, Eighth Edition provides students with a clear and well-illustrated explanation of the structural and functional changes associated [books.google.com]
There are excellent reviews in the literature that discuss the causes, pathophysiology, and medical management of acute renal failure in the neonate (see Acute Renal Failure Management in the Neonate in this issue of NeoReviews ). [neoreviews.aappublications.org]
Prevention
Abstract Background: Complications of renal failure may prevent timely evacuation of injured soldiers. Conventional renal replacement therapy is not available in forward surgical units. [doi.org]
Complications of renal failure may prevent timely evacuation of injured soldiers. Conventional renal replacement therapy is not available in forward surgical units. [ncbi.nlm.nih.gov]