Establishing an animal model for peritoneal catheter malfunction caused by omental wrapping using negative pressure suction: in vitro and in vivo exploration.

BACKGROUND: This study aims to establish a simplified and effective animal model of catheter malfunction caused by omental wrapped using negative pressure suction. METHOD: The peritoneal dialysis catheter outlet was linked to a negative-pressure (0-75mmHg) suction pump to intensify the negative pressure. Different negative pressures were tested for model construction in vitro. In vivo, a model of peritoneal catheter malfunction caused by omental wrapped was constructed in five beagles after catheter placement. Catheter drainage conditions and related complications were monitored before and after the model establishment. RESULTS: In the vitro experiment, the overall success rate of constructed models was 90% (36/40). The total malfunction rate was higher in 62.5 mmHg (10/10) and 75 mmHg (10/10) than in 12.5 mmHg (8/10) and 37.5 mmHg (8/10). The outflow velocity of dialysate at 62.5 mmHg was significantly lower than that at 12.5 mmHg and 37.5 mmHg, without a statistically significant difference compared to 75 mmHg. In the in vivo experiment, catheter outflow velocity increased, and residual fluid volume decreased after omental wrapped (99.6 ± 6.7 ml/min vs. 32.6 ± 4.6 ml/min at initial five minutes, p < 0.0001; 69.2 ± 16.3 ml vs. 581.0 ± 109.4 ml, p < 0.001). And the outflow velocity was finally below 2 ml/min. No severe related complications (such as infection, organ damage, or bleeding) were observed through laparoscopic examination and dialysate tests seven days post-operation. CONCLUSION: Utilizing negative pressure suction to increase negative pressure around catheter tip is a simple, safe, and effective method for establishing an animal model of omental wrapped leading to catheter malfunction.

Retinal detachments in a patient with minimal change nephrotic syndrome: Case report and review of the literature.

Background: To report an unusual case of minimal change nephrotic syndrome with sudden bilateral retinal detachment. Case presentation: A 54-year-old woman with minimal change nephrotic syndrome presented with sudden-onset visual blurring in both eyes. Optical coherence tomography scans revealed macular schisis and extramacular intraretinal separation. A kidney biopsy confirmed the diagnosis of minimal change disease. Glucocorticoid therapy was quickly started. During remission, her vision was restored, with complete resolution of the subretinal fluid observed on optical coherence tomography. Conclusions: In minimal change nephrotic syndrome, fluid accumulation in the retina layer may occur, and gravity-induced vitreous traction on the inferior retina may cause retinal detachment. Patients should be advised to avoid large swings of the head and neck, handstands, and other activities that may increase the risk of retinal detachment. The possibility of retinal detachment should be considered when blurred vision occurs.