ABSTRACT
Peritoneal dialysis is a treatment alternative in patients with advanced chronic kidney disease. The infusion of liquid into the peritoneal cavity leads to an increase in intra-abdominal pressure, which can sometimes produce leaks to the chest, giving rise to pleuroperitoneal communication. This is not a common complication, but it brings about high drop-out rates among patients using the technique. Diagnosis is easy and must be suspected in patients with sudden dyspnoea with low ultrafiltration and pleural effusion in the chest x-ray. Peritoneal rest and a temporary transfer to haemodialysis, and pleurodesis can be effective treatment strategies.
Subject(s)
Barotrauma/etiology , Fistula/etiology , Hydrothorax/etiology , Peritoneal Dialysis/adverse effects , Peritoneal Diseases/etiology , Peritoneum/injuries , Pleura/injuries , Respiratory Tract Fistula/etiology , Aged , Ascitic Fluid/chemistry , Female , Fistula/diagnosis , Fistula/diagnostic imaging , Glucose/analysis , Humans , Hydrothorax/diagnosis , Hydrothorax/diagnostic imaging , Hydrothorax/therapy , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Male , Middle Aged , Peritoneal Diseases/diagnosis , Peritoneal Diseases/diagnostic imaging , Pleurodesis , Radionuclide Imaging , Renal Dialysis , Respiratory Tract Fistula/diagnosis , Respiratory Tract Fistula/diagnostic imaging , Retrospective Studies , Rupture/etiology , Technetium Tc 99m Aggregated AlbuminABSTRACT
La diálisis peritoneal es una alternativa de tratamiento en los pacientes con enfermedad renal crónica avanzada. La infusión de líquido en la cavidad peritoneal conlleva un aumento de presión intraabdominal que, en algunas ocasiones, puede producir la fuga del mismo hacia el tórax dando lugar a una comunicación pleuroperitoneal. Es una complicación poco frecuente, pero supone una alta tasa de abandono de la técnica. El diagnóstico es sencillo y se debe sospechar ante la existencia de disnea súbita con baja ultrafiltración y derrame pleural en la radiografía de tórax. El descanso peritoneal, con transferencia temporal a hemodiálisis, y la pleurodesis pueden ser estrategias eficaces para su tratamiento (AU)
Peritoneal dialysis is a treatment alternative in patients with advanced chronic kidney disease. The infusion of liquid into the peritoneal cavity leads to an increase in intraabdominal pressure, which can sometimes produce leaks to the chest, giving rise to pleuroperitoneal communication. This is not a common complication, but it brings about high dropout rates among patients using the technique. Diagnosis is easy and must be suspected in patients with sudden dyspnoea with low ultrafiltration and pleural effusion in the chest xray. Peritoneal rest and a temporary transfer to haemodialysis, and pleurodesis can be effective treatment strategies (AU)
Subject(s)
Humans , Peritoneal Dialysis/adverse effects , Renal Insufficiency, Chronic/therapy , Peritonitis/etiology , Extravasation of Diagnostic and Therapeutic Materials/complications , Hydrothorax/etiology , Pleurodesis/methods , Hemodialysis Solutions/adverse effectsABSTRACT
No disponible
Subject(s)
Humans , Peritoneal Dialysis/methods , Education, Medical, Continuing/methods , Hemodialysis Units, Hospital , Teaching Care Integration Services , Professional TrainingABSTRACT
La estenosis de arteria renal en riñón único se asocia con un aumento de la morbimortalidad, y en la actualidad existe un dilema sobre su tratamiento: si es más conveniente realizar tratamiento conservador o revascularización. Presentamos el caso de una mujer de 72 años con hipertensión arterial, sin episodios de edema agudo de pulmón, riñón único funcionante derecho y estenosis de arteria renal derecha en la que se decide realizar tratamiento conservador dado el control de la tensión arterial con tratamiento farmacológico y por mantener una función renal estable en el último año. Se revisa la literatura y se discute sobre su tratamiento
Renal artery stenosis in single kidney is associated with an increase in morbidity-mortality. There is currently a dilemma on its treatment, on if it is better to perform a conservative treatment or revascularization. We present the case of a 72 year old woman with arterial hypertension, without episodes of acute pulmonary edema, right single functioning kidney and right renal artery stenosis, in which it was decided to perform conservative treatment given the control of the blood pressure with drug treatment and because she had maintained stable kidney function in the last year. The literature is reviewed and its treatment discussed
Subject(s)
Female , Aged , Humans , Renal Artery Obstruction/complications , Hypertension/complications , Ischemia/physiopathology , Kidney Diseases/therapySubject(s)
Ascitic Fluid/cytology , Leukocyte Count/instrumentation , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Peritoneal Dialysis/adverse effects , Peritonitis/diagnosis , Adult , Aged , Drainage , Female , Humans , Male , Middle Aged , Peritonitis/etiology , Peritonitis/therapy , RecurrenceABSTRACT
The increasing use of peritoneal maintenance dialysis in end renal insufficiency calls for a better understanding of its advantages, and a comparative study of residual fluid as a partial substitute for serum may be helpful in this respect. A comparative biochemical study was carried out with 53 samples taking simultaneously from 16 patients in peritoneal dialysis. Statistical results showed linear correlation coefficient to be higher than 0.64 in BUN, phosphorus, creatinine, uric acid, calcium and potassium, which allows a statistically certain conclusion to be drawn to the serum levels of residual peritoneal fluid. The results of glucose, chloride, bilirubin, osmolality, LDH, bicarbonate, albumin, cholesterol, sodium, globulines and alkaline phosphatase studies, gave an insufficient linear correlation coefficient, which makes it impossible to offer the necessary guarantees for the use of residual fluid.
