Hernias: a frequent complication in children treated with continuous peritoneal dialysis.
The course of 93 children, treated with continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) over a total of 1,819 months, was evaluated retrospectively regarding hernia development. Thirty-seven patients (40%) developed 60 hernias (one per 30 patient-months), of which 36 were ventral, 7 umbilical, 14 inguinal, and 3 scrotal. Hernia occurrence was inversely correlated to patient's age and duration of CAPD/CCPD. The rate of hernia development was highest within the first 3 months following initiation of CAPD/CCPD with a subsequent rapid decrease. The dialysate inflow volume was not related to hernia development. The only complication due to the presence of a hernia was one episode of incarceration of the small bowel that required immediate surgical intervention. Surgical repair was the treatment performed in 75% of the cases. The remaining hernias were managed with volume reduction, conversion from CAPD to CCPD, or discontinuation of the daytime dialysate dwell in patients undergoing CCPD. Our observations suggest that hernia development is a frequent complication in children treated with CAPD/CCPD.
von Lilien
T
T
Division of Pediatric Nephrology, UCLA School of Medicine.
Salusky
I B
IB
Yap
H K
HK
Fonkalsrud
E W
EW
Fine
R N
RN
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000209:etiology*; D006554:Hernia, Umbilical / Q000209:etiology*; D006555:Hernia, Ventral / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D012189:Retrospective Studies; D012611:Scrotum; D013997:Time Factors