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. 2023 Apr;27(2):320-327.
doi: 10.1111/1744-9987.13917. Epub 2022 Aug 16.

Prevalence and outcome of abdominal wall hernia in patients with end-stage renal disease on peritoneal dialysis

Niveditha Girimaji  1 , Anapalli Sunnesh  1 , Tandalam Nagalakshmi  1 , Maria Bethasaida Manuel  1 , Venkatarami Reddy Vutukuru  2 , Ram Rapur  1 , Sivakumar Vishnubhotla  1
Affiliations

Prevalence and outcome of abdominal wall hernia in patients with end-stage renal disease on peritoneal dialysis

Niveditha Girimaji et al. Ther Apher Dial. 2023 Apr.

Abstract

Introduction: We aimed to study the prevalence, risk factors, management, and outcome of hernias in end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) from India.

Methods: This was a retrospective study of ESRD-PD patients who developed hernias over 11 years.

Results: Of 470 PD patients, 21 developed hernias (4.2%). Mean age of patients was 49.9 ± 15.36 years; 15 (66.66%) were males; 18 (85.71%) patients had umbilical hernia, 3 (14.28%) had inguinal hernia. Continuous ambulatory PD (CAPD) versus automated PD (APD) (OR: 11.623, 95% CI: 2.060-65.581, p = 0.005) was the independent risk factor identified. Incarcerated umbilical/inguinal hernia was managed surgically (6 [28.57%]); uncomplicated umbilical hernia (15 [71.42%]) managed conservatively (shift to (APD) [33.33%]; switch to low-volume APD [20%], switch to low-volume CAPD [46.66%]). None had postoperative hernia recurrences; 4 (19%) had PD technique failure; median PD survival was 36 (IQR 17-55) months.

Conclusion: Although complicated hernias in PD require surgical repair, uncomplicated umbilical hernias can be managed conservatively by switching to APD/low-volume CAPD, with good long-term PD technique survival.

Keywords: abdominal hernia; automated peritoneal dialysis; chronic ambulatory peritoneal dialysis; chronic kidney disease.

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References

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