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. 2023 Oct 5;101(10):733-737.

Mechanical complications of peritoneal dialysis in Tunisian children

[Article in French]
Affiliations

Mechanical complications of peritoneal dialysis in Tunisian children

[Article in French]
Manel Jellouli et al. Tunis Med. .

Abstract

Introduction: Peritoneal dialysis (PD) is the method of choice for extra-renal replacement therapy (ERT) for children with end-stage renal disease (ESRD), because of its various advantages. However, it presents different infectious and non-infectious complications, causes of important morbidity and mortality.

Aim: To determine the mechanical complications of PD in our center and to identify risk factors of their occurrence.

Methods: We retrospectively collected the records of 99 patients who were treated with PD within the past eleven years in the department of pediatrics of the University Hospital Charles Nicolle of Tunis. Analysis examining possible risque factors were performed using parametric and non-parametric tests.

Results: A total of 63 patients had mechanical complications with an incidence of peritoneal dialysis catheter revision of 1 procedure every 38 months. The causes were dominated by catheter migration (27.5%) and obstruction by fibrin or blood clotting (19.8%). A history of peritonitis (p=0.046) and the presence of comorbidity (p=0.008) were the two independent risk factors for catheter revision. Inguinal hernia was noted in six patients. No patient presented with a hydrothorax. Seven patients presented an episode of hemoperitoneum.

Conclusion: Our results lead us to focus our efforts on preventing peritonitis and controlling morbidity. Prospective studies will enable us to confirm our results.

Introduction: La dialyse péritonéale (DP) est la méthode de choix d’épuration extra-rénale (EER) pour les enfants en insuffisance rénale chronique terminale (IRCT), ceci grâce aux divers avantages qu’elle présente. Cependant, elle présente différentes complications: infectieuses et non infectieuses, qui sont responsables d’une morbimortalité non négligeable. Objectif: Dans travail, nous avons cherché à déterminer les types de complications mécaniques en DP dans notre centre et à préciser les facteurs de risque de leur survenue. Méthodes: Nous avons effectué une étude descriptive rétrospective longitudinale qui a inclus 99 patients en DP sur une période de 11 ans au service de pédiatrie de l’hôpital Charles Nicolle de Tunis.L’étude analytique a utilisé les tests paramétriques et non paramétriques. Résultats: Soixante-trois patients avaient présenté des complications mécaniques avec une incidence de changement ou réinsertion de cathéter de dialyse péritonéale (KTDP) de 1 opération tous les 38 mois. Les causes de ces complications étaient dominées par le déplacement (27,5%) et l’obstruction du cathéter (19,8%). Les épisodes de peritonite (p=0,046) ainsi que les comorbidités (p=0,008) aient les deux facteurs de risque indépendants de repositionnement du KTDP. Pour les autre complications mécaniques, une hernie inguinale était retrouvée chez six patients, et sept patients avaient developpé un épisode d’hémopéritoine. Conclusion: Nos résultats nous poussent à axer nos efforts sur la prévention de survenue de péritonite et le contrôledes morbidité. Des études prospectives nous permettra de conforter nos résultats

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