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Relationship between intraperitoneal pressure and the development of hernias in peritoneal dialysis: confirmation for the first time of a widely accepted concept

  • Nephrology - Original Paper
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Abstract

Background

Intraperitoneal pressure (IPP) in peritoneal dialysis (PD) is an individual characteristic that can be modified by posture and intraperitoneal volume (IPV). It is considered one of the predisposing factors for complications in the abdominal wall, such as the appearance of hernias. No studies to date have confirmed this. The main aim of this study was to assess the relationship between the development of hernia in incident PD patients and IPP measured at PD onset.

Methods

A prospective observational study of incident patients in a PD programme between 2010 and 2020. IPP was measured using the Durand's method.

Results

One hundred and twenty-four incident patients on PD, 68% male, mean age 62.1 ± 15.23 years, body mass index (BMI) 27.7 ± 4.82 kg/m2, 44% were diabetic. IPP in supine was 16.6 ± 4.60 cm H2O for a mean IPV of 2047.1 ± 359.19 mL. Hernias were reported in 18.5% of patients during PD follow-up: 57% were inguinal hernias, 33% umbilical, and a further 10% presented in a combined form. PD hernias correlated positively with IPP in supine position (p = 0.037), patient age (p = 0.008), BMI (p = 0.043), a history of prior hernia (0.016), laparoscopic catheter placement (p = 0.026), and technique failure (p = 0.012). In the multivariate analysis, a higher IPP was independently related to the development of hernias (p = 0.028).

Conclusions

The development of hernias in PD was related to a higher IPP at PD onset, older age, higher BMI, history of prior hernia, catheter placement by laparoscopy, and technique failure.

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Data availability

The datasets generated during and analyzed during the current study are available fom the corresponding author on reasonable request.

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Acknowledgements

Committee of Ethics and Research with Medications (CEIM) of the Parc Taulí de Sabadell (Barcelona). The authors wish to thank Sylva-Astrik Torossian for her support in redacting this document.

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Authors and Affiliations

  1. Department of Nephrology, Parc Tauli Sabadell, University Hospital, Parc Tauli 1, 08208, Sabadell, Barcelona, Spain

    Loreley Betancourt, Sandy Pico, Estefania Rojas, Maria Jose Gordo, Jaume Almirall & Esther Ponz

  2. Department of Medicine UAB, Barcelona, Spain

    Loreley Betancourt, Sandy Pico, Estefania Rojas, Maria Jose Gordo, Jaume Almirall & Esther Ponz

  3. Department of Medicine UAB, Statistics Unit, Parc Tauli Sabadell, University Hospital, Barcelona, Spain

    Juan Carlos Oliva

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  1. Loreley Betancourt
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Correspondence to Loreley Betancourt.

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Betancourt, L., Pico, S., Rojas, E. et al. Relationship between intraperitoneal pressure and the development of hernias in peritoneal dialysis: confirmation for the first time of a widely accepted concept. Int Urol Nephrol 56, 759–765 (2024). https://doi.org/10.1007/s11255-023-03663-5

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