Skip to main content

Advertisement

SpringerLink
Log in

The prognostic values of estimating intraperitoneal pressure in the occurrence of abdominal wall complications in peritoneal dialysis patients

  • Original Article
  • Published:
Journal of Nephrology Aims and scope Submit manuscript

Abstract

Background

Increased intraperitoneal pressure is associated with abdominal wall complications and technical failure of peritoneal dialysis (PD). Several equations have been developed to estimate intraperitoneal pressure. We aimed to assess the prognostic yield of the intraperitoneal pressure as estimated by current equations on the occurrence of abdominal wall complications in peritoneal dialysis patients.

Methods

This is a retrospective analysis of data from a prospective cohort which recruited 1207 incident PD patients. Estimated intraperitoneal pressure was calculated using four available equations (according to Sigogne, Castellanos, Scanziani and de Jesus Ventura). Abdominal wall complications were recorded during follow-up. Univariate analysis and multivariate analysis with competing risk regression were used to assess the predictive power of the estimates of intraperitoneal pressure in the occurrence of abdominal wall complications.

Results

During a median follow-up of 30 months, 66 (5.5%) patients (1.6/100 patient-years) developed abdominal wall complications. The median time to the occurrence of abdominal wall complications was 5.7 months. Only the estimated intraperitoneal pressure by the de Jesus Ventura equation significantly predicted abdominal wall complications by using univariate analyses. Associations between estimated intraperitoneal pressure by the de Jesus Ventura equation and the occurrence of abdominal wall complications disappeared after adjusting for significant clinical factors.

Conclusions

We verified the prognostic value of estimation of intraperitoneal pressure by four available equations in predicting abdominal wall complications in our single-center PD cohort. Due to a low diagnostic yield, a novel equation for estimating the intraperitoneal pressure is urgently needed.

Graphical abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability statement

Data described in the manuscript, code book, and analytic code will not be made available because the Management of China’s Human Genetic Resources.

References

  1. Teitelbaum I (2021) Peritoneal dialysis. N Engl J Med 385(19):1786–1795. https://doi.org/10.1056/NEJMra2100152

    Article  CAS  PubMed  Google Scholar 

  2. Ye H, Yang X, Yi C et al (2019) Urgent-start peritoneal dialysis for patients with end stage renal disease: a 10-year retrospective study. BMC Nephrol 20(1):238. https://doi.org/10.1186/s12882-019-1408-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Workeneh B, Guffey D, Minard CG, Mitch WE (2015) Causes for withdrawal in an urban peritoneal dialysis program. Int J Nephrol 2015:652953. https://doi.org/10.1155/2015/652953

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hernández-Castillo JL, Balderas-Juárez J, Jiménez-Zarazúa O et al (2020) Factors associated with urgent-start peritoneal dialysis catheter complications in ESRD. Kidney Int Rep 5(10):1722–1728. https://doi.org/10.1016/j.ekir.2020.07.025

    Article  PubMed  PubMed Central  Google Scholar 

  5. Yang SF, Liu CJ, Yang WC et al (2015) The risk factors and the impact of hernia development on technique survival in peritoneal dialysis patients: a population-based cohort study. Perit Dial Int May-Jun 35(3):351–359. https://doi.org/10.3747/pdi.2013.00139

    Article  CAS  Google Scholar 

  6. Del Peso G, Bajo MA, Costero O et al (2003) Risk factors for abdominal wall complications in peritoneal dialysis patients. Perit Dial Int May-Jun 23(3):249–254

    Article  Google Scholar 

  7. Aksoy GK, Ekim M, Bakkaloğlu SA et al (2021) Evaluation of non-infectious complications of peritoneal dialysis in children: a multicenter study. Pediatr Nephrol 36(2):417–423. https://doi.org/10.1007/s00467-020-04719-9

    Article  PubMed  Google Scholar 

  8. Mekki MO, Fedail HM, Ali EM et al (2011) Non-infectious complications of peritoneal dialysis among Sudanese patients: five years experience. Arab J Nephrol Transplant 4(1):27–30. https://doi.org/10.4314/ajnt.v4i1.63152

    Article  PubMed  Google Scholar 

  9. Xu D, Liu T, Dong J (2017) Urgent-start peritoneal dialysis complications: prevalence and risk factors. Am J Kidney Dis 70(1):102–110. https://doi.org/10.1053/j.ajkd.2016.12.021

    Article  PubMed  Google Scholar 

  10. Aranda RA, Romão Júnior JE, Kakehashi E et al (2000) Intraperitoneal pressure and hernias in children on peritoneal dialysis. Pediatr Nephrol 14(1):22–24. https://doi.org/10.1007/s004670050005

    Article  CAS  PubMed  Google Scholar 

  11. Dejardin A, Robert A, Goffin E (2007) Intraperitoneal pressure in PD patients: relationship to intraperitoneal volume, body size and PD-related complications. Nephrol Dial Transplant 22(5):1437–1444. https://doi.org/10.1093/ndt/gfl745

    Article  PubMed  Google Scholar 

  12. Outerelo MC, Gouveia R, Teixeira e Costa F, Ramos A (2014) Intraperitoneal pressure has a prognostic impact on peritoneal dialysis patients. Perit Dial Int 34(6):652–654. https://doi.org/10.3747/pdi.2012.00192

    Article  PubMed  PubMed Central  Google Scholar 

  13. Castellanos LB, Clemente EP, Cabañas CB et al (2017) Clinical relevance of intraperitoneal pressure in peritoneal dialysis patients. Perit Dial Int Sep-Oct 37(5):562–567. https://doi.org/10.3747/pdi.2016.00267

    Article  CAS  Google Scholar 

  14. Durand PY, Chanliau J, Gamberoni J, Hestin D, Kessler M (1992) Routine measurement of hydrostatic intraperitoneal pressure. Adv Perit Dial 8:108–112

    CAS  PubMed  Google Scholar 

  15. Sigogne M, Kanagaratnam L, Mora C et al (2020) Identification of the factors associated with intraperitoneal pressure in adpkd patients treated with peritoneal dialysis. Kidney Int Rep 5(7):1007–1013. https://doi.org/10.1016/j.ekir.2020.04.012

    Article  PubMed  PubMed Central  Google Scholar 

  16. Scanziani R, Dozio B, Baragetti I, Maroni S (2003) Intraperitoneal hydrostatic pressure and flow characteristics of peritoneal catheters in automated peritoneal dialysis. Nephrol Dial Transplant 18(11):2391–2398. https://doi.org/10.1093/ndt/gfg353

    Article  PubMed  Google Scholar 

  17. de Jesús VM, Amato D, Correa-Rotter R, Paniagua R (2000) Relationship between fill volume, intraperitoneal pressure, body size, and subjective discomfort perception in CAPD patients Mexican Nephrology Collaborative Study Group. Perit Dial Int 20(2):188–193

    Article  Google Scholar 

  18. Fischbach M, Terzic J, Becmeur F et al (1996) Relationship between intraperitoneal hydrostatic pressure and dialysate volume in children on PD. Adv Perit Dial 12:330–334

    CAS  PubMed  Google Scholar 

  19. Smith SC Jr, Jackson R, Pearson TA et al (2004) Principles for national and regional guidelines on cardiovascular disease prevention: a scientific statement from the World Heart and Stroke Forum. Circulation 109(25):3112–3121. https://doi.org/10.1161/01.Cir.0000133427.35111.67

    Article  PubMed  Google Scholar 

  20. Karnofsky DBJ (1949) The clinical evaluation of chemotherapeutic agents in cancer. Columbia University Press, New York, p 3

    Google Scholar 

  21. Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47(11):1245–1251. https://doi.org/10.1016/0895-4356(94)90129-5

    Article  CAS  PubMed  Google Scholar 

  22. Du Bois D, Du Bois EF (1989) A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition 5(5):303–311

    PubMed  Google Scholar 

  23. Wang AY, Sanderson JE, Sea MM et al (2010) Handgrip strength, but not other nutrition parameters, predicts circulatory congestion in peritoneal dialysis patients. Nephrol Dial Transplant 25(10):3372–3379. https://doi.org/10.1093/ndt/gfq216

    Article  PubMed  Google Scholar 

  24. Dong J, Li YJ, Xu R, Yang ZK, Zheng YD (2015) Novel equations for estimating lean body mass in peritoneal dialysis patients. Perit Dial Int 35(7):743–752. https://doi.org/10.3747/pdi.2013.00246

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Van Dijk CM, Ledesma SG, Teitelbaum I (2005) Patient characteristics associated with defects of the peritoneal cavity boundary. Perit Dial Int Jul-Aug 25(4):367–373

    Article  Google Scholar 

  26. Schaefer F, Klaus G, Müller-Wiefel DE, Mehls O (1999) Current practice of peritoneal dialysis in children: results of a of a longitudinal survey. mid European Pediatric Peritoneal Dialysis Study Group (MEPPS). Perit Dial Int 19(Suppl 2):445–449

    Article  Google Scholar 

  27. Kathuria P, Twardowski ZJ (2000) Automated peritoneal dialysis. In: Gokal R, Khanna R, Krediet RT, Nolph KD (eds) Textbook of Peritoneal Dialysis. Netherlands, Springer, pp 435–463

    Chapter  Google Scholar 

  28. Bazanelli AP, Kamimura MA, Manfredi SR, Draibe SA, Cuppari L (2012) Usefulness of waist circumference as a marker of abdominal adiposity in peritoneal dialysis: a cross-sectional and prospective analysis. Nephrol Dial Transplant 27(2):790–795. https://doi.org/10.1093/ndt/gfr361

    Article  PubMed  Google Scholar 

  29. Stewart KJ, DeRegis JR, Turner KL et al (2003) Usefulness of anthropometrics and dual-energy x-ray absorptiometry for estimating abdominal obesity measured by magnetic resonance imaging in older men and women. J Cardiopulm Rehabil Mar-Apr 23(2):109–114. https://doi.org/10.1097/00008483-200303000-00008

    Article  Google Scholar 

  30. Sanches FM, Avesani CM, Kamimura MA et al (2008) Waist circumference and visceral fat in CKD: a cross-sectional study. Am J Kidney Dis 52(1):66–73. https://doi.org/10.1053/j.ajkd.2008.02.004

    Article  PubMed  Google Scholar 

  31. Afthentopoulos IE, Panduranga Rao S, Mathews R, Oreopoulos DG (1998) Hernia development in CAPD patients and the effect of 2.5 l dialysate volume in selected patients. Clin Nephrol 49(4):251–257

    CAS  PubMed  Google Scholar 

  32. Leblanc M, Ouimet D, Pichette V (2001) Dialysate leaks in peritoneal dialysis. Semin Dial Jan-Feb 14(1):50–54. https://doi.org/10.1046/j.1525-139x.2001.00014.x

    Article  CAS  Google Scholar 

  33. Twardowski ZJ, Khanna R, Nolph KD et al (1986) Intraabdominal pressures during natural activities in patients treated with continuous ambulatory peritoneal dialysis. Nephron 44(2):129–135. https://doi.org/10.1159/000184217

    Article  CAS  PubMed  Google Scholar 

  34. Li X, Ma T, Hao J et al (2023) Novel equations for estimating intraperitoneal pressure among peritoneal dialysis patients. Clin Kidney J 16(9):1447–1456. https://doi.org/10.1093/ckj/sfad021

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors express their appreciation to the patients, doctors, and nursing staff of the peritoneal dialysis center of Peking University First Hospital.

Funding

This work is supported by Scientific Research Project of Capital Health Development (2020–2-4079), New Century Excellent Talents from Education Department of China, and CAMS Innovation Fund for Medical Sciences (2019-I2M-5–046), Clinic Research Award from ISN GO R&P Committee for analysis and interpretation of the data.

Author information

Author notes

  1. Tiantian Ma and Xinqiu Li have equally contributed to this work.

Authors and Affiliations

  1. Key Laboratory of Renal Disease, Key Laboratory of Renal Disease, Renal Division, Department of Medicine, Ministry of Health, Ministry of Education, Institute of Nephrology, Peking University First Hospital, Peking University, Beijing, 100034, China

    Tiantian Ma, Xinqiu Li, Jiayu Hao, Di Song, Hongyan Wang, Tianjiao Liu, Yaling Zhang, Nanzha Abi, Xiao Xu & Jie Dong

Authors
  1. Tiantian Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xinqiu Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jiayu Hao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Di Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hongyan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tianjiao Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yaling Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Nanzha Abi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Xiao Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jie Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Research idea and study design: JD, TM, XL; data acquisition: TM, XL, JH, DS, HW, TL, YZ, NA, XX; statistical analysis: XL, TM, XX, JD; manuscript drafting or revision: XL, TM, JD; supervision or mentorship: JD. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved. All authors read and approved the final version. The authors express their appreciation to the patients and staff of the peritoneal dialysis center of Peking University First Hospital, for their continuing contribution to this study.

Corresponding author

Correspondence to Jie Dong.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study protocol was reviewed and approved by the Ethics Committee of Peking University First Hospital, approval number [2011–357].

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

40620_2024_1913_MOESM1_ESM.jpg

Supplementary file1 Supplyment Figure. Distribution of abdominal wall complications. Every color space represents the percentage of specific type of complications in the total abdominal complications. Blue represents inguinal hernias, yellow for hydrothorax, purple for umbilical hernias, green for hydrocele and orange for subcutaneous leak (JPG 50 kb)

Supplementary file2 (DOCX 17 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ma, T., Li, X., Hao, J. et al. The prognostic values of estimating intraperitoneal pressure in the occurrence of abdominal wall complications in peritoneal dialysis patients. J Nephrol (2024). https://doi.org/10.1007/s40620-024-01913-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s40620-024-01913-y

Keywords

Search

Navigation