Korean Journal of Nephrology 1987;6(2):19-21.

복막염 이외의 CAPD 합병증

방병기 , 송기호 , 우제영 , 홍관수 , 김석영 , 구완서 , 최의진 , 장윤식

Abstract

Although much progress of technology of continuous ambulatory peritoneal dialysis has been made since 1978, it might be associated with significant morbidity and mortality. The rnost frequent complications result- ing in catheter removal and even death is infectious complications especially peritonitis. But in this presen- tation, we reviewed late complications of CAPD other than peritonitis in 78 patients undergioing CAPD from Aug, 1983 to Aug, 1987. The results are as follows: 1) Twenty-seven percent (21 cases) of the patients noticed catheter related complications including 7 abdominal pain, 7 cuff erosion with exite site infection, 5 poor drainage, Z tear of Tenchhoff catheter. CAPD was discontinued in 4 cases of poor drainage, but in one case, occlusion of catheter was corrected by catheter irrigation with saline and urokinase. 2) Intraperitoneal pressure related complications were obserbed in 14 cases (18%). Catheters were removed in four out of six cases who developed catheter leak. Hydrothorax was encountered in 4 cases who discontinued CAPD due to recurrent hydrothorax. In one case of hydrothorax, pleurodesis was tried for prevention of peritoneopleural drainage with tetracy- cline, but it failed. Hernia deve]oped in 4 cases, and two incisional hernia were corrected by surgical repair without discantinuation of CAPD. 3) Metabolic complications were noticed in 24 patients (30.7%). 13 patients developed symptoms of nausea, anorexia which was gradually improved with- out catheter removal. In seven cases, the serum trig- lyceride was markedly increased, but no specificsymptoms were observed in these patients. Weight gain over 10% or obesity developed in 4 cases. 4) Various other complications were observed in 14 cases, including hypotension, blood eosinophilia, late bloody effuluent, duodenal ulcer, seizure and ototoxicity due to over dose of antibiotics (aminoglycoside). In conclusion, the main causes of catheter removal other than peritonitis were poor drainage, hydrothorax and catheter leak.