Mechanical complications of continuous ambulatory peritoneal dialysis: A hospital based retrospective study in Kashmir Valley

Abstract

Objectives: The objective of the study was to assess the mechanical and nonmechanical complications in patients with end-stage renal disease (ESRD) undergoing continuous ambulatory peritoneal dialysis (CAPD) and to access the contributing factors to improve the patient's survival and reduce morbidity and mortality. Materials and Methods: This observational study was carried out on 121 patients with ESRD undergoing CAPD at the Nephrology Unit of SKIMS, Srinagar, Jammu and Kashmir, India. We retrospectively reviewed the medical records of 121 CAPD patients, in which a double-cuffed straight Tenckhoff catheter was inserted using surgical technique from July 2012 to July 2016. Results: The mean age of the study patients was 45 ± 11.5 years. Males outnumbered female, with a ratio of 1.42:1. The most common etiology for ESRD was diabetes mellitus (38.84%), followed by hypertension (30.57%) and chronic glomerulonephritis (18.18%). About three-fourth of the study patients (77.19%) were on CAPD therapy for more than 6 months showing better acceptability of CAPD therapy. Peritonitis was the most common nonmechanical complication and was seen in 45.45% patients. 14.04% patients had recurrent episodes of peritonitis. Catheter-related complications are early encountered and are mostly due to faulty technique. Conclusion: The complications associated with CAPD are diverse and most of the mechanical complications are catheter related and often result from errors made during catheter implantation. Furthermore, the presence of comorbid factors plays a provital role in exacerbating these complications. Proper evaluation of the patient, care during catheter insertion, and postoperative period can markedly reduce most of these complications and reduce mortality and morbidity associated with CAPD.