Acute peritoneal dialysis following ruptured abdominal aortic aneurysms

American Journal of Surgery
H HajarizadehB S Cutler

Abstract

Acute renal failure is common after repair of ruptured abdominal aortic aneurysm. Early dialysis has recently been advocated to reduce the mortality associated with multiorgan failure, but hemodialysis (HD) is not well-tolerated in critically ill patients because of hemodynamic instability and risk of bleeding from anticoagulation therapy. Peritoneal dialysis (PD) has the advantage in that it causes minimal cardiopulmonary instability and does not require anticoagulation. The presence of a freshly-closed abdominal wound and an aortic graft, however, have previously been considered to be contraindications to PD. Peritoneal dialysis catheters were placed in 69 of the 105 patients who underwent grafting for a ruptured abdominal aortic aneurysm between 1982 and 1993. Criteria for placement included shock, perioperative oliguria, and preoperative renal insufficiency. All charts were reviewed retrospectively to evaluate the safety and efficacy of placing PD catheters and initiating early dialysis in patients at risk for developing acute renal failure. Acute tubular necrosis developed in 31 patients, 19 of whom required dialysis. Peritoneal dialysis alone provided effective dialysis in 8 patients, and it was combined with hemofiltrati...Continue Reading

References

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Citations

May 25, 2002·The British Journal of Surgery·M J BownR D Sayers
Nov 7, 1999·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·R BraamsB C Eikelboom
Jun 4, 2005·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·M J BownR D Sayers
Jun 15, 2012·The Cochrane Database of Systematic Reviews·Lei JiangYali Liu
Apr 28, 2019·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·John H CrabtreeFrank J M F Dor
May 22, 2003·The International Journal of Artificial Organs·P Passadakis, D Oreopoulos
Nov 4, 2021·The New England Journal of Medicine·Isaac Teitelbaum

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