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1.
Nephrol Ther ; 5(2): 122-33, 2009 Apr.
Artículo en Francés | MEDLINE | ID: mdl-19013122

RESUMEN

We report three original cases of sclerosing encapsulating peritonitis (SEP) which is a rare but severe complication of peritoneal dialysis (PD). In the report of case 1, SEP occurred in a 75-year-old diabetic patient mellitus 18 years after the arrest of PD technique recurrent infectious peritonitis. The switch to hemodialysis was associated with a chronic inflammatory state poorly explained until the discovery of SEP. For case 2, SEP started within seven months after automated PD initiation in a severe septic context leading to leg amputation in a 57-year-old unstable diabetic male. In the last case, 84-year-old woman presented SEP after several peritonitis episodes, including one due to acute pancreatitis. In all cases, SEP was confirmed by open surgery. All patients were treated by visceralysis. The outcome was favorable in two of these three patients. SEP mechanisms, risks factors, prognosis and treatment are discussed with reference to the literature.


Asunto(s)
Diálisis Peritoneal/efectos adversos , Peritonitis/etiología , Enfermedad Aguda , Antagonistas Adrenérgicos beta/efectos adversos , Anciano , Anciano de 80 o más Años , Terapia Combinada , Comorbilidad , Diabetes Mellitus Tipo 2/complicaciones , Resultado Fatal , Humanos , Intestinos/patología , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/terapia , Masculino , Pancreatitis/complicaciones , Peritonitis/diagnóstico , Peritonitis/microbiología , Peritonitis/patología , Peritonitis/terapia , Complicaciones Posoperatorias , Recurrencia , Factores de Riesgo , Esclerosis/etiología , Esclerosis/patología
2.
Nephrol Ther ; 7(4): 237-41, 2011 Jul.
Artículo en Francés | MEDLINE | ID: mdl-21601549

RESUMEN

Arteriovenous fistula (AVF) is still in 2010 the gold standard of vascular(2) access in haemodialysis (HD) patients. Nevertheless it may be difficult to obtain and/or to use AVF in elderly. With this prospective randomised pilot study, we compare two strategies of vascular access in 70 years old or more new HD patients. AVF were compared to tunnelled jugular vein catheters (TIJC) with taurolidine as bacterial lock solution. Results were as follow: [table: see text] The responses with the visual analogic scale of comfort was 8/10 for TIJC and 5/10 with AVF * P<0.05. In five TIJC patients, heparin was added with success to taurolidine because of partial clotting of catheters. Albuminemia was significantly lower in AVF failure patients compared to AVF success patients (24.8g/L vs 31.1g/L). This pilot study allows to conclude that TIJC is an acceptable challenge to AVF in haemodialysed patients of 70 years or more in a two years long use.


Asunto(s)
Antiinfecciosos Locales/uso terapéutico , Derivación Arteriovenosa Quirúrgica , Cateterismo Venoso Central , Catéteres de Permanencia , Venas Yugulares , Fallo Renal Crónico/terapia , Diálisis Renal , Taurina/análogos & derivados , Tiadiazinas/uso terapéutico , Anciano , Derivación Arteriovenosa Quirúrgica/métodos , Femenino , Humanos , Masculino , Proyectos Piloto , Estudios Prospectivos , Diálisis Renal/métodos , Taurina/uso terapéutico , Resultado del Tratamiento
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