RESUMO
Peritoneal dialysis is the ultrafiltration therapy of choice for the long-term ambulatory management of patients with diuretic-resistant refractory congestive heart failure. Here we report a case of patient with right heart failure, massive ascites, and refractory to medical treatment treated with continuous ambulatory peritoneal dialysis.
Assuntos
Ascite/terapia , Insuficiência Cardíaca/terapia , Diálise Peritoneal Ambulatorial Contínua , Idoso de 80 Anos ou mais , Feminino , HumanosAssuntos
Acetaminofen/efeitos adversos , Analgésicos não Narcóticos/efeitos adversos , Transplante de Rim/métodos , Falência Hepática Aguda/induzido quimicamente , Insuficiência Renal/terapia , Acetaminofen/toxicidade , Adulto , Analgésicos não Narcóticos/toxicidade , Morte Encefálica , Overdose de Drogas , Feminino , Sobrevivência de Enxerto , Humanos , Falência Hepática Aguda/patologia , Masculino , Pessoa de Meia-Idade , Diálise Renal , Resultado do TratamentoRESUMO
Peritoneal dialysis (PD) is associated with a number of complications, some of which can be attributed to raised intra-abdominal pressure. Intra-abdominal pressure is highest during coughing or straining--activities which, fortunately, are transient. High pressure, primarily due to high volumes of PD solution, can predispose patients to hernias, dialysate leaks, and back pain; it can also cause altered mechanics of breathing. This article reviews those various complications and their management.
Assuntos
Abdome/fisiopatologia , Diálise Peritoneal/efeitos adversos , Dor nas Costas/etiologia , Dor nas Costas/fisiopatologia , Soluções para Diálise , Hérnia Ventral/etiologia , Hérnia Ventral/fisiopatologia , Humanos , Hidrotórax/etiologia , Hidrotórax/fisiopatologia , Pressão , Transtornos Respiratórios/etiologia , Transtornos Respiratórios/fisiopatologiaRESUMO
The use of antibiotic prophylaxis before peritoneal dialysis (PD) catheter insertion has been a matter of great interest for both the surgical and the nephrology community. No uniform consensus exists on the timing, duration, or choice of antibiotic prophylaxis. The exact incidence of early postoperative peritonitis is unknown. The impact of the use of antibiotic prophylaxis in the prevention of early PD peritonitis and in long-term catheter survival is not clear. In that respect, many retrospective and prospective studies have been undertaken in the past, and they have shown conflicting results. Based on extensive data from the surgical and nephrology literature, and also based on our experience, we present a review of the use of antibiotic prophylaxis before peritoneal dialysis catheter insertion.
Assuntos
Antibioticoprofilaxia , Cateterismo , Diálise Peritoneal , Antibacterianos/administração & dosagem , Cateteres de Demora , Humanos , Diálise Peritoneal/efeitos adversos , Peritonite/etiologia , Peritonite/prevenção & controle , Fatores de RiscoRESUMO
OBJECTIVE: To examine a large well characterized cohort of patients with mixed connective tissue disease (MCTD) and determine longitudinally the prevalence of clinical and serologic features of Sjogren's syndrome in these patients. METHODS: Patients were followed longitudinally up to 30 years with systematic clinical and serologic analysis. Sera were analyzed for reactivity with SSA/Ro, SSB/La, and snRNP polypeptide U1-70kD and for anticardiolipin antibodies. RESULTS: Among a well characterized patient population with MCTD, 18/55 (32.7%) had antibodies to SSA/Ro, while 2/55 (3.6%) had antibodies to SSB/La, either initially or during the course of followup. All patients had antibodies to U1-70kD small nuclear ribonucleoprotein antigen. Sicca symptoms were common, occurring in 23/55 (41.8%) patients. Patients with MCTD who were anti-SSA/Ro positive had increased incidence of malar rash (p < 0.03) and photosensitivity (p < 0.001) compared to anti-SSA/Ro negative patients. CONCLUSION: Sicca symptoms are frequent in patients with MCTD, occurring in up to one-third of the patients studied. The presence of anti-SSA/Ro antibodies identifies a group of MCTD patients with a very high incidence of malar rash and photosensitivity.