RESUMO
INTRODUCCIÓN Y OBJETIVOS: La malposición del catéter peritoneal es una de las complicaciones más frecuentes de la diálisis peritoneal. Para recolocarlo se ha propuesto realizar la maniobra alfa, que consiste en devolver al catéter a su correcta posición a través de unas guías rígidas bajo control fluoroscópico. El objetivo del presente estudio es analizar los 107 procedimientos realizados en nuestro Centro tratando de determinar factores que puedan predecir el éxito de la técnica. MATERIAL Y MÉTODOS: El método de la maniobra alfa fue utilizado en 86 pacientes con un total de 107 procedimientos (en 70 pacientes solo una maniobra, en 16 pacientes dos maniobras o más). RESULTADOS: El éxito global de la técnica fue de un 60%. La tasa de éxito no mostró diferencias en cuanto al sexo (60% en varones frente a 40% mujeres, p = 0,104), tiempo de fallo del catéter (fallos precoces 60% frente a fallos tardíos 62%, p = 0,849), tipo de catéter (75% en autoposicionantes frente a 58% en espirales, p = 0,633), ni en cuanto a la posición inicial del catéter. Sólo hubo un caso de peritonitis secundaria al procedimiento. CONCLUSIONES: La maniobra alfa es un método eficaz y seguro en la corrección de la malposición del catéter peritoneal
INTRODUCTION AND OBJECTIVES: Peritoneal catheter displacement is one of the most common complications of peritoneal dialysis. The alpha manoeuvre has been proposed as a repositioning technique, which involves returning the catheter to its correct position using rigid guidewires under fluoroscopic guidance. The aim of this study is to analyse the 107 procedures performed at our Centre to identify factors that may predict the success of the technique. MATERIAL AND METHODS: The alpha manoeuvre method was used in 86 patients, with a total of 107 procedures (70 patients underwent one manoeuvre only, 16 patients underwent two or more manoeuvres). RESULTS: The overall success rate of the technique was 60%. There were no differences in success rate in terms of gender (60% male vs. 40% female, p = 0.104), time of catheter failure (early 60% vs. late 62%, p = 0.849), type of catheter (75% self-locating vs. 58% spiral, p = 0.633) or the initial position of the catheter. There was only one case of peritonitis related to the procedure. CONCLUSIONS: The alpha manoeuvre is an effective and safe method for correcting peritoneal catheter displacement
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Cateteres de Demora/efeitos adversos , Resultado do Tratamento , Diálise Peritoneal/efeitos adversos , Diálise Peritoneal/instrumentação , Cateterismo/métodos , Estudos Longitudinais , Estudos Retrospectivos , Abdome/diagnóstico por imagem , Fluoroscopia/métodos , Vancomicina/administração & dosagem , Falha de EquipamentoRESUMO
INTRODUCTION AND OBJECTIVES: Peritoneal catheter displacement is one of the most common complications of peritoneal dialysis. The alpha manoeuvre has been proposed as a repositioning technique, which involves returning the catheter to its correct position using rigid guidewires under fluoroscopic guidance. The aim of this study is to analyse the 107 procedures performed at our Centre to identify factors that may predict the success of the technique. MATERIAL AND METHODS: The alpha manoeuvre method was used in 86 patients, with a total of 107 procedures (70 patients underwent one manoeuvre only, 16 patients underwent two or more manoeuvres). RESULTS: The overall success rate of the technique was 60%. There were no differences in success rate in terms of gender (60% male vs. 40% female, p = 0.104), time of catheter failure (early 60% vs. late 62%, p = 0.849), type of catheter (75% self-locating vs. 58% spiral, p = 0.633) or the initial position of the catheter. There was only one case of peritonitis related to the procedure. CONCLUSIONS: The alpha manoeuvre is an effective and safe method for correcting peritoneal catheter displacement.
Assuntos
Cateteres de Demora/efeitos adversos , Diálise Peritoneal/instrumentação , Diálise Peritoneal/métodos , Idoso , Falha de Equipamento , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
No disponible
Assuntos
Humanos , Hemoperitônio/etiologia , Diálise Peritoneal/efeitos adversos , Insuficiência Renal Crônica/complicações , Diagnóstico Diferencial , Hemorragia/prevenção & controleAssuntos
Hemoperitônio/etiologia , Diálise Peritoneal/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Hemoperitônio/diagnóstico , Hemoperitônio/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Resultado do TratamentoAssuntos
Diálise Peritoneal/efeitos adversos , Fibrose Peritoneal/etiologia , Adulto , Síndrome de Bardet-Biedl/terapia , Evolução Fatal , Feminino , Glomerulonefrite/terapia , Glomerulosclerose Segmentar e Focal/terapia , Humanos , Transplante de Rim , Masculino , Fibrose Peritoneal/diagnóstico por imagem , Fibrose Peritoneal/tratamento farmacológico , Peritonite/etiologia , Complicações Pós-Operatórias/etiologia , Recidiva , Estudos Retrospectivos , Tamoxifeno/uso terapêutico , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Se describe el caso de una paciente con síndrome de Berardinelli-Seip, un tipo de lipodistrofia congénita generalizada, que inició a los 20 años, con marcada resistencia insulínica y complicaciones micro- y macroangiopáticas, entre ellas una enfermedad renal crónica que la ha llevado a iniciar tratamiento renal sustitutivo en la modalidad de diálisis peritoneal. Para ello llevamos un repaso de la historia de la paciente desde la edad pediátrica (momento en el que ya aparecen los primeros signos de la enfermedad) hasta la actualidad. Más allá de lo infrecuente de esta enfermedad, es de destacar que lo excepcional del caso es que se trata del único caso (al menos registrado en la literatura) de pacientes afectos de síndrome de Berardinelli-Seip en programa de diálisis (AU)
A case of Berardinelli-Seip syndrome, a congenital generalised lipodystrophy, is reported. Symptoms first appeared when the patient was 20 years old. She showed severe insulin resistance aswell as micro- and macro-angiopathic complications, including chronic kidney disease, which required renal replacement therapy with peritoneal dialysis. The patients clinical course was reviewed since paediatric age (when initial signs of the disease being already evident) to present time. Berardinelli-Seip syndromeis very uncommon, and the present case is particularly rare because it is the only case (at least as reported in the literature) in a patient receiving dialysis (AU)
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Lipodistrofia Generalizada Congênita/complicações , Insuficiência Renal Crônica/complicações , Diálise Peritoneal , Angiopatias Diabéticas/complicaçõesRESUMO
A case of Berardinelli-Seip syndrome, a congenital generalised lipodystrophy, is reported. Symptoms first appeared when the patient was 20 years old. She showed severe insulin resistance as well as micro- and macro-angiopathic complications, including chronic kidney disease, which required renal replacement therapy with peritoneal dialysis. The patient's clinical course was reviewed since paediatric age (when initial signs of the disease being already evident) to present time. Berardinelli-Seip syndrome is very uncommon, and the present case is particularly rare because it is the only case (at least as reported in the literature) in a patient receiving dialysis.
