Outcome of patients with intermittent stab peritoneal dialysis: a single centre experience

Background: Intermittent stab peritoneal dialysis (IPD) is still practiced in our centre as a modality used in patients refusing long term renal replacement therapy (RRT); and in elderly patients with significant comorbidities, who are unable to undergo RRT for various reasons. Objective: T...

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Main Authors:	Wan Ali, Wan Ahmad Syahril Rozli, Seman, Mohd Ramli, Draman, Che Rosle
Format:	Conference or Workshop Item
Language:	English English
Published:	2014
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/58983/ http://irep.iium.edu.my/58983/ http://irep.iium.edu.my/58983/11/Outcome%20of%20patients%20with%20stab%20PD.pdf http://irep.iium.edu.my/58983/17/58983_Outcome%20of%20patients.pdf

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recordtype	eprints
spelling	iium-589832017-11-23T06:06:22Z http://irep.iium.edu.my/58983/ Outcome of patients with intermittent stab peritoneal dialysis: a single centre experience Wan Ali, Wan Ahmad Syahril Rozli Seman, Mohd Ramli Draman, Che Rosle R Medicine (General) Background: Intermittent stab peritoneal dialysis (IPD) is still practiced in our centre as a modality used in patients refusing long term renal replacement therapy (RRT); and in elderly patients with significant comorbidities, who are unable to undergo RRT for various reasons. Objective: To analyze the characteristics and outcomes of stab peritoneal dialysis as a modality in acute dialysis, and prior to definitive renal replacement therapy. Methods: In this cross sectional study, fourty one episodes of stab peritoneal dialysis, involving thirty five patients undergoing stab peritoneal dialysis in Hospital Tg. Ampuan Afzan from December 2012 until June 2013 were recruited. The sociodemographic, laboratory investigations and other relevant profiles in these patients were assessed. Results: The majority of the patients were males (61.0 %). The mean age was 50.8 + 15.1 years old (95% CI 46.1 - 55.6). Diabetes mellitus was the commonest comorbid (75.6 %), followed by Hypertension (63.4%) and ischaemic heart disease (17.1%). Eighteen (43.9%) of the procedure was done in Nephrology ward, followed by seventeen (41.5%) in high dependency ward. Fourteen patients (40.0%) already underwent stab peritoneal dialysis more than once due to refusal for long RRT, and presented acutely in the ward. Six (14.6%) of the patients from the high dependency unit were intubated during the procedure, and all of them required high dose inotropic support. The mean systolic blood pressure was 144.3 + 4.1 mmHg (95% CI 136.0-152.6), and diastolic blood pressure was 79.6 + 2.5 mmHg (95% CI 74.6-84.5). Laboratory investigations prior to procedure showed mean Potassium 4.87 + 0.83 mmol/L, Urea pre 42.2 + 12.0 mmol/L, Creatinine pre 1054.9 + 564.0 mmol/L, Bicarbonate 16.6 + 4.4 mmol/L, Haemoglobin 9.1 + 2.6 g/dL, Albumin 29.4 + 7.2 g/L. The post procedure mean Urea was 31.4 + 10.5 mmol/L, Creatinine 854.7 + 532.1 mmol/L, and Potassium 3.9 + 0.5 mmol/L. The mean ultrafiltrate was 4356 + 3747 mililitres ( 95% CI 2601 – 6110 ). Nine (22.0%) patients developed poor flow and needs to be adjusted. Three (8.6%) patients need to be converted to Haemodialysis in view of very poor solute clearance. Only two (4.9%) patients developed minor bleeding, and one (2.8%) developed peritonitis. Conclusion: The IPD population consisted of middle-aged patients, majority were males, and diabetics. Multiple stab peritoneal dialysis has been done in some patients, with minimal complications. The main concern was the high ultrafiltration rates and low and slow solute clearance rates in patients undergoing IPD. References : - Intermittent peritoneal dialysis (IPD): an old but still effective modality for severely disabled ESRD patients. Fourtounas et.al. Nephrol Dial Transplant. 2009 Oct;24(10):3215-8 2014 Conference or Workshop Item NonPeerReviewed application/pdf en http://irep.iium.edu.my/58983/11/Outcome%20of%20patients%20with%20stab%20PD.pdf application/pdf en http://irep.iium.edu.my/58983/17/58983_Outcome%20of%20patients.pdf Wan Ali, Wan Ahmad Syahril Rozli and Seman, Mohd Ramli and Draman, Che Rosle (2014) Outcome of patients with intermittent stab peritoneal dialysis: a single centre experience. In: 30th Annual Congress of The Malaysian Society of Nephrology 2014, 20th-22th June 2014, Shangri-La Hotel, Kuala Lumpur. (Unpublished) https://www.msn.org.my/msn/fwbPagePublic.jsp?fwbPageId=pIndex
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Wan Ali, Wan Ahmad Syahril Rozli Seman, Mohd Ramli Draman, Che Rosle Outcome of patients with intermittent stab peritoneal dialysis: a single centre experience
description	Background: Intermittent stab peritoneal dialysis (IPD) is still practiced in our centre as a modality used in patients refusing long term renal replacement therapy (RRT); and in elderly patients with significant comorbidities, who are unable to undergo RRT for various reasons. Objective: To analyze the characteristics and outcomes of stab peritoneal dialysis as a modality in acute dialysis, and prior to definitive renal replacement therapy. Methods: In this cross sectional study, fourty one episodes of stab peritoneal dialysis, involving thirty five patients undergoing stab peritoneal dialysis in Hospital Tg. Ampuan Afzan from December 2012 until June 2013 were recruited. The sociodemographic, laboratory investigations and other relevant profiles in these patients were assessed. Results: The majority of the patients were males (61.0 %). The mean age was 50.8 + 15.1 years old (95% CI 46.1 - 55.6). Diabetes mellitus was the commonest comorbid (75.6 %), followed by Hypertension (63.4%) and ischaemic heart disease (17.1%). Eighteen (43.9%) of the procedure was done in Nephrology ward, followed by seventeen (41.5%) in high dependency ward. Fourteen patients (40.0%) already underwent stab peritoneal dialysis more than once due to refusal for long RRT, and presented acutely in the ward. Six (14.6%) of the patients from the high dependency unit were intubated during the procedure, and all of them required high dose inotropic support. The mean systolic blood pressure was 144.3 + 4.1 mmHg (95% CI 136.0-152.6), and diastolic blood pressure was 79.6 + 2.5 mmHg (95% CI 74.6-84.5). Laboratory investigations prior to procedure showed mean Potassium 4.87 + 0.83 mmol/L, Urea pre 42.2 + 12.0 mmol/L, Creatinine pre 1054.9 + 564.0 mmol/L, Bicarbonate 16.6 + 4.4 mmol/L, Haemoglobin 9.1 + 2.6 g/dL, Albumin 29.4 + 7.2 g/L. The post procedure mean Urea was 31.4 + 10.5 mmol/L, Creatinine 854.7 + 532.1 mmol/L, and Potassium 3.9 + 0.5 mmol/L. The mean ultrafiltrate was 4356 + 3747 mililitres ( 95% CI 2601 – 6110 ). Nine (22.0%) patients developed poor flow and needs to be adjusted. Three (8.6%) patients need to be converted to Haemodialysis in view of very poor solute clearance. Only two (4.9%) patients developed minor bleeding, and one (2.8%) developed peritonitis. Conclusion: The IPD population consisted of middle-aged patients, majority were males, and diabetics. Multiple stab peritoneal dialysis has been done in some patients, with minimal complications. The main concern was the high ultrafiltration rates and low and slow solute clearance rates in patients undergoing IPD. References : - Intermittent peritoneal dialysis (IPD): an old but still effective modality for severely disabled ESRD patients. Fourtounas et.al. Nephrol Dial Transplant. 2009 Oct;24(10):3215-8
format	Conference or Workshop Item
author	Wan Ali, Wan Ahmad Syahril Rozli Seman, Mohd Ramli Draman, Che Rosle
author_facet	Wan Ali, Wan Ahmad Syahril Rozli Seman, Mohd Ramli Draman, Che Rosle
author_sort	Wan Ali, Wan Ahmad Syahril Rozli
title	Outcome of patients with intermittent stab peritoneal dialysis: a single centre experience
title_short	Outcome of patients with intermittent stab peritoneal dialysis: a single centre experience
title_full	Outcome of patients with intermittent stab peritoneal dialysis: a single centre experience
title_fullStr	Outcome of patients with intermittent stab peritoneal dialysis: a single centre experience
title_full_unstemmed	Outcome of patients with intermittent stab peritoneal dialysis: a single centre experience
title_sort	outcome of patients with intermittent stab peritoneal dialysis: a single centre experience
publishDate	2014
url	http://irep.iium.edu.my/58983/ http://irep.iium.edu.my/58983/ http://irep.iium.edu.my/58983/11/Outcome%20of%20patients%20with%20stab%20PD.pdf http://irep.iium.edu.my/58983/17/58983_Outcome%20of%20patients.pdf
first_indexed	2023-09-18T21:23:28Z
last_indexed	2023-09-18T21:23:28Z
_version_	1777412036566712320

Outcome of patients with intermittent stab peritoneal dialysis: a single centre experience

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