The outcome of nephrectomy in peritoneal dialysis patients.

We examined mechanical complications including incisional hernia, peritoneal leak, and wound infection or dehiscence. Among biochemical outcomes (group B only), we analyzed serum creatinine, albumin, potassium, and phosphate for 1 year pre- and post-nephrectomy. Among the 8 patients identified (4 in group A, 4 in group B), 7 underwent unilateral nephrectomy, and 1, bilateral nephrectomy. Surgery was laparoscopic in 1 patient and open in 7 patients. The approach was transperitoneal in 5 patients, and retroperitoneal in 3 patients. Incisional hernia occurred in 4 patients (2 in each group), and retroperitoneal leak was seen in 1 patient in group B after 2 months. No wound dehiscence or other complications occurred. In group B, 2 patients required hybrid therapy in the form of once-weekly hemodialysis with continuous ambulatory PD. Among the biochemical complications, we noted that serum creatinine increased (as expected), and serum albumin significantly declined and remained lower post-nephrectomy. Our data show that, post-nephrectomy, PD patients have a high incidence of incisional hernia. They also experience a significant decline in serum albumin and a substantial loss in residual kidney function potentially requiring intensified dialysis. The retroperitoneal approach may on occasion predispose to retroperitoneal leak of dialysate. PMID: 24344486 [PubMed - indexed for MEDLINE]
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research