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An unusual case of lymphadenopathy due to Continuous Ambulatory Peritoneal Dialysis becomes a challenge during renal transplantation.

ABSTRACT: A 31-year-old male was diagnosed with Stage V Chronic Kidney Disease and treated with Continuous Ambulatory Peritoneal Dialysis (CAPD) for five years before agreeing to a renal transplantation. Prior to the procedure he suffered from lymphadenopathy due to peritonitis. This complication became an obstacle as it prevented vascular access to the iliac artery and vein. An extensive lymphadenectomy had to be performed before continuing with the procedure. Nevertheless, the procedure was carried out successfully. Iliac lymphadenopathy as a result of peritonitis due to CAPD could become a challenge during renal transplantation if it hindered vascular access during anastomosis.

SUBMITTER: Duarsa GWK

PROVIDER: S-EPMC6484279 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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An unusual case of lymphadenopathy due to Continuous Ambulatory Peritoneal Dialysis becomes a challenge during renal transplantation.

Duarsa Gede Wirya Kusuma GWK Gede Oka Anak Agung AA Santosa Kadek Budi KB Yudiana I Wayan IW Tirtayasa Pande Wisnu PW Kloping Yudhistira Pradnyan YP

Urology case reports 20190411

A 31-year-old male was diagnosed with Stage V Chronic Kidney Disease and treated with Continuous Ambulatory Peritoneal Dialysis (CAPD) for five years before agreeing to a renal transplantation. Prior to the procedure he suffered from lymphadenopathy due to peritonitis. This complication became an obstacle as it prevented vascular access to the iliac artery and vein. An extensive lymphadenectomy had to be performed before continuing with the procedure. Nevertheless, the procedure was carried out ...[more]

PMID: 31049288

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Project description:IntroductionThe impact of peritoneal dialysis modality on patient survival and peritonitis rates is not fully understood, and no large-scale randomized clinical trial (RCT) is available. In the absence of a RCT, the use of an advanced matching procedure to reduce selection bias in large cohort studies may be the best approach. The aim of this study is to compare automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) according to peritonitis risk, technique failure and patient survival in a large nation-wide PD cohort.MethodsThis is a prospective cohort study that included all incident PD patients with at least 90 days of PD recruited in the BRAZPD study. All patients who were treated exclusively with either APD or CAPD were matched for 15 different covariates using a propensity score calculated with the nearest neighbor method. Clinical outcomes analyzed were overall mortality, technique failure and time to first peritonitis. For all analysis we also adjusted the curves for the presence of competing risks with the Fine and Gray analysis.ResultsAfter the matching procedure, 2,890 patients were included in the analysis (1,445 in each group). Baseline characteristics were similar for all covariates including: age, diabetes, BMI, Center-experience, coronary artery disease, cancer, literacy, hypertension, race, previous HD, gender, pre-dialysis care, family income, peripheral artery disease and year of starting PD. Mortality rate was higher in CAPD patients (SHR1.44 CI95%1.21-1.71) compared to APD, but no difference was observed for technique failure (SHR0.83 CI95%0.69-1.02) nor for time till the first peritonitis episode (SHR0.96 CI95%0.93-1.11).ConclusionIn the first large PD cohort study with groups balanced for several covariates using propensity score matching, PD modality was not associated with differences in neither time to first peritonitis nor in technique failure. Nevertheless, patient survival was significantly better in APD patients.

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An unusual case of lymphadenopathy due to Continuous Ambulatory Peritoneal Dialysis becomes a challenge during renal transplantation.

Publications

An unusual case of lymphadenopathy due to Continuous Ambulatory Peritoneal Dialysis becomes a challenge during renal transplantation.

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