I have a patient who was maintained successfully on CAPD for 9 months and a huge inguinal hernia developed that prevent the continuation of the PD. We stopped dialysis and surgical correction of the hernia was done. When can we restart the PD? and is the CCPD a better option than the CAPD to prevent any strain on the new scar while ambulant?

Questions About PD

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Hala El-Wakil, Doctor/MD from Alexandria-Egypt asked
I have a patient who was maintained successfully on CAPD for 9 months and a huge inguinal hernia developed that prevent the continuation of the PD. We stopped dialysis and surgical correction of the hernia was done. When can we restart the PD? and is the CCPD a better option than the CAPD to prevent any strain on the new scar while ambulant?

1 answer

There is no reason for the patient to be maintained on temporary HD and there is no reason. Please see the recommendations in a paper from Canada (Shah et al, Perit Dial Int 2006; 26: 684-7)

• Continue on standard PD therapy until the morning of surgery
• Drain the PD fluid prior to the surgery
• No dialysis for the first 48 hours
• Laboratory investigation at start of IPD and weekly
• IPD 3 times per week (1-L exchange ×10 for 10 hours) for 2 weeks for CAPD patients and for 1 week for CCPD patients
• CAPD patients resume low volume (1–1.5 L × 5 exchanges for 2 weeks)
• CCPD patients to continue on NIPD for 4 more weeks
• All patients resume preoperative PD prescription after 4–5 weeks

Hope this helps.

#1

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