Patient characteristics associated with defects of the peritoneal cavity boundary.

Background: Conflicting literature exist regarding the patient characteristics that may confer an increased risk for anatomic complications of the peritoneal cavity boundaries.

Methods: We collected data from 75 randomly selected units in the United States and Canada, representing a total of 1864 peritoneal dialysis (PD) patients.

Results: 200 of these patients experienced a total of 217 anatomic complications between July 2000 and June 2001; 16 patients had more than 1 complication. Hernias comprised 60.4% of all complications: 24.9% inguinal, 18.9% umbilical, 13.8% ventral, 2.3% femoral, and 0.5% intrathoracic. Other complications included pericatheter or subcutaneous leak (25.3%), hydrothorax (6.0%), and miscellaneous (8.3%). Peritoneal dialysis modalities in use at the time of complication were automated PD (52.3%), continuous ambulatory PD (38.6%), and nocturnal intermittent PD (9.1%). The overall incidence of hernias was 7%.

Conclusions: Logistic regression analysis found no association between hernias and age, body surface area, PD modality, volume of dialysate, time of largest dwell (day/upright vs night/recumbent), or type of catheter used. Cystic disease conferred a 2.5-fold increase in risk for anatomic complications (p < 0.001); female gender conferred an 80% reduction in risk (p < 0.0001), and Kt/V > or = 2.0 conferred a 52% reduction in risk (p < 0.05) for hernia.