HERNIA DEVELOPMENT IN CAPD PATIENTS AND THE EFFECT OF 2.5 1 DIALYSATEVOLUME IN SELECTED PATIENTS

The aim of this study was to estimate the prevalence of hernia formati on in CAPD patients and to study the effect of increased dialysate vol ume (2.5 1) in selected population of patients who could tolerate it. We reviewed the charts of 454 individuals treated with CAPD in our cen ter during a five-year period (September 1991-September 1996). Out of 404 patients who used 2.0 1 dialysate exchange volume forty-nine(11%) developed hernia (umbilical 53%, inguinal 33%, incisional 14%) after h aving been on CAPD for an average of 10 +/- 11 months, while only one of the 50 patients who would tolerate 2.5 1 developed a hernia (inguin al 2%), after having been on CAPD for 12 months. All hernias were repa ired surgically and most of the patients returned to CAPD after tempor ary intermittent peritoneal dialysis. Age, sex, nutritional status, po lycystic kidneys, and diabetes do not seem to be predisposing factors for hernia formation, while previous operation for aortic abdominal an eurysm repair, or low body weight (<60 kg) were risk factors. The use of increased dialysate volume (2.5 1) in patients who could tolerate i t, did not result in a higher frequency of hernia development. Surpris ingly, patients with hernias seem to have a higher mortality than thos e without.