Indication of change of renal replacement therapy from peritoneal dialysis to chronic hemodialysis in patients of a second-level hospital.

Abstract

Introduction: The Mexicas Institute of Social Security (IMSS) has registered more than 60 thousand patients in renal replacement therapy (RRT): 41.7% in hemodialysis programs and 58.3% in peritoneal dialysis (PD). This observational study describes the etiologies of the change from renal replacement therapy from peritoneal dialysis to hemodialysis in a group of patients in a second-level hospital in Mexico City.

Methods: The present observational study was conducted at the Regional General Hospital Number 1, "Dr. Carlos Mac Gregor Sánchez Navarro," of the IMSS, from February 2017 to March 2019. Patients with RRT with PD were included. Descriptive population variables and the etiology of the RRT change were determined. The sample was non-probabilistic. A univariate analysis is performed with measures of central tendency, frequencies, and percentages.

Results: 122 patients were included, 57.38% men, 54.57 ± 15.6 years of age. 57.38% remained on PD for more than one year. 90.16% had a family support network, and 52.46% had primary schooling. The average number of days of stay was 9.59 days. The primary etiology of the change in RRT was peritonitis, complex abdominal surgery (19.7%), adhesions and peritoneal sclerosis (19.67%), low-efficiency dialysis (16.39%), and wall defects or pleural communication (11.48%).

Conclusions: Infection of the peritoneal cavity and loss of peritoneal function were the leading causes of change in RRT.