Does temporary transfer to preoperative hemodialysis influence postoperative outcomes in patients on peritoneal dialysis? A retrospective cohort study

Frontiers in Surgery

Surgery

Pengyuan Wang¹  Yuyang Zhang¹  Zeyang Chen¹  Qingqing Zhou²  Jie Dong² 

[1] Department of General Surgery, Peking University First Hospital, Beijing, Republic of China;Renal Division, Department of Medicine, Peking University First Hospital, Beijing, Republic of China;

关键词: end-stage renal disease;    hemodialysis;    peritoneal dialysis;    surgery;    preoperative dialysis;    peri-operative management;   

DOI  :  10.3389/fsurg.2022.1056908

 received in 2022-09-29, accepted in 2022-11-23,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe associations between preoperative transfer to hemodialysis (HD) and postoperative outcomes in patients on chronic peritoneal dialysis (PD) remain unknown. We conducted this retrospective cohort study to investigate whether preoperative HD could influence surgical outcomes in PD patients undergoing major surgeries.MethodsAll chronic PD patients who underwent major surgeries from January 1, 2007, to December 31, 2020, at Peking University First Hospital were screened. Major surgery was defined as surgical procedures under general, lumbar or epidural anesthesia, with more than an overnight hospital stay. Patients under the age of 18, with a dialysis duration of less than 3 months, and those who underwent renal implantation surgeries and procedures exclusively aimed at placing or removing PD catheters were excluded. Patients involved were divided into either HD or PD group based on their preoperative dialysis status for further analysis.ResultsOf 105 PD patients enrolled, 65 continued PD, and 40 switched to HD preoperatively. Patients with preoperative HD were significantly more likely to develop postoperative hyperkalemia. The total complication rates were numerically higher in patients undergoing preoperative HD. After adjustment, the incidence of postoperative hyperkalemia or any other postoperative complication rates were similar between groups. There were no differences in long-term survival between the two groups.ConclusionsIt does not seem indispensable for PD patients to switch to temporary HD before major surgeries.

【 授权许可】

Unknown   
© 2023 Zhang, Zhou, Chen, Dong and Wang.