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Gastrointestinal Non-Infectious Complications in Patients on Peritoneal Dialysis


Gastrointestinal complications are common among patients on peritoneal dialysis. Risk factors for the development of gastrointestinal complications in this patient population include: toxic effects of uremic toxins, frequent use of nonsteroidal anti-inflammatory drugs, Helicobacter pylori infection, angiodysplasia, increased intra-abdominal pressure, use of bioincompatible solution for peritoneal dialysis, increased glucose in solutions for peritoneal dialysis, secondary hyperparathyroidism (hypercalcemia), a disorder of lipid metabolism (hypertriglyceridemia), and the duration of peritoneal dialysis treatment. The most important non-infectious gastrointestinal complications in patients on peritoneal dialysis are: gastrointestinal bleeding, herniation and leaking of the dialysate from the abdomen (increased intra-abdominal pressure), impaired lung function (intra-abdominal hypertension), acute pancreatitis, and encapsulating sclerosis of the peritoneum. Intra-abdominal hypertension is defined as IAP ≥ 12 mmHg. Pouring the peritoneal dialysis solution leads to increased intra-abdominal pressure, which results in the development of hernias, pleuro-peritoneal dialysate leakage (hydrothorax), and restrictive pulmonary dysfunction. Risk factors for the development of acute pancreatitis in this patient population include: uraemia, secondary hyperparathyroidism with hypercalcemia, hypertriglyceridemia, features of the peritoneal dialysis solution (osmolarity, acidity, glucose, chemical irritation, and calcium in the solution for peritoneal dialysis lead to “local hypercalcemia”), toxic substances from the dialysate, the bags and tubing, and peritonitis and treatment of peritonitis with antibiotics and anticoagulants. Encapsulating sclerosis of the peritoneum is rare and is the most serious complication of long-term peritoneal dialysis. It is characterized by thickening of the peritoneum, including cancer, and signs and symptoms of obstructive ileus. Diagnosis is based on clinical, laboratory and radiological parameters. Encapsulating sclerosis of the peritoneum can be indicated by an AR-CA-125 concentration of less than 33 U/min and a concentration of AR-IL-6 greater than 350 pg/min in the effluent of patients with ultrafiltration weakness. Treatment consists of stopping peritoneal dialysis, using anti-inflammatory (corticosteroids) and anticicatricial drugs (tamoxifen), while surgical treatment includes enterolysis and adhesiolysis.

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Ibuprofen, a Potential Cause of Acute Hemorrhagic Gastritis in Children - A Case Report

;8:105–18. 8. Rafaniello C, Ferrajolo C, Sullo MG et al. Risk of gastrointestinal complications associated to NSAIDs, low-dose aspirin and their combinations: Results of a pharmacovigilance reporting system. Pharmacol Res. 2016;104:108–14. 9. Cardile S, Martinelli M, Barabino A et al. Italian survey on non-steroidal anti-inflammatory drugs and gastrointestinal bleeding in children. World J Gastroenterol. 2016;22:1877–83. 10. Lanza FL, Chan FKL, Quigley EMM, Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of

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Severe Renal Function Impairment in Adult Patients Acutely Poisoned with Concentrated Acetic Acid

Acetic acid is a widely used organic acid with corrosive properties that depend on its concentration. If acetic acid is ingested in concentrations above 30 % it may severely damage the upper gastrointestinal tract and cause intravascular haemolysis, which can result in severe kidney and liver disorders and disseminated intravascular coagulation. In this retrospective study, we analysed acetic acid ingestion data collected at the University Clinic for Toxicology of Skopje, Macedonia from 1 January 2002 to 31 December 2011. The analysis included systemic complications, kidney damage, and the outcomes in particular. Over the ten years, 84 patients were reported at the Clinic to have ingested highly concentrated acetic acid. Twenty-eight developed kidney disorders, while the remaining 56 had no complications. Fatal outcome was reported for 11 patients, seven of whom had systemic complications and four severe gastrointestinal complications.

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Rare Immunodeficiency In A Two-Months-Old Infant

N, et al. - Retroviral-mediated gene transfer of gp91phox into bone marrow cells rescues defect in host defense against Aspergillus fumigatus in murine X-linked chronic granulomatous disease. Blood. Jan 1 1997;89(1):41-8. [Medline]. 5. BARTON LL, MOUSSA SL, VILLAR RG, HULETT RL. - Gastrointestinal complications of chronic granulomatous disease: case report and literature review. Clin Pediatr (Phila). Apr 1998;37(4):231-6. [Medline]. 6. JESSICA S. KOSUT, MD; NAYNESH R. KAMANI, MD; BARBARA A. JANTAUSCH,MD. - One-Month-Old Infant With

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The Placement of Post-pyloric Feeding Tubes Using DRX-Revolution Mobile X-Ray System in an ICU. A Case Series

the efficacy and gastrointestinal complications of early jejunal feeding with early gastric feeding in critically ill patients. Crit Care Med. 2002;30:796-800. 4. Stone SJ, Pickett JD, Jesurum JT. Bedside placement of postpyloric feeding tubes. AACN Clin Issues. 2000;11:517-30. 5. Lenart S, Polissar NL. Comparison of 2 methods for postpyloric placement of enteral feeding tubes. Am J Crit Care. 2003;12:357-60. 6. Aguilar-Nascimentoa JE, Kudsk KA. Use of small-bore feeding tubes: successes and failures. Current Opinion

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Prevalence, sources and purpose of self-prescribed non-opioid analgesic among health professionals in Sokoto metropolis, Nigeria: a cause for concern

Health Care 2003; 5. Singh G. Recent considerations in nonsteroidal anti-inflammatory drug gastropathy. Am J Med 1998; 105(1B):31S-38S. 6. Garcia Rodriguez LA, Hernandez-Diaz S. Relative risk of upper gastrointestinal complications among users of acetaminophen and NSAIDs. Epidemiol. 2001;12:570-6. 7. Hussain A, Khanum A. Self-medication among university student of Islamabad, Pakistan; A preliminary study. Southern Med Review 2008;1(1):14-6. 8. Patil SB, Vardhamane SH, Patil BV, Santoshkumar J, Binjawadgi AS, Kanaki AR. Self-medication practice

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Implementation and evaluation of adverse drug reaction monitoring system in a tertiary care teaching hospital in Mumbai, India

-1096. Singh G, Triadafilopoulos G (1999). Epidemiology of NSAIDs induced gastrointestinal complications. J Rheumatol 56 : 18-24. Suh DC, Woodall BC, Shin SK, Shin SK, Hermes-De Santis ER. (2000). Clinical and economic impact of adverse drug reactions in hospitalized patients. Ann Pharmacother 34 : 1373-1378. Taylor D, Clark DW, Dovey SM, Tilyard MW. (1994). The prescribing and adverse reactions of non-steroidal anti-inflammatory drugs in general practice. A Dunedin study. NZ Med J 107 : 263-266. Uppal R, Jhaj R, Melhotra

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Obesity Treatment Strategies

European Journal of Obesity. 2008;1(2):106–116. 12. Abell TL, Minocha A. Gastrointestinal complications of bariatric surgery: diagnosis and therapy. Am J Med Sci. 2006;331(4):214–218. 13. Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet. 2010;375:1737-1748. 14. Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB. Annual deaths attributable to obesity in the United States. JAMA. 1999;282(16):1530–1538. 15. Barness LA, Opitz JM, Gilbert-Barness E. Obesity: genetic, molecular, and environmental aspects. Am J Med Genet. 2007;143A(24

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Artificial Nutrition in Therapeutic Approach of Acute Caustic Poisonings

-blind study comparing the efficacy and gastrointestinal complications of early jejunal feeding with early gastric feeding in critically ill patients. Crit Care Med. 2002;30(4):796-800. doi:10.1097/00003246-200204000-00013 PMID:11940748. Jabbar A, Mc Clave S. Pre-pyloric versus post-pyloric feeding. Clin Nutr. 2005;24(5):719-726. doi:10.1016/j.clnu.2005.03.003 PMID:16143431. Alinejad A. Caustic injury to upper gastrointestinal tract, Shiraz university of medical sciences, Depertment of Internal medicine. 2000

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Helicobacter pylori infection in HIV-positive patients with digestive complaints

epidemiology of Helicobacter pylori infection. Helicobacter. 2013 Sep;18(s1):5-11. DOI: 10.1111/hel.12071 16. Bhaijee F, Subramony C, Tang SJ, Pepper DJ. Human immunodeficiency virus-associated gastrointestinal disease: common endoscopic biopsy diagnoses. Patholog Res Int. 2011 Apr;2011:247923. DOI: 10.4061/2011/247923 17. Wilcox CM, Saag MS. Gastrointestinal complications of HIV infection: changing priorities in the HAART era. Gut. 2008 Jan;57:861-70. DOI: 10.1136/ gut.2006.103432 18. Malfertheiner P, Chan F, McCall K. Peptic

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