Deceptive air: Unravelling pseudo-peritonitis in peritoneal dialysis patients-A diagnostic challenge.

Pneumoperitoneum, or free air in the peritoneal cavity, typically indicates visceral organ perforation requiring urgent surgical intervention. In peritoneal dialysis (PD) patients, however, it can occur without prior surgery or trauma, often due to technical errors, and may mimic peritonitis, risking misdiagnosis and unnecessary treatment. We report a case of a 73-year-old male PD patient presenting with fever, abdominal pain, and bowel ileus, initially raising concerns for organ perforation due to pneumoperitoneum. A comprehensive diagnostic workup and history taking, including molecular testing, excluded infections and chemical causes such as icodextrin, drugs, bile, faeces, blood, and malignancy. The cause was traced to improper PD technique, specifically a lapse in the 'flush-before-fill' method. Conservative management and retraining led to full symptom resolution and disappearance of the free air. This case highlights the importance of thorough diagnostic evaluations to rule out serious causes of pneumoperitoneum in PD patients, emphasizing the role of proper PD technique and patient education in preventing complications. Pneumoperitoneum in PD patients can mimic peritonitis, posing a diagnostic challenge. Comprehensive evaluation and adherence to proper PD practices are essential to avoid unnecessary interventions.

被引量：- 发表：2025

Structures for quality assurance and measurements for kidney replacement therapies: A multinational study from the ISN-GKHA.

Optimal care for patients with kidney failure reduces the risks of adverse health outcomes, including cardiovascular events and death. We evaluated data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to assess the capacity for quality service delivery for kidney failure care across countries and regions. We explored the quality of kidney failure care delivery and the monitoring of quality indicators from data provided by an international survey of stakeholders from countries affiliated with the ISN from July to September 2022. One hundred and sixty seven countries participated in the survey, representing about 97.4% of the world's population. In countries where haemodialysis (HD) was available, 81% (n = 134) provided standard HD sessions (three times weekly for 3-4 h per session) to patients. Among countries with peritoneal dialysis (PD) services, 61% (n = 101) were able to provide standard PD care (3-4 exchanges per day). In high-income countries, 98% (n = 62) reported that >75% of centers regularly monitored dialysis water quality for bacteria compared to 28% (n = 5) of low-income countries (LICs). Capacity to monitor the administration of immunosuppression drugs was generally available in 21% (n = 4) of LICs, compared to 90% (n = 57) of high-income countries. There was significant variability between and within regions and country income groups in reporting the quality of services utilized for kidney replacement therapies. Quality assurance standards on diagnostic and treatment tools were variable and particularly infrequent in LICs. Standardization of delivered care is essential for improving outcomes for people with kidney failure.

被引量：- 发表：1970

Severe hypertension in tuberous sclerosis complex caused by renal artery stenosis: A case report.

被引量：- 发表：1970

Central venoplasty followed by 'double guidewire railroad technique' as a bailout strategy in difficult tunnelled dialysis catheter insertion.

被引量：- 发表：1970

Trends of bone mineral density and bone quality in a paediatric kidney transplant recipient: A case report.

被引量：- 发表：1970