ESPN 51th Annual Meeting

ESPN 2018


 
THE EFFECT OF CLEAN INTERMITTENT CATHETERIZATION ON INTRAPERITONEAL PRESSURE IN PERITONEAL DIALYSIS PATIENTS WITH NEUROPATHIC BLADDER
ERKIN SERDAROGLU 1 AYSEN TOKTAY 1 SUKRAN KESKIN GOZMEN 1

1- UNIVERSITY OF HEALTH SCIENCES DR. BEHCET UZ CHILDREN’S HOSPITAL DEPARTMENT OF PEDIATRIC NEPHROLOGY
 
Introduction:

Neuropathic bladder (NB) is frequent cause of chronic renal disease in children. Clean intermittent catheterization (CIC) is standard treatment of NB. Peritoneal dialysis (PD) is the one of treatment choice of renal replacement treatments. Intraperitoneal pressure (IPP) is related with fluid and solute transport and mechanical complications in PD. In this study, we aimed to determine relationship between IPP and CIC in children on PD.

Material and methods:

Six cases with NB secondary to myelomeningocele whose are on PD and CIC treatments were evaluated. IPP were measured using the Durand’s method in upright, sitting and supine positions before CIC.  Intravesical pressure and urine volume were measured using by urinary catheter and IPP measurements were repeated with empty bladder.

Results:

A total of six cases (5 male) were included in the study. The IPP was found 8.2±3.1 (median 8), 18.8±4.2 (median 18) and 22.9±4.3 (median 22.5) cmH2O while supine, upright and sitting positions respectively. Mean urine volume and intravesical pressure was 195±143 ml (median 200) and 10.6±6.3 (median 8.5) mmH2O. Mean IPP with empty bladder after CIC was 6.2±2.3 (median 6) cmH2O. The mean IPP value after CIC decreased by 1.9±1.6 cmH2O and the difference was found to be statistically significant (p=0.042). In the supine position, IPP before CIC was correlated with IPP after CIC (r=0.92) and urine volume discharged with CIC (r=0.62). Intravesical pressure measurements were negatively correlated with IPP before (r=-0.70) and after CIC (r=-0.70). Urine volumes were correlated with IPP before CIC on upright position (r=0.921), sitting position (r=0.667) and supine position (r=0.616).

Conclusions:

IPP measurements are important when PD prescribing and preventing mechanical complications. Failure to discharge the bladder periodically and completely may results with increase of IPP in patients with NB. Emptying bladder regularly and fully with CIC may help us to the control high IPP in patients with NB.