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PD Abdominal Hernia — ESENeph MCQ

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EasyPeritoneal DialysisPD Abdominal HerniaESENeph

A 60-year-old man on PD develops abdominal wall hernia after 2 years of PD. It is increasing in size and causing discomfort. His PD is otherwise working well. What is the management?

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Correct answer: C — Surgical hernia repair; temporarily reduce PD exchange volumes or switch to temporary HD perioperatively

Abdominal wall hernias are a complication of PD due to increased intra-abdominal pressure from dialysate. Surgical repair is indicated for symptomatic or enlarging hernias. Perioperatively, PD exchange volumes should be reduced or PD temporarily suspended (with temporary HD cover if needed). After surgical repair, PD can usually be resumed with low-volume supine exchanges initially, gradually increasing over 2-4 weeks. Laparoscopic repair allows earlier return to PD.

Reference: ISPD 2017 – PD Complications; UKKA 2017 – PD Guideline