Diagnóstico y manejo de la isquemia intestinal en enfermos renales crónicos sometidos a diálisis peritoneal. Revisión bibliográfica

Abstract

Introduction: Intestinal mesenteric ischemia is a condition with high morbidity and mortality rates, leading to significant healthcare costs. Chronic renal patients requiring peritoneal dialysis are at higher risk of developing atherosclerosis and hypotensive episodes that may result in reduced intestinal perfusion and subsequent mesenteric ischemia. Methodology: A narrative literature review was conducted on the diagnosis and management of intestinal ischemia in chronic renal patients undergoing peritoneal dialysis. Information was extracted from various scientific databases such as PubMed, Scielo, Cochrane Library, and Science Direct, using the PRISMA strategy. Results: The most common etiology of mesenteric ischemia in patients undergoing peritoneal dialysis is venous thrombosis secondary to the dialysis procedure and non-occlusive mesenteric ischemia due to vasoconstriction. A comprehensive anamnesis should be performed in patients with peritoneal dialysis and abdominal pain to rule out acute ischemic processes. If surgery is required, laparotomy with anesthetic block of the transverse plane should be considered. Endovascular resolution should be prioritized in patients with mesenteric ischemia and peritoneal dialysis. Conclusions: Mesenteric ischemia in patients undergoing peritoneal dialysis is a condition with low prevalence and incidence but high morbidity and mortality. Therefore, it is necessary to develop protocols for timely management since delayed diagnosis doubles its morbidity and mortality. In cases where endovascular therapy is not available, patients should be referred to a specialized center for prompt management