Can Patients with Ventriculoperitoneal Shunts Undergo Peritoneal Dialysis?

Q: Can Patients with Ventriculoperitoneal Shunts Undergo Peritoneal Dialysis?

Hello： The ventricular-peritoneal shunt is a drainage system that involves placing a catheter from the ventricles of the brain into the peritoneal cavity, allowing cerebrospinal fluid to drain from the ventricles into the abdominal cavity. <br>Peritoneal dialysis is performed by

Can a patient with a ventriculoperitoneal shunt undergo peritoneal dialysis treatment?

Hello doctor, my family member had a car accident two years ago and has a ventriculoperitoneal shunt.
Recently, their kidney function has worsened and they need dialysis treatment.
I saw online that peritoneal dialysis can be done at home.
Is this suitable for them? Thank you.

Xiao Fen, 40~49 year old female. Ask Date: 2022/02/19

Dr. Zhao Shaoqing reply Neurosurgery

Hello: The ventricular-peritoneal shunt is a drainage system that involves placing a catheter from the ventricles of the brain into the peritoneal cavity, allowing cerebrospinal fluid to drain from the ventricles into the abdominal cavity.
Peritoneal dialysis is performed by inserting a catheter into the peritoneal cavity and utilizing the peritoneum as a membrane for the exchange of fluids.
In cases of intra-abdominal infection, it can be challenging to determine the exact cause of the infection, and there is a risk that an intra-abdominal infection could worsen a retrograde infection in the brain.
Therefore, it is not recommended to pursue this at Changhua Hospital.

Reply Date: 2022/02/19

More Info

When considering whether patients with ventriculoperitoneal (VP) shunts can undergo peritoneal dialysis (PD), several important factors must be taken into account. A VP shunt is a medical device used to treat conditions such as hydrocephalus by draining excess cerebrospinal fluid (CSF) from the ventricles of the brain to the peritoneal cavity. This procedure can complicate the use of peritoneal dialysis, which also utilizes the peritoneal cavity for fluid exchange.

1. Risk of Infection: One of the primary concerns with performing peritoneal dialysis in patients with a VP shunt is the increased risk of infection. The presence of the shunt creates a potential pathway for bacteria to enter the peritoneal cavity, which could lead to peritonitis, a serious infection of the peritoneum. Patients with a history of infections related to their shunt may be at an even higher risk.

2. Shunt Functionality: It is crucial to assess the functionality of the VP shunt before considering peritoneal dialysis. If the shunt is functioning properly and there are no signs of obstruction or infection, it may be possible to proceed with PD. However, any signs of shunt malfunction or complications should be addressed prior to initiating dialysis.

3. Fluid Management: The volume of fluid used in peritoneal dialysis must be carefully managed. Excessive fluid can lead to increased intracranial pressure, especially in patients with a VP shunt. Therefore, the dialysis regimen may need to be adjusted to ensure that the patient does not experience adverse effects.

4. Consultation with Specialists: It is essential for patients with a VP shunt to consult both a nephrologist and a neurosurgeon before starting peritoneal dialysis. These specialists can evaluate the risks and benefits based on the patient's overall health, kidney function, and the status of the VP shunt.

5. Alternative Dialysis Options: If peritoneal dialysis is deemed too risky, hemodialysis may be considered as an alternative. Hemodialysis does not involve the peritoneal cavity and may be a safer option for patients with a VP shunt.

6. Home Dialysis Considerations: One of the advantages of peritoneal dialysis is the ability to perform it at home, which can be convenient for patients. However, the potential complications associated with having a VP shunt must be carefully weighed against this convenience.

In conclusion, while it is possible for patients with ventriculoperitoneal shunts to undergo peritoneal dialysis, it requires thorough evaluation and careful management to mitigate risks. The decision should be made collaboratively by the healthcare team, considering the patient's specific medical history and current health status. It is crucial to prioritize safety and ensure that any potential complications are addressed before proceeding with dialysis treatment.

Similar Q&A

Understanding the Lifespan and Risks of Ventriculoperitoneal Shunt Systems

Hello Dr. Chang, my mother is currently 57 years old. At the end of 2015, she underwent surgery for a cerebral hemorrhage at Linkou Chang Gung Memorial Hospital, where a cerebral aneurysm was clipped to remove the problematic blood vessel. Due to the cerebral hemorrhage, she deve...

Dr. Zhang Junwei reply Neurosurgery
Basically, the likelihood of damage to the ventricular-peritoneal shunt system is low, but there is a possibility of incorrect pressure or blockage. Please visit the neurosurgery outpatient clinic for a physician evaluation.

Managing Peritoneal Dialysis-Related Peritonitis: A Patient's Journey

Hello Dr. Yang, About six years ago, I started peritoneal dialysis due to chronic kidney failure. The past six years have gone quite smoothly, and I have been very attentive to cleanliness and hygiene. However, at the end of last year, I experienced abdominal pain and cloudy di...

Dr. Yang Zhongwei reply Internal Medicine
Hello: The biggest enemy of peritoneal dialysis (PD) is peritonitis. Generally, it can be resolved with antibiotic infusion treatment; however, there are certain situations where catheter removal and conversion to hemodialysis (HD) are necessary. For instance, in cases of fungal ...

Post-Operative Overdrainage in Ventriculoperitoneal Shunt Surgery

Hello Doctor: My father underwent a ventriculoperitoneal shunt surgery at National Taiwan University Hospital over a year ago due to a diagnosis of hydrocephalus. Recently, he exhibited symptoms similar to dementia and went to Renai Hospital for a CT scan, which showed excessive ...

Dr. Qiu Yushu reply Neurosurgery
Hello: There is a possibility of excessive drainage with ventricular-peritoneal shunting (though it is rare). It is advisable to replace it with a drainage device that has a different (higher) pressure setting (there are three types of external drainage device pressures). It is b...

Post-Operative Care for Ventriculoperitoneal Shunt Surgery: FAQs

Hello, doctor. I have undergone ventriculoperitoneal shunt surgery, and since the catheter passes through my neck, I would like to ask if turning my head or frequently shaking my head in daily life could cause the catheter to displace or break. Thank you.

Dr. Jiang Junyi reply Neurology
Hello: Ventriculoperitoneal shunt surgery is performed when there is an excessive production of cerebrospinal fluid or when the pathways are obstructed, leading to an accumulation of cerebrospinal fluid in the brain, resulting in hydrocephalus. This shunt surgery diverts the cere...