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Sample records for automated peritoneal dialysis

  1. Automated peritoneal dialysis in Brunei Darussalam.

    Directory of Open Access Journals (Sweden)

    Ishrat KAMAL

    2011-04-01

    Full Text Available Introduction: Chronic kidney disease in Brunei Darussalam is a growing problem. The number of patients reaching end stage kidney failure has increased dramatically in the last ten years. Currently, most are managed with haemodialysis while a smaller proportion is managed with continuous ambulatory peritoneal dialysis (CAPD. Automated peritoneal dialysis (APD is a form of peritoneal dialysis and has been used in Brunei Darussalam since May 2008. Materials and Methods: Eight patients participated in this prospective clinical trial. As all APD patients were previously on CAPD, comparisons are made between the outcomes of APD against CAPD. Results: The median and mean age of APD patients were 42 and 45.5 ± 12.73 years respectively. After switching to APD, the serum haemoglobin and albumin improved from 10.56 ± 1.95 gm/L and 27.88 ± 7.71 gm/dL to 12.26 ± 1.82 gm/L and 33.63 ± 6.89 gm/dL respectively (p values <0.05. This corresponded to improvements in seven (87.5% and six (75% patients respectively in both parameters. Erythropoietin requirement was reduced in six (75% patients, including three (37.5% patients who were able to stop erythropoietin completely. There was no peritonitis encountered. All patients reported improved quality of life with better sleep, appetite and general well-being. Conclusions: Our study showed that APD was as good as CAPD with improvement seen in both laboratory and quality of life parameters. There was also reduction in erythropoietin requirement. Based on these findings, we will actively encourage and promote APD usage as oppose to CAPD usage in our population.

  2. Patients in assisted automated peritoneal dialysis develop strategies for selfcare

    DEFF Research Database (Denmark)

    Holch, Kirsten

      Patients in Assisted Automated Peritoneal Dialysis develop strategies for self-care Background: Since 2000 a model for Assisted Automated Peritoneal Dialysis (AAPD) in the patients own home has been developed at Aarhus University Hospital, Skejby. The patient group consists of physically...... or mentally frail elderly needing chronic dialysis treatment. The patient group cannot manage the technical aspects of dialysis and is thus assisted by primary care staff. No previous studies have been made on the perceptions, experiences and needs of AAPD patients. Objectives To  Explore and describe How do...

  3. Sleep disorders in patients with end-stage renal disease undergoing dialysis: comparison between hemodialysis, continuous ambulatory peritoneal dialysis and automated peritoneal dialysis.

    Science.gov (United States)

    Losso, Ricardo L M; Minhoto, Gisele R; Riella, Miguel C

    2015-02-01

    Sleep disorders for patients on dialysis are significant causes of a poorer quality of life and increased morbidity and mortality. No study has evaluated patients undergoing automated peritoneal dialysis (APD) to assess their sleep disorders compared to hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). A total of 166 clinically stable patients who had been on dialysis for at least 3 months were randomly selected for the study and divided into HD, CAPD or APD. Socio-demographic, clinical and laboratory parameters and self-administered questionnaires were collected for the investigation of insomnia, restless legs syndrome (RLS), bruxism, rapid eye movement sleep behavior disorder, excessive daytime sleepiness (EDS), obstructive sleep apnea syndrome (OSAS), sleepwalking, sleep hygiene, depression and anxiety. Insomnia was detected in more than 80 % of patients on the three modalities. OSAS was lower for patients on HD (36 %) than on CAPD (65 %) (p sleepwalking, sleep hygiene, depression or anxiety. ESRD patients undergoing any one of the three dialysis modalities studied had a high prevalence of sleep disorders. Patients on HD had a lower proportion of OSAS than those on CAPD and APD, which is most likely attributed to their lower body mass indices. The possible causes of higher RLS rates in APD patients have not been established. PMID:25358390

  4. Psychosocial aspects of children and families of children treated with automated peritoneal dialysis

    OpenAIRE

    Kiliś-Pstrusińska, Katarzyna; Wasilewska, Anna; Medyńska, Anna; Bałasz-Chmielewska, Irena; Grenda, Ryszard; Kluska-Jóźwiak, Agnieszka; Leszczyńska, Beata; Olszak-Szot, Ilona; Miklaszewska, Monika; Szczepańska, Maria; Tkaczyk, Marcin; Urzykowska, Agnieszka; Zachwieja, Katarzyna; Zajączkowska, Maria; Ziółkowska, Helena

    2013-01-01

    Background The aim of this study was to analyze psychosocial aspects of chronic kidney disease (CKD) in children treated with automated peritoneal dialysis (APD). Methods The study assessed 41 children > 2  (range 2.1–18) years of age and their parents. Data concerning the illness and sociodemographic parameters were collected. Patients completed the Paediatric Quality of Life Inventory (PedsQL) and their parents the PedsQL-proxy version, General Health Questionnaire (GHQ-12), Berlin Social S...

  5. Patients in assisted automated peritoneal dialysis develop strategies for self-care

    DEFF Research Database (Denmark)

    Holch, Kirsten

    2008-01-01

      Background Since 2000, a model for Assisted Automated Peritoneal Dialysis (aAPD) for patients in their own home needing chronic dialysis treatment has been developed at Aarhus University Hospital, Skejby, Denmark. The patient group consists of physically or mentally frail elderly who cannot...... manage the technical aspects of dialysis and are thus assisted by primary care staff. No previous studies have been made on the perceptions, experiences and needs of aAPD patients.   Objectives Explore and describe How do patients experience aAPD treatment? What are their needs? How do patients meet...... people develop their own strategies for adapting aAPD to the way they have met their needs in their own home. The patients experience the treatment as part of the every day life and show increasing creativity to find solutions to satisfy their needs. Technical assistance concerning dialysis makes...

  6. Peritoneal dialysis in Asia.

    Science.gov (United States)

    Cheng, I K

    1996-01-01

    The socioeconomic status of Asian countries is diverse, and government reimbursement policies for treatment of patients suffering from end-stage renal disease (ESRD) vary greatly from one country to another. Both of these factors have a major impact not only on the choice of treatment for ESRD but also on the utilization of peritoneal dialysis (PD) in this region. Based on the data collected from 11 representative Asian countries, several observations can be made. First, the treatment rates for ESRD in these countries correlated closely with their gross domestic product (GDP) per capita income. Second, the PD utilization rate appeared to have a biphasic relationship with the GDP per capita income and treatment rate, in that countries with the highest and the lowest treatment rates tended to have lower PD utilization rates, whereas countries with modest treatment rates tended to have higher PD utilization rates. The reason for low PD utilization in countries with the highest treatment rates differs from that in countries with low treatment rates. In the former, because of full government reimbursement, there is little physician incentive to introduce PD as an alternative form of ESRD treatment to in-center hemodialysis (HD), whereas in the latter, the complete lack of government reimbursement prevents the introduction of PD as a form of treatment. This pattern is likely to change in the future because, of the 11 countries surveyed, all except Thailand have recorded a growth rate which is higher for PD than HD over the last three years. The rate of utilization of different PD systems varies greatly among different Asian countries. Automated PD has yet to gain popularity in Asia. Conventional straight-line systems remain the dominant PD systems in use in Hong Kong, Korea, Thailand, and the Philippines, while in Malaysia and Singapore UV germicidal connection devices are most popular. However, in all these countries there has been a progressive shift over the last

  7. Peritoneal dialysis peritonitis: risk factors and effects

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    Alikari V.

    2013-07-01

    Full Text Available Introduction: Peritonitis is the most frequent complication of peritoneal dialysis. It is the main cause of failure of the method and inclusion of patients in hemodialysis Purpose: The purpose of this study is to explore the risk factors of peritoneal dialysis peritonitis as well as the acute and long-term effects of peritonitis on peritoneal membrane function and success of the method. Methods: Literature review of relevant articles in the database Pubmed as well as the official website of the International Society of Peritoneal Dialysis (ISPD was carried out. The search included articles published during the period 1986 -2012.Results: Lack of patient compliance with the peritoneal changes protocol, lack of social support, systemic diseases and connection systems are risk factors of peritonitis. Peritonitis causes transient increase of peritoneum permeability, loss of the ability of the peritoneum for ultrafiltration and, consequently, overhydration. Long-term, recurrent episodes of peritonitis resulting in permanent loss of peritoneum capacity for ultrafiltration even fibrosis that leads to failure of the method. Finally, its effect on the reduction of the residual renal function seems to be remarkable. Conclusions: Peritonitis is the most common infectious complication of peritoneal dialysis and the main cause of morbidity associated with the method. Moreover, it is the major cause of failure of the method and patients accession in hemodialysis. Any attempt to prevent peritonitis passes through the careful patient selection and effective patient education on compliance with the rules of asepsis during peritoneal changes.

  8. Output of peritoneal cells during peritoneal dialysis.

    Science.gov (United States)

    Fakhri, O; Al-Mondhiry, H; Rifaat, U N; Khalil, M A; Al-Rawi, A M

    1978-01-01

    Peritoneal dialysis provides a good source for the collection of macrophages. Six patients with chronic renal failure undergoing peritoneal dialysis for the first time were studied, and maximum cell egress, mostly macrophages, occurred at 24-48 hours and diminished after 48 hours. PMID:670419

  9. Outcome of patients treated with automated peritoneal dialysis: Effects of selection of patients

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    Ayman Karkar

    2011-01-01

    Full Text Available To determine the effect of selection of peritoneal dialysis patients who used auto-mated PD (APD as a first renal replacement therapy (RRT option, we studied two groups of adult chronic kidney disease (CKD patients treated with APD over a period of 4 years: group 1 included 30 patients in whom APD was the first choice for RRT and group 2 included 40 patients transferred from failed hemodialysis (HD treatment. Both groups were matched for the original causes of CKD and comorbid conditions. However, group 1 had significantly higher residual renal function (RRF than group 2 [glomerular filtration rate (GFR 11.85 ± 4 mL/min and urine output 995 ± 465 mL/day vs. 3.69 ± 3.7 mL/min and 340 ± 447 mL/day, respectively, P = 0.0001] and Kt/v (2.7 ± 0.7 vs. 1.9 ± 0.4, respectively, P = 0.006. Most of the patients were compliant with their APD prescription, performed ideal PD techniques, achieved adequate dialysis and fluid ultra-filtration, and experienced much less than average infectious and non-infectious complications. However, group 1 achieved better clinical outcome than group 2, including relatively higher sur-vival rate and kidney transplantation, significantly fewer episodes of peritonitis per year (0.09 vs. 0.14, respectively, P = 0.0001, higher serum albumin (2.95 ± 0.3 vs. 2.7 ± 0.27 g/dL, respectively, P = 0.035, hemoglobin (11.5 ± 0.9 vs. 10.6 ± 0.7 g/dL, respectively, P = 0.022 and lower para-thormone levels (283 ± 117 vs. 389 ± 269 pg/mL, respectively, P = 0.02. They also maintained significantly higher total fluid removal compared to group 2 (1120 ± 330 vs. 560 ± 300 mL/day, respectively, P = 0.004, higher RRF (GFR 8 ± 2.6 mL/min vs. 1.8 ± 2.4 mL/min, respectively, P = 0.0001, and urine output (556 ± 447 mL/day vs. 240 ± 347 mL/day, respectively, P = 0.004, and significantly higher Kt/v (2.8 ± 0.7 vs. 1.9 ± 0.4, respectively, P = 0.2. In conclusion, in CKD patients, PD is a viable initial modality of RRT, and with better

  10. Increasing sodium removal on peritoneal dialysis: applying dialysis mechanics to the peritoneal dialysis prescription.

    Science.gov (United States)

    Fischbach, Michel; Schmitt, Claus Peter; Shroff, Rukshana; Zaloszyc, Ariane; Warady, Bradley A

    2016-04-01

    Optimal fluid removal on peritoneal dialysis (PD) requires removal of water coupled with sodium, which is predominantly achieved via the small pores in the peritoneal membrane. On the other hand, free-water transport takes place through aquaporin-1 channels, but leads to sodium retention and over hydration. PD prescription can be adapted to promote small pore transport to achieve improved sodium and fluid management. Both adequate dwell volume and dwell time are required for small pore transport. The dwell volume determines the amount of "wetted" peritoneal membrane being increased in the supine position and optimized at dwell volumes of approximately 1400 ml/m(2). Diffusion across the recruited small pores is time-dependent, favored by a long dwell time, and driven by the transmembrane solute gradient. According to the 3-pore model of conventional PD, sodium removal primarily occurs via convection. The clinical application of these principles is essential for optimal performance of PD and has resulted in a new approach to the automated PD prescription: adapted automated PD. In adapted automated PD, sequential short- and longer-dwell exchanges, with small and large dwell volumes, respectively, are used. A crossover trial in adults and a pilot study in children suggests that sodium and fluid removal are increased by adapted automated PD, leading to improved blood pressure control when compared with conventional PD. These findings are not explained by the current 3-pore model of peritoneal permeability and require further prospective crossover studies in adults and children for validation. PMID:26924063

  11. Peritoneal Dialysis (Beyond the Basics)

    Science.gov (United States)

    ... but not excessive, amount of protein and certain minerals. People who use peritoneal dialysis lose protein with every exchange, which usually means that they must eat an increased amount of protein in the diet. Protein is found in meat, milk, chicken, fish, and eggs; lower-quality protein is ...

  12. Peritoneal dialysis solution and nutrition.

    Science.gov (United States)

    Verger, Christian

    2012-01-01

    20-70% of peritoneal dialysis patients have some signs of malnutrition. Anorexia, protein and amino acid losses in dialysate, advanced age of elderly patients, inflammation and cardiac failure are among the main causes. Modern dialysis solutions aim to reduce these causes, but none of them is without side effects: glucose is relatively safe and brings additional energy but induces anorexia and lipid abnormalities, amino acids compensate dialysate losses but may increase uremia and acidosis, icodextrin helps control hyperhydration and chronic heart failure and minimizes glucose side effects, but may sometimes cause inflammation, and poly chamber bags allow the replacement of lactate by bicarbonate and are more biocompatible, decrease GDP, induce less inflammation and have a better effect on nutritional status. However, it appears that the management of nutrition with the different solutions available nowadays necessitates various combinations of solutions adapted to different patient profiles and there is not actually a single universal solution to minimize malnutrition in peritoneal dialysis patients. PMID:22652708

  13. Animal models in peritoneal dialysis

    Science.gov (United States)

    Nikitidou, Olga; Peppa, Vasiliki I.; Leivaditis, Konstantinos; Eleftheriadis, Theodoros; Zarogiannis, Sotirios G.; Liakopoulos, Vassilios

    2015-01-01

    Peritoneal dialysis (PD) has been extensively used over the past years as a method of kidney replacement therapy for patients with end stage renal disease (ESRD). In an attempt to better understand the properties of the peritoneal membrane and the mechanisms involved in major complications associated with PD, such as inflammation, peritonitis and peritoneal injury, both in vivo and ex vivo animal models have been used. The aim of the present review is to briefly describe the animal models that have been used, and comment on the main problems encountered while working with these models. Moreover, the differences characterizing these animal models, as well as, the differences with humans are highlighted. Finally, it is suggested that the use of standardized protocols is a necessity in order to take full advantage of animal models, extrapolate their results in humans, overcome the problems related to PD and help promote its use. PMID:26388781

  14. Animal Models in Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    OLGA eNIKITIDOU

    2015-09-01

    Full Text Available Peritoneal dialysis (PD has been extensively used over the past years as a method of kidney replacement therapy for patients with end stage renal disease. In an attempt to better understand the properties of the peritoneal membrane and the mechanisms involved in major complications associated with PD, such as inflammation, peritonitis and peritoneal injury, both in vivo and ex vivo animal models have been used. The aim of the present review is to briefly describe the animal models that have been used, and comment on the main problems encountered while working with these models. Moreover, the differences characterizing these animal models, as well as, the differences with humans are highlighted. Finally, it is suggested that the use of standardized protocols is a necessity in order to take full advantage of animal models, extrapolate their results in humans, overcome the problems related to PD and help promote its use.

  15. Clinical reports for peritoneal dialysis-related peritonitis

    Institute of Scientific and Technical Information of China (English)

    任海滨

    2014-01-01

    Objective To investigate causes and risk factors of peritoneal dialysis-related peritonitis,explore the pathogenic bacteria and drug sensitivity.Methods CAPD patients suffered peritoneal dialysis-related peritonitis were recruited in the First Affiliated Hospital of Nanjing Medical University in 2012.Gender,age and possible risk factors were analyzed by unvaried and multivariate logistic regression analysis.The causes,pathogenic bacteria,

  16. Diαgnostic approaches of peritoneal dialysis in peritonitis

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    Alikari V.

    2014-03-01

    Full Text Available Introduction: Peritonitis is the most important and frequent infectious complication of peritoneal dialysis. It is the most common cause of failure of the method and inclusion of patients in hemodialysis. Purpose: Τhe purpose of this study is to explore the diagnostic approaches of peritoneal dialysis peritonitis. Methods: Literature review of relevant articles in the database Pubmed as well as the official website of the International Society of Peritoneal Dialysis (ISPD was carried out. The search included articles published during 1996-2013. Results: According to the International Society of Peritoneal Dialysis, peritonitis requires the presence of two of the following criteria: (a cloudy peritoneal fluid, (b symptoms of inflammation of the peritoneum and (c the presence of microorganisms in the peritoneal fluid (> 100 leukocytes / μL of the solution of which most (> 50 % are polymorphnuclear. Some rules of sampling peritoneal fluid for culture and Gram staining are important for the right and immediate treatment of peritonitis: a the first cloudy peritoneal bag is the best sample b sending of the first bag for cultures should be done as early as possible in order to begin the appropriate antibiotic therapy. Gram stain, although in most cases is negative, it is particularly useful for the diagnosis of fungal peritonitis. Conclusions: Patient education, mainly of new Peritoneal Dialysis patients, about the early recognizing of cloudy fluids and exit-site infection, must be the primary concern of a Peritoneal Dialysis Unit. Careful use of antibiotics will reduce the frequency of negative cultures in order not to exceed the limit of 20% of the tests, as recommended by the International Society of Peritoneal Dialysis.

  17. Bidirectional peritoneal transport of albumin in continuous ambulatory peritoneal dialysis

    DEFF Research Database (Denmark)

    Joffe, P; Henriksen, Jens Henrik Sahl

    1995-01-01

    The present study was undertaken in order to assess bidirectional peritoneal kinetics of albumin after simultaneous i.v. and i.p. injection of radioiodinated albumin tracers (125I-RISA and 131I-RISA) in eight clinically stable uraemic patients undergoing continuous ambulatory peritoneal dialysis...... mass at the end of the dialysis (54 +/- 19 mumol, P

  18. Angiotensin II receptors and peritoneal dialysis-induced peritoneal fibrosis.

    Science.gov (United States)

    Morinelli, Thomas A; Luttrell, Louis M; Strungs, Erik G; Ullian, Michael E

    2016-08-01

    The vasoactive hormone angiotensin II initiates its major hemodynamic effects through interaction with AT1 receptors, a member of the class of G protein-coupled receptors. Acting through its AT1R, angiotensin II regulates blood pressure and renal salt and water balance. Recent evidence points to additional pathological influences of activation of AT1R, in particular inflammation, fibrosis and atherosclerosis. The transcription factor nuclear factor κB, a key mediator in inflammation and atherosclerosis, can be activated by angiotensin II through a mechanism that may involve arrestin-dependent AT1 receptor internalization. Peritoneal dialysis is a therapeutic modality for treating patients with end-stage kidney disease. The effectiveness of peritoneal dialysis at removing waste from the circulation is compromised over time as a consequence of peritoneal dialysis-induced peritoneal fibrosis. The non-physiological dialysis solution used in peritoneal dialysis, i.e. highly concentrated, hyperosmotic glucose, acidic pH as well as large volumes infused into the peritoneal cavity, contributes to the development of fibrosis. Numerous trials have been conducted altering certain components of the peritoneal dialysis fluid in hopes of preventing or delaying the fibrotic response with limited success. We hypothesize that structural activation of AT1R by hyperosmotic peritoneal dialysis fluid activates the internalization process and subsequent signaling through the transcription factor nuclear factor κB, resulting in the generation of pro-fibrotic/pro-inflammatory mediators producing peritoneal fibrosis. PMID:27167177

  19. Extensive peritoneal calcifications associated with continuous ambulatory peritoneal dialysis

    International Nuclear Information System (INIS)

    Peritoneal calcification, which can lead to intestinal obstruction and potentially lethal hemoperitoneum, is a rare complication of continuous ambulatory peritoneal dialysis. We describe a case in which extensive peritoneal calcification had arisen for this reason. Although the patient was asymptomatic, extensive calcification was present on the parietal and visceral peritoneum, including the hepatic and splenic surface. (author)

  20. Peritoneal membrane characteristics in patients on peritoneal dialysis

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    Jamal Al-wakeel

    2011-01-01

    Full Text Available Peritoneal dialysis (PD is a well-established modality for treatment of patients with end-stage renal disease, giving excellent patient and technique survival rates. In Saudi Arabia, data collected by the Saudi Center for Organ Transplantation showed that in 2008, patients on PD accounted for a mere 4.8% of total patients on renal replacement therapy, including hemodialysis and renal transplantation. This study was conducted to identify the characteristics of membrane per-meability in the Saudi population and to assess the role of various factors affecting solute transport across the peritoneal membrane. We followed up a total of 52 patients on Continuous Ambulatory Peritoneal Dialysis (CAPD as well as Automated Peritoneal Dialysis (APD, being treated in the PD unit of the King Khalid University Hospital, Riyadh. There were 30 female and 22 male patients; 14 patients were using CAPD while 38 patients were on APD. The mean age of the patients was 50.5 years, with a range of 14-86 years. The average body mass index (BMI was 27.1 kg/m 2 and the mean body surface area (BSA of the study patients was 1.71 m 2 . A standardized PET test was performed on all patients, 4-6 weeks after initiation of regular PD. The Kt/V and creatinine clearance measured 6-8 weeks after initiation of dialysis were 1.96 and 56.59 L/week, respectively. Residual renal function was assessed on the basis of daily urine output, using 24-hour urine collection. The mean serum urea con-centration was 16.91 mmol/L and mean serum creatinine was 702 μmol/L. According to the Peritoneal Equiliberation Test (PET, 8% of the subjects belonged to the high trans-porter category, 44% patients belonged to the high-average transport group, 46% to the low-average category and 2% came in the low transporter category. Our study suggests that the patient characteristics and demographic para-meters seen in the Saudi population are comparable to those seen in other studies from the Middle East and

  1. 21 CFR 876.5630 - Peritoneal dialysis system and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Peritoneal dialysis system and accessories. 876... Peritoneal dialysis system and accessories. (a) Identification. (1) A peritoneal dialysis system and... peritoneal dialysis, a source of dialysate, and, in some cases, a water purification mechanism. After...

  2. Resistant Yersinia Enterocolitica Peritonitis in a Peritoneal Dialysis Patient

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    Mehmet ÖZDEN

    2012-09-01

    Full Text Available Peritonitis is an important problem of peritoneal dialysis patients. Although Gram (+ bacteria are more frequent, Gram (- bacteria can rarely be the cause of peritonitis. Yersinia enterocolitica is a Gram (- enteric bacteria that especially causes gastrointestinal infections via contaminated food intake in immunosuppressive situations such as haemochromatosis, desferroxamine therapy or chronic hepatitis. We report a 51-year-old man who had been undergoing SAPD because of chronic renal failure for 2 years. We evaluated his peritoneal fl uid because of symptoms of peritonitis. His peritoneal cellular composition was consistent with peritonitis and after the microbiological culture of the fl uid we determined Yersinia enterocolitica as the pathogenic agent. The peritonitis persisted despite the administration of long term combined antibiotherapy and we removed the peritoneal catheter. In conclusion, Yersinia enterocolitica peritonitis is resistant to conventional antibiotic therapy and an indication for catheter removal.

  3. Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients

    OpenAIRE

    Jacek Waniewski; Stefan Antosiewicz; Daniel Baczynski; Jan Poleszczuk; Mauro Pietribiasi; Bengt Lindholm; Zofia Wankowicz

    2016-01-01

    During peritoneal dialysis (PD), the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21–87) years; median time on PD 19 (3–100) months) underwent sequential peritoneal equilibration test. Dialysis vintage and patient ag...

  4. Capnocytophaga cynodegmi peritonitis in a peritoneal dialysis patient

    DEFF Research Database (Denmark)

    Pers, Charlotte; Tvedegaard, Erling; Christensen, Jens Jørgen;

    2007-01-01

    The first reported case of peritonitis caused by Capnocytophaga cynodegmi is presented. The patient was treated with peritoneal dialysis and had contact with a cat. C. cynodegmi is part of the normal oral flora of dogs and cats but is very rarely isolated in clinical specimens from humans....

  5. Encapsulating peritoneal sclerosis: Common or rare in peritoneal dialysis?

    OpenAIRE

    Konstantina Triga

    2013-01-01

    Encapsulating peritoneal sclerosis (EPS) is a serious and often fatal complication of long-term peritoneal dialysis (PD) with severe malnutrition and poor prognosis. It causes progressive obstruction and encapsulation of the bowel loops. As EPS becomes more prevalent with longer duration of PD, large multicenter prospective studies are needed to establish its incidence and identify risk factors, therapeutic approach, and prognosis.

  6. Peritoneal dialysis in developing countries.

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    Nayak, K S; Prabhu, M V; Sinoj, K A; Subhramanyam, S V; Sridhar, G

    2009-01-01

    Peritoneal dialysis (PD) is acknowledged worldwide as a well-accepted form of renal replacement therapy (RRT) for end-stage renal disease (ESRD). Ideally, PD should be the preferred modality of RRT for ESRD in developing countries due to its many inherent advantages. Some of these are cost savings (especially if PD fluids are manufactured locally or in a neighboring country), superior rehabilitation and quality of life (QOL), home-based therapy even in rural settings, avoidance of hospital based treatment and the need for expensive machinery, and freedom from serious infections (hepatitis B and C). However, this is not the ground reality, due to certain preconceived notions of the health care givers and governmental agencies in these countries. With an inexplicable stagnation or decline of PD numbers in the developed world, the future of PD will depend on its popularization in Latin America and in Asia especially countries such as China and India, with a combined population of 2.5 billion and the two fastest growing economies worldwide. A holistic approach to tackle the issues in the developing countries, which may vary from region to region, is critical in popularizing PD and establishing PD as the first-choice RRT for ESRD. At our center, we have been pursuing a 'PD first' policy and promoting PD as the therapy of choice for various situations in the management of renal failure. We use certain novel strategies, which we hope can help PD centers in other developing countries working under similar constraints. The success of a PD program depends on a multitude of factors that are interlinked and inseparable. Each program needs to identify its strengths, special circumstances, and deficiencies, and then to strategize accordingly. Ultimately, teamwork is the 'mantra' for a successful outcome, the patient being central to all endeavors. A belief and a passion for PD are the fountainhead and cornerstone on which to build a quality PD program. PMID:19494625

  7. Evaluation of Peritonitis Incidence, Etiology, Associated Factors and Prognosis of Continuous Ambulatory Peritoneal Dialysis Patients

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    Nefise ÖZBALCI

    2013-05-01

    Full Text Available OBJECTIVE: Peritonitis is the most important complication of peritoneal dialysis (PD. We evaluated the incidence of peritonitis, active microorganisms and their susceptibility profile and determine prognosis. MATERIAL and METHODS: One hundred fifty three PD patients were evaluated for aetiology, drug usage, accompanying disease, type, duration and personal preference for PD, care-giver, protein catabolic rate (PCR, residual urine volume, ultrafiltration volume, type of peritoneal membrane transport and baseline laboratory values. RESULTS: The incidence of peritonitis was 0,284 attack/patient/year. The most common organisms were coagulase negative staphylococci (18.3% followed by S. aureus (14.8% and gram-negative bacillus (13.1%. Peritonitis was more common in elderly, those with longer PD duration, low residual urine volume, patients with low PCR and hepatitis C. However, patients using erythropoietin and automated PD had low incidence of peritonitis compared to others. Mortality rate was higher in gram-negative and fungal peritonitis and prognosis was worse in gramnegative peritonitis CONCLUSION: Peritonitis incidence and aetiology were compatible with literature. One must be careful to protect residual renal function (RRF as peritonitis incidence was significantly reduced in patients with RRF. PCR values were significantly lower in peritonitis. Adequate protein intake and nutritional support may be important in this respect.

  8. Encapsulating peritoneal sclerosis: Common or rare in peritoneal dialysis?

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    Konstantina Triga

    2013-01-01

    Full Text Available Encapsulating peritoneal sclerosis (EPS is a serious and often fatal complication of long-term peritoneal dialysis (PD with severe malnutrition and poor prognosis. It causes progressive obstruction and encapsulation of the bowel loops. As EPS becomes more prevalent with longer duration of PD, large multicenter prospective studies are needed to establish its incidence and identify risk factors, therapeutic approach, and prognosis.

  9. Specific opsonic activity for staphylococci in peritoneal dialysis effluent during continuous ambulatory peritoneal dialysis

    DEFF Research Database (Denmark)

    Nielsen, H; Espersen, F; Kharazmi, A;

    1992-01-01

    In a prospective study of intraperitoneal opsonins in 30 patients undergoing continuous ambulatory peritoneal dialysis (CAPD), the IgG concentration, the fibronectin concentration, the specific antistaphylococcal antibody level, and the opsonic activity against Staphylococcus epidermidis were...... measured in peritoneal dialysis effluent from the initiation of CAPD and monthly for 6 months. Significant correlation was found between the four assays, but the interindividual and intraindividual variations were considerable. No statistically significant correlation was observed between susceptibility...

  10. CT features of peritonitis associated with continuous ambulatory peritoneal dialysis

    International Nuclear Information System (INIS)

    To evaluate the CT findings of peritonitis associated with continuous ambulatory peritoneal dialysis(CAPD). We retrospectively analyzed CT scans of 14 symptomatic patients with peritonitis after CAPD. Diffuse abdominal pain was present in 11, fever in two, and abdominal mass with vomiting in one. The mean duration of CAPD ranged from 10 months to 5 years(mean : 3.9 years). On abdominal CT, we evaluated the presence and location of ascites, bowel wall thickening, cocoon formation, the pattern of enhancement of peritoneal thickening, the presence of calcifications in the peritoneum, and mesenteric and omental change. On enhanced CT, multiloculated ascites was observed in all cases(n=14) ; it was located mainly in the pelvic cavity with small multi-loculated fluid collections in the peritoneal cavity(n=13), including the lesser sac(n=3). In one patient, ascites was located in the space between the greater omentum and anterior peritoneal surface. CT showed ileus in 12 cases, small bowel wall thickening in 11, and cocoon formation in five. Uneven but smooth thickening of the peritoneum, with contrast enhancement, was seen in eight cases, and in five of these, peritoneal thickening was more prominent in the anterior peritoneum. Other findings included reticular opacity in two cases, hematoma of the rectus muscle in one, and umbilical hernia in one. Multiloculated fluid collection, ileus, small bowel wall thickening, uneven but smooth peritoneal thickening, and cocoon formation appear to be CT features of CAPD peritonitis

  11. Peritoneal Dialysis Dose and Adequacy

    Science.gov (United States)

    ... cavity are lined with a membrane called the peritoneum. During PD, a mixture of dextrose (sugar), salt, ... the permeability, or speed of diffusion, of the peritoneum—cannot be controlled. Dialysis solution comes in 1. ...

  12. Risk Factors Associated with Peritoneal-Dialysis-Related Peritonitis

    Directory of Open Access Journals (Sweden)

    Julia Kerschbaum

    2012-01-01

    Full Text Available Background. Peritonitis represents a major complication of peritoneal dialysis (PD. The aim of this paper was to systematically collect data on patient-related risk factors for PD-associated peritonitis, to analyze the methodological quality of these studies, and to summarize published evidence on the particular risk factors. Methods. Studies were identified by searches of Pubmed (1990–2012 and assessed for methodological quality by using a modified form of the STROBE criteria. Results. Thirty-five methodologically acceptable studies were identified. The following nonmodifiable risk factors were considered valid and were associated with an increased risk of peritonitis: ethnicity, female gender, chronic lung disease, coronary artery disease, congestive heart failure, cardiovascular disease, hypertension, antihepatitis C virus antibody positivity, diabetes mellitus, lupus nephritis or glomerulonephritis as underlying renal disease, and no residual renal function. We also identified the following modifiable, valid risk factors for peritonitis: malnutrition, overweight, smoking, immunosuppression, no use of oral active vitamin D, psychosocial factors, low socioeconomic status, PD against patient’s choice, and haemodialysis as former modality. Discussion. Modifiable and nonmodifiable risk factors analyzed in this paper might serve as a basis to improve patient care in peritoneal dialysis.

  13. Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Jacek Waniewski

    2016-01-01

    Full Text Available During peritoneal dialysis (PD, the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21–87 years; median time on PD 19 (3–100 months underwent sequential peritoneal equilibration test. Dialysis vintage and patient age did not correlate. Estimation of parameters of the two-pore model of peritoneal transport was performed. The estimated fluid transport parameters, including hydraulic permeability (LpS, fraction of ultrasmall pores (αu, osmotic conductance for glucose (OCG, and peritoneal absorption, were generally independent of solute transport parameters (diffusive mass transport parameters. Fluid transport parameters correlated whereas transport parameters for small solutes and proteins did not correlate with dialysis vintage and patient age. Although LpS and OCG were lower for older patients and those with long dialysis vintage, αu was higher. Thus, fluid transport parameters—rather than solute transport parameters—are linked to dialysis vintage and patient age and should therefore be included when monitoring processes linked to ageing of the peritoneal membrane.

  14. Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients.

    Science.gov (United States)

    Waniewski, Jacek; Antosiewicz, Stefan; Baczynski, Daniel; Poleszczuk, Jan; Pietribiasi, Mauro; Lindholm, Bengt; Wankowicz, Zofia

    2016-01-01

    During peritoneal dialysis (PD), the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21-87) years; median time on PD 19 (3-100) months) underwent sequential peritoneal equilibration test. Dialysis vintage and patient age did not correlate. Estimation of parameters of the two-pore model of peritoneal transport was performed. The estimated fluid transport parameters, including hydraulic permeability (LpS), fraction of ultrasmall pores (α u), osmotic conductance for glucose (OCG), and peritoneal absorption, were generally independent of solute transport parameters (diffusive mass transport parameters). Fluid transport parameters correlated whereas transport parameters for small solutes and proteins did not correlate with dialysis vintage and patient age. Although LpS and OCG were lower for older patients and those with long dialysis vintage, αu was higher. Thus, fluid transport parameters--rather than solute transport parameters--are linked to dialysis vintage and patient age and should therefore be included when monitoring processes linked to ageing of the peritoneal membrane. PMID:26989432

  15. The Effect of Ligustrazine on Peritoneal Transport in Peritoneal Dialysis

    Institute of Scientific and Technical Information of China (English)

    朱忠华; 彭维毅; 王玉梅; 朱红艳; 杨晓; 邓安国

    2002-01-01

    Summary: In order to investigate the effect of ligustrazine (Lig) i.p. on peritoneal permeability inperitoneal dialysis and its side effects, creatinine was given intravenously and continuously tomaintain the high plasma creatinine level. All the rabbits were divided into three groups: normalcontrol group (group A), group B treated with 0. 12 % Lig and group C treated with 0. 24 % Lig.The peritoneal dialysis of all rabbits lasted 2 h. The plasma and dialysate levels of glucose, proteinand creatinine were observed immediate, 30 min, 60 min, 90 min,120 min after dialysis. Creasti-nine dialysate/plasma ratio (D/P), protein D/P ratio, glucose D/Do at different time points afterdialysis and creatinine mass transfer area coefficient (MTAC) at 120 min were calculated. Thestructures of peritoneum were observed under optical microscope and electron microscope aftercontinuously intraperitoneal injection of Lig for 14 days. The results showed that the 90-min and120-min creatinine D/P ratios in the group C were higher than in the group A. The 120-min creatinine MATC in the group C was higher than in the group A. The rabbits treated with Lig did notshow significant structure changes of peritoneum and signs of peritoneal irritation. It was suggest-ed that Lig could increase mass transfer ability of peritoneum without significant side effects.

  16. Biocompatible Peritoneal Dialysis Fluids: Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    Yeoungjee Cho

    2012-01-01

    Full Text Available Peritoneal dialysis (PD is a preferred home dialysis modality and has a number of added advantages including improved initial patient survival and cost effectiveness over haemodialysis. Despite these benefits, uptake of PD remains relatively low, especially in developed countries. Wider implementation of PD is compromised by higher technique failure from infections (e.g., PD peritonitis and ultrafiltration failure. These are inevitable consequences of peritoneal injury, which is thought to result primarily from continuous exposure to PD fluids that are characterised by their “unphysiologic” composition. In order to overcome these barriers, a number of more biocompatible PD fluids, with neutral pH, low glucose degradation product content, and bicarbonate buffer have been manufactured over the past two decades. Several preclinical studies have demonstrated their benefit in terms of improvement in host cell defence, peritoneal membrane integrity, and cytokine profile. This paper aims to review randomised controlled trials assessing the use of biocompatible PD fluids and their effect on clinical outcomes.

  17. Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time.

    Directory of Open Access Journals (Sweden)

    Chia-Ter Chao

    Full Text Available Acinetobacter species are assuming an increasingly important role in modern medicine, with their persistent presence in health-care settings and antibiotic resistance. However, clinical reports addressing this issue in patients with peritoneal dialysis (PD peritonitis are rare.All PD peritonitis episodes caused by Acinetobacter that occurred between 1985 and 2012 at a single centre were retrospectively reviewed. Clinical features, microbiological data, and outcomes were analysed, with stratifications based upon temporal periods (before and after 2000.Acinetobacter species were responsible for 26 PD peritonitis episodes (3.5% of all episodes in 25 patients. A. baumannii was the most common pathogen (54%, followed by A. iwoffii (35%, with the former being predominant after 2000. Significantly more episodes resulted from breaks in exchange sterility after 2000, while those from exit site infections decreased (P = 0.01. The interval between the last and current peritonitis episodes lengthened significantly after 2000 (5 vs. 13.6 months; P = 0.05. All the isolates were susceptible to cefepime, fluoroquinolone, and aminoglycosides, with a low ceftazidime resistance rate (16%. Nearly half of the patients (46% required hospitalisation for their Acinetobacter PD-associated peritonitis, and 27% required an antibiotic switch. The overall outcome was fair, with no mortality and a 12% technique failure rate, without obvious interval differences.The temporal change in the microbiology and origin of Acinetobacter PD-associated peritonitis in our cohort suggested an important evolutional trend. Appropriate measures, including technique re-education and sterility maintenance, should be taken to decrease the Acinetobacter peritonitis incidence in PD patients.

  18. Spirometric Parameters: Hemodialysis Compared to Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Fariba Rezaeetalab

    2015-06-01

    Full Text Available Introduction: Renal failure affects the mechanical and the ventilatory function of the lungs. A few studies have evaluated the ventilatory and pulmonary function in dialysis patients. The present study aimed to compare Pulmonary Function Test (PFT results in patients undergoing Hemodialysis (HD and Peritoneal Dialysis (PD. Materials and Methods: We conducted a cross-sectional study on 50  patients with hemodialysis (HD and 50 cases with PD who  underwent PFT in Ghaem and Imam Reza hospitals Mashhad, Iran from November 2010 to July 2012. Spirometric parameters including forced expiratory volume in 1s (FEV1, FEV1/forced vital capacity (FVC, forced expiratory flow 25-75% (FEF and peak expiratory flow (PEF were compared between the two groups of patients. Results: Approximately 68% of the HD patients, 66% of the PD patients, and 67% of all the studied cases showed a normal spirometric pattern. Moreover, there were no significant differences between the two groups considering the mean of the aforementioned spirometric parameters(restrictive ,obstructive pattern (P=0.969. However, an insignificant inverse correlation was observed between the duration of dialysis with FEV1 (r=0.381, P=0.008, FVC (r=-0.298, P=0.04, FEF 25-75% (r=0.43, P=0.003, PEF (r= 0.349, P=0.02 and FEV1/FVC (r=-0.363, P=0.01, in the HD patients and between the patients’ age with FEV1/FVC (r=0.03, P=0.02 in the PD patients. Conclusion: This study showed no significant difference in pulmonary function in hemo and peritoneal dialysis,so according this result ,both of the dialysis had the same affect on the lung function.

  19. Escherichia coli Peritonitis in Peritoneal Dialysis: The Prevalence, Antibiotic Resistance and Clinical Outcomes in a South China Dialysis Center

    OpenAIRE

    FENG, XIAORAN; Yang, Xiao; Yi, Chunyan; Guo, Qunying; Mao, Haiping; Jiang, Zongpei; Li, Zhibin; Chen, Dongmei; Cui, Yingpeng; Yu, Xueqing

    2014-01-01

    ♦ Introduction: Escherichia coli (E. coli) peritonitis is a frequent, serious complication of peritoneal dialysis (PD). The extended-spectrum β-lactamase (ESBL)-producing E. coli peritonitis is associated with poorer prognosis and its incidence has been on continuous increase during the last decades. However, the clinical course and outcomes of E. coli peritonitis remain largely unclear.

  20. Unusual causes of peritonitis in a peritoneal dialysis patient: Alcaligenes faecalis and Pantoea agglomerans

    Directory of Open Access Journals (Sweden)

    Arikan Hakki

    2011-04-01

    Full Text Available Abstract An 87 -year-old female who was undergoing peritoneal dialysis presented with peritonitis caused by Alcaligenes faecalis and Pantoea agglomerans in consecutive years. With the following report we discuss the importance of these unusual microorganisms in peritoneal dialysis patients.

  1. Unusual causes of peritonitis in a peritoneal dialysis patient: Alcaligenes faecalis and Pantoea agglomerans

    OpenAIRE

    Arikan Hakki; Ari Elif; Tigen Elif; Asicioglu Ebru; Kahveci Arzu; Odabasi Zekaver; Ozener Cetin

    2011-01-01

    Abstract An 87 -year-old female who was undergoing peritoneal dialysis presented with peritonitis caused by Alcaligenes faecalis and Pantoea agglomerans in consecutive years. With the following report we discuss the importance of these unusual microorganisms in peritoneal dialysis patients.

  2. Surgical complications of continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Sanderson, M C; Swartzendruber, D J; Fenoglio, M E; Moore, J T; Haun, W E

    1990-12-01

    Surgical experience with 260 consecutive patients with chronic renal failure receiving continuous ambulatory peritoneal dialysis (CAPD) at one medical center from 1980 to 1989 is reviewed. Patients received CAPD for a mean of 24.2 months (range: 3 days to 91 months). Catheter longevity consistently improved in all but 1 year from 1984 to 1989, as did exit-site and tunnel infections. Of 311 catheters inserted, 151 (49%) required removal, of which 111 (74%) were attributed to peritonitis. Cumulative patient survival was 80%, 60%, and 53% at 1, 2, and 3 years, respectively. Diabetic patients had statistically significant lower survival rates. Additional complications including catheter leakage, catheter malposition, catheter obstruction, and abdominal wall hernias were negligible. Although CAPD is not free from serious complications, our data show remarkable improvement since 1980 in catheter longevity, hospital stay, and infection rates. PMID:2252113

  3. Effectiveness of Home Visits to Pediatric Peritoneal Dialysis Patients

    OpenAIRE

    Ellis, Eileen N.; Blaszak, Christine; Wright, Sherida; Van Lierop, Andrea

    2012-01-01

    Home visits by trained personnel to patients undergoing home dialysis are required, but little is reported about the effectiveness of such home visits. We retrospectively reviewed home visits to 22 pediatric patients undergoing continuous cycling peritoneal dialysis (PD) at home. A trained dialysis nurse completed each home visit. An average of 1.5 pertinent dialysis findings and 1 pertinent medication finding was noted for each home visit to these patients. The interdisciplinary dialysis tea...

  4. Peritoneal Dialysis in Cape Town, South Africa

    OpenAIRE

    Ikechi G Okpechi; Rayner, Brian L; Swanepoel, Charles R.

    2012-01-01

    ♦ Background: Chronic kidney disease is a major public health problem in sub-Saharan Africa (SSA), which encompasses 70% of the least-developed countries in the world. Most people in SSA have no access to any form of renal replacement therapy (RRT). Given its ease of performance and patient independence, peritoneal dialysis (PD) should be an ideal form of RRT in SSA, but several complex and interdependent factors make PD a difficult option in SSA. The present review describes the practice of ...

  5. [A new view on pathochemical mechanisms of prolonged peritoneal dialysis].

    Science.gov (United States)

    Petrovich, Iu A; Iarema, I V; Terekhina, N A; Kichenko, S M

    2010-01-01

    New data on etiology, pathogenesis, clinics, quantity estimation, treatment and complications of peritoneal dialysis are observed. The role of aquaporine, nitric oxide, NO-synthase, inflammation and sepsis markers (procalcitonine, C-reactive protein) in pathochemical mechanism of peritoneal dialysis is discussed. PMID:20734476

  6. Vitamin K Status of Canadian Peritoneal Dialysis Patients

    Science.gov (United States)

    Vitamin K –dependent proteins have been implicated in the regulation of vascular calcification, a condition that is prevalent among peritoneal dialysis patients. Vitamin K status in this patient population is unknown. In a cross-sectional study of 22 peritoneal dialysis patients selected from a Can...

  7. Peritoneal Dialysis Tailored to Pediatric Needs

    Directory of Open Access Journals (Sweden)

    C. P. Schmitt

    2011-01-01

    Full Text Available Consideration of specific pediatric aspects is essential to achieve adequate peritoneal dialysis (PD treatment in children. These are first of all the rapid growth, in particular during infancy and puberty, which must be accompanied by a positive calcium balance, and the age dependent changes in body composition. The high total body water content and the high ultrafiltration rates required in anuric infants for adequate nutrition predispose to overshooting convective sodium losses and severe hypotension. Tissue fragility and rapid increases in intraabdominal fat mass predispose to hernia and dialysate leaks. Peritoneal equilibration tests should repeatedly been performed to optimize individual dwell time. Intraperitoneal pressure measurements give an objective measure of intraperitoneal filling, which allow for an optimized dwell volume, that is, increased dialysis efficiency without increasing the risk of hernias, leaks, and retrofiltration. We present the concept of adapted PD, that is, the combination of short dwells with low fill volume to promote ultrafiltration and long dwells with a high fill volume to improve purification within one PD session. The use of PD solutions with low glucose degradation product content is recommended in children, but unfortunately still not feasible in many countries.

  8. Peritonitis due to Brevibacterium otitidis in a patient undergoing continuous ambulatory peritoneal dialysis.

    OpenAIRE

    Wauters, Georges; Van Bosterhaut, B; Avesani, V; Cuvelier, R.; Charlier, Jacqueline; Janssens, Michèle; Delmée, Michel

    2000-01-01

    Brevibacterium otitidis is a coryneform rod and, as far as is known, is isolated only from infected ears. We report the first known case of peritonitis caused by B. otitidis in a patient undergoing continuous ambulatory peritoneal dialysis.

  9. Peritonitis by Scedosporium apiospermum in a patient undergoing continuous ambulatory peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    SEVERO Luiz Carlos

    1999-01-01

    Full Text Available A case of peritonitis due to Scedosporium apiospermum in a boy undergoing continuous ambulatory peritoneal dialysis is reported. The finding of suggestive tissual form of the fungus in the effluent hastened the diagnosis of the infection.

  10. Analysis of microbial spectrum and antibiotic resistance in patients of peritoneal dialysis related peritonitis

    Institute of Scientific and Technical Information of China (English)

    詹周兵

    2014-01-01

    Objective To investigate the microbial spectrum and antibiotic resistance of continuous ambulatory peritoneal dialysis(CAPD)related peritonitis and guide the clinical rational use of antimicrobial agents.Methods A retrospective analysis was made of CAPD related peritonitis in236 cases with peritoneal dialysate culture results in the

  11. Bladder perforation in a peritoneal dialysis patient

    Directory of Open Access Journals (Sweden)

    M Ounissi

    2012-01-01

    Full Text Available The dysfunction of the catheter in peritoneal dialysis (PD is a frequent compli-cation. However, perforation of organs are rare, particularly that of the urinary bladder. This re-quires an early diagnosis and prompt treatment of patients. We report here the case of a 38-year-old woman having end-stage renal disease due to autosomal-dominant polycystic kidney disease treated by PD since November 2000. Three years later, she was treated for Staphylococcal peritonitis. Four months later, she presented with a severe urge to urinate at the time of the fluid exchanges. The biochemical analysis of the fluid from the bladder showed that it was dialysis fluid. Injection of contrast through the catheter demonstrated the presence of a fistula between the bladder and the peritoneal cavity. She underwent cystoscopic closure of the fistulous tract and the PD catheter was removed. Subsequently, the patient was treated by hemodialysis. One month later, a second catheter was implanted surgically after confirming the closure of the fistula. Ten days later, she presented with pain at the catheter site and along the tunnel, which was found to be swollen along its track. The injection of contrast produced swelling of the subcutaneous tunnel but without extravasation of the dye. PD was withdrawn and the patient was put back on hemodialysis. Bladder fistula is a rare complication in PD and diagnosis should be suspected when patient complains of an urge to pass urine during the exchanges, which can be confirmed by contrast study showing presence of dye in the bladder. PD may be possible after the closure of the fistula, but recurrence may occur.

  12. Satisfaction with care in peritoneal dialysis patients.

    Science.gov (United States)

    Kirchgessner, J; Perera-Chang, M; Klinkner, G; Soley, I; Marcelli, D; Arkossy, O; Stopper, A; Kimmel, P L

    2006-10-01

    Patient satisfaction is an important aspect of dialysis care, only recently evaluated in clinical studies. We developed a tool to assess peritoneal dialysis (PD) customer satisfaction, and sought to evaluate and validate the Customer Satisfaction Questionnaire (CSQ), quantifying PD patient satisfaction. The CSQ included questions regarding administrative issues, Delivery Service, PD Training, Handling Requests, and transportation. The study was performed using interviews in all Hungarian Fresenius Medical Care dialysis centers offering PD. CSQ results were compared with psychosocial measures to identify if patient satisfaction was associated with perception of social support and illness burden, or depression. We assessed CSQ internal consistency and validity. Factor analysis explored potential underlying dimensions of the CSQ. One hundred and thirty-three patients treated with PD for end-stage renal disease for more than 3 months were interviewed. The CSQ had high internal consistency. There was high patient satisfaction with customer service. PD patient satisfaction scores correlated with quality of life (QOL) and social support measures, but not with medical or demographic factors, or depressive affect. The CSQ is a reliable tool to assess PD customer satisfaction. PD patient satisfaction is associated with perception of QOL. Efforts to improve customer satisfaction may improve PD patients' quantity as well as QOL. PMID:16900092

  13. Oral Tori in Chronic Peritoneal Dialysis Patients

    Science.gov (United States)

    Hsu, Chia-Lin; Hsu, Ching-Wei; Chang, Pei-Ching; Huang, Wen-Hung; Weng, Cheng-Hao; Yang, Huang-Yu; Liu, Shou-Hsuan; Chen, Kuan-Hsing; Weng, Shu-Man; Chang, Chih-Chun; Wang, I-Kuan

    2016-01-01

    Background The pathogenesis of oral tori has long been debated and is thought to be the product of both genetic and environmental factors, including occlusal forces. Another proposed mechanism for oral tori is the combination of biomechanical forces, particularly in the oral cavity, combined with cortical bone loss and trabecular expansion, as one might see in the early stages of primary hyperparathyroidism. This study investigated the epidemiology of torus palatinus (TP) and torus mandibularis (TM) in peritoneal dialysis patients, and analyzed the influences of hyperparathyroidism on the formation of oral tori. Method In total, 134 peritoneal dialysis patients were recruited between July 1 and December 31, 2015 for dental examinations for this study. Patients were categorized into two subgroups based on the presence or absence of oral tori. Demographic, hematological, biochemical, and dialysis-related data were obtained for analysis. Results The prevalence of oral tori in our sample group was high at 42.5% (57 of 134), and most patients with oral tori were female (61.4%). The most common location of tori was TP (80.7%), followed by TP and TM (14.0%), then TM (5.3%). All 54 TP cases were at the midline, and most were <2 cm (59.3%), flat (53.7%), and located in the premolar region (40.7%). Of the 11 TM cases, all were bilateral and symmetric, mostly <2 cm (81.9%), lobular (45.4%), and located at premolar region (63.6%). Interestingly, patients with oral tori had slightly lower serum levels of intact parathyroid hormones than those without oral tori, but the difference was not statistically significant (317.3±292.0 versus 430.1±492.6 pg/mL, P = 0.126). In addition, patients with oral tori did not differ from patients without tori in inflammatory variables such as serum high sensitivity C-reactive protein levels (6.6±8.2 versus 10.3±20.2 mg/L, P = 0.147) or nutritional variables such as serum albumin levels (3.79±0.38 versus 3.77±0.45 g/dL, P = 0

  14. Oral Tori in Chronic Peritoneal Dialysis Patients.

    Directory of Open Access Journals (Sweden)

    Chia-Lin Hsu

    Full Text Available The pathogenesis of oral tori has long been debated and is thought to be the product of both genetic and environmental factors, including occlusal forces. Another proposed mechanism for oral tori is the combination of biomechanical forces, particularly in the oral cavity, combined with cortical bone loss and trabecular expansion, as one might see in the early stages of primary hyperparathyroidism. This study investigated the epidemiology of torus palatinus (TP and torus mandibularis (TM in peritoneal dialysis patients, and analyzed the influences of hyperparathyroidism on the formation of oral tori.In total, 134 peritoneal dialysis patients were recruited between July 1 and December 31, 2015 for dental examinations for this study. Patients were categorized into two subgroups based on the presence or absence of oral tori. Demographic, hematological, biochemical, and dialysis-related data were obtained for analysis.The prevalence of oral tori in our sample group was high at 42.5% (57 of 134, and most patients with oral tori were female (61.4%. The most common location of tori was TP (80.7%, followed by TP and TM (14.0%, then TM (5.3%. All 54 TP cases were at the midline, and most were <2 cm (59.3%, flat (53.7%, and located in the premolar region (40.7%. Of the 11 TM cases, all were bilateral and symmetric, mostly <2 cm (81.9%, lobular (45.4%, and located at premolar region (63.6%. Interestingly, patients with oral tori had slightly lower serum levels of intact parathyroid hormones than those without oral tori, but the difference was not statistically significant (317.3±292.0 versus 430.1±492.6 pg/mL, P = 0.126. In addition, patients with oral tori did not differ from patients without tori in inflammatory variables such as serum high sensitivity C-reactive protein levels (6.6±8.2 versus 10.3±20.2 mg/L, P = 0.147 or nutritional variables such as serum albumin levels (3.79±0.38 versus 3.77±0.45 g/dL, P = 0.790. Furthermore, there were no

  15. Peritonitis and catheter exit-site infection in patients on peritoneal dialysis at home1

    Science.gov (United States)

    Abud, Ana Cristina Freire; Kusumota, Luciana; dos Santos, Manoel Antônio; Rodrigues, Flávia Fernanda Luchetti; Damasceno, Marta Maria Coelho; Zanetti, Maria Lúcia

    2015-01-01

    Objective: to analyze the complications related to peritonitis and catheter exit-site infections, in patients on peritoneal dialysis at home. Method: quantitative and cross-sectional study, carried out with 90 patients on peritoneal dialysis at home, in a municipality in the Northeast region of Brazil. For data collection, it was used two structured scripts and consultation on medical records. Descriptive analysis and comparison tests among independent groups were used, considering p<0.05 as level of statistical significance. Results: by comparing the frequency of peritonitis and the length of treatment, it was found that patients over two years of peritoneal dialysis were more likely to develop peritonitis (X²=6.39; p=0.01). The number of episodes of peritoneal catheter exit-site infection showed association with the length of treatment (U=224,000; p=0.015). Conclusion: peritonitis and catheter exit-site infection are associated with the length of treatment. PMID:26487141

  16. Dialysate leakage into pericardium in an infant on long-term peritoneal dialysis.

    Science.gov (United States)

    Borzych, Dagmara; Ley, Sebastain; Schaefer, Franz; Billing, Heiko; Ley-Zaporozhan, Julia; Schenk, Jens; Schmitt, Claus Peter

    2008-02-01

    We report on a 2-year-old boy on automated peritoneal dialysis (PD) with a history of multiple hernias and dialysate leaks who developed pericardial effusion. Magnetic resonance imaging (MRI) demonstrated a peritoneo-pericardial fistula. Dialysis had to be discontinued, since head-down tilt reproducibly induced significant hypotension. In PD patients with pericardial effusion a peritoneo-pericardial leak should be considered. PMID:17922293

  17. Imaging features of encapsulating peritoneal sclerosis in continuous ambulatory peritoneal dialysis patients.

    LENUS (Irish Health Repository)

    Ti, Joanna P

    2010-07-01

    OBJECTIVE: The purpose of this article is to present the spectrum of radiologic findings of encapsulating peritoneal sclerosis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). CONCLUSION: Although a rare diagnosis, encapsulating peritoneal sclerosis in patients undergoing CAPD has a high morbidity and mortality. Diagnosis is often delayed because clinical features are insidious and nonspecific. Radiologic imaging may be helpful in the early diagnosis of encapsulating peritoneal sclerosis and in facilitating timely intervention for CAPD patients with encapsulating peritoneal sclerosis.

  18. Tamoxifen Ameliorates Peritoneal Membrane Damage by Blocking Mesothelial to Mesenchymal Transition in Peritoneal Dialysis

    OpenAIRE

    Jesús Loureiro; Pilar Sandoval; Gloria del Peso; Guadalupe Gónzalez-Mateo; Vanessa Fernández-Millara; Beatríz Santamaria; Maria Auxiliadora Bajo; José Antonio Sánchez-Tomero; Gonzalo Guerra-Azcona; Rafael Selgas; Manuel López-Cabrera; Aguilera, Abelardo I.

    2013-01-01

    Mesothelial-to-mesenchymal transition (MMT) is an auto-regulated physiological process of tissue repair that in uncontrolled conditions such as peritoneal dialysis (PD) can lead to peritoneal fibrosis. The maximum expression of peritoneal fibrosis induced by PD fluids and other peritoneal processes is the encapsulating peritoneal sclerosis (EPS) for which no specific treatment exists. Tamoxifen, a synthetic estrogen, has successfully been used to treat retroperitoneal fibrosis and EPS associa...

  19. [99mTc-MAA peritoneal scintigraphy in pleuroperitoneal comunication in peritoneal dialysis patients].

    Science.gov (United States)

    Hernández Martínez, A C; Marín Ferrer, M D; Coronado Poggio, M; Escabias Del Pozo, C; Coya Viña, J; Martín Curto, L

    2010-01-01

    Peritoneal dialysis is a fully-contrasted alternative for the treatment of end-stage renal disease although it is not exempt of complications. Peritonitis and exit-site infections are among the most frequent complications found. Pleural effusion secondary to pleuroperitoneal communication (PPC) is a serious and uncommon complication in these patients. We present the case of a 50-year old man diagnosed of end-stage renal disease undergoing treatment with peritoneal dialysis who presented progressive dyspnea and right pleural effusion. The peritoneal scintigraphy with (99m)Tc-MAA makes it possible to confirm communication of intraperitoneal dialysis fluid to the pleural cavity. PMID:20117860

  20. Gastrointestinal Non-Infectious Complications in Patients on Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Kostović Milica

    2016-06-01

    Full Text Available Gastrointestinal complications are common among patients on peritoneal dialysis. Risk factors for the development of gastrointestinal complications in this patient population include: toxic effects of uremic toxins, frequent use of nonsteroidal anti-inflammatory drugs, Helicobacter pylori infection, angiodysplasia, increased intra-abdominal pressure, use of bioincompatible solution for peritoneal dialysis, increased glucose in solutions for peritoneal dialysis, secondary hyperparathyroidism (hypercalcemia, a disorder of lipid metabolism (hypertriglyceridemia, and the duration of peritoneal dialysis treatment. The most important non-infectious gastrointestinal complications in patients on peritoneal dialysis are: gastrointestinal bleeding, herniation and leaking of the dialysate from the abdomen (increased intra-abdominal pressure, impaired lung function (intra-abdominal hypertension, acute pancreatitis, and encapsulating sclerosis of the peritoneum. Intra-abdominal hypertension is defined as IAP ≥ 12 mmHg. Pouring the peritoneal dialysis solution leads to increased intra-abdominal pressure, which results in the development of hernias, pleuro-peritoneal dialysate leakage (hydrothorax, and restrictive pulmonary dysfunction. Risk factors for the development of acute pancreatitis in this patient population include: uraemia, secondary hyperparathyroidism with hypercalcemia, hypertriglyceridemia, features of the peritoneal dialysis solution (osmolarity, acidity, glucose, chemical irritation, and calcium in the solution for peritoneal dialysis lead to “local hypercalcemia”, toxic substances from the dialysate, the bags and tubing, and peritonitis and treatment of peritonitis with antibiotics and anticoagulants. Encapsulating sclerosis of the peritoneum is rare and is the most serious complication of long-term peritoneal dialysis. It is characterized by thickening of the peritoneum, including cancer, and signs and symptoms of obstructive ileus

  1. Increasing fill volume reduces cardiac performance in peritoneal dialysis

    DEFF Research Database (Denmark)

    Ivarsen, Per; Povlsen, Johan V; Jensen, Jens Dam

    2007-01-01

    BACKGROUND: It is generally accepted that peritoneal dialysis (PD) affects systemic haemodynamics less than haemodialysis, but little is known about changes in haemodynamics during PD. It is unknown if increasing PD volume causes changes in cardiovascular haemodynamics possibly increasing...

  2. Peritonitis and catheter exit-site infection in patients on peritoneal dialysis at home

    OpenAIRE

    Ana Cristina Freire Abud; Luciana Kusumota; Manoel Antônio dos Santos; Flávia Fernanda Luchetti Rodrigues; Marta Maria Coelho Damasceno; Maria Lúcia Zanetti

    2015-01-01

    Objective: to analyze the complications related to peritonitis and catheter exit-site infections, in patients on peritoneal dialysis at home. Method: quantitative and cross-sectional study, carried out with 90 patients on peritoneal dialysis at home, in a municipality in the Northeast region of Brazil. For data collection, it was used two structured scripts and consultation on medical records. Descriptive analysis and comparison tests among independent groups were used, considering p

  3. Disaster planning for peritoneal dialysis programs.

    Science.gov (United States)

    Kleinpeter, Myra A; Norman, Lisa D; Krane, N Kevin

    2006-01-01

    Because of increased intensity of hurricanes in the Gulf Coast region of the United States, peritoneal dialysis (PD) programs have been disrupted and patients relocated temporarily following these catastrophic events. We describe the disaster planning, implementation, and follow-up that occurred in one such PD program in New Orleans following Hurricane Katrina. Each year at the beginning of the North American hurricane season, the PD program's disaster plan is reviewed by clinic staff and copies are distributed to patients. Patients are instructed to assemble a disaster kit and are provided with contact numbers for dialysis suppliers and for a PD program in their planned evacuation city. In July 2005, this disaster plan was tested when an early tropical storm and hurricane entered the Gulf and several patients briefly relocated or evacuated because of power loss and then returned without incident. However, when Hurricane Katrina, a category 5 storm, was predicted to strike the metropolitan area, patients were notified by telephone to evacuate, and contact information, including their evacuation city and telephone and cellular phone numbers, was obtained. Patients were also reminded to take all medications, bottled water, antibacterial soap, hand sanitizer, and 4-5 days of PD supplies. Following the storm, telephone and cellular phone services were severely disrupted. However, text messaging was available to contact patients to confirm safety and to provide further instructions. Arrangements with the major dialysis suppliers to ship emergency supplies to new locations were made by the PD nurse and the patients. Only 2 of 22 patients required hospitalization because of complications resulting from evacuation failure, contamination, and inability to perform dialysis for a prolonged period of time. Both of these patients were quickly released and have continued PD. Following the event, all patients remained on PD, and most have planned to return to their home PD

  4. Pathophysiology of the peritoneal membrane during peritoneal dialysis: the role of hyaluronan

    OpenAIRE

    Susan Yung; Tak Mao Chan

    2011-01-01

    During peritoneal dialysis (PD), constant exposure of mesothelial cells to bioincompatible PD solutions results in the denudation of the mesothelial monolayer and impairment of mesothelial cell function. Hyaluronan, a major component of extracellular matrices, is synthesized by mesothelial cells and contributes to remesothelialization, maintenance of cell phenotype, and tissue remodeling and provides structural support to the peritoneal membrane. Chronic peritoneal inflammation is observed in...

  5. PERITONEAL DIALYSIS AFTER REPAIR OF CONGENITAL HEART DISEASE IN CHILDREN

    Institute of Scientific and Technical Information of China (English)

    罗新锦; 许建屏; 沈向东; 陈霞

    2003-01-01

    Objective. To investigate the effect of peritoneal dialysis on fluid balance and outcome in childrenwho receive cardiac operation.Methods. From July to Dec. 2000, 12(2.08%) patients of 576 consecutive children who underwentheart operation required peritoneal dialysis because of acute renal failure. The mean age of these 12 pa-tients was (2.9±2.0) years (range, 5 months~7 years) and the mean body weight was (12±3) kg (range,7.4~18.5 kg ).Results. The interval between the operation and the initiation of peritoneal dialysis was (21.2±11.4)hours (4.4~42 hours). The duration of peritoneal dialysis was (6.3±4.8) days (0.47~15 days). Mortality inthese 12 patients was 25%. Fluid removed by peritoneal dialysis was(34.7±17.8) ml@kg1@day-1@ Asymop-tomatic hypokalemia, thrombocytopenia and hyperglycemia were frequent complications, which were easilymanaged. Hemodynamics and pulmonary function improved during the study period.Conclusion. The early initiation of peritoneal dialysis is an effective and safe method totreat acute renal failure after cardiac operation in children.

  6. Acute peritoneal dialysis in a Jehovah's Witness post laparotomy.

    Science.gov (United States)

    Appalsawmy, Usha Devi; Akbani, Habib

    2016-01-01

    A 56-year-old man who was a Jehovah's Witness with an advanced directive against autologous procedures developed acute kidney injury needing renal replacement therapy while he was intubated and ventilated on the intensive care unit. He was being treated for hyperosmolar hyperglycaemic state. He also had a healing laparotomy wound, having undergone a splenectomy less than a month ago following a road traffic accident. His hyperkalaemia and metabolic acidosis were refractory to medical treatment. As he became oligoanuric, decision was taken to carry out acute peritoneal dialysis (PD) by inserting a Tenckhoff catheter in his abdomen using peritoneoscopic technique. The patient was started on automated PD without any complications. His urine output gradually improved, and his renal function eventually recovered. On discharge from hospital, his renal function was within normal range, and he had no abdominal complications from the acute PD. PMID:27581233

  7. Acute hydrothorax from peritoneal dialysis successfully treated with new dialysis regime

    International Nuclear Information System (INIS)

    Hydrothorax is a rare and often unrecognized complication associated with peritoneal dialysis (PD). This is usually due to the presence of pleuroperitoneal fistula. Most nephrologist will choose to cease the peritoneal dialysis and rest the peritoneum. More than often surgical interventions include pleurodesis or thoracotomy will be required. In this report, we reported a patient who developed pleural effusion after starting continuous ambulatory peritoneal dialysis. She was successfully managed by the use of low volume exchange during daytime with avoidance of conversion to haemodialysis or any surgical intervention. (author)

  8. Relapsing peritonitis with Bacillus cereus in a patient on continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Magnussen, Eyð Tausen; Vang, Amanda Gratton; Á Steig, Torkil; Gaini, Shahin

    2016-01-01

    We present a case where Bacillus cereus was determined to be the causative agent of relapsing peritonitis in a patient on continuous ambulatory peritoneal dialysis (CAPD). The patient, a 70-year-old man from the Faroe Islands, was admitted with relapsing peritonitis four times over a 3-month period. Peritoneal cultures were positive for growth of B. cereus, a rare bacterial cause of peritonitis. The cultures demonstrated susceptibility to vancomycin, and therefore the patient was treated with intraperitoneal vancomycin, intraperitoneal gentamycin and oral ciprofloxacin. As a result of the relapsing B. cereus peritonitis diagnosis and a CT scan showing contraction of the peritoneum after longstanding inflammation, the peritoneal catheter was removed and the patient converted to haemodialysis. To date, the patient has not been readmitted due to peritonitis. A lack of proper hygiene when changing the dialysis bag was the suspected source of infection with B. cereus. PMID:27118739

  9. Dialysate interleukin-6 predicts increasing peritoneal solute transport rate in incident peritoneal dialysis patients

    OpenAIRE

    Cho, Yeoungjee; Johnson, David W.; Vesey, David A; Hawley, Carmel M; Pascoe, Elaine M.; Clarke, Margaret; Topley, Nicholas

    2014-01-01

    Background Repeated exposure to peritoneal dialysis (PD) solutions contributes to cumulative intraperitoneal inflammation and peritoneal injury. The present study aimed to explore the capacity of dialysate interleukin-6(IL-6) to a) predict peritoneal membrane function and peritonitis in incident PD patients, and b) to evaluate the influence of neutral pH, low glucose degradation product (GDP) PD solution on dialysate IL-6 levels. Methods The study included 88 incident participants from the ba...

  10. Pharmacokinetics of amikacin during hemodialysis and peritoneal dialysis

    DEFF Research Database (Denmark)

    Regeur, L; Colding, H; Jensen, H;

    1977-01-01

    The pharmacokinetics of amikacin were examined in six bilaterally nephrectomized patients undergoing hemodialysis and in four patients with a minimal residual renal function undergoing peritoneal dialysis. The mean elimination half-life before the dialysis was 86.5 h in the anephric patients and 44...... renal function. During hemodialysis the half-life decreased to less than 10% (5.6 h) of the pretreatment value. The effectiveness of peritoneal dialysis was less as the half-life decreased to only about 30% (17.9 h) of the pretreatment value. During the dialyses a significant correlation between...... the half-life of amikacin and the decrease in blood urea and serum creatinine was demonstrated. The pharmacokinetic data were used to make dosage regimen recommendations for the treatment of patients undergoing intermittent hemodialysis or peritoneal dialysis....

  11. Aliskiren prevents the toxic effects of peritoneal dialysis fluids during chronic dialysis in rats.

    Directory of Open Access Journals (Sweden)

    Juan Pérez-Martínez

    Full Text Available The benefits of long-term peritoneal dialysis (PD in patients with end-stage renal failure are short-lived due to structural and functional changes in the peritoneal membrane. In this report, we provide evidence for the in vitro and in vivo participation of the renin-angiotensin-aldosterone system (RAAS in the signaling pathway leading to peritoneal fibrosis during PD. Exposure to high-glucose PD fluids (PDFs increases damage and fibrosis markers in both isolated rat peritoneal mesothelial cells and in the peritoneum of rats after chronic dialysis. In both cases, the addition of the RAAS inhibitor aliskiren markedly improved damage and fibrosis markers, and prevented functional modifications in the peritoneal transport, as measured by the peritoneal equilibrium test. These data suggest that inhibition of the RAAS may be a novel way to improve the efficacy of PD by preventing inflammation and fibrosis following peritoneal exposure to high-glucose PDFs.

  12. Sonographic evaluation of complications in patients with peritoneal dialysis

    International Nuclear Information System (INIS)

    Ultrasonography was performed prospectively in 20 patients who were undergoing continuous ambullatory peritoneal dialysis for evaluation of complications. We examined the abdominal wall along the course of catheter and the peritoneal cavity with special attention to the dialysate distribution, dialysate echogenecity, thickness of the peritoneum small bowel distribution and the position of the catheter tip. Peritonitis was the most common complication (n=7); sonographic findings were small bowel adhesion (n=5) multiseptated ascites(n=1), peritoneal thickening(n=4), and tunnel infection(n=1) and exith site infection(n=1). Our initial experience suggests that ultrasonography is useful for diagnosis of complications and monitoring of patient during long term peritoneal dialysis

  13. Diabetes Influences Peritoneal Morphology in Uremic Patients at the Initiation of Peritoneal Dialysis

    OpenAIRE

    Mizumasa, Tohru; Hirakata, Hideki; Kuroki, Yusuke; Katafuchi, Ritsuko; Yotsueda, Hideki; Mitsuiki, Koji; Nakashima, Yutaka; Tsuruya, Kazuhiko

    2013-01-01

    ♦ Background: The peritoneum begins to undergo morphologic changes before the start of peritoneal dialysis (PD), particularly in diabetic patients. The present study was conducted to investigate the effects of diabetes on the peritoneum.

  14. Morphological changes of the peritoneum in peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    方炜; 钱家麒; 余志远; 陈诗书

    2004-01-01

    Background Long-term peritoneal dialysis (PD) requires that the peritoneal membrane remain effective for dialysis. Research directed toward human peritoneal morphology and structure is limited. The present study was performed to investigate morphological changes of the human peritoneal membrane during PD and to elucidate the possible mechanisms of its functional deterioration. Methods A total of 32 peritoneal biopsies were performed in normal subjects (n=10), uremic nondialysis patients (n=12) at the time of catheter insertion, and PD patients (n=10) at the time of catheter removal or reinsertion or at the time of renal transplantation. Peritoneal morphology was examined by light microscopy, scanning electron microscopy, and transmission electron microscopy. Results The peritoneal membrane in normal subjects consisted of a monolayer of mesothelial cells on a basement membrane and a layer of connective tissue containing cells, blood vessels, and lymphatic vessels. Mesothelial cells were polygonal, often elongated, and had numerous microvilli on their luminal surface. There were lots of oval or roundish pinocytotic vesicles in the cytoplasm of the mesothelial cells. The peritoneal morphology of uremic nondialysis patients was similar to that of normal subjects. However, significant abnormalities of the peritoneal membrane were observed in PD patients, and the changes were found to be progressive. Microvilli were the first site of damage which involved microvilli shortening, a gradual reduction in their number, and, eventually, the total disappearance of microvilli. Mesothelial cells then detached from the basement membrane, disappearing completely in some cases. In the end, the peritoneal membrane consisted only of submesothelial connective tissue without any cells.Conclusions PD can modify peritoneal morphology and structure. The morphological change is progressive and may be one of the important causes of peritoneal failure. Peritoneal biopsies can provide lots of

  15. Clinical application of right low-position modified peritoneal dialysis catheterization

    OpenAIRE

    Ren, Wei; Chen, Wei; PAN, HUI-XUAN; Lan, Lei; WANG, PENG; HUANG, YE-HUA; KONG, MING; Wang, Yan

    2012-01-01

    The aim of this study was to investigate peritoneal dialysis catheter malposition following low-position modified peritoneal dialysis catheterization and its clinical application value. A total of 48 patients receiving traditional peritoneal dialysis catheterization (the traditional group) and 95 patients receiving right low-position modified peritoneal dialysis catheterization (the modified group) from 2006 to 2011 were selected. The inflow time, outflow time, ultrafiltration volume of perit...

  16. Transperitoneal transport of sodium during hypertonic peritoneal dialysis

    DEFF Research Database (Denmark)

    Graff, J; Fugleberg, S; Brahm, J;

    1996-01-01

    The mechanisms of transperitoneal sodium transport during hypertonic peritoneal dialysis were evaluated by kinetic modelling. A total of six nested mathematical models were designed to elucidate the presence or absence of diffusive, non-lymphatic convective and lymphatic convective solute transport....... Experimental results were obtained from 26 non-diabetic patients undergoing peritoneal dialysis. The model validation procedure demonstrated that only diffusive and non-lymphatic convective transport mechanisms were identifiable in the transperitoneal transport of sodium. Non-lymphatic convective sodium...... transport was the most important quantitative transport mechanism during the first 90 min of the dwell. Significant sodium sieving was demonstrated and explains the observation of hypernatremia in dialysis with hypertonic dialysis fluid....

  17. Two Cases of Massive Hydrothorax Complicating Peritoneal Dialysis

    International Nuclear Information System (INIS)

    Massive hydrothorax complicating continuous ambulatory peritoneal dialysis (CAPD) is relatively rare. A 67-year-old male and a 23-year-old female patients during CAPD presented massive pleural effusion, They have been performing peritoneal dialysis due to end-stage renal disease for 8 months and 2 weeks respectively. We injected '99mTc-labelled radiopharmaceutical (phytate and MAA, respectively) into peritoneal cavity with the dialysate. The anterior, posterior and right lateral images were obtained. The studies reveal visible radioactivity in the right chest indicating the communication between the peritoneal and the pleural space. After sclerotherapy with tetracycline, the same studies reveal no radioactivity in the right chest suggesting successful therapy. We think nuclear imaging is a simple and noninvasive method for the differential diagnosis of pleural effusion in patients during CAPD and the evaluation of therapy.

  18. Encapsulating Peritoneal Sclerosis – A rare and serious complication of peritoneal dialysis: Case series

    OpenAIRE

    Mihalache, O; Bugă, C; Doran, H; Catrina, E; Bobircă, F; Pătrașcu, T

    2014-01-01

    Introduction. Encapsulating peritoneal sclerosis is a pathological entity mainly associated with peritoneal dialysis (PD). The clinical syndrome is characterized by various degrees of intestinal obstruction due to thickening, sclerosis and calcification of peritoneum resulting in the encapsulation and cocooning of the bowel. It is a rare but potentially devastating complication associated with a considerable morbidity and mortality. Materials and methods. Cases of encapsulating peritoneal scl...

  19. Aspergillus niger peritonitis in a patient on continuous ambulatory peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Usha Kalawat

    2013-07-01

    Full Text Available Fungal peritonitis is an uncommon condition which is associated with high morbidity and mortality in patients on continuous ambulatory peritoneal dialysis (CAPD. It is associated with several complications and many of the patients who develop this condition are unable to resume CAPD treatment and have to shift to haemodialysis. Here we report the rare occurrence of fungal peritonitis due to Aspergillus niger in a patient on CAPD.

  20. A case of peritoneal dialysis-associated peritonitis caused by Sphingomonas paucimobilis

    OpenAIRE

    Lee, Jae Un; Kim, Joong Keun; Yun, So Hee; Park, Moon Sik; Lee, Na Eun; Sun, In O; Lee, Kwang Young

    2012-01-01

    Sphingomonas paucimobilis is an aerobic Gram-negative bacillus found in soil and water. Knowledge regarding the role of this infectious agent is limited because it is rarely isolated from human material. Furthermore, it is an unusual pathogen in cases of peritoneal dialysis (PD)-associated peritonitis. The clinical courses and outcomes of peritonitis caused by S. paucimobilis are variable. Whereas some patients were cured with appropriate antibiotic therapy, others required catheter removal. ...

  1. Analysis of depression in continuous ambulatory peritoneal dialysis patients.

    OpenAIRE

    Kim, Jung Ah; Lee, Yung Kee; Huh, Woo Seong; Kim, Yoon-Goo; Kim, Dae Joong; Oh, Ha-Young; Kang, Soon Ah; Kim Moon, Yang Ha; Kim, Han-Woo; Kim, Ji-Hae

    2002-01-01

    It is well known that depression and sense of hopelessness worsen the quality of life in end-stage renal disease (ESRD) patients receiving dialysis. However, the characteristics of depression in continuous ambulatory peritoneal dialysis (CAPD) patients have not been analyzed in detail. We performed this study to investigate the severity of depression and the factors affecting depression in CAPD patients. With 96 CAPD patients, we evaluated each patient's depressive mood and hopelessness with ...

  2. Changes of serum leptin levels and the influential factors in peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    晏焕青

    2014-01-01

    Objective To investigate the changes of serum leptin levels and the influential factors in maintenance peritoneal dialysis patients.Methods Seventy-six peritoneal dialysis patients were chosen at the time before,and 3months,6 months,12 months,18 months and 24months after they began the peritoneal dialysis therapy,to examine body mass index(BMI),

  3. PERITONEAL DIALYSIS: FROM ALTERNATIVE TO CONCEPT OF INTEGRATED END-STAGE RENAL DISEASE PATIENT’S CARE

    OpenAIRE

    Marina Avramović

    2004-01-01

    In the last 30 years peritoneal dialysis win the position in end-stage renal disease care. The numerous technical improvements were done: new types of peritoneal catheters were introduced, new dialysis systems, connecting devices, but also biocompatible dialysis solutions and machines for peritoneal dialysis-cyclers. The improved dialysis technique led to significant decline in incidence of peritonitis, as the most common complication on peritoneal dialysis. The attention is then directed to ...

  4. An unusual cause of peritonitis in peritoneal dialysis patients: Pantoea agglomerans.

    Science.gov (United States)

    Kazancioglu, Rumeyza; Buyukaydin, Banu; Iraz, Meryem; Alay, Murat; Erkoc, Reha

    2014-07-01

    Peritonitis is a serious infection and early diagnosis and treatment is mandatory. A variety of microorganisms are identified in these cases and during recent years a new one was included, Pantoea agglomerans. In this case report, a female patient on continuous ambulatory peritoneal dialysis therapy with a peritonitis episode caused by this organism is described. The source of infection was thought to be due to contact of catheter with non-sterile surfaces. In microbiologic culture, this organism was identified and the patient successfully treated with a three week course of gentamicin therapy. The number of reported cases with this organism has increased in last years and various infection localizations and clinical progress patterns have been identified. In peritoneal dialysis patients presenting with peritonitis, this organism must be kept in mind. PMID:25022305

  5. The Association Between Peritoneal Charge Barrier Dysfunction and Protein Lost During Continuous Ambulatory Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Guo-Qing Yu

    2013-07-01

    Full Text Available Background/Aims: The main purpose of the present study was to determine the effect of peritoneal charge barrier dysfunction on hypoalbuminemia during CAPD. Methods: We measured the association of dialysis dose, peritoneal equilibration test (PET results (ratio of dialysate and plasma creatinine, and peritoneal charge barrier index (ratio of pancreatic and salivary α-amylase clearance on protein loss in 33 patients on maintenance CAPD. All patients were from a single institution and were diagnosed with chronic nephritis (n = 18 cases, diabetic nephropathy (n = 8, hypertension (n = 5, and hepatitis B virus-associated glomerulonephritis (n = 2. Results: The mean (± SD dialysate protein loss was 4.04 g (± 1.97 per day. Protein loss was positively correlated with dialysis dose (r = 0.438, p = 0.01 but was not significantly correlated with PET results. The mean (± SD peritoneal charge barrier index was 6.12 (± 21.20 and was inversely correlated with protein loss into the peritoneal dialysate (r = -0.532, p Conclusions: Taken together, our study of CAPD patients indicates that protein loss into the peritoneal dialysate increases with peritoneal dialysis dose and with disruption of the peritoneal charge barrier.

  6. Preventive effect of continuous quality improvement on the malnutrition,inflammation,peritoneal dialysis adequacy and cardiovascular events in elderly peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    赵班

    2013-01-01

    Objective To investigate the preventive effect of continuous quality improvement (CQI) on malnutrition,inflammation,peritoneal dialysis adequacy and cardiovascular events in elderly patients undergoing peritoneal dialysis.Methods A single-center prospective self-controlled study was performed.32 stable elderly patients to undergo continuous ambulatory peritoneal dialysis (CAPD) were included.The continuous quality improvement program was conducted by using the 4-step problem-solving

  7. Peritoneal dialysis in an ageing population: a 10-year experience.

    LENUS (Irish Health Repository)

    Smyth, Andrew

    2012-02-01

    Chronic kidney disease (CKD) is becoming increasingly prevalent and there are increasing numbers of older patients with advanced CKD. Peritoneal dialysis (PD) is a potential treatment. This study aims to compare PD outcomes in age-defined populations in the largest PD centre in the Republic of Ireland over 10 years.

  8. Optimising intraperitoneal gentamicin dosing in peritoneal dialysis patients with peritonitis (GIPD study

    Directory of Open Access Journals (Sweden)

    Lipman Jeffrey

    2009-12-01

    Full Text Available Abstract Background Antibiotics are preferentially delivered via the peritoneal route to treat peritonitis, a major complication of peritoneal dialysis (PD, so that maximal concentrations are delivered at the site of infection. However, drugs administered intraperitoneally can be absorbed into the systemic circulation. Drugs excreted by the kidneys accumulate in PD patients, increasing the risk of toxicity. The aim of this study is to examine a model of gentamicin pharmacokinetics and to develop an intraperitoneal drug dosing regime that maximises bacterial killing and minimises toxicity. Methods/Design This is an observational pharmacokinetic study of consecutive PD patients presenting to the Royal Brisbane and Women's Hospital with PD peritonitis and who meet the inclusion criteria. Participants will be allocated to either group 1, if anuric as defined by urine output less than 100 ml/day, or group 2: if non-anuric, as defined by urine output more than 100 ml/day. Recruitment will be limited to 15 participants in each group. Gentamicin dosing will be based on the present Royal Brisbane & Women's Hospital guidelines, which reflect the current International Society for Peritoneal Dialysis Peritonitis Treatment Recommendations. The primary endpoint is to describe the pharmacokinetics of gentamicin administered intraperitoneally in PD patients with peritonitis based on serial blood and dialysate drug levels. Discussion The study will develop improved dosing recommendations for intraperitoneally administered gentamicin in PD patients with peritonitis. This will guide clinicians and pharmacists in selecting the most appropriate dosing regime of intraperitoneal gentamicin to treat peritonitis. Trial Registration ACTRN12609000446268

  9. MRI in the diagnosis of a peritoneal leak in continuous ambulatory peritoneal dialysis

    International Nuclear Information System (INIS)

    Mechanical problems in continuous ambulatory peritoneal dialysis (CAPD) can result in ultrafiltration failure and disruption of CAPD therapy. The recently described tool of CT peritoneography with water-soluble contrast medium has the disadvantage of radiation and instillation of nephrotoxic substances. We report a child with a peritoneal leak diagnosed by MRI after instillation of a gadodiamide-dialysate mixture. This method provided good anatomical detail without radiation or nephrotoxic agents. (orig.)

  10. Higher Peritoneal Protein Clearance as a Risk Factor for Cardiovascular Disease in Peritoneal Dialysis Patient

    OpenAIRE

    Chang, Tae Ik; Kang, Ea Wha; Lee, Yong Kyu; Shin, Sug Kyun

    2013-01-01

    Background and Aims Although a number of studies have been published on peritoneal protein clearance (PrCl) and its association with patient outcomes, the results have been inconsistent. Therefore, the intent of this study was to evaluate the impact of PrCl on cardiovascular disease (CVD) and mortality in peritoneal dialysis (PD) patients. Methods This prospective observational study included a total of 540 incident patients who started PD at NHIC Ilsan Hospital, Korea from January 2000 to De...

  11. PI3K / Akt signaling regulates epithelialmesenchymal transition of peritoneal mesothelial cells in peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    彭翔

    2014-01-01

    Objective To investigate the role of PI3K/Akt signaling in the regulation of epithelial-mesenchymal transition(EMT)of peritoneal mesothelial cells(PMCs)in peritoneal dialysis in vitro and in vivo.Methods The level of phosphorylated serine/threonine kinase Akt and the expression of EMT associated gene and protein,including ZO-1,Vimentin and FN,were measured in mice EMT model.In vitro study,phosphorylation level and

  12. Sclerosing encapsulating peritonitis in chronic ambulatory peritoneal dialysis;preoperative catheter drainage : a case report

    International Nuclear Information System (INIS)

    Sclerosing encapsulating peritonitis is a well recognized, but uncommon, complication of chronic ambulatory peritoneal dialysis. I report a case of sclerosing encapsulating peritonitis in which percutaneous catheter drainage was performed preoperatively. Ultrasonography(US) and computed tomography(CT) showed a large multi-septated cystic mass which occupied nearly all the peritoneal cavity. Percutaneous drainage with two 8.5 French catheters was preoperatively performed under fluoroscopy and about 2100 ml of bloody fluid was drained for 20 days. On follow-up CT, the size of the cyst had significantly decreased and anoperation was performed. It is considered that percutaneous catheter drainage is useful in the preoperative decompression of sclerosing encapsulating peritonitis

  13. Biocompatible peritoneal dialysis solutions: many questions but few answers.

    Science.gov (United States)

    Blake, Peter G; Jain, Arsh K; Yohanna, Sechelle

    2013-11-01

    The clinical value of biocompatible peritoneal dialysis solutions is uncertain because of inconsistent findings in randomized controlled trials. A systematic review by Cho et al. examining 20 such trials suggests a beneficial effect on residual renal function. However, the finding is not robust and may relate to decreased ultrafiltration causing hypervolemia. Future prescribing of these biocompatible solutions will probably continue to be driven by opinion, marketing, and cost considerations rather than by evidence-based medicine. PMID:24172730

  14. Association between blood cadmium levels and malnutrition in peritoneal dialysis

    OpenAIRE

    Hsu, Ching-Wei; Lin, Ja-Liang; Lin-Tan, Dan-Tzu; Huang, Wen-Hung; Chen, Kuan-Hsing; Yen, Tzung-Hai

    2014-01-01

    Background Malnutrition is associated with an increased risk of cardiovascular death and may cause protein-energy wasting in individuals with chronic kidney disease. A previous study demonstrated that blood cadmium levels (BCLs) were associated with malnutrition in maintenance hemodialysis (MHD) patients. However, the correlation between cadmium exposure and malnutrition remains unclear in chronic peritoneal dialysis (CPD) patients. This study examined the possible adverse effects of environm...

  15. The importance of ultrasonographic measurement of peritoneal wall thickness in pediatric chronic peritoneal dialysis patients.

    Science.gov (United States)

    Yavaşcan, Önder; Aksu, Nejat; Alparslan, Caner; Sarıtaş, Serdar; Elmas, Cengiz Han; Eraslan, Ali Nihat; Duman, Soner; Mir, Sevgi

    2015-04-01

    Loss of peritoneal function due to peritoneal fibrosing syndrome (PFS) is a major factor leading to treatment failure in chronic peritoneal dialysis (PD) patients. Although the precise biologic mechanisms responsible for these changes have not been defined, the general assumption is that alterations in peritoneal function are related to structural changes in the peritoneal membrane. Studies of the peritoneal membrane by non-invasive ultrasonography (US) in chronic PD patients are limited. The aim of the present study is to assess the relationship between functional parameters of peritoneum and peritoneal thickness measured by US in children treated by chronic PD. We recruited two groups of patients: 23 subjects (13 females, 10 males) on chronic PD (patient group) and 26 (7 females, 19 males) on predialysis out-patient follow-up (creatinine clearance: 20-60 mL/min/1.73 m(2)) (control group). Age, sex, weight, height, body mass index (BMI), chronic PD duration, episodes of peritonitis and the results of peritoneal equilibration test (PET) were recorded. Hemoglobin (Hb), blood pressure (BP), left ventricular mass index (LVMI) and renal osteodystrophy (ROD) parameters were also obtained. The thickness of the parietal peritoneum was measured by trans-abdominal US in all children. Statistical analyses were performed by using Student's t and Pearson's correlation tests. Mean peritoneal thickness in chronic PD patients (1028.26 ± 157.26 μm) was significantly higher than control patients (786.52 ± 132.33). Mean peritoneal thickness was significantly correlated with mean body height (R(2) = 0.93, p measurement of peritoneal membrane thickness is a simple and non-invasive method in chronic PD children. This diagnostic tool likely enables to assess peritoneal structure and function in these patients. PMID:25594613

  16. Risk of peritonitis during peritoneal dialysis in carriers of Staphylococcus aureus and coagulase-negative staphylococci

    Directory of Open Access Journals (Sweden)

    J. E. N. Batalha

    2006-01-01

    Full Text Available The presence of Staphylococcus aureus in the nasal cavities and pericatheter skin of peritoneal dialysis patients put them at high risk of developing peritonitis. However, it is not clear whether the presence of coagulase-negative staphylococci (CNS in the nasal passages and skin of patients is related to subsequent occurrence of peritoneal infection. The aim of the present study was to verify the relationship between endogenous sources of S. aureus and CNS and occurrence of peritonitis in patients undergoing peritoneal dialysis. Thirty-two patients on peritoneal hemodialysis were observed for 18 months. Staphylococcus species present in their nasal passage, pericatheter skin and peritoneal effluent were identified and compared based on drug susceptibility tests and dendrograms, which were drawn to better visualize the similarity among strains from extraperitoneal sites as well as their involvement in the causes of infection. Out of 288 Staphylococcus strains isolated, 155 (53.8% were detected in the nasal cavity, 122 (42.4% on the skin, and 11 (3.8% in the peritoneal effluent of patients who developed peritonitis during the study. The most frequent Staphylococcus species were CNS (78.1%, compared with S. aureus (21.9%. Among CNS, S. epidermidis was predominant (64.4%, followed by S. warneri (15.1%, S. haemolyticus (10.7%, and other species (9.8%. Seven (64% out of 11 cases of peritonitis analyzed presented similar strains. The same strain was isolated from different sites in two (66% out of three S. aureus infection cases. In the six cases of S. epidermidis peritonitis, the species that caused infection was also found in the normal flora. From these, two cases (33% presented highly similar strains and in three cases (50%, it was difficult to group strains as to similarity. Patients colonized with multidrug-resistant S. epidermidis strains were more predisposed to infection. Results demonstrated that an endogenous source of S. epidermidis could

  17. Pleuroperitoneal Leak Complicating Peritoneal Dialysis: A Case Series

    Directory of Open Access Journals (Sweden)

    C. Kennedy

    2011-01-01

    Full Text Available Pressure related complications such as abdominal wall hernias occur with relative frequency in patients on peritoneal dialysis. Less frequently, a transudative pleural effusion containing dialysate can develop. This phenomenon appears to be due to increased intra-abdominal pressure in the setting of congenital or acquired diaphragmatic defects. We report three cases of pleuroperitoneal leak that occurred within a nine-month period at our institution. We review the literature on this topic, and discuss management options. The pleural effusion resolved in one patient following drainage of the peritoneum and a switch to haemodialysis. One patient required emergency thoracocentesis. The third patient developed a complex effusion requiring surgical intervention. The three cases highlight the variability of this condition in terms of timing, symptoms and management. The diagnosis of a pleuroperitoneal leak is an important one as it is managed very differently to most transudative pleural effusions seen in this patient population. Surgical repair may be necessary in those patients who wish to resume peritoneal dialysis, or in those patients with complex effusions. Pleuroperitoneal leak should be considered in the differential diagnosis of a pleural effusion, particularly a right-sided effusion, in a patient on peritoneal dialysis.

  18. Pleuroperitoneal leak complicating peritoneal dialysis: a case series.

    LENUS (Irish Health Repository)

    Kennedy, C

    2012-02-01

    Pressure related complications such as abdominal wall hernias occur with relative frequency in patients on peritoneal dialysis. Less frequently, a transudative pleural effusion containing dialysate can develop. This phenomenon appears to be due to increased intra-abdominal pressure in the setting of congenital or acquired diaphragmatic defects. We report three cases of pleuroperitoneal leak that occurred within a nine-month period at our institution. We review the literature on this topic, and discuss management options. The pleural effusion resolved in one patient following drainage of the peritoneum and a switch to haemodialysis. One patient required emergency thoracocentesis. The third patient developed a complex effusion requiring surgical intervention. The three cases highlight the variability of this condition in terms of timing, symptoms and management. The diagnosis of a pleuroperitoneal leak is an important one as it is managed very differently to most transudative pleural effusions seen in this patient population. Surgical repair may be necessary in those patients who wish to resume peritoneal dialysis, or in those patients with complex effusions. Pleuroperitoneal leak should be considered in the differential diagnosis of a pleural effusion, particularly a right-sided effusion, in a patient on peritoneal dialysis.

  19. microRNA Regulation of Peritoneal Cavity Homeostasis in Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Melisa Lopez-Anton

    2015-01-01

    Full Text Available Preservation of peritoneal cavity homeostasis and peritoneal membrane function is critical for long-term peritoneal dialysis (PD treatment. Several microRNAs (miRNAs have been implicated in the regulation of key molecular pathways driving peritoneal membrane alterations leading to PD failure. miRNAs regulate the expression of the majority of protein coding genes in the human genome, thereby affecting most biochemical pathways implicated in cellular homeostasis. In this review, we report published findings on miRNAs and PD therapy, with emphasis on evidence for changes in peritoneal miRNA expression during long-term PD treatment. Recent work indicates that PD effluent- (PDE- derived cells change their miRNA expression throughout the course of PD therapy, contributing to the loss of peritoneal cavity homeostasis and peritoneal membrane function. Changes in miRNA expression profiles will alter regulation of key molecular pathways, with the potential to cause profound effects on peritoneal cavity homeostasis during PD treatment. However, research to date has mainly adopted a literature-based miRNA-candidate methodology drawing conclusions from modest numbers of patient-derived samples. Therefore, the study of miRNA expression during PD therapy remains a promising field of research to understand the mechanisms involved in basic peritoneal cell homeostasis and PD failure.

  20. microRNA Regulation of Peritoneal Cavity Homeostasis in Peritoneal Dialysis

    Science.gov (United States)

    Lopez-Anton, Melisa; Bowen, Timothy; Jenkins, Robert H.

    2015-01-01

    Preservation of peritoneal cavity homeostasis and peritoneal membrane function is critical for long-term peritoneal dialysis (PD) treatment. Several microRNAs (miRNAs) have been implicated in the regulation of key molecular pathways driving peritoneal membrane alterations leading to PD failure. miRNAs regulate the expression of the majority of protein coding genes in the human genome, thereby affecting most biochemical pathways implicated in cellular homeostasis. In this review, we report published findings on miRNAs and PD therapy, with emphasis on evidence for changes in peritoneal miRNA expression during long-term PD treatment. Recent work indicates that PD effluent- (PDE-) derived cells change their miRNA expression throughout the course of PD therapy, contributing to the loss of peritoneal cavity homeostasis and peritoneal membrane function. Changes in miRNA expression profiles will alter regulation of key molecular pathways, with the potential to cause profound effects on peritoneal cavity homeostasis during PD treatment. However, research to date has mainly adopted a literature-based miRNA-candidate methodology drawing conclusions from modest numbers of patient-derived samples. Therefore, the study of miRNA expression during PD therapy remains a promising field of research to understand the mechanisms involved in basic peritoneal cell homeostasis and PD failure. PMID:26495316

  1. Causes for Withdrawal in an Urban Peritoneal Dialysis Program

    Directory of Open Access Journals (Sweden)

    Biruh Workeneh

    2015-01-01

    Full Text Available Background. Peritoneal dialysis (PD is an underutilized dialysis modality in the United States, especially in urban areas with diverse patient populations. Technique retention is a major concern of dialysis providers and might influence their approach to patients ready to begin dialysis therapy. Methods. Records from January 2009 to March 2014 were abstracted for demographic information, technique duration, and the reasons for withdrawal. Results. The median technique survival of the 128 incident patients during the study window was 781 days (2.1 years. The principle reasons for PD withdrawal were repeated peritonitis (30%; catheter dysfunction (18%; ultrafiltration failure (16%; patient choice or lack of support (16%; or hernia, leak, or other surgical complications (6%; and a total of 6 patients died during this period. Of the patients who did not expire and were not transplanted, most transferred to in-center hemodialysis and 8% transitioned to home-hemodialysis. Conclusions. Our findings suggest measures to ensure proper catheter placement and limiting infectious complications should be primary areas of focus in order to promote technique retention. Lastly, more focused education about home-hemodialysis as an option may allow those on PD who are beginning to demonstrate signs of technique failure to stay on home therapy.

  2. Total volume culture technique for the isolation of microorganisms from continuous ambulatory peritoneal dialysis patients with peritonitis.

    OpenAIRE

    Dawson, M S; Harford, A M; Garner, B K; Sica, D A; Landwehr, D M; Dalton, H P

    1985-01-01

    A total volume method of culturing dialysis fluid from continuous ambulatory peritoneal dialysis patients during episodes of peritonitis was developed. Concentrated culture media stored in small blood transfer bags were added directly to the drained dialysate exchange bags by the same technique used to carry out the dialysate exchange. The exchange bag with the added culture medium was incubated at 35 degrees C and observed for turbidity. Seventy-eight dialysis exchange bags from patients wit...

  3. Arthritis associated with calcium oxalate crystals in an anephric patient treated with peritoneal dialysis

    International Nuclear Information System (INIS)

    The authors report a case of calcium oxalate arthropathy in a woman undergoing intermittent peritoneal dialysis who was not receiving pharmacologic doses of ascorbic acid. She developed acute arthritis, with calcium oxalate crystals in Heberden's and Bouchard's nodes, a phenomenon previously described in gout. Intermittent peritoneal dialysis may be less efficient than hemodialysis in clearing oxalate, and physicians should now consider calcium oxalate-associated arthritis in patients undergoing peritoneal dialysis who are not receiving large doses of ascorbic acid

  4. Bioimpedance Spectroscopy for the Detection of Fluid Overload in Chinese Peritoneal Dialysis Patients

    OpenAIRE

    Kwan, Bonnie Ching-Ha; Szeto, Cheuk-Chun; Chow, Kai-Ming; Law, Man-Ching; Cheng, Mei Shan; Leung, Chi-Bon; Pang, Wing-Fai; Kwong, Vickie Wai-Ki; Li, Philip Kam-tao

    2014-01-01

    ♦ Background: Fluid overload probably contributes to the cardiovascular risk of peritoneal dialysis (PD) patients. We studied the relationship between over-hydration as determined by bioimpedance spectroscopy and dialysis adequacy, nutritional status, and arterial stiffness in Chinese PD patients.

  5. Peritoneal Dialysis in Childhood Acute Kidney Injury: Experience in Southwest Nigeria

    Science.gov (United States)

    Ademola, Adebowale Dele; Asinobi, Adanze Onyenonachi; Ogunkunle, Oluwatoyin Olufunmilayo; Yusuf, Bamidele Nurudeen; Ojo, Olalekan Ezekiel

    2012-01-01

    ♦ Background: The choices for renal replacement therapy (RRT) in childhood acute kidney injury (AKI) are limited in low-resource settings. Peritoneal dialysis (PD) appears to be the most practical modality for RRT in young children with AKI in such settings. Data from sub-Saharan Africa on the use of PD in childhood AKI are few. ♦ Methods: We performed a retrospective study of children who underwent PD for AKI at a tertiary-care hospital in southwest Nigeria from February 2004 to March 2011 (85 months). ♦ Results: The study included 27 children (55.6% female). Mean age was 3.1 ± 2.6 years, with the youngest being 7 days, and the oldest, 9 years. The causes of AKI were intravascular hemolysis (n = 11), septicemia (n = 8), acute glomerulonephritis (n = 3), gastroenteritis (n = 3), and hemolytic uremic syndrome (n = 2). Peritoneal dialysis was performed manually using percutaneous or adapted catheters. Duration of PD ranged from 6 hours to 12 days (mean: 5.0 ± 3.3 days). The main complications were peritonitis (n = 10), pericatheter leakage (n = 9), and catheter outflow obstruction (n = 5). Of the 27 patients, 19 (70%) survived till discharge. ♦ Conclusions: In low-resource settings, PD can be successfully performed for the management of childhood AKI. In our hospital, the use of adapted catheters may have contributed to the high complication rates. Peritoneal dialysis should be promoted for the management of childhood AKI in low-resource settings, and access to percutaneous or Tenckhoff catheters, dialysis fluid, and automated PD should be increased. PMID:22550119

  6. Transperitoneal transport in diabetic and non-diabetic patients on peritoneal dialysis

    DEFF Research Database (Denmark)

    Graff, J; Fugleberg, Steen; Nielsen, S L;

    1999-01-01

    To investigate differences in the transport characteristics of the peritoneal membrane between diabetic and non-diabetic patients on chronic peritoneal dialysis, a study was conducted in 21 non-diabetic and 18 diabetic patients. Transperitoneal transport of small solutes was evaluated in terms......-labelled human albumin. Despite a significantly increased transcapillary escape rate of albumin in the diabetic patients, no differences in peritoneal membrane characteristics could be demonstrated between diabetic and non-diabetic patients on peritoneal dialysis....

  7. The potential role of HMGB1 release in peritoneal dialysis-related peritonitis.

    Directory of Open Access Journals (Sweden)

    Shirong Cao

    Full Text Available High mobility group box 1 (HMGB1, a DNA-binding nuclear protein, has been implicated as an endogenous danger signal in the pathogenesis of infection diseases. However, the potential role and source of HMGB1 in the peritoneal dialysis (PD effluence of patients with peritonitis are unknown. First, to evaluate HMDB1 levels in peritoneal dialysis effluence (PDE, a total of 61 PD patients were enrolled in this study, including 42 patients with peritonitis and 19 without peritonitis. Demographic characteristics, symptoms, physical examination findings and laboratory parameters were recorded. HMGB1 levels in PDE were determined by Western blot and ELISA. The concentrations of TNF-α and IL-6 in PDE were quantified by ELISA. By animal model, inhibition of HMGB1 with glycyrrhizin was performed to determine the effects of HMGB1 in LPS-induced mice peritonitis. In vitro, a human peritoneal mesothelial cell line (HMrSV5 was stimulated with lipopolysaccharide (LPS, HMGB1 extracellular content in the culture media and intracellular distribution in various cellular fractions were analyzed by Western blot or immunofluorescence. The results showed that the levels of HMGB1 in PDE were higher in patients with peritonitis than those in controls, and gradually declined during the period of effective antibiotic treatments. Furthermore, the levels of HMGB1 in PDE were positively correlated with white blood cells (WBCs count, TNF-α and IL-6 levels. However, pretreatment with glycyrrhizin attenuated LPS-induced acute peritoneal inflammation and dysfunction in mice. In cultured HMrSV5 cells, LPS actively induced HMGB1 nuclear-cytoplasmic translocation and release in a time and dose-dependent fashion. Moreover, cytosolic HMGB1 was located in lysosomes and secreted via a lysosome-mediated secretory pathway following LPS stimulation. Our study demonstrates that elevated HMGB1 levels in PDE during PD-related peritonitis, at least partially, from peritoneal mesothelial cells

  8. Successful treatment of Cryptococcus laurentii peritonitis in a patient on peritoneal dialysis.

    Science.gov (United States)

    Asano, Marina; Mizutani, Makoto; Nagahara, Yasuko; Inagaki, Koji; Kariya, Tetsuyoshi; Masamoto, Daijiro; Urai, Makoto; Kaneko, Yukihiro; Ohno, Hideaki; Miyazaki, Yoshitsugu; Mizuno, Masashi; Ito, Yasuhiko

    2015-01-01

    A 32-year-old man on peritoneal dialysis (PD) was hospitalized for seven days due to fever. A diagnosis of yeast-like fungal peritonitis was made by Gram staining. The patient was started on intravenous micafungin and oral fluconazole therapy following removal of the PD catheter. A fungal pathogen was isolated from the peritoneal fluid and identified as Cryptococcus species. Based on antifungal susceptibility testing, the treatment was changed to voriconazole and continued for 3 months. A genetic analysis identified the isolate as Cryptococcus laurentii (C. laurentii). This patient was diagnosed with C. laurentii PD-related peritonitis and was successfully treated with voriconazole and removal of the PD catheter. PMID:25876577

  9. Newer antibiotics for the treatment of peritoneal dialysis-related peritonitis.

    Science.gov (United States)

    Ma, Terry King-Wing; Leung, Chi Bon; Chow, Kai Ming; Kwan, Bonnie Ching-Ha; Li, Philip Kam-Tao; Szeto, Cheuk Chun

    2016-08-01

    Peritonitis is a debilitating infectious complication of peritoneal dialysis (PD). Drug-resistant bacterial peritonitis typically has a lower response rate to antibiotics. In the past 15 years, newer antibiotics with activities against drug-resistant Gram-positive bacteria have been developed. In most circumstances, peritonitis due to methicillin-resistant staphylococci responds to vancomycin. If vancomycin cannot be used due to allergy and/or non-susceptibility, there is increasing evidence that linezolid and daptomycin are the drugs of choice. It is reasonable to start linezolid orally or intravenously, but subsequent dose reduction may be necessary in case of myelosuppression. Daptomycin can be given intravenously or intraperitoneally and has excellent anti-biofilm activity. Other treatment options for drug-resistant Gram-positive bacterial peritonitis include teicoplanin, tigecycline and quinupristin/dalfopristin. Teicoplanin is not available in some countries (e.g. the USA). Tigecycline can only be given intravenously. Quinupristin/dalfopristin is ineffective against Enterococcus faecalis and there is only low-quality evidence to support its efficacy in the treatment of peritonitis. Effective newer antibiotics against drug-resistant Gram-negative bacteria are lacking. Polymyxins can be considered, but evidence on its efficacy is limited. In this review, we will discuss the potential use of newer antibiotics in the treatment of drug-resistant bacterial peritonitis in PD patients. PMID:27478608

  10. Consecutive episodes of peritonitis in a patient undergoing peritoneal dialysis caused by unusual organisms: Brevibacterium and Pantoea agglomerans

    OpenAIRE

    Choi, Joon Seok; Kim, Chang Seong; Park, Jeong Woo; Bae, Eun Hui; Ma, Seong Kwon; Kim, Soo Wan

    2012-01-01

    A 52-year-old man undergoing continuous ambulatory peritoneal dialysis presented with two consecutive episodes of peritonitis caused by unusual organisms, namely, Brevibacterium and Pantoea agglomerans. The patient was successfully treated with a 2-week course of cefazolin and ceftazidime for the Brevibacterium-associated peritonitis, and a 3-week course of gentamicin for the P. agglomerans-associated peritonitis. Although these environmental organisms are rarely responsible for human infecti...

  11. Clinical and microbiological evaluation of four culture methods for the diagnosis of peritonitis in patients on continuous ambulatory peritoneal dialysis.

    OpenAIRE

    Doyle, P W; Crichton, E. P.; Mathias, R G; Werb, R

    1989-01-01

    A prospective study was performed to evaluate four culture methods for the diagnosis of bacterial peritonitis in patients on continuous ambulatory peritoneal dialysis. Peritonitis was present in 44 of 85 patient admissions (52%). The overall sensitivity of the culture methods in detecting peritonitis was 66%. The sensitivities of the individual methods were as follows: bag culture method, 61%; blood culture broth method, 51%; filter method, 54%; and plate method, 39%. Our broad definition of ...

  12. Evaluation of the Importance of Patient Education in Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Meltem Gürsu

    2010-03-01

    Full Text Available Aim: Peritoneal dialysis is the type of renal replacement therapy which requires active participation of the patient; therefore, the education of the patient is of major importance. We aimed to evaluate objectively the importance of continuation of education in patients on peritoneal dialysis (PD. Methods: Thirty patients included in our study were asked to perform two questionnaires before and after an education session lasting about 45 minutes. The questions were about the functions of the kidneys, renal failure and PD techniques in the first one, and peritonitis, hypervolemia and nutrition in the second questionnaire. The numbers of correct answers before and after the education were compared. Results: The mean number of correct answers raised from 5.48±1.7 to 6.26±1.6 with the education in the first (p=0.002 and from 5.14±1.5 to 7.14±0.9 in the second questionnaire (p<0.001. Although there was a significant improvement with education, it was more obvious in the second questionnaire, suggesting better performance of both the teaching nurses and patients. In the first questionnaire, fifteen patients’ results improved with the education, while correct answers did not change in six of them. The number of correct answers increased in nineteen patients, while in three of them it did not change in the second questionnaire. Conclusion: The success rate of about only 60% in a test performed during the following months of treatment, in spite of a dense education program at the beginning of the dialysis, shows that this education must be repeated regularly. (The Medical Bulletin of Haseki 2010; 48: 14-7

  13. Dialysis

    Science.gov (United States)

    ... kidney transplant, you will need a treatment called dialysis. There are two main types of dialysis. Both types filter your blood to rid your ... clinic for treatments several times a week. Peritoneal dialysis uses the lining of your abdomen, called the ...

  14. Peritoneal Dialysis and the Process of Modality Selection

    OpenAIRE

    Blake, Peter G.; Quinn, Robert R; Matthew J Oliver

    2013-01-01

    The process of modality selection and how it works is a critical determinant of peritoneal dialysis (PD) utilization. This very complex process has not been well analyzed. Here, we break it down into 6 steps and point out how problems at each step can significantly reduce the proportion of endstage renal disease patients initiating PD. It is important that any program wising it to grow its use of PD understand the steps and the points at which problems may be arising. Examples are presented.

  15. A proposal on auxiliary business insurance for peritoneal dialysis treatment

    Institute of Scientific and Technical Information of China (English)

    WANG Juan; WANG Tao; FANG Ji-qian

    2008-01-01

    Background The peritoneal dialysis (PD) therapy for end stage renal disease (ESRD) is expensive. The main reason for non-acceptance onto dialysis programs is the great cost. In the present study, we design an auxiliary business insurance program to provide the potential ESRD patients who have no access to governmental medical insurance or can not afford the remaining part besides the limited reimbursement for peritoneal dialysis therapy.Methods The information applied in this study was extracted from the medical records of 641 PD patients, who were treated in two dialysis centers of the first and the third teaching hospitals of the Peking University respectively. A collective risk model was employed to estimate the expenses on PD therapy. Survival analyses were performed to obtain the average survival time of PD patients and the average length of time from the onset of the primary disease to the beginning of PD. An annuity method was used to determine the pure premium.Results For chronic nephritis, diabetes mellitus and hyperpietic as primary diseases, the mean survival time ± standard errors were (55.1±3.7) months, (38.9±3.2) months and (61.4±4.6) months respectively, and they were significantly different from each other (all P=0.000). The expenses of whole PD therapy were 242 159.05 Yuan, 182 525.02 Yuan and 284 579.24 Yuan respectively.Conclusions An auxiliary business insurance for PD patients was designed with the pure premium for any individual who had chronic nephritis, diabetes mellitus or hyperpietic as primary disease was RMB 35.94 Yuan/year, 87.73Yuan/year or 7.71 Yuan/year respectively without considering the additional premium for coping with the business expenditures and accidental risks.

  16. Cardiovascular morbidity and mortality risk factors in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Jovanović Dijana B.

    2008-01-01

    Full Text Available Cardiovascular (CVS morbidity and mortality in the endstage renal disease (ESRD patients on peritoneal dialysis therapy is 10-30 folds higher than in general population. The prevalence of well known traditional risk factors such as age, sex, race, arterial hypertension, hyperlipidaemia, diabetes, smoking, physical inactivity is higher in the uraemic patients. Besides these, there are specific, nontraditional risk factors for dialysis patients. Mild inflammation present in peritoneal dialysis (PD patients which can be confirmed by specific inflammatory markers is the cause of CVS morbidity and mortality in these patients. Hypoalbuminaemia, hyperhomocysteinaemia and a higher level of leptin are important predictors of vascular complications as well as CVS events in the PD patients. Plasma norepinephrine, an indicator of sympathetic activity, is high in the ESRD patients and higher in the PD patients than in the patients on haemodialysis (HD. Therefore, norepinephrine may be a stronger risk factor in the PD patients. The same applies to asymmetric dimethylargine (ADMA, an endogenous inhibitor of nitric oxide synthase, which is an important risk factor of CVS morbidity and mortality 15 % higher in the PD than the HD patients. Hyperphosphataemia, secondary hyperparathyroidism and high calcium x phosphate product have been associated with the progression of the coronary artery calcification and valvular calcifications and predict all-cause CVS mortality in the PD patients. Residual renal function (RRF declines with time on dialysis but is slower in the PD than the HD patients. RRF decline is associated with the rise of proinflammatory cytokines and the onset of hypervolaemia and hypertension which increase the risk of CVS diseases, mortality in general and CVS mortality. In conclusion, it is very important to establish all CVS risk factors in the PD patients to prevent CVS diseases and CVS mortality in this population.

  17. Care of the Patient with Renal Disease: Peritoneal Dialysis and Transplants, Nursing 321A.

    Science.gov (United States)

    Hulburd, Kimberly

    A description is provided of a course, "Care of the Patient with Renal Disease," offered at the community college level to prepare licensed registered nurses to care for patients with renal disease, including instruction in performing the treatments of peritoneal dialysis and continuous ambulatory peritoneal dialysis (CAPD). The first sections of…

  18. Non-infectious complications of continuous ambulatory peritoneal dialysis: evaluation with peritoneal computed tomography

    International Nuclear Information System (INIS)

    The purpose of the study was to evaluate the non-infectious complications of continuous ambulatory peritoneal dialysis (CAPD) using peritoneal computed tomography (PCT). Twenty symptomatic patients were included in the study. Initially 2000 ml of dialysate fluid was infused into the peritoneal cavity and standard peritoneal computed cavity and standard peritoneal computed tomography (SPCT) serial scans with 10 mm thickness were performed from the mid-thoracic region to the genital organs. Afterwards, 100 ml of non-ionic contrast material containing 300 mg/ml iodine was injected through the catheter and was distributed homogeneously in the intra-abdominal dialysate fluid by changing the positions of the patients; after waiting for 2-4 h, the CT scan was repeated as peritoneal contrast computed tomography (PCCT). In patients (n = 20) both SPCT and PCCT revealed 90 % (n = 18) pathological findings. But PCCT showed 60 % (n = 12) additional pathological findings. We believe that PCT is beneficial for evaluation of non-infectious complications of CAPD. But PCCT is superior to SPCT in evaluating non-infectious complications encountered in patients on CAPD treatment. (author)

  19. Prophylactic antibiotics for endoscopy-associated peritonitis in peritoneal dialysis patients.

    Directory of Open Access Journals (Sweden)

    Hsin-Hsu Wu

    Full Text Available INTRODUCTION: Continuous ambulatory peritoneal dialysis (CAPD peritonitis may develop after endoscopic procedures, and the benefit of prophylactic antibiotics is unclear. In the present study, we investigated whether prophylactic antibiotics reduce the incidence of peritonitis in these patients. PATIENTS AND METHODS: We retrospectively reviewed all endoscopic procedures, including esophagogastroduodenoscopy (EGD, colonoscopy, sigmoidoscopy, cystoscopy, hysteroscopy, and hysteroscopy-assisted intrauterine device (IUD implantation/removal, performed in CAPD patients at Chang Gung Memorial Hospital, Taiwan, between February 2001 and February 2012. RESULTS: Four hundred and thirty-three patients were enrolled, and 125 endoscopies were performed in 45 patients. Eight (6.4% peritonitis episodes developed after the examination. Antibiotics were used in 26 procedures, and none of the patients had peritonitis (0% vs. 8.1% without antibiotic use; p=0.20. The peritonitis rate was significantly higher in the non-EGD group than in the EGD group (15.9% [7/44] vs. 1.2% [1/81]; p<0.005. Antibiotic use prior to non-EGD examinations significantly reduced the endoscopy-associated peritonitis rate compared to that without antibiotic use (0% [0/16] vs. 25% [7/28]; p<0.05. Peritonitis only occurred if invasive procedures were performed, such as biopsy, polypectomy, or IUD implantation, (noninvasive procedures, 0% [0/20] vs. invasive procedures, 30.4% [7/23]; p<0.05. No peritonitis was noted if antibiotics were used prior to examination with invasive procedures (0% [0/10] vs. 53.8% [7/13] without antibiotic use; p<0.05. Although not statistically significant, antibiotics may play a role in preventing gynecologic procedure-related peritonitis (antibiotics, 0% [0/4] vs. no antibiotics, 55.6% [5/9]; p=0.10. CONCLUSION: Antibiotic prophylaxis significantly reduced endoscopy-associated PD peritonitis in the non-EGD group. Endoscopically assisted invasive procedures, such

  20. [Assisted peritoneal dialysis: home-based renal replacement therapy for the elderly patient].

    Science.gov (United States)

    Wiesholzer, Martin

    2013-06-01

    The number of elderly patients with end stage renal disease is constantly increasing. Conventional hämodiaylsis as the mainstay of renal replacement therapy is often poorly tolerated by frail eldery patients with multiple comorbidities. Although many of these patients would prefer a home based dialysis treatment, the number of elderly patients using peritoneal dialysis (PD) is still low. Impaired physical and cognitive function often generates insurmountable barriers for self care peritoneal dialysis. Assisted peritoneal dialysis can overcome many of these barriers and give elderly patients the ability of a renal replacement therapy in their own homes respecting their needs. PMID:23797681

  1. Psychosocial effects on caregivers for children on chronic peritoneal dialysis.

    Science.gov (United States)

    Tsai, T-C; Liu, S-I; Tsai, J-D; Chou, L-H

    2006-12-01

    The study was designed to explore the psychosocial effects on caretakers of children in Taiwan on chronic peritoneal dialysis (CPD). This is a case-control study, performed with subjects drawn from eight medical centers. The study group consisted of caretakers of 32 children with renal failure being treated with CPD. For comparison, a control group of caretakers of 64 healthy children as well as the regional Taiwanese studies were used. Two instruments were used to explore the presence of probable depression and quality of life (QOL) of the caretakers: the Taiwanese Depression Questionnaire, and the World Health Organization QOL BRIEF-Taiwan Version. In the study group, only 25% of caregivers had full-time jobs, and 66% of families had an annual income of less than US dollar 15,000. Of the 32 families in the study group, 16% had only a single parent. The prevalence of probable depression was significantly more common in the study group compared with control and referent group (28% vs 5% and 9.44%; P = 0.001). QOL scores in four domains were also significantly lower in the study group. In conclusion, even with the advances of peritoneal dialysis techniques, caring for children on CPD in Taiwan has significant adverse psychosocial effects on the primary caregivers. Attention should be paid to the psycho-social status of the caregivers. PMID:16985519

  2. Pharmacokinetics of Quinupristin-Dalfopristin in Continuous Ambulatory Peritoneal Dialysis Patients

    OpenAIRE

    Johnson, Curtis A.; Taylor, Claude A.; Zimmerman, Stephen W.; Bridson, William E.; Chevalier, Paul; Pasquier, Olivier; Baybutt, Robert I.

    1999-01-01

    Quinupristin-dalfopristin may be useful for treatment of organisms causing peritoneal dialysis-related peritonitis, including methicillin-resistant coagulase-negative staphylococci, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant enterococci. The pharmacokinetic profiles of single intravenous doses of this combination streptogramin antibiotic of 7.5 mg/kg of body weight were characterized for eight noninfected patients receiving continuous ambulatory peritoneal dialysis....

  3. Efficacy of bolus intravenous iron treatment in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Jovanović Nataša

    2005-01-01

    Full Text Available Introduction. Normocytic, normochromic anemia is one of the first signs of chronic renal failure and it is common in patients on chronic dialysis treatment. It causes decrease in oxygen supply to tissues, increases cardiac minute volume, causes left ventricular hyperthrophy, cardiac insufficiency, disorders related to cognitive functions and immune response, and increases morbidity and mortality rates. The leading cause of anemia in patients on chronic peritoneal dialysis (PD is iron depletion and most patients on PD need oral or parenteral iron supplementation. The aim of this study was to evaluate our first experience with bolus intravenous ferrogluconate therapy in patients on chronic peritoneal dialysis at the Nephrology Clinic of the Clinical Center of Serbia (CCS. Material and Methods. We examined 11 patients, 7 males and 4 females, mean-age 49 years (range 31 to 68 years on chronic PD. All patients received blood transfusions, oral or intramuscular iron supplementation before 465 to 665 mg ferrogluconate therapy was given in 500 ml. saline intravenous infusion; 5 of them were on erythropoietin therapy and 2 of them started with EPO therapy after the ferrogluconate therapy. Results. The blood count improved during the first 3 months after application of bolus intravenous iron therapy (ferrogluconate; erythropoietin dose was not increased during the follow-up. Some patients suffered from side effects during infusion and 6 patients received the complete treatment. Discussion. Blood count improves in a number of patients affected by end-stage renal disease during the first months on continuous ambulatory peritoneal dialysis (CAPD treatment. But a large number of patients on chronic CAPD treatment are iron-depleted and they require oral or parenteral substitution. Side effects and complications of intravenous iron therapy were not severe and only one patient suffered from allergic manifestations. Ferremia and blood count improved in patients

  4. The Use of Acute Peritoneal Dialysis in Critically Ill Newborns.

    Science.gov (United States)

    Ustyol, Lokman; Peker, Erdal; Demir, Nihat; Agengin, Kemal; Tuncer, Oguz

    2016-01-01

    BACKGROUND To evaluate the efficacy, complications, and mortality rate of acute peritoneal dialysis (APD) in critically ill newborns. MATERIAL AND METHODS The study included 31 newborns treated in our center between May 2012 and December 2014. RESULTS The mean birth weight, duration of peritoneal dialysis, and gestational age of the patients were determined as 2155.2±032.2 g (580-3900 g), 4 days (1-20 days), and 34 weeks (24-40 weeks), respectively. The main reasons for APD were sepsis (35.5%), postoperative cardiac surgery (16%), hypoxic ischemic encephalopathy (13%), salting of the newborn (9.7%), congenital metabolic disorders (6.1%), congenital renal diseases (6.5%), nonimmune hydrops fetalis (6.5%), and acute kidney injury (AKI) due to severe dehydration (3.2%). APD-related complications were observed in 48.4% of the patients. The complications encountered were catheter leakages in nine patients, catheter obstruction in three patients, peritonitis in two patients, and intestinal perforation in one patient. The general mortality rate was 54.8%, however, the mortality rate in premature newborns was 81.3%. CONCLUSIONS APD can be an effective, simple, safe, and important therapy for renal replacement in many neonatal diseases and it can be an appropriate treatment, where necessary, for newborns. Although it may cause some complications, they are not common. However, it should be used carefully, especially in premature newborns who are vulnerable and have a high mortality risk. The recommendation of APD therapy in such cases needs to be verified by further studies in larger patient populations. PMID:27121012

  5. Nasal Carriage and Peritonitis by Staphylococcus Aureus in Patients on Continuous Ambulatory Peritoneal Dialysis: a prospective study

    NARCIS (Netherlands)

    G.J.A. Wanten; P. van Oost; P.M. Schneeberger (Peter); M.I. Koolen (Marianne)

    1996-01-01

    textabstractThe objective of this study was to establish whether or not patients on continuous ambulatory peritoneal dialysis (CAPD) using current infection control measures who are nasal carriers of staphylococcus aureus are at risk for the development of S. aureus peritonitis.

  6. CT in predicting abdominal cocoon in patients on peritoneal dialysis

    International Nuclear Information System (INIS)

    Aim: To evaluate the computed tomography (CT) signs of encapsulating peritoneal sclerosis (EPS) in patients on peritoneal dialysis (PD) as predictive factors for the evolution to abdominal cocoon (AC). Materials and methods: Clinical features and CT signs of 90 patients on PD were retrospectively reviewed. According to the clinical features, they were divided into three groups (asymptomatic, moderate, or severe). Clinical results were correlated with previously reported CT signs of EPS, i.e., peritoneal thickening, peritoneal calcifications, loculated fluids, small bowel faeces sign, small bowel obstruction, clustered bowel loops, pseudo sac, signs of bowel ischaemia or necrosis. AC was defined at CT by the association of clustered bowel loops and a pseudo sac. Statistical analysis was performed using the Fisher's exact test and the t-test. Results: Although demonstrated in symptomatic patients (p = 0.041), the occurrence of AC was not correlated with the severity of the symptoms (p = 0.16). Among the CT signs, the presence of loculated fluids (p = 0.011), a small bowel faeces sign (p = 0.002); and small bowel obstruction (p = 0.0001) were found to be statistically correlated with the appearance of an AC. Moreover, the association of loculated fluids, small bowel faeces sign, small bowel obstruction was extremely sensitive and specific in the development of AC (sensitivity = 67%, specifity = 100%, positive predictive value = 100%, negative predictive value = 96%). Conclusion: CT should be carried out in every symptomatic patient on PD. Indeed, the association of loculated fluid, small bowel faeces sign, and small bowel obstruction enables the prediction of the development of AC, which is likely to curtail PD and require surgery.

  7. Tc-99m DTPA scintigraphy for diagnosis of pleuro-peritoneal leak related to chronic peritoneal dialysis

    International Nuclear Information System (INIS)

    This study analyzes the feasibility of Tc-99m DTPA peritoneal scintigraphy for the diagnosis of pleuroperitoneal leakage. A 29 year old woman with end-stage renal disease, who was receiving continuous ambulatory peritoneal dialysis for 5 months, was hospitalized with severe dyspnea and oedema of lower extremities. A chest radiograph confirmed the presence of a right-sided pleural effusion. Hydro-soluble contrast agent was injected into the peritoneal cavity and a CT scan of the abdomen and thorax was performed, confirming the right pleural effusion which was further demonstrated as contrast-free. Peritoneal scintigraphy was done after intraperitoneal administration of Tc-99m DTPA through the peritoneal dialysis catheter together with the dialysis solution. Images were acquired immediately and 2 hours after radiotracer administration. In early and delayed images we observed the presence of the radiotracer in the right hemithorax, in the projection of the right lung field. This case report demonstrates that peritoneal scintigraphy performed with Tc-99m DTPA is effective in demonstrating pleuroperitoneal leak in patients with end stage renal disease who undergo peritoneal dialysis. (author)

  8. Antibody response following Hepatitis B vaccination in peritoneal dialysis patients: does normalized urea clearance matter?

    OpenAIRE

    Erkan Dervisoglu; Melih Simsek; Ahmet Yilmaz

    2011-01-01

    OBJECTIVES: Data on the factors that contribute to the antibody response to hepatitis B virus vaccination in peritoneal dialysis patients are scarce. The current study was conducted on a group of peritoneal dialysis patients to learn how the response to hepatitis B virus vaccination varies according to the patient's clearance of urea normalized to total body water (Kt/V). METHODS: A convenience sample of 33 peritoneal dialysis patients (13 women and 20 men, with a mean age of 49¡12 years) was...

  9. Nationwide peritoneal dialysis nurse training in Thailand: 3-year experience.

    Science.gov (United States)

    Thaiyuenwong, Jutiporn; Mahatanan, Nanta; Jiravaranun, Somsong; Boonyakarn, Achara; Rodpai, Somrak; Eiam-Ong, Somchai; Tungsanga, Kriang; Dhanakijcharoen, Prateep; Kanjanabuch, Talerngsak

    2011-09-01

    Peritoneal dialysis (PD) center is not possible to operate if there is no availability of dedicated PD nurse. Generally, the nurse has to play many roles, including educator coordinator, and sometimes leader. As professionalism, the PD nurses need to have both theoretical and practical skills. With the tremendous leap of PD population after the launch of "PD First" policy in Thailand, the shortage of skillful PD nurse is concerned. Hence, the nationwide PD nurse training course was established with the collaborations of many organizations and institutes. Until now, 3 generations of 225 PD nurses are the productions of the course. This number represents 80 percent of PD nurses distributed throughout the whole nation. The survey operated in the year 2010 demonstrated that the output of the course was acceptable in terms of quality since most of the trained PD nurses had a confidence in taking care of PD patients. The quality of patient care is good as indicated by KPIs. PMID:22043585

  10. Recurrent Chronic Ambulatory Peritoneal Dialysis-Associated Infection due to Rothia dentocariosa

    Directory of Open Access Journals (Sweden)

    Shaun K Morris

    2004-01-01

    Full Text Available Rothia dentocariosa is a commensal organism of the human oropharynx. Clinical infection due to this organism is rare. A case of recurrent peritoneal dialysis-related peritonitis caused by R dentocariosa and a review of the literature is reported. Isolation of R dentocariosa from dialysate fluid should not be dismissed as a contaminant. Although there are no interpretive criteria for antimicrobial susceptibility testing, R dentocariosa appears to be susceptible to a variety of antibiotics including beta-lactams, vancomycin and aminoglycosides. Optimal therapy of peritoneal dialysis peritonitis caused by this organism may also require removal of the catheter.

  11. Adequate peritoneal dialysis: theoretical model and patient treatment.

    Science.gov (United States)

    Tast, C

    1998-01-01

    The objective of this study was to evaluate the relationship between adequate PD with sufficient weekly Kt/V (2.0) and Creatinine clearance (CCR) (60l) and necessary daily dialysate volume. This recommended parameter was the result of a recent multi-centre study (CANUSA). For this there were 40 patients in our hospital examined and compared in 1996, who carried out PD for at least 8 weeks and up to 6 years. These goals (CANUSA) are easily attainable in the early treatment of many individuals with a low body surface area (BSA). With higher BSA or missing RRF (Residual Renal Function) the daily dose of dialysis must be adjusted. We found it difficult to obtain the recommended parameters and tried to find a solution to this problem. The simplest method is to increase the volume or exchange rate. The most expensive method is to change from CAPD to APD with the possibility of higher volume or exchange rates. Selection of therapy must take into consideration: 1. patient preference, 2. body mass, 3. peritoneal transport rates, 4. ability to perform therapy, 5. cost of therapy and 6. risk of peritonitis. With this information in mind, an individual prescription can be formulated and matched to the appropriate modality of PD. PMID:10392062

  12. Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Helal Imed

    2010-01-01

    Full Text Available Cardiovascular diseases are a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD. The aim of our investigation was the evaluation of an extensive cardiovascular profile in hemodialysis (HD and peritoneal dialysis (PD patients. We studied 74 patients with ESRD (38 males, 36 females, maintained either on chronic HD (n= 50 or chronic PD (n= 24 and age and sex matched 20 healthy subjects as controls. The lipid profile, homo-cysteine (Hcy and C reactive protein (CRP were measured. When compared to a healthy popu-lation, HD patients displayed a marked atherogenic profile, as attested by increased levels of total cholesterol (TC, triglycerides (TG, low-density lipoprotein-cholesterol (LDL-C, apolipoprotein A (Apo A, CRP, Hcy and lower concentrations of high-density lipoprotein-cholesterol (HDL-C, Apo B, albumin (ALB. A significant difference was noted concerning the rates of Apo B, HDL-C, TC, ALB and Hcy. Same biological disorders that those found at HD patients were noted in these PD patients. One also noted lower concentration in Apo A. there were a significant diffe-rence with the reference group concerning the rates of albumin, Apo A, HDL-Cl and Hcy. When compared to PD patients, HD patients had significantly decreased concentration of LDL-C. The peculiar metabolic changes observed in the present study confirm the marked tendency of patients with impaired renal function for developing cardiovascular diseases, irrespectively of the type of dialysis. We suggest including uremia-related risk factors in the panel for evaluation of cardio-vascular risk in dialysis patients.

  13. Comparison of different volume markers in peritoneal dialysis

    International Nuclear Information System (INIS)

    Four peritoneal volume markers (carbon 14-labeled dextran, dextran blue, radioactive albumin, and hemoglobin) were compared. In six rabbits 14C-dextran was compared with dextran blue during a 4-hour dwell with a 4.25% dextrose solution. The recovery of 14C-dextran at the end of the dwell was 71% +/- 3% vs. 92% +/- 1% for dextran blue (P less than 0.001). In six other rabbits, radioactive albumin (RISA) was compared with dextran blue. The recovery of RISA was 78% +/- 4%, compared with 85% +/- 2% for dextran blue (P less than 0.05). The calculated peritoneal volumes, uncorrected for disappearance of the markers, were consistently higher than when correction was made. After correction, the calculated end volumes were similar to actually measured end volumes. In six patients with chronic ambulatory peritoneal dialysis, the intraperitoneal volume during a single dwell of 6 hours was estimated in paired observations with lactated Ringer's solution and 1.5% dextrose dialysate, using simultaneously autologous hemoglobin and RISA. In eight additional patients, a single dwell with 4.25% dextrose dialysate was studied. The recoveries of both markers were related to the osmotic strength of the dialysate. Recoveries were 66.7% +/- 2.3% and 69.6% +/- 0.9% in lactated Ringer's solution, and increased to 81% +/- 3% and 82% +/- 2% in 4.25% dextrose for hemoglobin and RISA, respectively. With each dialysate, after correction for disappearance of the marker, no differences in volume profiles or between calculated or measured end volumes could be found with either hemoglobin or RISA

  14. Use of biogenic nanomaterials to improve the peritoneal dialysis technique: A Translational Research Perspective

    CERN Document Server

    Kumar, Dinesh

    2015-01-01

    Intraperitoneal and catheter exit site infections are the most common complications associated with prolonged peritoneal dialysis (PD) therapy used for treating the patients with end stage renal failure (ESRF). Recurrent and persistent infections often cause inflammation of the peritoneum, a condition known as infectious peritonitis and to resolve the condition, patients require antibiotic treatment. However, if the treatment is delayed or if it fails due to antibiotic resistance, the peritonitis may lead to permanent malfunctioning of peritoneal membrane causing technique failure and transferring the patients to haemodialysis. Severe and prolonged peritonitis is not only the major cause of technique failure, it is also the leading cause of mortality and morbidity in PD patients. Therefore, there is an urgent need to improve the existing PD technique so that the frequency of PD associated infections could be reduced and infectious peritonitis episodes thereof during prolonged peritoneal dialysis. In this pers...

  15. Solute clearance measurement in the assessment of dialysis adequacy among African continuous ambulatory peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Aliyu Abdu

    2015-01-01

    Full Text Available Solute clearance measurement is an objective means of quantifying the dose of peritoneal dialysis (PD. Despite continued debate on the interpretation and precise prognostic value of small solute clearance in PD patients, guidelines based on solute clearance values are common in clinical practice. There is limited information on the solute clearance indices and PD adequacy parameters among this predominantly low socioeconomic status PD population. We investigated the solute clearance among continuous ambulatory peritoneal dialysis (CAPD patients at the Charlotte Maxeke Johannesburg Academic Hospital and its relationship with other parameters of PD adequacy. Seventy patients on CAPD were studied in this cross-sectional study. Solute clearance was assessed using urea clearance (Kt/V. Linear regression analysis was used to determine factors associated with solute clearance, while analysis of variance was used to test the influence of weekly Kt/V on blood pressure (BP, hemoglobin (Hb and other biochemical parameters. The mean age of the study population was 37.9 ± 12.4 years, 43% were females and 86% were black Africans. The mean duration on CAPD was 19.7 ± 20.8 months. Mean systolic and diastolic BP were 144 ± 28 and 92 ± 17 mm Hg, respectively. The mean Hb was 11.1 ± 2.2 g/dL and the mean weekly Kt/V was 1.7 ± 0.3. Factors like systolic BP, Hb level, serum levels of cholesterol, calcium, phosphate, parathyroid hormone and albumin were not significantly associated with the weekly Kt/V. We conclude that the dose of PD received by the majority of our patients in terms of the weekly Kt/V is within the recommended values and that this finding is significant considering the low socioeconomic background of our patients. There is no significant association between Kt/V and other indices of dialysis adequacy.

  16. [Candida peritonitis and sepsis due to Acinetobacter baumannii in peritoneal dialysis: an association with prognosis not always unfavourable].

    Science.gov (United States)

    Rapisarda, Francesco; Aliotta, Roberta; Pocorobba, Barbara; Portale, Grazia; Ferrario, Silvia; Zanoli, Luca; Fatuzzo, Pasquale

    2015-01-01

    Fungal infections have a high incidence in patients receiving peritoneal dialysis. (1)
Peritoneal dialysis is often complicated by peritonitis which has only minimally mycotic etiology, but nonetheless it is associated with 15-45% mortality (8).
 The opportunistic pathogens such as Candida can cause infection in immunocompromised conditions. Even the Acinetobacter tends to infect immunocompromised individuals and it has the same risk factors for infection as Candida: immunosuppression, malignancy, HIV positivity and all the other conditions of immunosuppression, central venous catheterization, mechanical ventilation and prolonged antibiotic therapy. The sepsis by Acinetobacter predicts a negative prognosis with the mortality rate between 20 to 60% (12), especially in cases of isolation of multi-resistant germs.
 We present a case report of a CKD patient undergoing peritoneal dialysis therapy who was hospitalized for acute pancreatitis, later complicated by the development of pancreatic pseudocysts, C. albicans peritonitis with hematologic spread of the fungus, superimposed Acinetobacter baumannii sepsis and pneumonia. She has been subjected to percutaneous drainage of pseudocysts, to switch from peritoneal dialysis to hemodialysis, to various evacuative thoracentesis, and to polymicrobial therapy (meropenem, teicoplanina, tigeciclina, linezolid, colimicina, fluconazolo, etc.) that allowed the resolution of sepsis. The peculiarity of this case is represented by the numerous morbidity that the patient developed simultaneously, with the genesis of a complex clinical picture, by the combination of infections due to Candida albicans and Acinetobacter baumannii. Successful treatment strategies allowed to fight and cure a medical condition associated with a high mortality rate. PMID:26845211

  17. Removal of the Protein-Bound Solutes Indican and P-Cresol Sulfate by Peritoneal Dialysis

    OpenAIRE

    Pham, Nhat M.; Recht, Natalie S.; Hostetter, Thomas H.; Meyer, Timothy W.

    2008-01-01

    Background and objectives: Protein-bound solutes are poorly cleared by peritoneal dialysis. We examined the hypothesis that plasma concentrations of bound solutes would therefore rise as residual renal function is lost.

  18. Preperitoneal Tunneling—A Novel Technique in Peritoneal Dialysis Catheter Insertion

    OpenAIRE

    Modaghegh, Mohammad-Hadi Saeed; Kazemzadeh, Gholamhossein; Rajabnejad, Yaser; Nazemian, Fatemeh

    2014-01-01

    ♦ Introduction: This study describes a new preperitoneal tunneling (PPT) method for inserting a peritoneal dialysis catheter (PDC), thereby lessening surgical complications and increasing the catheter’s survival.

  19. Pleuroperitoneal Leak: An Unusual Cause of Acute Shortness of Breath in a Peritoneal Dialysis Patient

    Directory of Open Access Journals (Sweden)

    D. P. Ramaema

    2014-01-01

    Full Text Available Introduction. Pleuroperitoneal leak is an uncommon complication of continuous ambulatory peritoneal dialysis (CAPD, with an estimated incidence of 1.6%. It should be suspected in these patients when they present with recurrent unilateral pleural effusions and/or acute shortness of breath following dialysate infusion. Case Presentation. We present the case of a 25-year-old female patient who had acute hydrothorax as a result of pleuroperitoneal leak complicating continuous ambulatory peritoneal dialysis (CAPD, which was confirmed on peritoneal scintigraphy. Conclusion. Continuous ambulatory peritoneal dialysis patients presenting with acute shortness of breath and/or recurrent unilateral pleural effusion should be investigated with peritoneal scintigraphy to exclude pleuroperitoneal leak.

  20. Quality of life, mental health and health beliefs: comparison between haemodialysis and peritoneal dialysis patients

    OpenAIRE

    Theofilou P

    2010-01-01

    Aim: The comparative study between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (PD) patients regarding self-reported quality of life (QoL) as well as some psychological dimensions that may affect and may be affected by the patient’s state of health, like health locus of control beliefs, depression and anxiety. Material and Method: The sample consists of 144 patients in-centre haemodialysis or continuous ambulatory peritoneal dialysis (CAPD). Patient-reported ass...

  1. Comparison of Toxoplasma gondii seropositivity in hemodialysis and peritoneal dialysis patients

    OpenAIRE

    Faezeh Hamidi; Jalal Etemadi; Nader Ghabouli Mehrabani; Mahmoud Mahami Oskouei; Roza Motavalli; Mohammad Reza Ardalan

    2015-01-01

    Objective: To compare the seropositivity of Toxoplasma gondii in a group of peritoneal dialysis patients with hemodialysis patients and a general local population as a control group in Tabriz, Northwest Iran. Methods: A total of 176 individuals were participated in the present study. Among them, 42 were peritoneal dialysis patients, 84 were hemodialysis patients and 50 were healthy volunteers. Anti-Toxoplasma immunoglobulin G and immunoglobulin M serologic study was administ...

  2. Effect of peritoneal dialysis fluid and pH on bactericidal activity of ciprofloxacin.

    OpenAIRE

    McCormick, E M; Echols, R M

    1987-01-01

    Ciprofloxacin is active in vitro against most bacteria that cause peritonitis associated with peritoneal dialysis. We compared the effects of pH (5.5 and 7.4) and medium (dialysis fluid) on the bactericidal activity of ciprofloxacin, tobramycin, vancomycin plus rifampin, and rifampin against Pseudomonas aeruginosa, Escherichia coli, and three strains of staphylococci. The bactericidal activity of ciprofloxacin was not significantly affected by pH or medium, in contrast to the activity of tobr...

  3. Inhibiting effect of short hairpin RNA on expression of transforming growth factor-β1 in human peritoneal mesothelial cells induced by peritoneal dialysis solution

    Institute of Scientific and Technical Information of China (English)

    LIU Fu-you; LING Guang-hui; LIU Hong; PENG You-ming; LIU Ying-hong; DUAN Shao-bin

    2005-01-01

    @@ The peritoneum response to peritoneal dialysis can lead to fibrosis. The transforming growth factor-β1 (TGF-β1) plays an important role in regulating tissue repair and remodeling after injury. Excessive synthesis and deposition of matrix proteins by peritoneal mesothelial cells can lead to structural and functional changes in the peritoneal membrane, jeopardizing the long-term efficacy of peritoneal dialysis (PD).

  4. Effects of oral enalapril and verapamil on dialysis adequacy and solute clearance in chronic ambulatory peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Shahnaz Atabak

    2013-01-01

    Full Text Available Peritoneal dialysis offers several advantages such as better clearance of intermediate/large molecules and better preservation of renal residual function when compared with hemodialysis. However, dialysis adequacy is one of the subjects of concern of this modality. There are some drugs that are capable of influencing solute transport in the peritoneum, such as acetyle co-enzyme inhibitors (ACE-I medications and calcium channel blockers. Captopril and Verapamil are often mentioned, but their use has shown varying conclusions and initial studies were performed with the intra-peritoneal administration of these drugs and there are only a few studies on the effect of the oral administration of these drugs. This study was undertaken with the aim to evaluate the effects of oral administration of Verapamil and Enalapril among continuous ambulatory peritoneal dialysis (CAPD patients. The results of this study showed that Verapamil and Enalapril do not have any effects on glucose, creatinine, sodium, potassium and urea clearance (during the 4-h peritoneal equilibration test (PET test. However, it was shown that Enalapril significantly increased the peritoneal urea Kt/V and caused a meaningful decrease in the diastolic and mean blood pressures. Therefore, we feel that Enalapril may be administered as an anti-hypertensive medication of choice in CAPD patients, which can also result in better dialysis adequacy. However, further studies with larger sample sizes are needed in the future.

  5. Peritoneal transport characteristics with glucose polymer-based dialysis fluid in children.

    NARCIS (Netherlands)

    Rusthoven, E.; Krediet, R.T.; Willems, J.L.; Monnens, L.A.H.; Schröder, C.H.

    2004-01-01

    Scarce data are available on the use of glucose polymer-based dialysate in children. The effects of glucose polymer-based dialysate on peritoneal fluid kinetics and solute transport were studied in pediatric patients who were on chronic peritoneal dialysis, and a comparison was made with previously

  6. Higher peritoneal protein clearance as a risk factor for cardiovascular disease in peritoneal dialysis patient.

    Directory of Open Access Journals (Sweden)

    Tae Ik Chang

    Full Text Available BACKGROUND AND AIMS: Although a number of studies have been published on peritoneal protein clearance (PrCl and its association with patient outcomes, the results have been inconsistent. Therefore, the intent of this study was to evaluate the impact of PrCl on cardiovascular disease (CVD and mortality in peritoneal dialysis (PD patients. METHODS: This prospective observational study included a total of 540 incident patients who started PD at NHIC Ilsan Hospital, Korea from January 2000 to December 2009. Two different types of analyses such as intention-to-treat and as-treated were used. RESULTS: Correlation analyses revealed that PrCl was positively correlated with diabetes, pulse pressure, C-reactive protein (CRP level, dialysate/plasma creatinine ratio (D/P cr at 4 h, and peritoneal Kt/V urea. PrCl was inversely correlated with serum albumin and triglyceride levels. On multivariate analysis, serum albumin, pulse pressure, D/P cr at 4 h, and peritoneal Kt/V urea were found to be independent determinants of PrCl. A total of 129 (23.9% patients in intention-to-treat analysis and 117 (21.7% patients in as-treated analysis developed new cardiovascular events. Time to occurrence of cardiovascular event was significantly longer in patients with a value of PrCl below the median (89.4 ml/day. In multivariate analysis, older age, presence of diabetes or previous CVD, and higher PrCl were independent predictors of cardiovascular events. Patients above the median value of PrCl had a significantly lower rate of survival than those below the median. However, a higher PrCl was not associated with increased mortality in multivariate Cox analysis. CONCLUSIONS: A higher PrCl is a risk for occurrence of cardiovascular event, but not mortality in PD patients. Large randomized clinical trials are warranted to confirm this finding.

  7. Aeromonas hydrophila as a causative organism in peritoneal dialysis-related peritonitis: case report and review of the literature.

    Science.gov (United States)

    Liakopoulos, V; Arampatzis, S; Kourti, P; Tsolkas, T; Zarogiannis, S; Eleftheriadis, T; Giannopoulou, M; Stefanidis, I

    2011-02-01

    Most episodes of peritoneal dialysis (PD)-related peritonitis could be attributed to a single organism, but in almost 10% of peritonitis episodes multiple organisms are identified. Polymicrobial peritonitis is often related to intra-abdominal pathology, and the prognosis may be poor. Aeromonas spp. have rarely been identified as the causative pathogen in PD-related peritonitis, and a very small number of cases has been reported in the literature. These rod-shaped, gram-negative microorganisms have been isolated from wastewater drainage systems, food, vegetables, and soil. Herein we report a case of polymicrobial peritonitis in a continuous ambulatory peritoneal dialysis (CAPD) patient with systemic lupus erythematosus (SLE), due to a combination of Streptococcus viridans and Aeromonas hydrophila infection. The patient was involved in gardening and was not compliant with her technique protocol. She did not wear a mask and omitted thorough hand washing. The patient was treated with i.p. vancomycin and ceftazidime and peritonitis was resolved. The patient's technique was reassessed, and she was retrained by our PD nurses. PMID:21269597

  8. Chronic Kidney Disease-Mineral Bone Disorder in the Elderly Peritoneal Dialysis Patient

    DEFF Research Database (Denmark)

    Heaf, James Goya

    2015-01-01

    PURPOSE: The purpose of this paper was to review the literature concerning the treatment of chronic kidney disease-mineral bone disorder (CKD-MBD) in the elderly peritoneal dialysis (PD) patient. ♦ RESULTS: Chronic kidney disease-mineral bone disorder is a major problem in the elderly PD patient......, with its associated increased fracture risk, vascular calcification, and accelerated mortality fracture risk. Peritoneal dialysis, however, bears a lower risk than hemodialysis (HD). The approach to CKD-MBD prophylaxis and treatment in the elderly PD patient is similar to other CKD patients, with some...... to other dialysis patient groups, physicians should be aware of the special problems of the elderly group....

  9. Correlation between dialysis solution type and cardiovascular morbidity rate in patients undergoing continuous ambulatory peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Stanković-Popović Verica

    2008-01-01

    Full Text Available Background/Aim. Peritoneal dialysis (PD patients have an increased risk for cardiovascular diseases. The aim of the study was to evaluate the cardiovascular changes in patients undergoing chronic PD and the eventual existing differences depending on biocompatibility of dialysis solutions. Methods. After 3±2 years of starting PD, 21 PD patients on the treatment with bioincompatible dialysis solutions (conventional glucose- based solutions: PDP-1, average age 47.43±12.87 years, and 21 PD patients on the treatment with biocompatible dialysis solutions (neutral solutions with lower level of glucose degradation products, lower concentration of Ca2+ and neutral pH: PDP-2, average age 68.62±13.98 years, participated in the longitudinal study. The average number of episodes of peritonitis was similare in both groups: 1 episode per 36 months of the treatment. The control group included 21 patients with preterminal phase of chronic renal failure (Glomerular Filtration Rate: 22.19±10.73 ml/min, average age 65.29± 13.74 years. All the patients underwent transthoracal echocardiography (in order to detect: eject fraction (EF, left ventricular hypertrophy (LVH, and valvular calcification (VC and B-mode ultrasonography of common carotid artery (CCA: IMT, lumen narrowing, and plaque detection. Results. The values of EF were: in PDP-1 group 62.05±5.65%, in PDP-2 group 53.43±7.47%, and in the control group 56.71±8.12% (Bonferroni test, p = 0.001. The recorded LVH was: in PDP-1 group in 47.6% of the patients; in PDP-2 group in 61.9% of the patients; and in control the group in 52.4% (χ2 test; p = 0.639. The detected VC was: in PDP-1 in 52.4% of the patients, in PDP-2 group in 42.9% of the patients, and in the control group in 23.8% of the patients (χ2 test; p = 0.776. The IMT was: in PDP-1 group 1.26±0.54 mm, in PDP-2 group 1.23±0.32, and in the control group 1.25±0.27 mm (Bonferroni test; p = 0.981. An average lumen narrowing was: in PDP-1 group 13

  10. Solutions for peritoneal dialysis in children: recommendations by the European Pediatric Dialysis Working Group.

    Science.gov (United States)

    Schmitt, Claus Peter; Bakkaloglu, Sevcan A; Klaus, Günter; Schröder, Cornelis; Fischbach, Michel

    2011-07-01

    The purpose of this article is to provide recommendations on the choice of peritoneal dialysis (PD) fluids in children by the European Pediatric Dialysis Working Group. The literature on experimental and clinical studies with PD solutions in children and adults was analyzed together with consensus discussions within the group. A grading was performed based on the international KDIGO nomenclature and methods. The lowest glucose concentration possible should be used. Icodextrin may be applied once daily during the long dwell, in particular in children with insufficient ultrafiltration. Infants on PD are at risk of ultrafiltration-associated sodium depletion, while anuric adolescents may have water and salt overload. Hence, the sodium chloride balance needs to be closely monitored. In growing children, the calcium balance should be positive and dialysate calcium adapted according to individual needs. Limited clinical experience with amino acid-based PD fluids in children suggests good tolerability. The anabolic effect, however, is small; adequate enteral nutrition is preferred. CPD fluids with reduced glucose degradation products (GDP) content reduce local and systemic toxicity and should be preferred whenever possible. Correction of metabolic acidosis is superior with pH neutral bicarbonate-based fluids compared with single-chamber, acidic, lactate-based solutions. Prospective comparisons of low GDP solutions with different buffer compositions are still few, and firm recommendations cannot yet be given, except when hepatic lactate metabolism is severely compromised. PMID:21448787

  11. Heart rhythm complexity impairment in patients undergoing peritoneal dialysis

    Science.gov (United States)

    Lin, Yen-Hung; Lin, Chen; Ho, Yi-Heng; Wu, Vin-Cent; Lo, Men-Tzung; Hung, Kuan-Yu; Liu, Li-Yu Daisy; Lin, Lian-Yu; Huang, Jenq-Wen; Peng, Chung-Kang

    2016-06-01

    Cardiovascular disease is one of the leading causes of death in patients with advanced renal disease. The objective of this study was to investigate impairments in heart rhythm complexity in patients with end-stage renal disease. We prospectively analyzed 65 patients undergoing peritoneal dialysis (PD) without prior cardiovascular disease and 72 individuals with normal renal function as the control group. Heart rhythm analysis including complexity analysis by including detrended fractal analysis (DFA) and multiscale entropy (MSE) were performed. In linear analysis, the PD patients had a significantly lower standard deviation of normal RR intervals (SDRR) and percentage of absolute differences in normal RR intervals greater than 20 ms (pNN20). Of the nonlinear analysis indicators, scale 5, area under the MSE curve for scale 1 to 5 (area 1–5) and 6 to 20 (area 6–20) were significantly lower than those in the control group. In DFA anaylsis, both DFA α1 and DFA α2 were comparable in both groups. In receiver operating characteristic curve analysis, scale 5 had the greatest discriminatory power for two groups. In both net reclassification improvement model and integrated discrimination improvement models, MSE parameters significantly improved the discriminatory power of SDRR, pNN20, and pNN50. In conclusion, PD patients had worse cardiac complexity parameters. MSE parameters are useful to discriminate PD patients from patients with normal renal function.

  12. The effects of angiotensin-converting enzyme inhibitors on peritoneal protein loss and solute transport in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Taner Basturk

    2012-08-01

    Full Text Available OBJECTIVE: The objective of this study was to examine the effects of angiotensin-converting enzyme inhibitors on peritoneal membrane transport, peritoneal protein loss, and proteinuria in peritoneal dialysis patients. METHODS: Fifty-four peritoneal dialysis patients were included in the study. The patients were divided into two groups. Group 1 (n = 34 was treated with angiotensin-converting enzyme inhibitors. Group 2 (n = 20 did not receive any antihypertensive drugs during the entire follow-up. Eleven patients were excluded from the study thereafter. Thus, a total of 30 patients in Group 1 and 13 patients in Group 2 completed the study. We observed the patients for six months. Group 1 patients received maximal doses of angiotensin-converting enzyme inhibitors for six months. Parameters at the beginning of study and at the end of six months were evaluated. RESULTS: At the end of six months, total peritoneal protein loss in 24-hour dialysate effluent was significantly decreased in Group 1, whereas it was increased in Group 2. Compared to the baseline level, peritoneal albumin loss in 24-hour dialysate effluent and 4-hour D/P creatinine were significantly increased in Group 2 but were not significantly changed in Group 1. A covariance analysis between the groups revealed a significant difference only in the decreased amount of total protein loss in 24-hour dialysate. Proteinuria was decreased significantly in Group 1. CONCLUSION: This study suggests that angiotensin-converting enzyme inhibitors reduce peritoneal protein loss and small-solute transport and effectively protect peritoneal membrane transport in peritoneal dialysis patients.

  13. Methylglyoxal Induced Basophilic Spindle Cells with Podoplanin at the Surface of Peritoneum in Rat Peritoneal Dialysis Model

    OpenAIRE

    Ichiro Hirahara; Hideki Sato; Toshimi Imai; Akira Onishi; Yoshiyuki Morishita; Shigeaki Muto; Eiji Kusano; Daisuke Nagata

    2015-01-01

    Peritoneal dialysis (PD) is a common treatment for patients with reduced or absent renal function. Long-term PD leads to peritoneal injury with structural changes and functional decline. At worst, peritoneal injury leads to encapsulating peritoneal sclerosis (EPS), which is a serious complication of PD. In order to carry out PD safely, it is important to define the mechanism of progression of peritoneal injury and EPS. We prepared rat models of peritoneal injury by intraperitoneal administrat...

  14. Lack of correlation of slime production with pathogenicity in continuous ambulatory peritoneal dialysis peritonitis caused by coagulase negative staphylococci.

    Science.gov (United States)

    Alexander, W; Rimland, D

    1987-12-01

    In order to evaluate the association of slime production by coagulase-negative staphylococci (CNS) and pathogenicity in the setting of continuous ambulatory peritoneal dialysis (CAPD), we prospectively studied 23 CAPD patients with positive dialysate cultures for CNS during a 12-mo period. Patients were categorized into groups with peritonitis or contaminants. In addition, 24 skin flora isolates of CNS from nine uninfected CAPD patients were compared to the other two groups. We found 14 patients with peritonitis and nine with contaminants. Fifty percent of the peritonitis isolates produced slime, compared to 67% of the contaminants (p = 0.72) and 54% of the skin flora isolates (p = 0.93). Slime production was not associated with specific antibiotic susceptibility patterns or speciation. In this prospective study, slime production was not associated with pathogenicity in CAPD peritonitis caused by coagulase-negative staphylococci. PMID:3449316

  15. Extended dosing of darbepoetin alfa in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Bridges Ian

    2011-03-01

    Full Text Available Abstract Background Anemia is common among peritoneal dialysis (PD patients, and most patients require erythropoiesis-stimulating agents (ESA to maintain their hemoglobin concentrations within current guideline recommendations. Darbepoetin alfa is an ESA with a 3-fold longer half-life and greater in vivo biological activity than recombinant human erythropoietin, allowing less frequent dosing that may simplify anemia management in these patients, providing benefits to patients, care givers and health care providers. Clinical studies have confirmed the efficacy and safety of darbepoetin alfa administered at extended dosing intervals. However, there are limited data on the management of anemia with ESAs in PD patients in routine clinical practice. The aim of this multicenter observational study in European and Australian dialysis patients was to evaluate darbepoetin alfa administered once every 2 weeks (Q2W in routine clinical practice for 12 months. Methods PD patients ≥18 years old and converting to treatment with darbepoetin alfa Q2W were eligible for enrollment regardless of previous or current ESA use. Patients enrolled in the study were treated according to local usual clinical practice. Data were collected up to 6 months prior to and 12 months after conversion to darbepoetin alfa Q2W. The primary endpoint was hemoglobin concentration 12 months after conversion to darbepoetin alfa Q2W. Results Of the 741 eligible PD patients (mean age, 61 years; male, 57%, 640 (86% completed the study. Mean hemoglobin concentration (g/dL was 11.69 (95% CI, 11.53-11.86 6 months before the conversion, 12.25 (95% CI, 12.13-12.38 at conversion, and 11.88 (95% CI, 11.74-12.02 12 months after conversion to darbepoetin alfa Q2W. The weekly equivalent ESA dose (μg/wk was a geometric mean of 25.24 (95% CI, 23.46-27.15 6 months before conversion, 20.90 (95% CI, 19.13-22.83 immediately before conversion, 18.89 (95% CI, 18.13-19.68 at conversion and 19.04 (95% CI, 17

  16. Comparison of Toxoplasma gondii seropositivity in hemodialysis and peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    Faezeh Hamidi; Jalal Etemadi; Nader Ghabouli Mehrabani; Mahmoud Mahami Oskouei; Roza Motavalli; Mohammad RezaArdalan

    2015-01-01

    Objective: To compare the seropositivity of Toxoplasma gondii in a group of peritoneal dialysis patients with hemodialysis patients and a general local population as a control group in Tabriz, Northwest Iran. Methods: A total of 176 individuals were participated in the present study. Among them, 42 were peritoneal dialysis patients, 84 were hemodialysis patients and 50 were healthy volunteers. Anti-Toxoplasma immunoglobulin G and immunoglobulin M serologic study was administered on the collected serums and then the obtained data were analyzed using statistical methods. Results: In the present research, 70.2% of hemodialysis patients, 66.6% of peritoneal dialysis patients and 68% of control group had positive results for anti-Toxoplasma immunoglobulin G antibody. All individuals of the groups had negative serologic results for anti-Toxoplasma immunoglobulin M antibody. There was no significant difference between Toxoplasma gondii seropositivity in hemodialysis patients and peritoneal dialysis patients and general population (P> 0.05). Conclusions: The findings showed that either peritoneal dialysis or hemodialysis doesn’t increase the risk of Toxoplasma seropositivity in our region (Northwest Iran). It could be explained by the fact that the present research is carried out in a high seroprevalent area scale in which the majority of normal population had previous exposure to this parasitical infection.

  17. Comparison of Toxoplasma gondii seropositivity in hemodialysis and peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Faezeh Hamidi

    2015-08-01

    Full Text Available Objective: To compare the seropositivity of Toxoplasma gondii in a group of peritoneal dialysis patients with hemodialysis patients and a general local population as a control group in Tabriz, Northwest Iran. Methods: A total of 176 individuals were participated in the present study. Among them, 42 were peritoneal dialysis patients, 84 were hemodialysis patients and 50 were healthy volunteers. Anti-Toxoplasma immunoglobulin G and immunoglobulin M serologic study was administered on the collected serums and then the obtained data were analyzed using statistical methods. Results: In the present research, 70.2% of hemodialysis patients, 66.6% of peritoneal dialysis patients and 68% of control group had positive results for anti-Toxoplasma immunoglobulin G antibody. All individuals of the groups had negative serologic results for anti-Toxoplasma immunoglobulin M antibody. There was no significant difference between Toxoplasma gondii seropositivity in hemodialysis patients and peritoneal dialysis patients and general population (P > 0.05. Conclusions: The findings showed that either peritoneal dialysis or hemodialysis doesn’t increase the risk of Toxoplasma seropositivity in our region (Northwest Iran. It could be explained by the fact that the present research is carried out in a high seroprevalent area scale in which the majority of normal population had previous exposure to this parasitical infection.

  18. Association Between Blood Cadmium Levels and Mortality in Peritoneal Dialysis.

    Science.gov (United States)

    Lee, Cheng-Chia; Weng, Cheng-Hao; Huang, Wen-Hung; Yen, Tzung-Hai; Lin, Ja-Liang; Lin-Tan, Dan-Tzu; Chen, Kuan-Hsing; Hsu, Ching-Wei

    2016-05-01

    The negative impact of environmental exposure of cadmium has been well established in the general population. However, the effect of cadmium exposure in chronic peritoneal dialysis (PD) patients remains uncertain.A total of 306 chronic PD patients were included in this 36-month observational study. Patients were stratified into 3 groups by the tertile of baseline blood cadmium levels (BCLs): high (>0.244 μg/L, n = 101), middle (0.130-0.244 μg/L, n = 102), and low (death were recorded for longitudinal analyses.Patients in the high-BCL group were older, more likely to have diabetes mellitus, had lower levels of serum albumin and lower percentage of lean body mass than patients in the low-BCL group. A multivariate logistic regression analysis revealed that logarithmic transformed BCL was independently associated with a higher risk of low turnover bone disease (odds ratio = 3.8, P = 0.005). At the end of the 36-month follow-up, 66 (21.6%) patients died. Mortality rates increased with higher BCLs (P for trend = 0.005). A Cox multivariate analysis showed that, using the low-BCL group as the reference, the high-BCL group had increased hazard ratios (HR) for all-cause mortality in chronic PD patients after adjusting for related variables (HR = 2.469, 95% confidence interval = 1.078-5.650, P = 0.043).In conclusion, BCL showed significant association with malnutrition and low turnover bone disease in chronic PD patients. Furthermore, BCL is an important determinant of mortality. Our findings suggest that avoiding environmental exposure to cadmium as much as possible is warranted in chronic PD patients. PMID:27175714

  19. Brevibacterium casei isolated as a cause of relapsing peritonitis

    OpenAIRE

    Althaf, Mohammed Mahdi; Abdelsalam, Mohamed Said; Alsunaid, Mohammed Sunaid; Hussein, Maged Hassan

    2014-01-01

    We report a case of relapsing peritonitis in a 33-year-old woman on automated peritoneal dialysis. End-stage renal disease was secondary to systemic lupus erythematosus complicated with lupus nephritis. The organism isolated was Brevibacterium casei that was not readily identified, delaying appropriate management with an extended antibiotic course. Definite management of B casei peritonitis was peritoneal dialysis catheter removal.

  20. Obese and diabetic patients with end-stage renal disease: Peritoneal dialysis or hemodialysis?

    Science.gov (United States)

    Ekart, Robert; Hojs, Radovan

    2016-07-01

    Obesity is a chronic disease that is increasingly prevalent around the world and is a well-recognized risk factor for type 2 diabetes and hypertension, leading causes of end-stage renal disease (ESRD). The obese diabetic patient with ESRD is a challenge for the nephrologist with regard to the type of renal replacement therapy that should be suggested and offered to the patient. There is no evidence that either peritoneal dialysis or hemodialysis is contraindicated in obese ESRD patients. In the literature, we can find a discrepancy in the impact of obesity on mortality among hemodialysis vs. peritoneal dialysis patients. Several studies in hemodialysis patients suggest that a higher BMI confers a survival advantage - the so-called "reverse epidemiology". In contrast, the literature among obese peritoneal dialysis patients is inconsistent, with various studies reporting an increased risk of death, no difference, or a decreased risk of death. Many of these studies only spanned across a few years, and this is probably too short of a time frame for a realistic assessment of obesity's impact on mortality in ESRD patients. The decision for dialysis modality in an obese diabetic patient with ESRD should be individualized. According to the results of published studies, we cannot suggest PD or HD as a better solution for all obese diabetic patients. The obese patient should be educated about all their dialysis options, including home dialysis therapies. In this review, the available literature related to the dialysis modality in obese patients with diabetes and ESRD was reviewed. PMID:27067614

  1. Combined peritoneography and computerized tomography for evaluating abdominal complications in patients undergoing continuous peritoneal dialysis

    International Nuclear Information System (INIS)

    Continuous ambulatory peritoneal dialysis (CAPD) is a generally well-tolerated treatment. However, some patients exhibit such complications as to prevent the continuation of treatment. Peritonitis is the major problem, but the continuation of treatment may also be undermined by different complications, such as peritoneal leakage, hernia, catheter malfunctioning, and scrotal-penile edema; a careful investigation of the patient is always needed in such cases. From November 1985 to February 1990, we examined 20 patients, who had presented with different types of complications in the course of dialysis. Peritoneography demonstrated 3 cases of abdominal hernias, 2 cases of patency of the peritoneal-vaginal duct, and 2 cases of catheter obstruction. Peritoneal CT allowed the identification of leakage in 3 patients, while the combined use of the two techniques showed adhesions or pathologic peritoneal recesses in 7 cases. In 3 patients normal patterns were observed. Peritoneography, especially if combined with CT, can carry out a double function, that is in both the screening and choice of the subjects to the destine to peritoneal dialysis, and in therapeutics, to evaluate complications. Moreover, the technique is extremely reliable thanks to both its simple execution and lack of disadvantages

  2. Risk and Prognosis of Bacteremia and Fungemia among Peritoneal Dialysis Patients

    DEFF Research Database (Denmark)

    Dalgaard, Lars S; Nørgaard, Mette; Povlsen, Johan V;

    2016-01-01

    ♦ Background: The incidence of bacteremia and fungemia (BAF) is largely unknown in end-stage renal disease (ESRD) patients initiating peritoneal dialysis (PD). ♦ Objective: The main objective was to estimate and compare incidence rates of first episodes of BAF in incident PD patients and a compar......♦ Background: The incidence of bacteremia and fungemia (BAF) is largely unknown in end-stage renal disease (ESRD) patients initiating peritoneal dialysis (PD). ♦ Objective: The main objective was to estimate and compare incidence rates of first episodes of BAF in incident PD patients.......3%). Escherichia coli (27.3%) also ranked first among population controls. Thirty-day mortality following BAF was 20.8% (95% CI, 12.6 - 31.0) and 20.7% (95% CI, 16.3 - 25.9) among PD patients and population controls, respectively. ♦ Conclusions: Peritoneal dialysis patients are at markedly higher risk of BAF than...

  3. Parameter estimation in six numerical models of transperitoneal transport of potassium in patients undergoing peritoneal dialysis

    DEFF Research Database (Denmark)

    Graff, J; Fugleberg, S; Joffe, P;

    1995-01-01

    The mechanisms of transperitoneal potassium transport during peritoneal dialysis were evaluated by validation of different mathematical models. The models were designed to elucidate the presence or absence of diffusive, non-lymphatic convective and lymphatic convective solute transport. Experimen......The mechanisms of transperitoneal potassium transport during peritoneal dialysis were evaluated by validation of different mathematical models. The models were designed to elucidate the presence or absence of diffusive, non-lymphatic convective and lymphatic convective solute transport....... Experimental results were obtained from 26 non-diabetic patients undergoing peritoneal dialysis. The validation procedure demonstrated that models including both diffusive and non-lymphatic convective solute transport were superior to the other models. Lymphatic convective solute transport was not identifiable...

  4. Influence of peritoneal dialysis solution biocompatibility on long-term survival of patients on continuous ambulatory peritoneal dialysis and the technique itself

    Directory of Open Access Journals (Sweden)

    Stanković-Popović Verica

    2013-01-01

    Full Text Available Background/Aim. Morbidity and mortality of continous ambulatory peritoneal dialysis (CAPD patients is still very high. The aim of the study was to evaluate the effects of peritoneal dialysis (PD solutions (standard vs biocompatible on long-term patients’ and the techique survival. Methods. A total of 42 stable patients on CAPD participated in this crosssectional study. They were prospectively followed-up during the twelve years. Patients with severe anemia (Hb 1 mm; carotid narrowing degree > 50%, presence of carotid plaques in both common carotide, ischaemic heart disease, cerebrovascular event and peripheral vascular disease with or without amputation were independent predictors of overall patient survival. Duration of dialysis was only independent predictor of overall technique survival. Conclusion. Although patients treated with biocompatible solutions showed significantly better survival, the role of biocompatibility of CAPD solutions in patients and technique survival have to be confirmed. Namely, multivariate analysis confirmed that duration of dialysis, serum triglyceride and cardiovascular score significantly predicted overall CAPD patients survival, while only duration of dialysis was found to be independent predictor of overall techique survival.

  5. Residual renal function and nutritional status in patients on continuous ambulatory peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Jovanović Nataša

    2005-01-01

    Full Text Available Introduction During the last years, an increasing number of patients with end-stage renal failure caused by various underlying diseases, all over the world, is treated by renal replacement therapy. Nutritional status Malnutrition is often found in patients affected by renal failure; it is caused by reduced intake of nutritional substances due to anorexia and dietary restrictions hormonal and metabolic disorders, comorbid conditions and loss of proteins, amino-acids, and vitamins during the dialysis procedure itself. Nutritional status significantly affects the outcome of patients on chronic dialysis treatment. Recent epiodemiological trials have proved that survival on chronic continuous ambulatory peritoneal dialysis program depends more on residual renal function (RRF than on peritoneal clearances of urea and creatinine. Material and methods The aim of the study was to analyze the influence of RRF on common biochemical and anthropometric markers of nutrition in 32 patients with end-stage renal failure with various underlying diseases during the first 6 months on continuous ambulatory peritoneal dialysis (CAPD. The mean residual creatinine clearance was 8,3 ml/min and the mean RRF was 16,24 week in our patients at the beginning of the chronic peritoneal dialysis treatment. Results and conclusion During the follow-up, the RRF slightly decreased, while the nutritional status of patients significantly improved. Gender and age, as well as the leading disease and peritonitis didn't influence the RRF during the first 6 months of CAPD treatment. We found several positive correlations between RRF and laboratory and anthropometric markers of nutrition during the follow-up, proving the positive influence of RRF on nutritional status of patients on chronic peritoneal dialysis.

  6. Mesenchymal Conversion of Mesothelial Cells Is a Key Event in the Pathophysiology of the Peritoneum during Peritoneal Dialysis

    OpenAIRE

    Manuel López-Cabrera

    2014-01-01

    Peritoneal dialysis (PD) is a therapeutic option for the treatment of end-stage renal disease and is based on the use of the peritoneum as a semipermeable membrane for the exchange of toxic solutes and water. Long-term exposure of the peritoneal membrane to hyperosmotic PD fluids causes inflammation, loss of the mesothelial cells monolayer, fibrosis, vasculopathy, and angiogenesis, which may lead to peritoneal functional decline. Peritonitis may further exacerbate the injury of the peritoneal...

  7. Influence of Peritoneal Transport Characteristics on Nutritional Status and Clinical Outcome in Chinese Diabetic Nephropathy Patients on Peritoneal Dialysis

    Institute of Scientific and Technical Information of China (English)

    Ji-Chao Guan; Wei Bian; Xiao-Hui Zhang; Zhang-Fei Shou; Jiang-Hua Chen

    2015-01-01

    Background:High peritoneal transport status was previously thought to be a poor prognostic factor in peritoneal dialysis (PD) patients.However,its effect on diabetic nephropathy PD patients is unclear in consideration of the adverse impact of diabetes itself.The purpose of this study was to investigate the influence of peritoneal transport characteristics on nutritional status and clinical outcome in diabetic nephropathy patients on PD.Methods:One hundred and two diabetic nephropathy patients on PD were enrolled in this observational cohort study.According to the initial peritoneal equilibration test result,patients were divided into two groups:Higher transport group (HT,including high and high average transport) and lower transport group (LT,including low and low-average transport).Demographic characteristics,biochemical data,dialysis adequacy,and nutritional status were evaluated.Clinical outcomes were compared.Risk factors for death-censored technique failure and mortality were analyzed.Results:Compared with LT group (n =37),serum albumin was significantly lower and the incidence of malnutrition by subjective global assessment was significantly higher in HT group (n =65) (P < 0.05).Kaplan-Meier analyses showed that death-censored technique failure and mortality were significantly increased in HT group compared with that in LT group.On multivariate Cox analyses,higher peritoneal transport status and lower residual renal function (RRF) were independent predictors of death-censored technique failure when adjusted for serum albumin and total weekly urea clearance (Kt/V).Independent predictors of mortality were advanced age,anemia,hypoalbuminemia,and lower RRF,but not higher peritoneal transport status.Conclusions:Higher peritoneal transport status has an adverse influence on nutrition for diabetic nephropathy patients on PD.Higher peritoneal transport status is a significant independent risk factor for death-censored technique failure,but not for mortality in

  8. Gastric emptying and the effects of peritoneal dialysis, among other things: a case study

    International Nuclear Information System (INIS)

    Full text: A 27 year old female presented to the Nuclear Medicine department with diabetes acute renal failure and constant nausea and vomiting with the diagnosis of gastroparesis secondary to autonomic neuropathy in question. A solid gastric empty study was performed with the patients peritoneal dialysis fluid in situ, and the results were noted. The study was then repeated, this time after draining the peritoneal dialysis fluid to see if this had any effect.The results were extremely remarkable, and causes for this will be discussed. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  9. Aluminum concentrations in serum, dialysate, urine and bone among patients undergoing continuous ambulatory peritoneal dialysis (CAPD)

    DEFF Research Database (Denmark)

    Joffe, P; Olsen, F; Heaf, J G;

    1989-01-01

    Aluminum (Al) concentration in serum, urine, and dialysate was estimated in 21 patients undergoing continuous ambulatory peritoneal dialysis (CAPD). In 12 of the patients bone Al concentration was measured as well. Mean serum Al level was 32.4 +/- 21.0 micrograms/l. The Al concentrations in the d......Aluminum (Al) concentration in serum, urine, and dialysate was estimated in 21 patients undergoing continuous ambulatory peritoneal dialysis (CAPD). In 12 of the patients bone Al concentration was measured as well. Mean serum Al level was 32.4 +/- 21.0 micrograms/l. The Al concentrations...

  10. Substance P and intensity of pruritus in hemodialysis and peritoneal dialysis patients

    OpenAIRE

    Œnit, Mirosław; Gawlik, Radosław; Łącka-GaŸdzik, Beata; KuŸniewicz, Roman; Dwornicki, Marek; Owczarek, Aleksander; Walaszczyk, Małgorzata; Grabiec, Piotr; Grzeszczak, Władysław

    2013-01-01

    Background Uremic pruritus is a common complication in patients undergoing dialysis. The pathophysiological mechanisms of pruritus in patients with end-stage renal disease remain unknown. Neuropeptides, including substance P, are postulated to play an important role in the pathogenesis of pruritus. The aim of this study was to evaluate the role of substance P in uremic pruritus in patients on hemodialysis and peritoneal dialysis. Material/Methods We included 197 patients with end-stage renal ...

  11. Quality of Life in Patients Undergoing Hemodialysis or Peritoneal Dialysis Treatment

    OpenAIRE

    Theofilou, Paraskevi

    2011-01-01

    Background “Does the type of dialysis treatment make a difference to the quality of life (QoL) and mental health of renal patients in Athens?” The study investigated the differences in 84 in-center hemodialysis (HD) and 60 continuous ambulatory peritoneal dialysis (CAPD/PD) patients. Methods Patient-reported assessments included: WHOQOL-BREF inventory of World Health Organization, General Health Questionnaire (GHQ-28) of Goldberg, State-Trait Anxiety Inventory, Center for Epidemiologic Studie...

  12. Levels of vascular endothelial growth factor during first six months of peritoneal dialysis

    OpenAIRE

    Stojimirović Biljana; Jovanović Nataša; Trbojević-Stanković Jasna; Krstić Slobodan; Nešić Dejan; Žunić-Božinovski Snežana

    2015-01-01

    Introduction. Chronic peritoneal dialysis (PD) up-regulates vascular endothelial growth factor (VEGF) synthesis and VEGF is found in drained dialysate (dd). Objective. Aims of this prospective study were to evaluate serum (s) and ddVEGF concentration during the first six months of PD, relationships between these concentrations and demographic and biochemical parameters, presence of diabetes, peritonitis, and the use of medications. Methods. The study includ...

  13. Patent Processus Vaginalis in Patients Undergoing continuous Ambulatory Peritoneal Dialysis - Two Cases Confirmed by Radionuclide Peritoneal Scintiscan -

    International Nuclear Information System (INIS)

    Continuous ambulatory peritoneal dialysis (CAPD) is a well established method of treating end stage renal failure, and is commonly used as an alternative to hemodialysis. Several complications have been observed. These include catheter malfunction, abdominal and inguinal hernia, and peritonitis. A relatively frequent complication is swelling of external genitalia, due to bowel fluid passing through a patent processus vaginalis. Special diagnostic procedures are necessary to determine the nature of the abnormality and to guide the surgical correction. We reported two cases of patent processus vaginalis in patient on CAPD proved by radionuclide peritonea scintiscan using 99mTc-tin colloid.

  14. Deciphering the contribution of biofilm to the pathogenesis of peritoneal dialysis infections: characterization and microbial behaviour on dialysis fluids

    OpenAIRE

    Sampaio, J.; Machado, Diana; Gomes, Ana Marta; Machado, Idalina; Santos, Cledir; Lima, Nelson; Carvalho, Maria João; Cabrita, António; Rodrigues, Anabela; Martins, Margarida Isabel Barros Coelho

    2016-01-01

    Infections are major complications in peritoneal dialysis (PD) with a multifactorial etiology that comprises patient, microbial and dialytic factors. This study aimed at investigating the contribution of microbial biofilms on PD catheters to recalcitrant infections and their interplay with PD related-factors. A prospective observational study was performed on 47 patients attending Centro Hospitalar of Porto and Vila Nova de Gaia/Espinho to whom the catheter was removed due to infectious (n = ...

  15. Level of 8-OHdG in drained dialysate appears to be a marker of peritoneal damage in peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Morishita Y

    2011-12-01

    Full Text Available Yoshiyuki Morishita, Minami Watanabe, Ichiro Hirahara, Tetsu Akimoto, Shigeaki Muto, Eiji KusanoDivision of Nephrology, Department of Medicine, Jichi Medical University, Tochigi, JapanPurpose: Peritoneal dialysis (PD is a successful renal replacement therapy; however, long-term PD leads to structural and functional peritoneal damage. Therefore, the monitoring and estimation of peritoneal function are important in PD patients. Oxidative stress has been implicated as one possible mechanism of peritoneal membrane damage. The aim of this study was to evaluate the association between an oxidative stress marker, 8-hydroxydeoxyguanosine (8-OHdG, and peritoneal damage in PD patients.Methods: The authors evaluated 8-OHdG in drained dialysate by enzyme immunoassay to investigate the association between 8-OHdG and solute transport rate estimated by peritoneal equilibration test and matrix metalloproteinase-2 (MMP-2 level in 45 samples from 28 PD patients.Results: The 8-OHdG level was significantly correlated with dialysate:plasma creatine ratio (r = 0.463, P < 0.05 and significantly inversely correlated with D/D0 glucose (where D is the glucose level of peritoneal effluents obtained 4 hours after the injection and D0 is the glucose level obtained immediately after the injection (r = -0.474, P < 0.05. The 8-OHdG level was also significantly correlated with MMP-2 level (r = 0.551, P < 0.05, but it was not correlated with the age of subjects, the duration of PD, or blood pressure.Conclusion: The level of 8-OHdG in drained dialysate may be a useful novel marker of peritoneal damage in PD.Keywords: oxidative stress, solute transport rate, MMP-2, peritoneal equilibration test

  16. Systemic amyloidosis involving the diaphragm and acute massive hydrothorax during peritoneal dialysis.

    Science.gov (United States)

    Gagnon, R F; Thirlweil, M; Arzoumanian, A; Mehio, A

    2002-06-01

    Hydrothorax secondary to trans-diaphragmatic fluid leakage through a peritoneo-pleural communication is an occasional, potentially serious complication of peritoneal dialysis. The etiology of this condition is not clear, being thought to be due either to congenital or acquired diaphragmatic fenestrations or acquired scarcity of muscle fibers in the tendinous part of the diaphragm which are compounded by increased intra-abdominal pressure during the dwell period of peritoneal dialysis. We report a 54-year-old woman who developed irreversible acute renal failure from adjuvant chemotherapy for ovarian cancer previously resected surgically. Three days after the onset of continuous ambulatory peritoneal dialysis, she developed acute respiratory distress associated with a massive right hydrothorax secondary to a peritoneo-pleural communication demonstrated by scintigraphy. At autopsy 2 weeks later, systemic amyloidosis was surprisingly found and histologic examination of the right hemidiaphragm showed the presence of amyloid, among sparse muscle fibers. This is the first case report of a distinct pathological process, i.e. amyloidosis, involving the diaphragm associated with a peritoneo-pleural communication causing massive hydrothorax at the onset of peritoneal dialysis. PMID:12078953

  17. Correction of malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance

    International Nuclear Information System (INIS)

    To determine the efficacy of correction of a malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance. Between November 1994 and March 1997, we performed 15 manipulations in 12 patients in whom a dual-cuff, straight Tenckhoff peritoneal dialysis catheter had been implanted due to chronic renal failure. The causes of catheter malfunctioning were inadequate drainage of the dialysate(n=14) and painful dialysis(n=1). Under fluoroscopic guidance, adhesiolysis and repositioning of the malfunctioning catheter were performed with an Amplatz Super Stiff guidewire and the stiffener from a biliary drainage catheter. The results of procedures were categorized as either immediate or durable success, this latter being defined as adequate catheter function for at least one month after the procedure. Immediate success was achieved in 14 of 15 procedures (93%), and durable success in 7 of 15(47%). The mean duration of catheter function was 157 (range, 30 to 578) days. After manipulation, abdominal pain developed in eight patients and peritonitis in two, but with conservative treatment, these symptoms improved. The correction of a malfunctioning peritoneal dialysis catheter with guidewire and stiffener under fluoroscopic guidance is an effective means of restoring catheter function and may be an effective alternative to surgical reimplantation of the catheter, or hemodialysis

  18. Association between endothelial dysfunction and arterial stiffness in continuous ambulatory peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    顾玥

    2014-01-01

    Objective To investigate the association between endothelial dysfunction and arterial stiffness in continuous ambulatory peritoneal dialysis(CAPD)patients.Methods Ninety-four stable CAPD patients from a single center were enrolled in this cross-sectional study.Ultrasound evaluation was conducted on brachial artery to estimate endothelial-dependent

  19. Circadian variation of blood pressure in patients with chronic renal failure on continuous ambulatory peritoneal dialysis

    DEFF Research Database (Denmark)

    Clausen, P; Feldt-Rasmussen, B; Ladefoged, Jens

    1995-01-01

    The circadian pattern of blood pressure variation was investigated in 10 patients with advanced chronic renal failure on continuous ambulatory peritoneal dialysis (CAPD) and in an age-matched group of controls without renal disease with similar office blood pressure level. Monitoring was done using...

  20. Biocompatibility and tolerability of a purely bicarbonate-buffered peritoneal dialysis solution.

    NARCIS (Netherlands)

    Weiss, L.; Stegmayr, B.; Malmsten, G.; Tejde, M.; Hadimeri, H.; Siegert, C.E.; Ahlmen, J.; Larsson, R.; Ingman, B.; Simonsen, O.; Hamersvelt, H.W. van; Johansson, A.C.; Hylander, B.; Mayr, M.; Nilsson, P.H.; Andersson, P.O.; Los Rios, T. De

    2009-01-01

    BACKGROUND: Novel peritoneal dialysis solutions are characterized by a minimal content of glucose degradation products and a neutral pH. Many studies have shown the biocompatibility of neutral lactate-buffered solutions; however, until now, the effect of purely bicarbonate-buffered solutions has not

  1. Evaluation of percutaneous radiologic placement of peritoneal dialysis catheters: technical aspects, results, and complications

    International Nuclear Information System (INIS)

    To evaluate the technical aspects, results and complications of the percutaneous radiologic placement of peritoneal dialysis catheters. Between December 1999 and April 2001, 26 peritoneal dialysis catheters were placed percutaneously in 26 consecutive patients by interventional radiologists. The patient group consisted of 16 men and ten women with a mean age of 55 (range, 30-77) years. The results and complications arising were reviewed, and the expected patency of the catheters was determined by means of Kaplan-Meier survival analysis. The technical success rate for catheter placement was 100% (26/26 patients). Severe local bleeding occurred in one patient due to by inferior epigastric artery puncture, and was treated by compression and electronic cautery. The duration of catheter implantation ranged from 1 to 510 days and the patency rate was 416±45 days. Catheter malfunction occurred in four patients. In two, this was restored by manipulation in the intervention room, and in one, through the use of urokinase. In three patients, peritonitis occurred. Catheters were removed from four patients due to malfunction (n=2), peritonitis (n=1), and death (n=1). Percutaneous radiologic placement of a peritoneal dialysis catheter is a relatively simple procedure that reduces the complication rate and improves catheter patency

  2. Relative survival of peritoneal dialysis and haemodialysis patients

    DEFF Research Database (Denmark)

    Heaf, James G; Wehberg, Sonja

    2014-01-01

    INTRODUCTION: Epidemiological studies consistently show an initial survival advantage for PD patients compared to HD. It has recently been suggested that this is due to the fact that many HD patients are referred late, and start dialysis on an acute, in-patient basis. The present study was perfor......INTRODUCTION: Epidemiological studies consistently show an initial survival advantage for PD patients compared to HD. It has recently been suggested that this is due to the fact that many HD patients are referred late, and start dialysis on an acute, in-patient basis. The present study...... was performed to investigate (1) whether, and if so, how, PD and HD prognosis had changed in recent years, (2) whether a potential survival advantage of PD versus HD is constant over dialysis duration, and (3) whether differences in prognosis could be explained by patient age, renal diagnosis of diabetic...... nephropathy, or mode of dialysis initiation. PATIENTS AND METHODS: 12095 patients starting dialysis therapy between 1990 and 2010 in Denmark were studied. Prognosis was assessed according to initial dialysis modality on an intention-to-treat basis, censored for transplantation. Results were adjusted for age...

  3. Acute Hydrothorax Complicating continuous Ambulatory Peritoneal Dialysis: A Case Report and Review of Literature.

    Science.gov (United States)

    Kechrid, M C; Malik, G H; Shaikh, J F; Al-Mohaya, S; Al-Wakeel, J S; El Gamal, H

    1999-01-01

    We describe here hydrothorax that occurred in a patient on continuous ambulatory peritoneal dialysis (CAPD) and highlight the problems of diagnosis and management. A 48 years-old man with history of obstructive uropathy secondary to urolithiasis was stared on CAPD when he reached end-stage renal failure. Two months later, he was admitted with two days history of shortness of breath on exertion and dry cough increasing in supine position. Chest examination was suggestive of right sided pleural effusion confusion confirmed by chest X-ray. Radioisotope Technetium 99m labeled albumin instilled through the peritoneal catheter was detected in the right pleural fluid confirming the peritoneo-pleural leak. The peritoneal dialysis (PD) was discontinued and the patient was switched to hemodialysis. The pleural effusion subsided and has not recurred for the following three years. PMID:18212427

  4. Acute Hydrothorax Complicating continuous Ambulatory Peritoneal Dialysis: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Kechrid Mohammad

    1999-01-01

    Full Text Available We describe here hydrothorax that occurred in a patient on continuous ambulatory peritoneal dialysis (CAPD and highlight the problems of diagnosis and management. A 48 years-old man with history of obstructive uropathy secondary to urolithiasis was stared on CAPD when he reached end-stage renal failure. Two months later, he was admitted with two days history of shortness of breath on exertion and dry cough increasing in supine position. Chest examination was suggestive of right sided pleural effusion confusion confirmed by chest X-ray. Radioisotope Technetium 99m labeled albumin instilled through the peritoneal catheter was detected in the right pleural fluid confirming the peritoneo-pleural leak. The peritoneal dialysis (PD was discontinued and the patient was switched to hemodialysis. The pleural effusion subsided and has not recurred for the following three years.

  5. Antibody response following Hepatitis B vaccination in peritoneal dialysis patients: does normalized urea clearance matter?

    Directory of Open Access Journals (Sweden)

    Erkan Dervisoglu

    2011-01-01

    Full Text Available OBJECTIVES: Data on the factors that contribute to the antibody response to hepatitis B virus vaccination in peritoneal dialysis patients are scarce. The current study was conducted on a group of peritoneal dialysis patients to learn how the response to hepatitis B virus vaccination varies according to the patient's clearance of urea normalized to total body water (Kt/V. METHODS: A convenience sample of 33 peritoneal dialysis patients (13 women and 20 men, with a mean age of 49¡12 years was administered double doses (20 μg IM in each deltoid muscle of recombinant hepatitis B vaccine at 0, 1, 2, and 6 months. Response to immunization was measured at one to three months after the final dose of vaccine. The subjects were divided into groups according to the level of antibodies to hepatitis B surface antigen (anti-HBs, including non-responders ( 100 IU/L. RESULTS: Among non-responders, weak responders, and good responders, significant differences were found in age (54 ± 12 vs. 56 ± 9 vs. 45¡12 years, respectively; p = 0.049 and recombinant human erythropoietin use (20 vs. 29 vs. 76%, respectively; p = 0.016. No significant differences in weekly total Kt/V (p = 0.704, weekly peritoneal Kt/V (p = 0.064 and residual glomerular filtration rate (p = 0.355 were found across the three groups. CONCLUSIONS: Delivered clearance measured by weekly peritoneal Kt/V and total clearance measured by weekly total Kt/V did not predict the response to hepatitis B virus vaccination in patients on peritoneal dialysis.

  6. Isotope investigation of the fluid flow in a continuous peritoneal dialysis in a rabbit

    International Nuclear Information System (INIS)

    The peritoneal dialysis has become more and more popular in treating some diseases of the kidneys. In the standard technique, the dialization fluid is fed intermittently through a single catheter introduced into the peritoneal cavity. The efficiency of the procedure can be increased by using a continuous fluid flow. In 17 rabbits a continuous mode of peritoneal dialyses was employed by using two catheters introduced by a single injection. The studies were made on two groups of animals using a different distance between the catheter ends. The dialization fluid contained 131I labelled albumin. By determining the amount of the isotope in the outflowing fluid the degree of the fluid intermixing in the peritoneal cavity was evaluated. An open one-compartamental model was found to be useful in the estimation of the dynamics of the fluid flow during the continuous peritoneal dialysis. When the distance between both catheter ends was larger the fluid was better intermixed in the peritoneal cavity. This made it possible to obtain a high gradient of the concentrations of various substances between the blood and the dialization fluid. (author)

  7. Successful pregnancy in a 31-year-old peritoneal dialysis patient with bilateral nephrectomy.

    Science.gov (United States)

    Abu-Zaid, Ahmed; Nazer, Ahmed; Alomar, Osama; Al-Badawi, Ismail A

    2013-01-01

    Frequency of pregnancy among childbearing age women with end-stage renal disease (ESRD) undergoing long-term periodic dialysis ranges from 1% to 7%. Although pregnancy in dialysis women with ESRD is considered a largely high-risk pregnancy, occurrence of successful pregnancy is not impossible with success rates approaching 70%. Rates of successful pregnancy are greatly impacted by early pregnancy diagnosis and preserved residual renal functions. Herein, to the best of our knowledge, we report the first case of successful pregnancy (despite late diagnosis at 14 weeks of gestation) in a 31-year-old peritoneal dialysis patient with bilateral nephrectomy and no whatsoever preserved residual renal function. Moreover, a literature review on pregnancy in dialysis patients is presented. PMID:24198990

  8. Successful Pregnancy in a 31-Year-Old Peritoneal Dialysis Patient with Bilateral Nephrectomy

    Directory of Open Access Journals (Sweden)

    Ahmed Abu-Zaid

    2013-01-01

    Full Text Available Frequency of pregnancy among childbearing age women with end-stage renal disease (ESRD undergoing long-term periodic dialysis ranges from 1% to 7%. Although pregnancy in dialysis women with ESRD is considered a largely high-risk pregnancy, occurrence of successful pregnancy is not impossible with success rates approaching 70%. Rates of successful pregnancy are greatly impacted by early pregnancy diagnosis and preserved residual renal functions. Herein, to the best of our knowledge, we report the first case of successful pregnancy (despite late diagnosis at 14 weeks of gestation in a 31-year-old peritoneal dialysis patient with bilateral nephrectomy and no whatsoever preserved residual renal function. Moreover, a literature review on pregnancy in dialysis patients is presented.

  9. How are families taught to look after their children on peritoneal dialysis?

    Directory of Open Access Journals (Sweden)

    Reem S Alhameedi

    2016-01-01

    Full Text Available For patients to be started on peritoneal dialysis (PD, they need to be trained on how to perform dialysis at home. Understanding how to carry out dialysis is difficult for adults, but perhaps even more challenging for parents of children. This study was performed to examine the PD teaching programs for parents of children with end-stage renal disease (ESRD and to explore the issues related to educating parents of children with ESRD. A survey method was used to carry out the research through the distribution of self-completed questionnaires to pediatric dialysis units (ten units in Saudi Arabia in both governmental and non-governmental hospitals. The questionnaire content was identified using information gained from other research performed in the field of home PD training. The questionnaire was piloted with experienced renal nurses. Questionnaires were distributed to 87 specialized nurses within the ten PD units. Descriptive statistical analysis SPSS (19.00 was used to analyze the data. Statistical tests were used to distinguish the relationship and the significant effects between variables. The response rate was 72% (n = 63. Peritonitis rates varied in each hospital, and ranged from zero to three episodes per patient-year (median 1.17 episodes per patient-year. There was a significant association between home visits and peritonitis rates (P <0.01. This study has provided an initial overview of pediatric PD training programs in Saudi Arabia and has provided valuable data in this regard.

  10. Pretransplant peritoneal dialysis and graft thrombosis following pediatric kidney transplantation: a NAPRTCS report.

    Science.gov (United States)

    McDonald, Ruth A; Smith, Jodi M; Stablein, Donald; Harmon, William E

    2003-06-01

    Graft thrombosis is a common cause of graft failure in pediatric renal transplantation. Several previous studies, including a North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) review of pretransplant dialysis status and graft outcomes, have described a potential correlation of peritoneal dialysis (PD) and graft thrombosis. This issue is of particular concern for pediatric transplant programs as more than 65% of children with end stage renal disease are treated with PD. We reviewed 7247 pediatric renal transplants performed between 1987 and 2001. Thrombosis was the cause of graft loss in 2.7% (199) of all the transplants performed. Among failed transplants, thrombosis was the third most common cause of graft loss in both index (11.6%) and subsequent transplants (14.5%). Thrombosis becomes the most common cause of graft failure (21%, 61/294) if one looks at transplants in the later cohort, from 1996 to 2001. This change is primarily because of a decrease in the incidence of acute rejection. In the PD group, 3.4% of all grafts were lost as a result of thrombosis. This compares with 1.9% in the hemodialysis group, 2.4% in the pre-emptive transplant group, and 4.1% among patients who received both dialysis modalities. There was a statistically significant difference in thrombosis failure risk in the different dialysis groups (p = 0.005) with those who received only peritoneal dialysis having the highest risk. Additional significant risk factors for graft thrombosis included; cadaver donor source (p 24 h (p 5 pretransplant blood transfusions (p = 0.02). Using stepwise proportional hazards modeling, only pretransplant peritoneal dialysis, >24 h cold ischemia time, prior transplant, and donor age thrombosis. We conclude that pretransplant PD is associated with an increased risk of graft thrombosis. Special precautions should be undertaken in pediatric renal transplant patients who have received PD, especially infants and young children. PMID:12756045

  11. Palliative care for patients with malignancy and end-stage renal failure on peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Lv Jing

    2014-01-01

    Full Text Available Background: Many patients on peritoneal dialysis experience a poor quality of life because of a high burden of comorbid conditions. Dialysists must pay more attention to reducing a patient′s pain and suffering, both physical and psychological and improve the quality of life for the patients as much as possible. A consensus regarding eligibility for palliative care and the delivery of these inventions does not currently exist. Objective: The present study aimed to describe the implementation of palliative care for end-stage renal failure patients on peritoneal dialysis. Design: A report on three cases. Materials and Methods: This study included three outpatients on peritoneal dialysis who received palliative care and died between January 2008 and June 2010. Measurements: The patients′ comorbidities, nutritional status, and functional status were evaluated using the Charlson comorbidity score, subjective global assessment, and Karnofsky Performance Score index, respectively. The Hamilton depression and Hamilton anxiety scales were also employed. The patients′ clinical manifestations and treatments were reviewed. Results: Each patient displayed 11-16 symptoms. The Charlson comorbidity scores were from 11 to 13, the subjective global assessment indicated that two patients were class assigned to "C" and one to class "B", and the mean Karnofsky index was <40. Among these patients, all experienced depression and two experienced anxiety, Low doses of hypertonic glucose solutions, skin care, psychological services, and tranquillizers were intermittently used to alleviate symptoms, after making the decision to terminate dialysis. The patients died 5 days to 2 months after dialysis withdrawal. Conclusion: The considerable burden associated with comorbid conditions, malnutrition, poor functional status, and serious psychological problems are predictors of poor patient prognoses. Withdrawal of dialysis, palliative care, and psychological interventions

  12. Recompensation of heart and kidney function after treatment with peritoneal dialysis in a case of congestive heart failure.

    Science.gov (United States)

    Kihm, Lars P; Hankel, Vinzent; Zugck, Christian; Remppis, Andrew; Schwenger, Vedat

    2011-01-01

    We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function increased during the long-term followup, and subsequently peritoneal dialysis was ceased. Pulmonary artery pressure and left ventricular ejection fraction remained stable and the patient did well. This case demonstrates the possibility of treating hyperhydration due to congestive heart failure with peritoneal dialysis resulting in recompensation of both heart and kidney functions. PMID:22162698

  13. Recompensation of Heart and Kidney Function after Treatment with Peritoneal Dialysis in a Case of Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Lars P. Kihm

    2011-01-01

    Full Text Available We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function increased during the long-term followup, and subsequently peritoneal dialysis was ceased. Pulmonary artery pressure and left ventricular ejection fraction remained stable and the patient did well. This case demonstrates the possibility of treating hyperhydration due to congestive heart failure with peritoneal dialysis resulting in recompensation of both heart and kidney functions.

  14. Animal Models of Peritoneal Dialysis: Thirty Years of Our Own Experience

    Directory of Open Access Journals (Sweden)

    Krzysztof Pawlaczyk

    2015-01-01

    Full Text Available Experimental animal models improve our understanding of technical problems in peritoneal dialysis PD, and such studies contribute to solving crucial clinical problems. We established an acute and chronic PD model in nonuremic and uremic rats. We observed that kinetics of PD in rats change as the animals are aging, and this effect is due not only to an increasing peritoneal surface area, but also to changes in the permeability of the peritoneum. Changes of the peritoneal permeability seen during chronic PD in rats are comparable to results obtained in humans treated with PD. Effluent dialysate can be drained repeatedly to measure concentration of various bioactive molecules and to correlate the results with the peritoneal permeability. Additionally we can study in in vitro conditions properties of the effluent dialysate on cultured peritoneal mesothelial cells or fibroblasts. We can evaluate acute and chronic effect of various additives to the dialysis fluid on function and permeability of the peritoneum. Results from such study are even more relevant to the clinical scenario when experiments are performed in uremic rats. Our experimental animal PD model not only helps to understand the pathophysiology of PD but also can be used for testing biocompatibility of new PD fluids.

  15. Recompensation of Heart and Kidney Function after Treatment with Peritoneal Dialysis in a Case of Congestive Heart Failure

    OpenAIRE

    Andrew Remppis; Christian Zugck; Vinzent Hankel; Kihm, Lars P; Vedat Schwenger

    2011-01-01

    We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function ...

  16. Comparison of the Effects of Dialysis Methods (Haemodialysis vs Peritoneal Dialysis) on Diastolic Left Ventricular Function Dialysis Methods and Diastolic Function

    Science.gov (United States)

    Ellouali, Fedoua; Berkchi, Fatimazahra; Bayahia, Rabia; Benamar, Loubna; Cherti, Mohammed

    2016-01-01

    Introduction: In patients undergoing chronic dialysis, several factors appear to influence the occurrence of cardiac abnormalities. The aim of our study was to evaluate the effects of two different methods of renal replacement therapy (chronic haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD)) on left ventricular (LV) diastolic function. Patients and Methods: We enrolled 63 patients: 21 patients on CAPD, and 42 age- and gender-matched patients on HD; 35 patients were men (55.6%). Median of age was 46.4 (35-57) years. The median duration of renal replacement therapy was 3(2-5) years. Results: The two groups (HD vs PD) were similar concerning body mass index, dialysis duration and cardiovascular risk factors. The comparison of echocardiographic parameters showed statistically significant differences between two groups, regarding the presence of calcification, cardiac effusion, severely abnormal left ventricular hypertrophy(LVH) and the ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/e’) >13 (p= 0.001, p= 0.003, p= 0.02, p= 0.004, respectively). In multivariate analysis, an E/e’>13 was higher in PD group ( OR= 5.8, CI [1.3-25.5], p=0.002). Conclusion: The method of dialysis seems to influence LV diastolic function. We observed a higher prevalence of diastolic LV dysfunction in the PD group. Echocardiographic follow up is essential as this could improve the management of cardiovascular complications in dialysis patients. PMID:27583042

  17. Concomitant bidirectional transport during peritoneal dialysis can be explained by a structured interstitium.

    Science.gov (United States)

    Stachowska-Pietka, Joanna; Waniewski, Jacek; Flessner, Michael F; Lindholm, Bengt

    2016-06-01

    Clinical and animal studies suggest that peritoneal absorption of fluid and protein from dialysate to peritoneal tissue, and to blood and lymph circulation, occurs concomitantly with opposite flows of fluid and protein, i.e., from blood to dialysate. However, until now a theoretical explanation of this phenomenon has been lacking. A two-phase distributed model is proposed to explain the bidirectional, concomitant transport of fluid, albumin and glucose through the peritoneal transport system (PTS) during peritoneal dialysis. The interstitium of this tissue is described as an expandable two-phase structure with phase F (water-rich, colloid-poor region) and phase C (water-poor, colloid-rich region) with fluid and solute exchange between them. A low fraction of phase F is assumed in the intact tissue, which can be significantly increased under the influence of hydrostatic pressure and tissue hydration. The capillary wall is described using the three-pore model, and the conditions in the peritoneal cavity are assumed commencing 3 min after the infusion of glucose 3.86% dialysis fluid. Computer simulations demonstrate that peritoneal absorption of fluid into the tissue, which occurs via phase F at the rate of 1.8 ml/min, increases substantially the interstitial pressure and tissue hydration in both phases close to the peritoneal cavity, whereas the glucose-induced ultrafiltration from blood occurs via phase C at the rate of 15 ml/min. The proposed model delineating the phenomenon of concomitant bidirectional transport through PTS is based on a two-phase structure of the interstitium and provides results in agreement with clinical and experimental data. PMID:26945084

  18. Dislipemia in patients undergoing continuous ambulatory peritoneal dialysis: pharmacological therapy (simvastatin) versus hemodialysis.

    Science.gov (United States)

    Marangoni, R; Civardi, F; Masi, F; Cimino, R; Maltagliati, L; Romei Longhena, G

    1993-01-01

    Peritoneal dialysis can worsen dislipemia, which is frequent in chronically uremic patients. In order to verify the therapeutic possibilities, we retrospectively studied 20 chronically uremic patients who had been previously treated with continuous ambulatory peritoneal dialysis (CAPD) and who had developed an IV-type dislipemia. Twelve have continued CAPD treatment and have been simultaneously treated with simvastatin; 8 have withdrawn from CAPD and have begun HD, without any antidislipemic pharmacological support. The results, after 3, 6, 12, and 18 months of treatment, showed the following: in patients treated with CAPD and simvastatin, highly significant decreases were noted in total cholesterol (T-cho) and triglycerides (TG) (p dislipemia only, can continue the treatment, because simvastatin is capable of correcting dislipemia, while those patients who have displemia as well as other complications strictly due to CAPD must abandon treatment and must be transferred to extracorporeal methods. PMID:8399632

  19. New mathematical model for fluid-glucose-albumin transport in peritoneal dialysis

    CERN Document Server

    Cherniha, Roman

    2011-01-01

    A mathematical model for fluid transport in peritoneal dialysis is constructed. The model is based on a three-component nonlinear system of two-dimensional partial differential equations for fluid, glucose and albumin transport with the relevant boundary and initial conditions. Non-constant steady-state solutions of the model are studied. The restrictions on the parameters arising in the model are established with the aim to obtain exact formulae for the non-constant steady-state solutions. As the result, the exact formulae for the fluid fluxes from blood to tissue and across the tissue were constructed together with two linear autonomous ODEs for glucose and albumin concentrations. The analytical results were checked for their applicability for the description of fluid-glucose-albumin transport during peritoneal dialysis.

  20. Dynamic changes in calcium and phosphate plasma concentrations in the patients on peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Jovanović Nataša

    2006-01-01

    Full Text Available Background/Aim. The disturbances of active forms of vitamin D synthesis and disturbances in calcium and posphate metabolism develop early in chronic renal failure, when creatinine clearance is about 30 ml/min. Chronic hemodialysis and peritoneal dialysis only partially correct the biochemical environment of patients on chronic renal replacement therapy because of end-stage renal disease. These dialysis modalities can’t significantly affect the endocrine disturbances of chronic renal failure and they have minimal modulatory effect. The management of disturbed calcium (Ca and phosphate (P metabolism and the maintainance of Ca × P product below 4.4 mmol/l thanks to the use of dialysate solutions with the appropriate calcium concentration and the careful dosage of phosphate binders, calcium and active vitamin D metabolits, are extremely important for the prevention of renal osteodystrophy, secondary hyperparathyroidism as well as low-bone turnover disease. The aim of the study was to analyze the plasma levels of calcium, phosphate, albumin, alkaline phosphatase and parathormon (PTH in 58 patients who were treated with continuous ambulatory peritoneal dialysis (CAPD from March to August 2003. The use of phosphate binders and the substitution with active vitamin D metabolits were also analyzed. Methods. We examined 58 patients, 30 males and 28 female, mean-age 52 years (range, 26-78 years, affected by end-stage renal disease of the different leading cause. The average time on peritoneal dialysis program was 20 months (2-66 months. Most of the patients were treated by CAPD, while only few of them performed automatic, cyclic or intermittent peritoneal dialysis. Most of the patients used a dialysate with 1.75 mmol/l calcium concentration. Results. The study showed that our patients on chronic CAPD program during several months had normal calcemia, phosphatemia and the level of alkaline phosphatase, and that they had Ca × P product in the recommended

  1. Serum Gamma-Glutamyltransferase Levels Predict Mortality in Patients With Peritoneal Dialysis

    OpenAIRE

    Park, Woo-Yeong; Kim, Su-Hyun; Kim, Young Ok; Jin, Dong Chan; Song, Ho Chul; Choi, Euy Jin; Kim, Yong Lim; Kim, Yon Su; Kang, Shin Wook; Kim, Nam Ho; Yang, Chul Woo; Kim, Yong Kyun

    2015-01-01

    Abstract Serum gamma-glutamyltransferase (GGT) level has been considered marker of oxidative stress as well as liver function. Serum GGT level has been reported to be associated with the mortality in hemodialysis patients. However, it is not well established whether serum GGT level is associated with all-cause mortality in peritoneal dialysis (PD) patients. The aim of this study was to determine the association between serum GGT levels and all-cause mortality in PD patients. PD patients were ...

  2. Acute Hydrothorax Complicating continuous Ambulatory Peritoneal Dialysis: A Case Report and Review of Literature

    OpenAIRE

    Kechrid Mohammad; Malik Ghulam; Shaikh Jamil; Al-Mohaya Suleiman; Al-Wakeel Jamal; El Gamal Hazem

    1999-01-01

    We describe here hydrothorax that occurred in a patient on continuous ambulatory peritoneal dialysis (CAPD) and highlight the problems of diagnosis and management. A 48 years-old man with history of obstructive uropathy secondary to urolithiasis was stared on CAPD when he reached end-stage renal failure. Two months later, he was admitted with two days history of shortness of breath on exertion and dry cough increasing in supine position. Chest examination was suggestive of right sided pleural...

  3. Ear, nose and throat manifestations in pediatric chronic renal failure patients undergoing peritoneal dialysis

    OpenAIRE

    Kumar, Sandeep; Chakravarti, A; Sahni, J. K.; Dubey, N. K.

    2004-01-01

    Ear, Nose and Throat manifestations have been frequently observed in patients with chronic renal failure. Many factors viz. ototoxic drugs, associated conditions of renal failure such as electrolyte imbalance, alteration in blood urea etc. have been implicated for these manifestations. The present study has been conducted to evaluate ear, nose and throat manifestations in thirty pediatric patients (age group 4-16 year) of chronic renal failure undergoing peritoneal dialysis. Probable patho-ph...

  4. Gastrointestinal symptoms in patients undergoing peritoneal dialysis: Multivariate analysis of correlated factors

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To investigate gastrointestinal (GI) symptoms in peritoneal dialysis (PD) patients and to explore related factors contributing to GI symptoms. METHODS: One hundred and twelve patients undergoing PD participated in the study. The gastrointestinal symptom rating scale was used for measuring GI symptoms. Information on age, height, weight, body mass index, disease leading to chronic renal failure, history of corticosteroid therapy, presence of predialytic GI symptoms, daily dosage of pills, and duration, ...

  5. Evaluation of hepatitis B vaccine responsiveness in hemodialysis and peritoneal dialysis patients

    OpenAIRE

    Salama Elsayed Farag; Tarek A Ghonemy; Sameh A. Soliman; Ahmed Bihery

    2015-01-01

    Background: Hepatitis B Virus (HBV) infection is considered as a major cause of liver cirrhosis and hepatocellular carcinoma. Patients with End Stage Renal Disease (ESRD) are a risk group for HBV infection. The vaccine of hepatitis B has been recommended for prevention of HBV infection in ESRD patient especially on renal replacement therapy. Methods: Eighty seven patients with ESRD on peritoneal dialysis and hemodialysis requiring primary hepatitis B vaccination were enrolled in the stud...

  6. Endothelial Dysfunction Is Associated With Major Adverse Cardiovascular Events in Peritoneal Dialysis Patients

    OpenAIRE

    Lee, Mi Jung; Han, Seung Hyeok; Lee, Jung Eun; Choi, Hoon Young; Yoon, Chang-Yun; Kim, Eun Jin; Han, Jae Hyun; Han, Ji Suk; Oh, Hyung Jung; Park, Jung Tak; Kang, Shin-Wook; Yoo, Tae-Hyun

    2014-01-01

    Abstract Endothelial dysfunction is implicated in increased cardiovascular risk in nondialyzed population. However, the prognostic impact of endothelial dysfunction on cardiovascular outcome has not been investigated in peritoneal dialysis (PD) patients. We prospectively determined endothelial function by brachial artery endothelium-dependent vasodilation (flow-mediated dilation [FMD]) in 143 nondiabetic PD patients and 32 controls. Primary outcome was a major adverse cardiac and cerebrovascu...

  7. Wernicke's encephalopathy that developed during the introduction period of peritoneal dialysis.

    Science.gov (United States)

    Nakashima, Yuko; Ito, Kenji; Nakashima, Hitoshi; Shirakawa, Aki; Abe, Yasuhiro; Ogahara, Satoru; Sasatomi, Yoshie; Yasunaga, Tomoe; Ifuku, Masakazu; Tsugawa, Jun; Tsuboi, Yoshio; Saito, Takao

    2013-01-01

    A 43-year-old man was admitted with end-stage renal disease caused by IgA nephropathy, and was treated with maintenance peritoneal dialysis. The patient developed general fatigue and appetite loss, and his symptoms were gradually aggravated by depression. After approximately 2 months on dialysis, the patient presented with altered consciousness and ophthalmoplegia. Wernicke's encephalopathy was diagnosed based on the presence of classic symptoms and the findings on magnetic resonance imaging. Thiamine replacement therapy was immediately initiated. The patient recovered from most of his neurological symptoms; however, the sequela of Korsakoff syndrome remained. A marginal thiamine deficiency in combination with predisposing factors must be considered when treating dialysis patients. PMID:24042519

  8. Preditores de peritonite em pacientes em um programa de diálise peritoneal Predictor factors of peritoneal dialysis-related peritonitis

    Directory of Open Access Journals (Sweden)

    João Victor Duarte Lobo

    2010-06-01

    Full Text Available INTRODUÇÃO: Peritonite é a principal complicação relacionada com a diálise peritoneal (DP. OBJETIVO: Avaliar possíveis preditores para o seu desenvolvimento em pacientes em programa crônico na modalidade. MÉTODO: Realizou-se estudo de coorte retrospectivo em 330 pacientes (média de idade 53 ± 19 anos em programa de DP na Clínica de Nefrologia de Sergipe (Clinese, em Aracaju/ SE, Brasil, entre 1.º de janeiro de 2003 e 31 de dezembro de 2007. Variáveis sociodemográficas e clínicas foram avaliadas comparativamente entre pacientes que apresentaram (141% - 42,7% ou não (189% - 57,3% peritonite. Na análise estatística, utilizaramse teste t de Student, qui-quadrado e modelo de regressão com múltiplas variáveis. RESULTADOS : Ocorreu um episódio de peritoniteacada28,4pacientes/mês(0,42episódio/ paciente/ano. O Staphylococcus aureus foi o agente etiológico mais frequente (27,8%. Não se utilizava antibioticoterapia profilática e 136 pacientes (41,2% haviam apresentado previamente infecção de sítio de saída do cateter peritoneal (ISSCP. Identificou-se maior risco de peritonite nos pacientes com albuminemia INTRODUCTION: Peritonitis remains a major complication of peritoneal dialysis (PD. OBJECTIVE: Evaluate peritonitis incidence, etiology and outcome in cronic PD patients. METHODS: A retrospective cohort study was carried out on 330 patients (mean age of 53 ± 19 years who had been treated by PD in a dialysis center in Aracaju/SE, Brazil between January 1st, 2003 and December 31th, 2007. Data of patients with and without peritonitis were compared using Student's ttest, chi-squared statistic and multiple logistic regression. RESULTS: There were 213 peritonitis among 141 patients (1.51 episode/patient resulting in a rate of 28.44 patient/episode/ month (0.42 patient/episode/year. Staphylococcus aureus was the most frequent micro-organism isolated (27.8%, followed by Escherichia coli (13.4% and 32.5% were culture

  9. Recent Development on Home Peritoneal Dialysis in Hainan Province

    Institute of Scientific and Technical Information of China (English)

    陈裕盛

    2001-01-01

    Objective:In order to experience and contrast incidence rate of intection peritonitis. Exit-site infection,lunnitis, patients re cover one's works,still living survival and withdraw rate from CAPD in particular on home PD of Subtropical Zone of China. Method:134 cases patients PD with CRF were from January 1,1981 to February 1998. We used three kinds of device and dialysate to complete CAPD. 134 patients into three groups according to PD device and form. Group Ⅰ: Non o-set 74 cases. Pat to use bottled dialysate/bag dialysate infusion abdominal cavity made by general emulsion tube/or once emulsion tube for CAPD. Group Ⅱ: 60 cases. Made by the o-set(Baxter H. Itd. USA).Group Ⅲ:45 cases. Made by o-set for on home PD. Result: The occur rate of infection peritonitis in Ⅰ,Ⅱ,Ⅲ Group were one/11.17,94.87 and 121.80 patient months. The infec tion rate of exit-site in Ⅰ,Ⅱ,Ⅲ Group were 18.91%,6.66%,6.66%. The lunnitis incidence rate in Ⅰ,Ⅱ,Ⅲ Group were 8.1%, 3.33%, and 4.44%, respectively. The patients recover one's works in group Ⅰ almost come to nought, group Ⅱ 30% and 45.6% in group Ⅲ. Survival still living: Group Ⅰ 12.83. Group Ⅱ≥23.25. Group Ⅲ≥27 months and among them ≥36 months 7 cases (15.55%).About withdraw:Group Ⅰ average 2%/year. Group Ⅱ and Group Ⅲ 1.4%/year. The death rate of average year in Ⅰ and Ⅱ Group patients were 2.66% lower than of HD death rate 10%. Conclusion: o-set it's indeed a device of develop of PD and home PD, because the o-set able to most limit lower occur rate of intection peritonitis especially fit into home PD subtropical zone area.

  10. Evaluation of stability of 99mTc-HSA complex during clinical peritoneal dialysis in vivo (short communication)

    International Nuclear Information System (INIS)

    For the assessment of the intra-dialysis stability of the 99mTc-HSA complex, a scintigraphic scanning of the organs accumulation of the free 99mTcO4- was carried out during peritoneal dialysis. 740 MBg 99mTc-HSA in dialization fluid was administered during kinetic peritoneal examination of the patient. The organs accumulating the free pertechnetion (head and neck), as well as whole body imaging of pt were carried out. The results show that the radioactivity is accumulated mainly in peritoneal cavity. Minimal radioactivity was indicated in the head and neck (∼2.3% of the total whole body radioactivity). Our results show that the 99mTc-HSA complex is stable during 3.5 h peritoneal dialysis in vivo. (author)

  11. SURVIVAL OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS CATHETERS: AN EVALUATION OF SURGICAL AND NON-SURGICAL FACTORS (SINGLE CENTER STUDY

    Directory of Open Access Journals (Sweden)

    A. Keshvari

    2006-06-01

    Full Text Available Peritoneal dialysis is an established form of renal replacement therapy used in many patients with end-stage renal disease. The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. This study was conducted in order to evaluate the catheter survival and its related factors in Imam Khomeini Hospital. A total of 80 catheters were inserted into 69 patients (52 men and 28 women with end-stage chronic renal failure during a period of 84 months. Retrospectively the correlation between catheter survival (overall and event free with demographic factors (sex and age, surgical factors (surgeons and surgical methods, nephrologic factors (the causes of peritoneal dialysis selection and the history of hemodialysis and peritonitis factors (the history and number of peritonitis has been evaluated. The mean age of the patients was 48.35 years (16 to 79 years. The overall survival of catheters or the probability of having a functioning catheter after one, two and three years was 53%, 41%, 22%, respectively. The event free survival of the catheter or the probability of having a functioning catheter without any problems after one year was 14%. It has been found out that among all factors in this study only history of hemodialysis had statistically significant effect on the overall survival of continuous ambulatory peritoneal dialysis catheter (P = 0.04. It seems that the overall survival of catheters is better when CAPD is started before any other attempts for hemodialysis.

  12. A comparison of sleep disturbances and sleep apnea in patients on hemodialysis and chronic peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Hamdan Al-Jahdali

    2011-01-01

    Full Text Available Studies have shown that sleep disorders are common among dialysis patients; however, few studies have compared the prevalence of different sleep disorders in patients on peritoneal dialysis (PD and hemodialysis (HD. We used questionnaires to assess the prevalence of common sleep disorders in dialysis patients. We compared the prevalence of sleep apnea (SA risk, restless legs syndrome (RLS, insomnia, and excessive daytime sleepiness (EDS, as well as sleep quality, in both groups. Of the 227 patients who were enrolled in the study, the total number of patients on HD was 188 (82%, while the total number of patients on PD was 39 (18%. There were no significant differences between the two groups regarding age, neck size, or duration on dialysis (all P >0.05. The estimated overall prevalence of SA was significantly higher in PD patients in comparison with HD patients (92% and 67%, respectively; P <0.05. The prevalence of insomnia was similar in both groups. The prevalence of RLS was significantly greater in PD than in HD patients (69% and 46%, respectively; P <0.05. In addition, EDS was significantly higher in PD than in HD patients (77% and 37%, respectively; P <0.05. Our study shows that sleep disorders are common in dialysis patients; however, SA, EDS, and RLS were more common in PD patients than in HD pa-tients. Poor sleep quality and insomnia were comparable in both groups.

  13. Factors Associated with the Choice of Peritoneal Dialysis in Patients with End-Stage Renal Disease

    Directory of Open Access Journals (Sweden)

    Pei-Chun Chiang

    2016-01-01

    Full Text Available Background. The purpose of this study was to analyze the factors associated with receiving peritoneal dialysis (PD in patients with incident end-stage renal disease (ESRD in a hospital in Southern Taiwan. Methods. The study included all consecutive patients with incident ESRD who participated in a multidisciplinary predialysis education (MPE program and started their first dialysis therapy between January 1, 2008, and June 30, 2013, in the study hospital. We provided small group teaching sessions to advanced CKD patients and their family to enhance understanding of various dialysis modalities. Multivariate logistic regression models were used to analyze the association of patient characteristics with the chosen dialysis modality. Results. Of the 656 patients, 524 (80% chose hemodialysis and 132 chose PD. Our data showed that young age, high education level, and high scores of activities of daily living (ADLs were positively associated with PD treatment. Patients who received small group teaching sessions had higher percentages of PD treatment (30.5% versus 19.5%; P=0.108 and preparedness for dialysis (61.1% versus 46.6%; P=0.090. Conclusion. Young age, high education level, and high ADL score were positively associated with choosing PD. Early creation of vascular access may be a barrier for PD.

  14. Broadening Options for Long-term Dialysis in the Elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patients

    OpenAIRE

    Brown, Edwina A.; Johansson, Lina; Farrington, Ken; Gallagher, Hugh; Sensky, Tom; Gordon, Fabiana; Da Silva-Gane, Maria; Beckett, Nigel; Hickson, Mary

    2010-01-01

    Background. Health-related quality of life (QOL) is an important outcome for older people who are often on dialysis for life. Little is, however, known about differences in QOL on haemodialysis (HD) and peritoneal dialysis (PD) in older age groups. Randomising patients to either modality to assess outcomes is not feasible. Methods. In this cross-sectional, multi-centred study we conducted QOL assessments (Short Form-12 Mental and Physical Component Summary scales, Hospital Anxiety and Depress...

  15. Applications of Procalcitonin in Peritoneal Dialysis Related Peritonitis%降钙素原在腹膜透析相关性腹膜炎中的应用

    Institute of Scientific and Technical Information of China (English)

    朱琳(综述); 解汝娟(审校)

    2015-01-01

    降钙素原是一种炎症标志物,其在多种临床感染性疾病中均显示出高度的特异性及敏感性。鉴于传统的腹膜透析相关性腹膜炎的检测手段均具有一定的局限性,国内外学者开始倾向于将降钙素原纳入腹膜透析相关性腹膜炎的诊断指标,研究表明腹膜透析相关性腹膜炎患者的血清降钙素原水平显著升高。因此,降钙素原可以作为腹膜透析相关性腹膜炎患者在诊断和治疗过程中的重要检测指标,其对腹膜透析相关性腹膜炎的指导意义值得进一步探索。%Procalcitonin has been clearly specified as an infection marker for many clinical diagnosis of bacterial infections with high sensitivity and specificity .In view of some certain limitations on traditional diag-nostic standards of peritoneal dialysis related peritonitis, both domestic and foreign scholars tended to intro-duce procalcitonin as one of peritoneal dialysis related peritonitis indicators .A large number of studies showed that patients suffering from peritoneal dialysis related peritonitis gained significantly higher concentra-tion of serum procalcitonin.Therefore, procalcitonin can be used as an important detection index in the diag-nosis and treatment of peritoneal dialysis related peritonitis,the guiding significance of which deserves further exploration.

  16. Polyclonal gammopathy related to renal bleeding in a peritoneal dialysis patient

    Directory of Open Access Journals (Sweden)

    Eun-Mi Cho

    2013-07-01

    Full Text Available Polyclonal gammopathy represents the diffuse activation of B cells and is usually related to inflammation or immune-related diseases. However, the mechanisms leading to polyclonal gammopathy are essentially speculative. Generally, infectious, inflammatory, or various other reactive processes may be indicated by the presence of a broad-based peak or band in the gamma region on serum protein electrophoresis results. A 15-year-old girl, who had been receiving peritoneal dialysis, presented with polyclonal gammopathy and massive gross hematuria. Renal artery embolization was performed, after which the continuous bleeding subsided and albumin-globulin dissociation resolved. This is a rare case of polyclonal gammopathy related to renal bleeding.

  17. Correlational studies on insulin resistance and leptin gene polymorphisms in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Liou Cao

    2015-09-01

    Full Text Available Objective(s:The aim of the study was to investigate the relationship between insulin resistance (IR and leptin (LEP gene polymorphisms in peritoneal dialysis (PD patients. Materials and Methods: From July 1, 2011 to August 1, 2011, patients who received chronic PD were chosen and divided into three groups (DM, high HOMR-IR, and low HOMR-IR. Two PCR products of LEP were sequenced and aligned and the distribution of polymorphisms was analyzed using χ2 analysis. In addition, serum leptin level, PD conditions, and biochemical parameters according to different genotype of G-2548A and A19G were statistically analyzed (P-value

  18. Applications of longitudinal and transversal bioimpedance measurements in peritoneal dialysis at 50 kHz

    OpenAIRE

    Nescolarde Selva, Lexa Digna; Doñate, T.; Casañas Bueno, Roberto; Rosell Ferrer, Francisco Javier

    2010-01-01

    More relevant information of the fluid changes in peritoneal dialysis (PD) might be obtained with segmental bioimpedance measurements rather than whole-body measurement, who hidden information of body composition. Whole-body and segmental bioimpedance measurements were obtained using 5 configurations (whole-body or right-side (RS), longitudinal-leg (L-LEG), longitudinal-abdomen (L-AB), transversal-abdomen (T-AB), and transversal-leg (T-LEG)) in 20 patients: 15 males (56.5 ± 9.4...

  19. Value of scintigraphy in the diagnosis of infections related to continuous ambulatory peritoneal dialysis (CAPD)

    International Nuclear Information System (INIS)

    Full text: Complications related to CAPD result in temporary or permanent discontinuation of CAPD. Approximately a 20 % of the patients on peritoneal dialysis are transferred to hemodialysis due to different complications, chief among these is peritonitis. Other complications are exit-site infections, catheter-related problems, hernias, poor ultrafiltration or clearance, etc. Although peritonitis remains the major cause of transfer to hemodialysis the accurate identification and localization the other infectious complications is necessary for their appropriate treatment. The aim of this study is to assess prospectively the value of scintigraphic with 99mTc-HMPAO labeled white blood cells (WBC) in-patients on CAPD with suspicious of infectious complications. From 1997 to 2000, 27 scintigraphies with 99mTc HMPAO labeled WBC were performed in 17 patients with suspicious of catheter related abdominal wall infection, assessed by Twardowski scale, or peritonitis. In five patients we carried out study of control after the onset of therapy to assess response. The procedure for radiolabeling WBC with 99mTc-HMPAO in our department is similar to the ISORBE consensus protocol. Planar images were obtained 30 minutes, 2 hours, and in some cases at 24 hours, after administration of 740-925 MBq of labeled WBC. Four patients with clinical evidence of peritonitis showed a diffuse uptake, in two of them we carried out scintigraphy after antibiotic therapy and we did not find abnormalities. From 18 scintigraphies with catheter-related local infection 6 showed focal uptake in patients with positive culture and pericatheter exudate. All patients with negative culture had normal scintigraphies. In 3 of them after antibiotic therapy and negative culture did not find pathologic abnormalities. Peritoneal and wall abdominal scintigraphy with WBC radiolabeling with 99mTc-HMPAO is useful method for evaluation of several CAPD-related infectious complications. (author)

  20. Theoretical analysis of osmotic agents in peritoneal dialysis. What size is an ideal osmotic agent?

    Science.gov (United States)

    Rippe, B; Zakaria el-R; Carlsson, O

    1996-01-01

    In this article the difference between osmotic fluid flow (ultrafiltration) as driven by osmotic pressure and diffusion through thin leaky membranes is discussed. It is pointed out that water transport induced by osmosis is fundamentally different from the process of water diffusion. Applying modern hydrodynamic pore theory, the molar solute concentration and the solute concentration in grams per 100 mL, exerting the same initial transmembrane osmotic pressure as a 1% glucose solution, was investigated as a function of solute molecular weight (MW). It was then assumed, base on experimental data, that the major pathway responsible for the peritoneal osmotic barrier characteristics is represented by pores of radius approximately 47 A. With increasing solute radius, the osmotic reflection coefficient (sigma) and, hence, the osmotic efficiency per mole of solute will increase. However, simultaneously, the molar concentration per unit solute weight will decrease. The balance point between these two events apparently occurs at a solute MW of approximately 1 kDa. An additional advantage of using solutes of high MW as osmotic agents during peritoneal dialysis (PD), rather than increased osmotic efficiency per se, lies in the fact that large solutes, due to their low peritoneal diffusion capacity, will maintain a sustained rate of ultrafiltration (osmosis) over a prolonged period. To illustrate this, we have performed computer simulations of peritoneal fluid transport according to the three-pore model of peritoneal permselectivity. According to these simulations, 4% of an 800 Da polymer solution (+50 mmol/L above isotonicity) will produce the same cumulative amount of intraperitoneal fluid volume ultrafiltered (UF) during 360-400 minutes as 4% of a 2 kDa polymer solution (+20 mmol/L) or 6.5% of a 10 kDa polymer solution (+6.5 mmol/L) having the same electrolyte concentration as dialysis solutions conventionally used for PD. Similar cumulative UF volumes (during 400 minutes

  1. Treatment of necrotizing acute pancreatitis with peritoneal lavage and dialysis by a new simplified technique insert catheters

    Science.gov (United States)

    Li, Qi; Zhu, Bai; Zhu, Xueyan; Piao, Chenglin; Cui, Wenpeng; Wang, Yangwei; Sun, Jing; Chen, Wenguo; Miao, Lining

    2016-01-01

    Abstract Peritoneal lavage and dialysis is an approach to treat necrotizing acute pancreatitis as it removes dialyzable toxins and reduces severe metabolic disturbances. Successful catheter implantation is important for delivering adequate peritoneal lavage and dialysis. The aim of the present study was to describe a new modified percutaneous technique for the placement of peritoneal dialysis catheters and assess the effectiveness and safety of peritoneal lavage and dialysis used for treatment of necrotizing acute pancreatitis. We conducted a retrospective data review of 35 patients of necrotizing acute pancreatitis from January 2010 to December 2014 in Jilin City Central Hospital and The First Affiliated Hospital of ZheJiang University. In total, 18 patients underwent peritoneal lavage and dialysis after inserting catheters by our new technique (group A), whereas 17 patients underwent ultrasound-guided percutaneous catheter drainage (group B). By analyzing the patients’ data, the drainage days and mean number of hours between the debut of the symptoms and the hospital admission were lower in group A (P < 0.05, P < 0.05, respectively). The complication rate of 5.6 and 17.6%, respectively (P = 0.261), and a mortality rate of 16.7 and 5.9% for each group, respectively (P = 0.316). Likewise, hospitalization time was similar for the group A: 31 ± 25.3 days compared with 42.8 ± 29.4 days in the group B (P = 0.211). Peritoneal lavage and dialysis can be used in necrotizing acute pancreatitis, and our new modified percutaneous technique offers the same complication and mortality rate as ultrasound-guided drainage but with a shorter drainage days. PMID:27281083

  2. Brevibacterium casei isolated as a cause of relapsing peritonitis.

    Science.gov (United States)

    Althaf, Mohammed Mahdi; Abdelsalam, Mohamed Said; Alsunaid, Mohammed Sunaid; Hussein, Maged Hassan

    2014-01-01

    We report a case of relapsing peritonitis in a 33-year-old woman on automated peritoneal dialysis. End-stage renal disease was secondary to systemic lupus erythematosus complicated with lupus nephritis. The organism isolated was Brevibacterium casei that was not readily identified, delaying appropriate management with an extended antibiotic course. Definite management of B casei peritonitis was peritoneal dialysis catheter removal. PMID:24648477

  3. Methylglyoxal Induced Basophilic Spindle Cells with Podoplanin at the Surface of Peritoneum in Rat Peritoneal Dialysis Model

    Directory of Open Access Journals (Sweden)

    Ichiro Hirahara

    2015-01-01

    Full Text Available Peritoneal dialysis (PD is a common treatment for patients with reduced or absent renal function. Long-term PD leads to peritoneal injury with structural changes and functional decline. At worst, peritoneal injury leads to encapsulating peritoneal sclerosis (EPS, which is a serious complication of PD. In order to carry out PD safely, it is important to define the mechanism of progression of peritoneal injury and EPS. We prepared rat models of peritoneal injury by intraperitoneal administration of glucose degradation products, such as methylglyoxal (MGO or formaldehyde (FA, chlorhexidine gluconate (CG, and talc. In rats treated with MGO, peritoneal fibrous thickening with the appearance of basophilic spindle cells with podoplanin, cytokeratin, and α-smooth muscle actin at the surface of the peritoneum was observed. These cells may have been derived from mesothelial cells by epithelial-to-mesenchymal transition. In FA- or CG-treated rats, the peritoneum was thickened, and mesothelial cells were absent at the surface of the peritoneum. The CG- or MGO-treated rats presented with a so-called abdominal cocoon. In the talc-treated rats, extensive peritoneal adhesion and peritoneal thickening were observed. MGO-induced peritoneal injury model may reflect human histopathology and be suitable to analyze the mechanism of progression of peritoneal injury and EPS.

  4. Methylglyoxal Induced Basophilic Spindle Cells with Podoplanin at the Surface of Peritoneum in Rat Peritoneal Dialysis Model.

    Science.gov (United States)

    Hirahara, Ichiro; Sato, Hideki; Imai, Toshimi; Onishi, Akira; Morishita, Yoshiyuki; Muto, Shigeaki; Kusano, Eiji; Nagata, Daisuke

    2015-01-01

    Peritoneal dialysis (PD) is a common treatment for patients with reduced or absent renal function. Long-term PD leads to peritoneal injury with structural changes and functional decline. At worst, peritoneal injury leads to encapsulating peritoneal sclerosis (EPS), which is a serious complication of PD. In order to carry out PD safely, it is important to define the mechanism of progression of peritoneal injury and EPS. We prepared rat models of peritoneal injury by intraperitoneal administration of glucose degradation products, such as methylglyoxal (MGO) or formaldehyde (FA), chlorhexidine gluconate (CG), and talc. In rats treated with MGO, peritoneal fibrous thickening with the appearance of basophilic spindle cells with podoplanin, cytokeratin, and α-smooth muscle actin at the surface of the peritoneum was observed. These cells may have been derived from mesothelial cells by epithelial-to-mesenchymal transition. In FA- or CG-treated rats, the peritoneum was thickened, and mesothelial cells were absent at the surface of the peritoneum. The CG- or MGO-treated rats presented with a so-called abdominal cocoon. In the talc-treated rats, extensive peritoneal adhesion and peritoneal thickening were observed. MGO-induced peritoneal injury model may reflect human histopathology and be suitable to analyze the mechanism of progression of peritoneal injury and EPS. PMID:26064894

  5. Association between ambient carbon monoxide and secondary hyperparathyroidism in nondiabetic patients undergoing peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Weng CH

    2015-09-01

    Full Text Available Cheng-Hao Weng,1,2 Ching-Chih Hu,3 Tzung-Hai Yen,1,2 Wen-Hung Huang1,2 1Department of Nephrology, Division of Clinical Toxicology, Chang Gung Memorial Hospital, Linkou, 2College of Medicine, Chang Gung University, Taoyuan, 3Liver Research Unit, Department of Hepatogastroenterology, Chang Gung Memorial Hospital, Keelung, Taiwan Background: Secondary hyperparathyroidism (SHPT is a major disorder in patients with chronic renal disease with or without dialysis. Air pollution has been confirmed as being associated with increased incidence of human morbidity and mortality. To our knowledge, investigating air pollution as a dialysis-unrelated factor for SHPT in patients undergoing dialysis is limited. We developed this study to assess the effect of air pollution and other important risk factors on SHPT in patients undergoing peritoneal dialysis (PD. Materials and methods: We recruited a total of 141 patients who did not have diabetes mellitus, were nonsmokers, and were undergoing PD in this cross-sectional study. We analyzed the difference in air quality based on the patients’ living areas. We estimated demographic, hematological, nutritional, inflammatory, biochemical, air pollutant, and dialysis-related data based on this cross-sectional study. Subgroup analysis of the relationship between air pollutants and the clinical variables and having or not having hyperparathyroidism (HPT (intact parathyroid hormone level ≥180 pg/dL was also performed. Results: A total of 141 patients undergoing PD (30 men and 111 women were enrolled in the study. Sixty-eight patients had SHPT. In a binary logistic regression, high environmental CO exposure (odds ratio [OR] 3.22, 95% confidence interval [CI] 1.42–7.28; P=0.005, serum phosphate levels (OR 1.66, 95% CI 1.17–2.37; P=0.005, hypoalbuminemia (OR 3.76, 95% CI 1.29–10.94; P=0.015, and use of calcitriol (OR 8.25, 95% CI 3.43–19.85; P<0.001 were positively associated with SHPT. Conclusion: The findings of

  6. Application of longitudinal and transversal bioimpedance measurements in peritoneal dialysis at 50 kHz

    Science.gov (United States)

    Nescolarde, L.; Doñate, T.; Casañas, R.; Rosell-Ferrer, J.

    2010-04-01

    More relevant information of the fluid changes in peritoneal dialysis (PD) might be obtained with segmental bioimpedance measurements rather than whole-body measurement, who hidden information of body composition. Whole-body and segmental bioimpedance measurements were obtained using 5 configurations (whole-body or right-side (RS), longitudinal-leg (L-LEG), longitudinal-abdomen (L-AB), transversal-abdomen (T-AB), and transversal-leg (T-LEG)) in 20 patients: 15 males (56.5 ± 9.4 yr, 24.2 ± 4.2 kg/m2) and 5 females (58.4 ± 7.1 yr, 28.2 ± 5.9 kg/m2) in peritoneal dialysis (PD). The aim of this study is to analyze the relationship between whole-body, longitudinal-segmental (L-LEG and L-AB) and transversal-segmental (TAB and TLEG) bioimpedance measurement at 50 kHz, with clinical parameters of cardiovascular risk, dyslipidemia, nutrition and hydration. The Kolmogorov-Smirnov test was used for the normality test of all variables. Longitudinal bioimpedance parameters were normalized by the height of the patients. The Spearman correlation was used to analyze the correlation between bioimpedance and clinical parameters. The statistical significance was considered with P bioimpedance measurements have higher correlation with clinical parameters than longitudinal measurements.

  7. Quality of life, mental health and health beliefs: comparison between haemodialysis and peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Theofilou P

    2010-10-01

    Full Text Available Aim: The comparative study between in-centre haemodialysis (HD and continuous ambulatory peritoneal dialysis (PD patients regarding self-reported quality of life (QoL as well as some psychological dimensions that may affect and may be affected by the patient’s state of health, like health locus of control beliefs, depression and anxiety. Material and Method: The sample consists of 144 patients in-centre haemodialysis or continuous ambulatory peritoneal dialysis (CAPD. Patient-reported assessments included: a WHOQOL-BREF, b General Health Questionnaire (GHQ-28, c Multidimensional Health Locus of Control Questionnaire (MHLC, d State - Trait Anxiety Inventory (STAI I, II and e Center for Epidemiologic Studies Depression Scale (CES-D.Results: HD patients presented lower scores in WHOQOL-BREF domain of environment. Furthermore, they reported higher scores in the GHQ-28 sub-scales of anxiety/insomnia and severe depression as well as of the total score of the questionnaire. Regarding health beliefs, statistically significant difference was observed in HD patients, who presented higher scores in the internal health locus of control. Conclusions: Patients in HD treatment modality were experiencing a more compromised QoL indicating greater discontent with different aspects of their environment. Further, they reported more symptoms of anxiety, sleeping problems, depression or suicidal thoughts.

  8. A review of acute and chronic peritoneal dialysis in developing countries

    Science.gov (United States)

    Abraham, Georgi; Varughese, Santosh; Mathew, Milly; Vijayan, Madhusudan

    2015-01-01

    Various modalities of renal replacement therapy (RRT) are available for the management of acute kidney injury (AKI) and end-stage renal disease (ESRD). While developed countries mainly use hemodialysis as a form of RRT, peritoneal dialysis (PD) has been increasingly utilized in developing countries. Chronic PD offers various benefits including lower cost, home-based therapy, single access, less requirement of highly trained personnel and major infrastructure, higher number of patients under a single nephrologist with probably improved quality of life and freedom of activities. PD has been found to be lifesaving in the management of AKI in patients in developing countries where facilities for other forms of RRT are not readily available. The International Society of Peritoneal Dialysis has published guidelines regarding the use of PD in AKI, which has helped in ensuring uniformity. PD has also been successfully used in certain special situations of AKI due to snake bite, malaria, febrile illness, following cardiac surgery and in poisoning. Hemodialysis is the most common form of RRT used in ESRD worldwide, but some countries have begun to adopt a ‘PD first’ policy to reduce healthcare costs of RRT and ensure that it reaches the underserved population. PMID:26034593

  9. Aspects of osseous, peritoneal and renal handling of bisphosphonate during peritoneal dialysis: a methodological study

    DEFF Research Database (Denmark)

    Joffe, P; Henriksen, Jens Henrik Sahl

    1996-01-01

    -acetic acid (51Cr-EDTA). Eight patients on CAPD were studied cross-sectionally. The mean plasma clearances of 99mTc-MBP and 51Cr-EDTA in the steady state (4h) were 38.2 and 12.2 ml min-1 (p < 0.01), the peritoneal clearances (0-4 h) were 5.2 and 7.2 ml min-1 (p < 0.01), and the renal clearances (0-4 h) were 2......Tc-MBP equal the clearances of 51Cr-EDTA is correct from a clinical point of view. We found that the uptake of the tracers in soft tissue and the renal handling of 51Cr-EDTA and 99mTc-MBP are also similar. The differences between the clearance values for 51Cr-EDTA and 99mTc-MBP may be explained by their...

  10. Dialysis - peritoneal

    Science.gov (United States)

    ... walls of your abdomen. A membrane called the peritoneum covers the walls of your abdomen. PD involves ... fluid passes from your blood vessels through the peritoneum and into the solution. After a set amount ...

  11. End-stage renal disease use in hurricane-prone areas: should nephrologists increase the utilization of peritoneal dialysis?

    Science.gov (United States)

    Kleinpeter, Myra A

    2007-01-01

    Hurricane Katrina resulted in massive destruction of the gulf coast of the United States in 2005. In the immediate aftermath, displaced dialysis patients required urgent hemodialysis or additional peritoneal dialysis (PD) supplies. Massive damage to the health care infrastructure in these communities disrupted dialysis services for several months. As a result of this event and subsequent storms during the 2005 Atlantic hurricane season, many decisions regarding future services to dialysis patients in hurricane prone communities (HPCs) need to occur. Nephrologists, dialysis nurses, dialysis providers, and patients need to discuss the ramifications of and types of continued dialysis services in HPC. Nephrologists should encourage PD, and efforts to educate on other renal replacement therapies including PD and transplant should occur. With the potential for interruption of electrical, sewerage, and water services, more patients should consider PD. Recovery from future events begins with appropriate disaster planning. Many questions are considered and need answering in planning for dialysis services in HPC and other communities subject to natural disasters. This summary provides the basis to begin discussions when planning for dialysis services in communities prone to natural disasters. PMID:17200049

  12. Evaluation of radiochemical purity and stability of 99mTc-HSA complex in fluid for peritoneal dialysis in vitro

    International Nuclear Information System (INIS)

    Human serum albumin (HSA) labeled with 131I or 99mTc was adopted in isotopic diagnostics for evaluation of volume and dynamics of vascular system. Because of high doses absorbed by patient's body due to long half-life period and high energy of 131I application of 99mTc (low energy, short half-life) to HSA labelling would be useful. Condition for applying of 99mTc-HSA in monitoring of peritoneal dialysis kinetics is complex stability during four-hour period in peritoneal dialysis conditions. Evaluation of stability of 99mTc-HSA complex in period from 30 minutes to 4 hours after complex preparation was done by means of paper radiochromatography and column chromatography. Additionally, separation of the complex after one- and four-hour incubations with solutions for peritoneal dialysis was done. The studies carried out proved stability of the complex during 4-hour period after preparation and incubation with solutions for peritoneal dialysis. 99mTc-HSA complex content was above 98% at all time intervals. The result obtained point out possibility of replacing of albumin labeled with 131I by albumin labeled with 99mTc

  13. Peritonite esclerosante encapsulante pós-diálise peritoneal Sclerosing encapsulating peritonitis after peritoneal dialysis

    OpenAIRE

    Alexandre Tagliari Cestari; Marina Lourenço de Conti; João Antonio Gonçalves Garreta Prats; Henri Sato Junior; Hugo Abensur

    2013-01-01

    Pacientes com insuficiência renal crônica terminal em uso de diálise peritoneal (DP) estão sujeitos a diversas complicações da própria terapia de substituição renal. Relatamos uma complicação rara da DP na qual o peritôneo, após anos de contato com a substância hipertônica dialisante, é gradualmente substituído por tecido fibroso. O paciente em questão teve diversas intercorrências após o início da DP, incluindo uma peritonite bacteriana, hiperparatireoidismo terciário (sendo tratado com duas...

  14. Non-adherence in patients on peritoneal dialysis: a systematic review.

    Directory of Open Access Journals (Sweden)

    Konstadina Griva

    Full Text Available BACKGROUND: It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions. METHODS: A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. RESULTS: The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of non-adherence varied across studies: 2.6-53% for dialysis exchanges, 3.9-85% for medication, and 14.4-67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. CONCLUSION: Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population.

  15. Fibroblast Growth Factor 21 (FGF-21 in Peritoneal Dialysis Patients: Natural History and Metabolic Implications.

    Directory of Open Access Journals (Sweden)

    Elena González

    Full Text Available Human fibroblast growth factor 21 (FGF-21 is an endocrine liver hormone that stimulates adipocyte glucose uptake independently of insulin, suppresses hepatic glucose production and is involved in the regulation of body fat. Peritoneal dialysis (PD patients suffer potential interference with FGF-21 status with as yet unknown repercussions.The aim of this study was to define the natural history of FGF-21 in PD patients, to analyze its relationship with glucose homeostasis parameters and to study the influence of residual renal function and peritoneal functional parameters on FGF-21 levels and their variation over time.We studied 48 patients with uremia undergoing PD. Plasma samples were routinely obtained from each patient at baseline and at 1, 2 and 3 years after starting PD therapy.Plasma FGF-21 levels substantially increased over the first year and were maintained at high levels during the remainder of the study period (253 pg/ml (59; 685 at baseline; 582 pg/ml (60.5-949 at first year and 647 pg/ml (120.5-1116.6 at third year (p<0.01. We found a positive correlation between time on dialysis and FGF-21 levels (p<0.001, and also, those patients with residual renal function (RRF had significantly lower levels of FGF-21 than those without RRF (ρ -0.484, p<0.05. Lastly, there was also a significant association between FGF-21 levels and peritoneal protein losses (PPL, independent of the time on dialysis (ρ 0.410, p<0.05.Our study shows that FGF-21 plasma levels in incident PD patients significantly increase during the first 3 years. This increment is dependent on or is associated with RRF and PPL (higher levels in patients with lower RRF and higher PPL. FGF-21 might be an important endocrine agent in PD patients and could act as hormonal signaling to maintain glucose homeostasis and prevent potential insulin resistance. These preliminary results suggest that FGF-21 might play a protective role as against the development of insulin resistance over

  16. The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry study

    Directory of Open Access Journals (Sweden)

    Cho Yeoungjee

    2012-06-01

    Full Text Available Abstract Background The aim of the study was to determine whether distance between residence and peritoneal dialysis (PD unit influenced peritonitis occurrence, microbiology, treatment and outcomes. Methods The study included all patients receiving PD between 1/10/2003 and 31/12/2008, using ANZDATA Registry data. Results 365 (6% patients lived ≥100 km from their nearest PD unit (distant group, while 6183 (94% lived S. aureus peritonitis (adjusted odds ratio [OR] 1.64, 95% CI 1.09-2.47. Distant patients with first peritonitis episodes were less likely to be hospitalised (64% vs 73%, p = 0.008 and receive antifungal prophylaxis (4% vs 10%, p = 0.01, but more likely to receive vancomycin-based antibiotic regimens (52% vs 42%, p  Conclusions Living ≥100 km away from a PD unit was associated with increased risk of S. aureus peritonitis, modified approaches to peritonitis treatment and peritonitis outcomes that were comparable to, or better than patients living closer to a PD unit. Staphylococcal decolonisation should receive particular consideration in remote living patients.

  17. Síndrome metabólico en diálisis peritoneal Metabolic syndrome in peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Francisco Cirera Segura

    2011-12-01

    origin. We set out to: • Determine the prevalence of metabolic syndrome in peritoneal dialysis and see how it evolved. • Evaluate its influence on mortality. • Review the Nursing interventions aimed at preventing it. Material and Methods: A 5-year retrospective descriptive study was carried out. The metabolic syndrome diagnostic criteria classification proposed by NCEP ATP III, modified by Kam-Tao Li, was used. The other variables were obtained from the clinical history. Results: The sample was made up of 53 patients with an average age of 62.02 years. The average time on dialysis was 28.02 months. The factors that describe metabolic syndrome in peritoneal dialysis were studied. They did not differ, except for glucaemia (p=0.012. The patients diagnosed with metabolic syndrome increased, without significance (p=0.18. The survival of patients with metabolic syndrome was lower, although without a significant difference (p=0.990. Discussion: The role of Nursing in the prevention and treatment of metabolic syndrome is fundamentally, as we can act on all the factors. The "Knowledge Deficit" should be assessed systematically in order to reinforce the intervention. We found the importance of establishing Nursing diagnoses and re-assessing interventions designed to obtain the expected results. We have not managed to improve metabolic syndrome, which forces us to consider more effective actions, because • We have a high percentage of patients with metabolic syndrome, which increases every year. • They had lower survival, although the difference was not significant. • We should correct Nursing diagnoses and interventions.

  18. Incidencia de peritonitis por gérmenes resistentes a oxacilina-cefazolina en diálisis peritoneal Incidence of peritonitis caused by oxacillin-cephazolin resistant germs in peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Carmen Domínguez Tristancho

    2005-09-01

    Full Text Available Los estafilococos coagulasa-negativos y dorados siguen siendo los germenes responsables mas frecuentes de las peritonitis en pacientes tratados con diálisis peritoneal. Una porción variable de estos gérmenes han desarrollado resistencia a antibióticos tales como oxacilina, cefazolina y glicopeptidos. Se analizan un total de 75 peritonitis acontecidas durante los 5 últimos años en 38 pacientes, para determinar el porcentaje de gérmenes gram positivos resistentes a oxacilina-cefazolina y describir la evolución de dichas peritonitis con tratamiento empírico con teicoplanina-ceftazidima, investigando las características distintivas con respecto a las causadas por gérmenes sensibles a estos antibióticos. Los resultados de los cultivos fueron: esteriles 15%, estafilococo coagulasa-negativo 37%, estafilococo dorado 8%, gram negativos 23%, otros gram positivos 13% y otros 4%. No se observó resistencia a la teicoplanina en ninguno de los gérmenes gram positivos, ni a la ceftazidima en los gram negativos; sin embargo, un 50% de estafilococos fue resistente a la oxacilina y cefazolina. El porcentaje de curación fue superior al 90% no permitiendo distinguir características entre ellas. En conclusión, la alta tasa de curación de las peritonitis por gram positivos tratados con teicoplanina-ceftazidima se suman a los argumentos a favor de validar este tratamiento como elección en las peritonitis en diálisis peritoneal.Coagulase-negative Staphylococcus and Staphylococcus aureus continue to the germs most often responsible for peritonitis in patients treated using peritoneal dialysis. A variable portion of these germs have developed resistance to antibiotics such as oxacillin, cephazolin and glycopeptides. A total of 75 cases of peritonitis occurring in the last 5 years in 38 patients were analysed, to determine the percentage of gram positive germs resistant to oxacillin-cephazolin and to describe the evolution of these cases of peritonitis

  19. Peritoneal dialysis in an infant with type 1 diabetes and hyperosmolar coma.

    Science.gov (United States)

    Multari, G; Werner, B; Cervoni, M; Lubrano, R; Costantino, F; Demiraj, V; Pozzilli, P

    2001-02-01

    Hyperosmolar coma which is characterized by severe hyperglycemia in absence of chetosis is very rare in pediatric age with only 11 cases reported in the literature. The outcome of the condition is usually poor with mental retardation being the most common event. Here a case of hyperosmolar coma is described in a female of three months of age who was treated with peritoneal dialysis 11 hours after admittance to hospital. This female patient has been receiving insulin from three months of age and today at the age of 10 years she leads a normal life despite being on insulin therapy. A very low level of C-peptide (<0.3 ng/ml) clearly confirms she is affected by Type 1 diabetes. To our knowledge this is the first case report of hyperosmolar coma in a neonate with Type 1 diabetes who survived this condition without late neurological consequences. PMID:11263466

  20. Evaluation of bone metabolism in patients with chronic renal failure treated by continuous ambulatory peritoneal dialysis

    International Nuclear Information System (INIS)

    Bone metabolism inpatients with chronic renal failure treated by continuous ambulatory peritoneal dialysis (CAPD) was evaluated. IRMA, RRA and RIA were used to detect PTH, 25 (OH)D3, 1,25(OH)2D3, BGP, Ca and P levels in the blood of 24 CAPD patients. PTH and BGP were increased in uremic patients ad decreased after CAPD. 25(OH)D3 and 1,25 (OH)2D3 were decreased in the patients, but their levels were not changed further after CAPD. PTH had negative correlation with 25 (OH)D3 (r = -0.379, P 2D3 (r = -0.451, P < 0.01). PTH had positive correlation with BGP (r 0.501, P < 0.01) in CAPD patients, and the correlativity was decreased by CAPD. The results showed: PTH hypersecretion is a main factor inducing bone metabolism disturbance, and bone turnover rate is decreased in these patients by CAPD

  1. Modified computed tomography peritoneography: clinical utility in continuous ambulatory peritoneal dialysis patients

    International Nuclear Information System (INIS)

    The purpose of the present paper is to review the indications, results, clinical correlation and implications for management of a modified CT peritoneography (CTP) technique in the evaluation of continuous ambulatory peritoneal dialysis (CAPD) patients. Forty CTP in 33 patients were reviewed by two observers blinded to clinical history or outcome. The CTP technique included 100 mL non-ionic intraperitoneal contrast, 1 h of ambulation and prone positioning during the CT. No precontrast or delayed examinations were performed. A CAPD-related complication was diagnosed in 33 of 40 (82%) CTP . Twenty-nine CTP were performed for evaluation of suspected dialysate leaks. In this group there were 18 leaks, a total of seven umbilical hernias (five as isolated findings) and five normal studies. Nine of 18 (50%) leaks resolved with conservative management and six of nine patients (67%) of the remainder continued CAPD after appropriate surgery. Seven patients were evaluated for scrotal swelling (one bilateral), and there were five communicating hydroceles (all with inguinal fat herniation and all surgically confirmed) and three non-communicating hydroceles (none of which progressed). Umbilical hernias were present in nine of 33 patients (27%). No false positive or false negative studies were identified. The CTP technique described provides accurate diagnostic information in the management of common CAPD-related complications, particularly dialysate leak, genital swelling, abdominal wall hernias and peritoneal adhesions. Computed tomography peritoneography directs appropriate conservative or surgical management. Copyright (1999) Blackwell Science Pty Ltd

  2. Coping methods to stress among patients on hemodialysis and peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Kobra Parvan

    2015-01-01

    Full Text Available Dialysis patients need to deal and cope with various aspects of their disease. Identifying the adaptation methods provides valuable information for planning specific treatment and medical care delivery and improving the performance of medical teams. The present study aims to evaluate the coping strategies to stress among patients undergoing hemodialysis (HD and peritoneal dialysis (PD at the Imam Reza Educational-Medical Hospital, Tabriz, West Azarbaijan, Iran. This descriptive and analytical study was conducted on 70 patients in the year 2012. The subjects were selected through census method and simple random sampling method. Data were collected using a customized questionnaire and consisted of demographic information and the Jalowiec Coping Scale (JCS through a structured interview. Descriptive and inferential statistics were used to analyze the data in SPSS (version 13. The mean score of frequency of use of the coping strategy as "sometimes used" for the HD patients was 70.94 ± 18.91 and also for PD patients as "seldom used" was 58.70 ± 12.66. The mean score of helpfulness of coping strategies in the HD group was 49.57 ± 19.42 as "slightly helpful", whereas in the PD group it was 37.21 ± 14.38 as "slightly helpful" Furthermore, both groups used the emotion-oriented coping styles more frequently than the problem-oriented methods. HD patients used coping methods more frequently than the PD patients. The majority of patients used emotion-oriented coping strategies to deal with stress factors. Use of educational, counseling and supportive programs to assist in coping techniques can facilitate the coping process with stress factors in dialysis patients.

  3. Deciphering the Contribution of Biofilm to the Pathogenesis of Peritoneal Dialysis Infections: Characterization and Microbial Behaviour on Dialysis Fluids.

    Directory of Open Access Journals (Sweden)

    Joana Sampaio

    Full Text Available Infections are major complications in peritoneal dialysis (PD with a multifactorial etiology that comprises patient, microbial and dialytic factors. This study aimed at investigating the contribution of microbial biofilms on PD catheters to recalcitrant infections and their interplay with PD related-factors. A prospective observational study was performed on 47 patients attending Centro Hospitalar of Porto and Vila Nova de Gaia/Espinho to whom the catheter was removed due to infectious (n = 16 and non-infectious causes (n = 31. Microbial density on the catheter was assessed by culture methods and the isolated microorganisms identified by matrix-assisted laser desorption/ionization time-of-flight intact cell mass spectrometry. The effect of conventional and three biocompatible PD solutions on 16 Coagulase Negative Staphylococci (CNS and 10 Pseudomonas aeruginosa strains planktonic growth and biofilm formation was evaluated. Cultures were positive in 87.5% of the catheters removed due infectious and 90.3% removed due to non-infectious causes. However, microbial yields were higher on the cuffs of catheters removed due to infection vs. non-infection. Staphylococci (CNS and Staphylococcus aureus and P. aeruginosa were the predominant species: 32% and 20% in the infection and 43.3% and 22.7% in the non-infection group, respectively. In general, PD solutions had a detrimental effect on planktonic CNS and P. aeruginosa strains growth. All strains formed biofilms in the presence of PD solutions. The solutions had a more detrimental effect on P. aeruginosa than CNS strains. No major differences were observed between conventional and biocompatible solutions, although in icodextrin solution biofilm biomass was lower than in bicarbonate/lactate solution. Overall, we show that microbial biofilm is universal in PD catheters with the subclinical menace of Staphylococci and P. aeruginosa. Cuffs colonization may significantly contribute to infection. PD solutions

  4. Successfully managing a rapidly growing peritoneal dialysis program in Southern China

    Institute of Scientific and Technical Information of China (English)

    YANG Xiao; MAO Hai-ping; GUO Qun-ying; YU Xue-qing

    2011-01-01

    Background The maximal use of the limited resource to improve peritoneal dialysis (PD) penetration and clinical outcomes is a challenge for all PD centers.In this study,we reported the experience and outcomes in successfully managing a rapidly growing PD center in Southern China.Methods A standard PD program with a team consisted of 6 nephrologists (3 doctors were in charge of catheter insertion and in-patients care,the other 3 doctors focused on PD patients' follow-up and education) and 11 nurses in a PD center at Sun Yat-sen University was established for PD patients follow-up in 2005.A prospective and observational study was conducted in all patients undergoing continuous ambulatory PD (CAPD) at our center from January 1,2006 to December 31,2009.Results The yearly number of prevalent CAPD patients was 297,409,547 and 695 in 2006,2007,2008 and 2009,respectively.The PD catheter insertion was performed by the nephrologists with open surgical procedure and 94% of catheters were patent at one year.In 841 incident CAPD patients,the survival rates at the end of 1,2,3 and 4 years were 94%,87%,83% and 76%,respectively,while cumulative technique survival rates (death-censored) were 98%,95%,91% and 90%,respectively.Peritonitis rate was 1/68.5 patient months.Conclusions Better patient and technical survival rates as well as lower peritonitis episode have been achieved in our rapidly growing PD center.A standardized PD program,well-trained team members of PD doctors and nurses,and continuous quality improvement of PD are important elements in managing a successful PD program.

  5. The Extracellular Water Corrected for Height Predicts Technique Survival in Peritoneal Dialysis Patient

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    Meltem SEZİŞ DEMİRCİ

    2013-05-01

    Full Text Available OBJECTIVE: Most patients on peritoneal dialysis (PD consume a normal Western diet that contains a large amount of salt. This causes increase in extracellular volume (“fluid overload” that has to be removed mostly with the dialysis fluid, as residual renal function (if present cannot cope with it. In the present study, we prospectively investigated whether an increased extracellular volume (corrected for height predicted technique survival in PD patients. MATERIAL and METHODS: Ninety-five prevalent PD patients from one center (mean age 50±13 years, 10 of them diabetic were studied. Extracellular water (ECW, total body water (TBW, and intracellular water (ICW were measured by multi-frequency bioimpedance analysis (m-BIA. Echocardiography was performed in all patients. Volume status was also evaluated by measuring left atrium diameter (LAD and left ventricular end-diastolic diameter (LVEDD. Demographical, biochemical analyses, peritoneal equilibration test, weekly total Kt/V urea and weekly total creatinine clearance (CCr results were obtained from patient chart. We identified a cut-off value for ECW/height by drawing ROC curves that differentiate patients with FO and those without, using LAD and LVEDD measured by echocardiography as confirmatory parameters. Technique survival (TS was defined as the time on PD treatment until transfer to hemodialysis. Technique survival (TS was assessed at the end of the follow-up and significant predictors of technique survival were investigated. RESULTS: During the follow-up, 62 patients dropped out. Thirty-six patients were switched to hemodialysis (severe peritonitis in twelve, hernia in one, peritoneal leaks in five, inadequate dialysis in seventeen and unwillingness in one patient, twelve patients received transplants, five patients were transferred to other center and nine patients died (4 patients from infection, 4 patients from cardiovascular disease and 1 patient from malignancy. Patients switched to

  6. Study of effect of peritoneal dialysis and cell therapy on syndrome of intestinal insufficiency in necrotizing pancreatitis

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    KebkaloA.B.

    2013-03-01

    Full Text Available The aim was to prove the effectiveness of the use of methods of detoxification and stimulation of reparative processes in the complex treat¬ment of patients with intestinal insufficiency syndrome with necrotizing pancreatitis. For detoxification in patients with necrotizing pancreatitis, we chose the method of fractional peritoneal dialysis, that represents periodic injection of the dosed volumes of dialysate into abdominal cavity, which is removed after a fixed period of time. For stimulation of detoxication pro¬perties of liver and reparative processes in the body, stem cells of cord blood were used. Cord blood at a dose of 10 ml was slowly injected intravenously with dilution with physiological solution 1:1 starting from 2-3 days after the beginning of disease within 3-5 days. Intraabdominal pressure was measured in the bladder using tonometer of low pressure. Material for bacteriological examination was taken during puncture intervention under ultrasound control. Identification of pure culture was performed by the staging of "motley series", and also by bacteriological analyzer VITEK-2. To study the effectiveness of the combined methods of detoxification in toxemia phase, patients with necrotizing pancreatitis were divided into three groups. The control group consisted of 30 patients with necrotizing pancreatitis treated with standard detoxification. The group of comparison consisted of 25 patients with necrotizing pancreatitis, only with fractional peritoneal dialysis, only, and a basic group of 15 patients with the combined use of fractional peritoneal dialysis and the stem cells of cord blood. Basing on this study it was found that in patients of control group intestinal paresis was during 5,82±0,2 days. In application of fractional peritoneal dialysis length of intestinal paresis was 2,82±0,9 days, and in the group with complex treatment including cell therapy 2,39 ± 0,7 days. The combined use of fractional peritoneal dialysis and

  7. The John F. Maher Award Recipient Lecture 2006. The continuum of chronic kidney disease and end-stage renal disease: challenges and opportunities for chronic peritoneal dialysis in the United States.

    Science.gov (United States)

    Mehrotra, Rajnish

    2007-01-01

    End-stage renal disease (ESRD) patients undergoing renal replacement therapy have a high mortality rate and suffer from considerable morbidity. Degree of nutritional decline, disordered mineral metabolism, and vascular calcification are some of the abnormalities that predict an adverse outcome for ESRD patients. All these abnormalities begin early during the course of chronic kidney disease (CKD), long before the need for maintenance dialysis. Thus, CKD represents a continuum of metabolic and vascular abnormalities. Treatment of these abnormalities early during the course of CKD and a timely initiation of dialysis have the potential of improving patient outcomes. However, the thesis that successful management of these abnormalities will favorably modify the outcomes of dialysis patients remains untested. The proportion of incident USA ESRD patients starting chronic peritoneal dialysis (CPD) has historically been low. Limited physician training and inadequate predialysis patient education appear to underlie the low CPD take-on in the USA. Furthermore, two key changes have occurred in the USA: steep decline in CPD take-on and progressive increase in the use of automated peritoneal dialysis. The decline in CPD take-on has afflicted virtually every subgroup examined and has occurred, paradoxically, when the CPD outcomes in the country have improved. Understanding the reasons for historically low CPD take-on and recent steep declines in utilization may allow the development of plans to reverse these trends. PMID:17299144

  8. Glucose challenge test (50-g GCT) in detection of glucose metabolism disorders in peritoneal dialysis patients: preliminary study

    OpenAIRE

    Madziarska, Katarzyna; Zmonarski, Slawomir; Penar, Jozef; Krajewska, Magdalena; Mazanowska, Oktawia; Augustyniak-Bartosik, Hanna; Gołebiowski, Tomasz; Klak, Renata; Weyde, Waclaw; Klinger, Marian

    2014-01-01

    Background The aim was to evaluate the clinical utility of the oral glucose tolerance screening test (50-g GCT—glucose challenge test) for the detection of glucose metabolism disorders (GMD) in peritoneal dialysis (PD) patients with normal fasting glucose levels. Methods The 50-g GCT was performed in 20 prevalent patients without history of diabetes before PD treatment onset, who had been on dialysis for a median time of 15.34 months. In addition, other indicators of glucose metabolism were m...

  9. A comparison of the quality of life of the patients undergoing hemodialysis versus peritoneal dialysis and its correlation to the quality of dialysis

    Directory of Open Access Journals (Sweden)

    Abdolamir Atapour

    2016-01-01

    Full Text Available Over the years, there has been a steady increase in the number of patients requiring dialysis. However, no consensus exists between choosing either hemodialysis (HD or peritoneal dialysis (PD as the preferred method of dialysis for patients. In this study, we have compared the quality of life of the patients undergoing either HD or PD. This cross-sectional study was performed in the dialysis center of the Noor and Saint Ali Asghar University Hospital in Isfahan, Iran in 2012. Forty-six patients who underwent PD (28 males and 18 females and 46 similar patients undergoing HD (26 males and 20 females were compared. A standardized Persian version of the short form-36 (SF-36 tool was used to assess the quality of life and to assess the quality of dialysis weekly Kt/V in patients undergoing PD and single random Kt/V sampling in HD patients were assessed. Patients undergoing PD reported higher scores in physical functioning. The lowest scores in both groups were reported in mental health section. In physical functioning section, physical role functioning section and overall score of the SF-36 tool, PD patients reported significantly higher scores compared to the HD patients (P <0.05. There was no significant difference between the qualities of the dialysis in the two patient groups. Aspects of quality of life such as physical functioning, physical role functioning, bodily pain, general health perceptions, and overall score were significantly different between the two groups. If these results are substantiated by subsequent longitudinal studies, then the choice of dialysis could be better guided in patients by the quality of life issues.

  10. The impact of oxidized serum albumin on the oncotic pressure and hydration status of peritoneal dialysis patients

    OpenAIRE

    Hassan, Kamal

    2016-01-01

    Kamal Hassan,1,2 Batya Kristal,1,2 Fadi Hassan,3 Saad Abo Saleh,4 Regina Michelis5 1Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel; 2Peritoneal Dialysis Unit, Department of Nephrology and Hypertension, Galilee Medical Center, Nahariya, Israel; 3Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 4Department of Urology, Galilee Medical Center, Nahariya, Israel; 5Eliachar Research Laboratory, Galilee Medical Center, Nahariya, Israel Objective: Hypoalbum...

  11. Resorption and tolerance of the high doses of ferrous sulfate and ferrous gluconate in the patients on peritoneal dialysis

    OpenAIRE

    Laušević Mirjana; Jovanović Nataša; Ignjatović Svetlana; Grujić-Adanja Gordana; Stojimirović Biljana

    2006-01-01

    Background/Aim. Iron supplementation plays a crucial role in peritoneal dialysis (PD) patients. Oral iron substitution is more convenient than intravenous therapy in PD patients, but impaired absorption and adverse effects may be limiting factors for oral treatment. The aim of this study was to compare the absorption and side effects of high doses ferrous sulphate and ferrous gluconate in PD patients. Methods. Blood samples were taken from 29 PD patients at baseline, as well as 2, 4 and 8 hou...

  12. Pharmacokinetics of Colistin Methanesulfonate and Formed Colistin in End-Stage Renal Disease Patients Receiving Continuous Ambulatory Peritoneal Dialysis

    OpenAIRE

    Koomanachai, Pornpan; Landersdorfer, Cornelia B.; Chen, Gong; Lee, Hee Ji; Jitmuang, Anupop; Wasuwattakul, Somkiat; Sritippayawan, Suchai; Jian LI; Nation, Roger L; Thamlikitkul, Visanu

    2014-01-01

    Colistin, administered intravenously as its inactive prodrug colistin methanesulfonate (CMS), is increasingly used as last-line therapy to combat multidrug-resistant Gram-negative bacteria. CMS dosing needs to be adjusted for renal function. The impact of continuous ambulatory peritoneal dialysis (CAPD) on the pharmacokinetics of both CMS and colistin has not been studied. No CMS dosing recommendations are available for patients receiving CAPD. Eight CAPD patients received a single intravenou...

  13. Serum Hepcidin Levels and Reticulocyte Hemoglobin Concentrations as Indicators of the Iron Status of Peritoneal Dialysis Patients

    OpenAIRE

    Kosaku Nitta; Shinichiro Oguni; Koji Kataoka; Yukio Hamaguchi; Misao Tsukada; Takahiro Mochizuki; Aya Eguchi; Ken Tsuchiya

    2012-01-01

    Hepcidin is the key mediator of renal anemia, and reliable measurement of serum hepcidin levels has been made possible by the ProteinChip system. We therefore investigated the iron status and serum hepcidin levels of peritoneal dialysis (PD) patients who had not received frequent doses of an erythrocytosis-stimulating agent (ESA) and had not received iron therapy. In addition to the usual iron parameters, the iron status of erythrocytes can be determined by measuring reticulocyte hemoglobin (...

  14. The transport of phosphate between the plasma and dialysate compartments in peritoneal dialysis is influenced by an electric potential difference

    DEFF Research Database (Denmark)

    Graff, J; Fugleberg, S; Brahm, J; Fogh-Andersen, N

    1996-01-01

    Six kinetic models of transperitoneal phosphate transport were formulated and validated on the basis of experimental results obtained from 22 non-diabetic patients undergoing peritoneal dialysis. The models were designed to elucidate the presence or absence of diffusive, non-lymphatic convective......, and lymphatic convective phosphate transport. Calculations allowed for a 20% protein binding of phosphate. The validation procedure demonstrated that only diffusive and non-lymphatic convective phosphate transport mechanisms were identifiable. A lymphatic convective phosphate transport mechanism was...

  15. Bilateral inguinal hernias detected by peritoneal scintigraphy during the evaluation of scrotal swelling in a patient on continuous ambulatory peritoneal dialysis

    International Nuclear Information System (INIS)

    A 47-year-old man with end-stage renal disease due to diabetic nephropathy underwent a peritoneal scintigraphy to evaluate the cause of recently developed scrotal swelling. Two liters of dialystate mixed with 111 MBq of Tc-99m sulfur colloid were adminstered into the peritoneal cavity via the dialysis catheter. Various anterior images of the abdomen and pelvis were obtained at 15 min, 2 hr and 4 hr after the tracer instillation. At 15 min, anterior images of the abdomen and pelvis demonstrated linear tracts of activity through both inguinal canals, which were more prominent in the right side (A). Images at 2 hr revealed a passage of the radioactive fluid into the right hemiscrotum. At the same time, there was a considerable accumulation of activity in the right inguinal canal (B). In the delayed image, there was a progressive accumulation of activity in the inguinal canals and a prominent passage of the tracer into the scrotum (C). Both abdominal and inguinal hernias are commonly associated with continuous ambulatory peritoneal dialysis (CAPD). Overall incidence of CAPD-induced hernia ranges from 2.7% to 25%. Inguinal hernias were frequently manifested as scrotal swelling. Leakages f dialysate fluid into the scrotum has been noted in CAPD patients with scrotal swelling, with or without clincal findings of inguinal hernia. In the present case, the right side had leakage from a clinical inguinal hernia and the left side, leakage, from a subclinial inguinal hernia. A subclinical inguinal hernia was easily demonstrable with peritoneal scintigraphy. Peritoneal scintigraphy is extremely helpful in the evaluation of scrotal swelling in a patient on CAPD

  16. Environmental NO2 level is associated with 2-year mortality in patients undergoing peritoneal dialysis.

    Science.gov (United States)

    Lin, Jui-Hsiang; Yen, Tzung-Hai; Weng, Cheng-Hao; Huang, Wen-Hung

    2015-01-01

    An ongoing issue related to global urbanization is the association of air pollution with increased incidences of morbidity and mortality. However, no in-depth study has investigated this issue focusing on peritoneal dialysis (PD) patients. Therefore, this study assessed the effects of traffic-related air pollutants and other important mortality-associated factors on 2-year mortality in PD patients.A total of 160 PD patients were recruited in this 2-year retrospective observational study. Differences in air quality were analyzed with respect to the patients' living areas. The PD patients were categorized into 2 groups according to high (n = 65) and low (n = 95) nitrogen dioxide (NO2) exposure. Demographic, hematological, nutritional, inflammatory, biochemical, air pollutants, and dialysis-related data were analyzed. Univariate and multivariate Cox regression analyses were used for 2-year mortality analysis.A total of 160 PD patients (38 men and 122 women) were enrolled. Fourteen patients (8.8%) died within 2 years; among them, the causes of death were infection (n = 10), malignancy (n = 1), and cardiovascular events (n = 3). Among the 10 patients who died from infection, 5, 4, and 1 died from pneumonia, PD-related peritonitis, and sepsis of unknown origin, respectively. All patients who died from pneumonia were living in high environmental NO2 exposure areas. Multivariate Cox regression analysis showed that age (hazard ratio [HR] 1.073, 95% confidence interval [CI] [1.013-1.137]; P = 0.017), white blood cell count (HR 1.41, 95% CI [1.116-1.781]; P = 0.004), log normalized protein nitrogen appearance (HR 0.0001, 95% CI [0-0.073]; P = 0.005), high cardiothoracic ratio (HR 14.28, 95% CI [1.778-114.706]; P = 0.012), and high environmental NO2 exposure (HR 3.776, 95% CI [1.143-12.47]; P = 0.029) were significantly associated with 2-year mortality.PD patients with high environmental NO2 exposure had a higher 2-year mortality rate

  17. Effect of combining different calcium concentration dialysate on calcium balance in peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    ZHAO Hui-ping; WU Bei; LU Li-xia; QIAO Jie; WU Xiang-lan; WANG Mei

    2012-01-01

    Background Calcium and phosphorus metabolic disturbance are common in dialysis patients and associated with increased morbidity and mortality.Therefore,maintaining the balance of calcium and phosphate metabolism and suitable intact parathyroid hormone(iPTH)level has become the focus of attention.We investigated the effects of different peritoneal dialysate calcium concentrations on calcium phosphate metabolism and iPTH in continuous ambulatory peritoneal dialysis(CAPD)patients.Methods Forty stable CAPD patients with normal serum calcium were followed for six months of treatment with 1.25 mmol/L calcium dialysate(DCa1.25,PD4,22 patients)or a combination of 1.75 mmol/L calcium dialysate(DCa1.75,PD2)and PD4(18 patients)twice a day respectively.Total serum calcium(after albumin correction),serum phosphorus,iPTH,alkaline phosphatase(ALP)and blood pressure were recorded before and 1,3 and 6 months after treatment commenced.Results No significant difference was found in baseline serum calcium,phosphorus between the two patient groups,but the levels of iPTH were significantly different.No significant changes were found in the dosage of calcium carbonate and active vitamin D during 6 months.In the PD4 group,serum calcium level at the 1st,3rd,6th months were significantly lower than the baseline(P<0.05).There was no significant difference in serum phosphorus after 6 months treatment.iPTH was significantly higher(P<0.001)at the 1st,3rd,and 6th months compared with the baseline.No differences were seen in ALP and blood pressure.In the PD4+PD2 group,no significant changes in serum calcium,phosphorus,iPTH,ALP and BP during the 6-month follow-up period.Conclusions Treatment with 1.25 mmol/L calcium dialysate for six months can decrease serum calcium,increase iPTH,without change in serum phosphorus,ALP,and BP.The combining of PD4 and PD2 can stabilize the serum calcium and avoid fluctuations in iPTH levels.

  18. What is the place of peritoneal dialysis in the integrated treatment of renal failure?

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    Coles, G A; Williams, J D

    1998-12-01

    The role of peritoneal dialysis (PD) in renal replacement therapy (RRT) remains unclear. There are no controlled trials to provide hard evidence of its efficacy. Comparative studies with haemodialysis from different centres and countries have given conflicting results even when allowing for case mix. Data from the United States on patients starting or receiving treatment in the late 1980s suggested a worse prognosis for older patients, particularly diabetics receiving PD as compared to HD. Analysis of the USRDS data base for patients starting in the early 1990s shows an improvement in outcome but with no difference in overall mortality. The Canadian registry has recently published data showing a better survival with PD than with HD in the first two years of RRT. Morbidity is similar with both therapies, although hospitalization is increased with PD. Unfortunately long-term technique survival is not as good with PD. However, PD has certain medical advantages, particularly the maintenance of residual renal function that contributes to solute and fluid removal. It may also postpone the onset of amyloidosis. Patients transplanted after previous PD have a decreased risk of early acute renal failure and equally good long-term results when compared to those patients who were on HD before transplantation. The quality of life is as good with PD as with center HD, and there are social advantages to PD including an increased chance of employment, more flexible holidays and avoidance of thrice weekly travel to a dialysis center. PD also has logistical advantages and can be utilized by the majority of new patients. We therefore conclude that PD has potential advantages early in the course of RRT, and should therefore be offered as a first option to all suitable new patients. Whether PD has a major or minor role in later years (> 5) remains unclear. PMID:9853290

  19. A new approach to optimizing urea clearances in hemodialysis and continuous ambulatory peritoneal dialysis.

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    Nolph, K D; Keshaviah, P; Emerson, P; Van Stone, J C; Twardowski, Z J; Khanna, R; Moore, H L; Collins, A; Edward, A

    1995-01-01

    Recent studies suggest that the relationship of the net normalized protein catabolic rate (which is the normalized protein equivalent of nitrogen appearance [nPNA]) to the weekly clearance of urea normalized to total body water (Kt/V urea) in patients on continuous ambulatory peritoneal dialysis (CAPD) is curvilinear, rather than linear, as has been thought. The authors have reexamined the relationship of nPNA to weekly Kt/V urea in a CAPD population by cross-sectional analysis to see if the curvilinear definition of the relationship is as good as or better than the usual linear description. They also examined this relationship in the hemodialysis populations at the Dialysis Clinics Inc. in Columbia, Missouri, and in the Renal Kidney Disease Program in Minneapolis, Minnesota. It seems obvious that there should be a plateau of nPNA in each therapy because extension of linear regressions would predict protein intakes of normal individuals exceeding 8 g/kg/body weight/day. The authors compared their findings to other published results. Intuitively and analytically, the curvilinear relationships seem likely. The authors observed that the nPNA plateau is achieved at lower Kt/V in patients on CAPD than in those on hemodialysis, which is compatible with the peak concentration hypothesis. Asymptotes for CAPD and hemodialysis are similar. Weekly Kt/V urea requirements to achieve nPNA values at 95% of the asymptote are greater than those usually delivered. However, such nearly complete elimination of uremic appetite suppression may not be practical or necessary for achieving acceptable nutritional status and long-term survival in most patients. Optimum therapy may be well above adequate therapy relative to minimizing appetite suppression by uremia. PMID:8573843

  20. Fluid status in peritoneal dialysis patients: the European Body Composition Monitoring (EuroBCM study cohort.

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    Wim Van Biesen

    Full Text Available BACKGROUND: Euvolemia is an important adequacy parameter in peritoneal dialysis (PD patients. However, accurate tools to evaluate volume status in clinical practice and data on volume status in PD patients as compared to healthy population, and the associated factors, have not been available so far. METHODS: We used a bio-impedance spectroscopy device, the Body Composition Monitor (BCM to assess volume status in a cross-sectional cohort of prevalent PD patients in different European countries. The results were compared to an age and gender matched healthy population. RESULTS: Only 40% out of 639 patients from 28 centres in 6 countries were normovolemic. Severe fluid overload was present in 25.2%. There was a wide scatter in the relation between blood pressure and volume status. In a multivariate analysis in the subgroup of patients from countries with unrestricted availability of all PD modalities and fluid types, older age, male gender, lower serum albumin, lower BMI, diabetes, higher systolic blood pressure, and use of at least one exchange per day with the highest hypertonic glucose were associated with higher relative tissue hydration. Neither urinary output nor ultrafiltration, PD fluid type or PD modality were retained in the model (total R² of the model = 0.57. CONCLUSIONS: The EuroBCM study demonstrates some interesting issues regarding volume status in PD. As in HD patients, hypervolemia is a frequent condition in PD patients and blood pressure can be a misleading clinical tool to evaluate volume status. To monitor fluid balance, not only fluid output but also dietary input should be considered. Close monitoring of volume status, a correct dialysis prescription adapted to the needs of the patient and dietary measures seem to be warranted to avoid hypervolemia.

  1. High-sensitivity C-reactive protein predicts mortality and technique failure in peritoneal dialysis patients.

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    Shou-Hsuan Liu

    Full Text Available INTRODUCTION: An elevated level of serum C-reactive protein (CRP is widely considered an indicator of an underlying inflammatory disease and a long-term prognostic predictor for dialysis patients. This cross-sectional cohort study was designed to assess the correlation between the level of high-sensitivity CRP (HS-CRP and the outcome of peritoneal dialysis (PD patients. METHODS: A total of 402 patients were stratified into 3 tertiles (lower, middle, upper according to serum HS-CRP level and and followed up from October 2009 to September 2011. During follow-up, cardiovascular events, infection episodes, technique failure, and mortality rate were recorded. RESULTS: During the 24-month follow-up, 119 of 402 patients (29.6% dropped out from PD, including 28 patients (7.0% who died, 81 patients (20.1% who switched to hemodialysis, and 10 patients (2.5% who underwent kidney transplantation. The results of Kaplan-Meier analysis and log-rank test demonstrated a significant difference in the cumulative patient survival rate across the 3 tertiles (the lowest rate in upper tertile. On multivariate Cox regression analysis, only higher HS-CRP level, older age, the presence of diabetes mellitus (DM, lower serum albumin level, and the occurrence of cardiovascular events during follow-up were identified as independent predictors of mortality. Every 1 mg/L increase in HS-CRP level was independently predictive of a 1.4% increase in mortality. Multivariate Cox regression analysis also showed that higher HS-CRP level, the presence of DM, lower hemoglobin level, lower serum albumin level, higher dialysate/plasma creatinine ratio, and the occurrence of infective episodes and cardiovascular events during follow-up were independent predictors of technique failure. CONCLUSIONS: The present study shows the importance of HS-CRP in the prediction of 2-year mortality and technique survival in PD patients independent of age, diabetes, hypoalbuminemia, and the occurrence of

  2. Vascular Endothelial Cell Injury Is an Important Factor in the Development of Encapsulating Peritoneal Sclerosis in Long-Term Peritoneal Dialysis Patients

    Science.gov (United States)

    Tawada, Mitsuhiro; Ito, Yasuhiko; Hamada, Chieko; Honda, Kazuho; Mizuno, Masashi; Suzuki, Yasuhiro; Sakata, Fumiko; Terabayashi, Takeshi; Matsukawa, Yoshihisa; Maruyama, Shoichi; Imai, Enyu; Matsuo, Seiichi; Takei, Yoshifumi

    2016-01-01

    Background and Objectives Encapsulating peritoneal sclerosis (EPS) is a rare but serious and life-threatening complication of peritoneal dialysis (PD). However, the precise pathogenesis remains unclear; in addition, predictors and early diagnostic biomarkers for EPS have not yet to be established. Methods Eighty-three peritoneal membrane samples taken at catheter removal were examined to identify pathological characteristics of chronic peritoneal deterioration, which promotes EPS in patients undergoing long-term PD treatment with low occurrence of peritonitis. Results According to univariable logistic regression analysis of the pathological findings, thickness of the peritoneal membrane (P = 0.045), new membrane formation score (P = 0.006), ratio of luminal diameter to vessel diameter (L/V ratio, P<0.001), presence of CD31-negative vessels (P = 0.021), fibrin deposition (P<0.001), and collagen volume fraction (P = 0.018) were associated with EPS development. In analyses of samples with and without EPS matched for PD treatment period, non-diabetes, and PD solution, univariable analysis identified L/V ratio (per 0.1 increase: odds ratio (OR) 0.44, P = 0.003) and fibrin deposition (OR 6.35, P = 0.027) as the factors associated with EPS. L/V ratio was lower in patients with fibrin exudation than in patients without fibrin exudation. Conclusions These findings suggest that damage to vascular endothelial cells, as represented by low L/V ratio, could be a predictive finding for the development of EPS, particularly in long-term PD patients unaffected by peritonitis. PMID:27119341

  3. Body composition measurements using bioimpedance analysis in peritoneal dialysis patients are affected by the presence of dialysate.

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    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2014-11-01

    The presence of peritoneal dialysate when performing bioimpedance analysis may affect body composition measurements. The aim of this study was to evaluate the impact of dialysate on body composition measurements in Asians. Forty-one patients undergoing maintenance peritoneal dialysis in our hospital peritoneal dialysis unit were included in this study. Dialysate was drained from the abdomen prior to measurement, and bioimpedance analysis was performed using multi-frequency bioimpedance analysis, with each subject in a standing position (D-). Dialysate was then administered and the measurement was repeated (D+). The presence of peritoneal dialysate led to an increase in intracellular water (ICW), extracellular water (ECW), and total body water (D-: 20.33 ± 3.72 L for ICW and 13.53 ± 2.54 L for ECW; D+: 20.96 ± 3.78 L for ICW and 14.10 ± 2.59 L for ECW; P bioimpedance analysis. PMID:25307155

  4. Sleep disorders and its related risk factors in patients undergoing chronic peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    Li Han; Li Xiaobei; Feng Sujuan; Zhang Guizhi; Wang Wei; Wang Shixiang

    2014-01-01

    Background The prevalence of sleep disorders has been shown to be high in patients with chronic dialysis patients and may contribute to impaired quality of life and higher mortality in this population.However,there are few data on the relationship of sleep disorders and their risk factors in chronic dialysis patients.The aim of this study was to evaluate the relationship of sleep disorders and their risk factors in chronic dialysis patients.Methods A total of 42 continuous ambulatory peritoneal dialysis (CAPD) patients were involved in this cross-sectional study.Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI).Restless legs syndrome (RLS) was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group.And depression was assessed by Hamilton depression scale.General information and laboratory data were collected.Results The prevalence of sleep disorders was 47.6% in the CAPD patients.According to the PSQI,the 42 CAPD patients were divided into sleep disturbance group and non-sleep disorders group.There were no significant differences in age,gender,dialysis duration,hemoglobin,serum creatinine,urea nitrogen,β2-microglobulin,parathyroid hormone,calcium,and phosphorus between CAPD patients with sleep disorders and those without sleep disorders.But the level of serum albumin (AIb) in CAPD patients with sleep disorders was significantly lower than that in CAPD patients without sleep disorders (31.3±1.4 vs.34.3±3.7,t=3.603,P=0.001).And the prevalence of RLS and depression was significantly higher than that in CAPD patients without sleep disorders (RLS:11/22 vs.1/20,x2=10.395,P=0.001; depression:7/22 vs.1/20,x2=4.886,P=0.027).In CAPD patients with RLS,the prevalence of sleep disorders was significantly higher than that in CAPD patients without RLS (11/22 vs.11/30,x2=10.395,P=0.001).And in CAPD patients with depression,the prevalence of sleep disorders was significantly higher than that in CAPD patients without

  5. Nutritional and behavioural aspects of nasogastric tube feeding in infants receiving chronic peritoneal dialysis.

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    Warady, B A; Kriley, M; Belden, B; Hellerstein, S; Alan, U

    1990-01-01

    Eight infants initiated chronic peritoneal dialysis and received nasogastric tube feedings during their first month of life. In each case, the nasogastric tube feedings were initiated because of poor oral intake and the desire to avert the development of an aversive feeding interaction between parent and child. The nutritional regimen was designed to allow normal or catch up weight gain appropriate for height age. The caloric and protein intake of the infants averaged 98.5 +/- 10.2 kcal/kg/day and 2.7 gm/kg/day, respectively, during the first year of life. Between 25% and 100% of the formula intake was provided by the nasogastric route. Group standard deviation score for height was -1.74 +/- 0.7 at one year. Five of the infants received behavioral therapy because of persistent food refusal. Therapy consisted of reinforcing prompted food acceptance and ignoring food refusal. This approach was conducted by a multidisciplinary team and successfully converted the non-oral feeder to a total oral feeding regimen in each case. PMID:1982822

  6. Relationship between segmental and whole-body phase angle in peritoneal dialysis patients

    International Nuclear Information System (INIS)

    The relation between the right-side (RS) electrical impedance phase angle (PA) and segmental PA in five configurations at 50 kHz was analyzed in 23 peritoneal dialysis male patients before complete drainage of the abdominal cavity. The impedance vector (Z/H) components were standardized by the height H of the subjects (R/H and Xc/H). BIVA software was used to analyze the individual RS vector. The Pearson correlation was used to analyze the correlation between RS and segmental configurations. Student's t test and Hotelling's T2 test were used to analyze the separation of groups obtained by BIVA. The highest significant Pearson correlation was between RS and right leg total (RLEGT) in a longitudinal direction (r = 0.925, P 2 test, and in PA using Student's t test. The transverse measurement in the leg (RTRLEG) showed the lowest correlation (r = 0.261). In conclusion, we can obtain similar information through the phase angle, whether RS is measured or if we measure on RLEGT. The phase angle of the transverse measurements provides different information from the phase angle of the longitudinal measurements. (note)

  7. [Treatment of acute renal failure--concepts and controversies. 2. Extracorporeal renal replacement and peritoneal dialysis].

    Science.gov (United States)

    Gabriel, A; Müller, E; Tarnow, J

    2001-04-01

    Therapy of prolonged acute renal failure regularly requires a renal replacement therapy. This can be achieved by different extracorporal renal replacement therapies (ERRT) or by peritoneal dialysis. ERRT are classified according to the physical principle underlying toxin elimination as hemodialysis (diffusion) and hemofiltration (convection). Another classification refers to intermittent or continuous application modes. Biocompatibility of membranes is judged according to their activation of the complement system. Prospective randomized studies did not consolidate the assumptions about the benefit of particular modalities proposed on theoretical foundations. Mortality, duration and complication rates of acute renal failure are not significantly decreased by use of biocompatible membranes. Continuous modalities are not generally preferable but optimize treatment in hemodynamically unstable patients, in whom they endorse fluid balancing and maintenance of sufficient arterial blood pressure. The use of demanding hemofiltration techniques for cytokine removal should be limited to clinical studies. The effects of ERRT-"intensity" and the best timing for initiation of ERRT have not been evaluated sufficiently. The choice of the ERRT modality is subject to clinical judgement (criterion: hemodynamic situation), practical aspects (criteria: availability of equipment and handling experience), and costs. Prior to their general use new and expensive technical modalities and membrane types should be thoroughly evaluated in studies with regard to outcome-related aspects such as patient survival and preservation of renal function. PMID:11386089

  8. T1 changes of canine brain in hyponatremic hypoosmosis induced by peritoneal dialysis with water

    International Nuclear Information System (INIS)

    Changes of canine brain T1s measured in right and left white (W-T1) and gray (G-T1) matter, thalamus (T-T1), and caudate nucleus (C-T1) in coronal view with a head coil was studied in anesthesized and automatically ventilated 11 mongrel dogs (9.2±2.2 kg) using 0.1 T MR imager (Mark-J, Siemens-Asahi Meditech) before and every 30 minutes after infusion of distilled water warmed at 37degC into abdominal cavity (192±50 ml/kg) up to 120 minute later. Hemolysis (2→85 mg/dl: before→after 120 min) increased in association with total protein (5.9→8.0 g/dl) while sodium (147→122 mEq/l) and osmolarity (302→263 mOsm/kg) decreased. G-T1 (388→394 ms) and W-T1 (287→305 ms) did not change significantly, but T-T1 prolonged early (331→349 ms) at 60 min (p1 (356→376 ms) did at 90 min (p1 (363 ms) and C-T1 (382 ms) elongated from initial each T1 significantly (p<0.01) 7% and 6% at 120 min, respectively. Basal nuclei, especially thalamus, in canine brain became edematous at the early stage of hyponatremic hypoosmosis induced by peritoneal dialysis with water. (author)

  9. Comparison of outcomes between surgically placed and percutaneously placed peritoneal dialysis catheters: A retrospective study.

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    Sivaramakrishnan, R; Gupta, S; Agarwal, S K; Bhowmik, D; Mahajan, S

    2016-01-01

    There is lack of adequate data on comparison of outcomes between percutaneously placed peritoneal dialysis (PD) catheters inserted by nephrologists and PD catheters placed by surgeons. The aim of this study is to retrospectively analyze the outcomes of PD catheters inserted by surgeons (by open surgical or laparoscopic technique) and compare them with those inserted by nephrologists among ESRD patients who underwent elective PD catheter insertions between January 2009 and December 2012. The primary outcome measure was the proportion of catheters removed because of primary nonfunction. The secondary outcome measures were catheter survival, patient survival, and incidence of complications of catheter insertion. A total of 143 PD catheter insertions (88 by surgeons and 55 by nephrologists) performed in 132 patients were considered for the analysis. The primary nonfunction rate of PD catheter insertions in both groups was comparable (18.2% and 7.3%, P = 0.08). Break-in period was shorter in Group N (p = <0.001). No differences were noted in patient or catheter survival. Percutaneously placed PD catheters performed by nephrologists have comparable outcomes with surgically placed PD catheters among selected cases and have the advantage of lower costs, avoidance of operation theater scheduling issues, smaller incision length, and shorter break-in period. Therefore, more nephrologists should acquire the expertise on percutaneous PD catheter placement as it leads to lesser waiting times and better utilization of PD. PMID:27512299

  10. BIOKID: Randomized controlled trial comparing bicarbonate and lactate buffer in biocompatible peritoneal dialysis solutions in children [ISRCTN81137991

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    Misselwitz Joachim

    2004-10-01

    Full Text Available Abstract Background Peritoneal dialysis (PD is the preferred dialysis modality in children. Its major drawback is the limited technique survival due to infections and progressive ultrafiltration failure. Conventional PD solutions exert marked acute and chronic toxicity to local tissues. Prolonged exposure is associated with severe histopathological alterations including vasculopathy, neoangiogenesis, submesothelial fibrosis and a gradual loss of the mesothelial cell layer. Recently, more biocompatible PD solutions containing reduced amounts of toxic glucose degradation products (GDPs and buffered at neutral pH have been introduced into clinical practice. These solutions contain lactate, bicarbonate or a combination of both as buffer substance. Increasing evidence from clinical trials in adults and children suggests that the new PD fluids may allow for better long-term preservation of peritoneal morphology and function. However, the relative importance of the buffer in neutral-pH, low-GDP fluids is still unclear. In vitro, lactate is cytotoxic and vasoactive at the concentrations used in PD fluids. The BIOKID trial is designed to clarify the clinical significance of the buffer choice in biocompatible PD fluids. Methods/design The objective of the study is to test the hypothesis that bicarbonate based PD solutions may allow for a better preservation of peritoneal transport characteristics in children than solutions containing lactate buffer. Secondary objectives are to assess any impact of the buffer system on acid-base status, peritoneal tissue integrity and the incidence and severity of peritonitis. After a run-in period of 2 months during which a targeted cohort of 60 patients is treated with a conventional, lactate buffered, acidic, GDP containing PD fluid, patients will be stratified according to residual renal function and type of phosphate binding medication and randomized to receive either the lactate-containing Balance solution or the

  11. COMPARED VALUES OF URINARY AND PERITONEAL FRACTIONAL EXCRETION OF MAGNESIUM AND PHOSPHORUS AMONG PATIENTS ON PERITONEAL DIALYSIS WITH RESIDUAL DIURESIS, CHRONIC RENAL FAILURE (STAGE III AND HEALTHY VOLUNTEERS

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    Musso CG

    2012-09-01

    Full Text Available Background: Magnesium and phosphorus are one of the electrolytes whose balance is altered during advanced chronic renal failure (CRD-V. It has already been reported in the literature that there is a progressive increase in urinary electrolyte excretion in CRD-V in relation with the glomerular filtration rate reduction, but it has not been extensively studied yet for these divalent ions. Therefore we decided to perform a study for evaluating compared values of urinary and peritoneal fractional excretion of these divalent ions (magnesium and phosphorus among patients on peritoneal dialysis with residual diuresis (CRD-V, stage III - chronic renal failure, and healthy volunteers. Results: Urinary fractional excretion (FEu of magnesium (Mg and phosphorus (P were significantly (p= < 0.05 lower in healthy volunteers (FEuMg: 3 ± 1%, FEuP: 9 ± 0.5%, and significantly higher in CRD-V (FEuMg: 30 ± 4%, FEuP: 40 ± 0.2%. Regarding peritoneal fractional excretion (FEp of magnesium and phosphorus, they were significantly higher (p= < 0.05 (FEpMg: 36 ± 5%, FEpP: 62 ± 9% than the urinary ones in the same population: CRD-V. Conclusion: Magnesium and phosphorus urinary fractional excretion values were significantly higher in the CRD-V group, while these values were significantly lower than the peritoneal ones in the same population: CRD-V.

  12. Plasma p-cresol lowering effect of sevelamer in peritoneal dialysis patients: evidence from a Cross-Sectional Observational Study.

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    Bruna Guida

    Full Text Available p-Cresol is a by-product of the metabolism of aromatic aminoacid operated by resident intestinal bacteria. In patients with chronic kidney disease, the accumulation of p-cresol and of its metabolite p-cresyl-sulphate causes endothelial dysfunction and ultimately increases the cardiovascular risk of these patients. Therapeutic strategies to reduce plasma p-cresol levels are highly demanded but not available yet. Because it has been reported that the phosphate binder sevelamer sequesters p-cresol in vitro we hypothesized that it could do so also in peritoneal dialysis patients. To explore this hypothesis we measured total cresol plasma concentrations in 57 patients with end-stage renal disease on peritoneal dialysis, 29 receiving sevelamer for the treatment of hyperphosphatemia and 28 patients not assuming this drug. Among the patients not assuming sevelamer, 16 were treated with lanthanum whereas the remaining 12 received no drug because they were not hyperphosphatemic. Patients receiving sevelamer had plasma p-cresol and serum high sensitivity C-reactive protein concentrations significantly lower than those receiving lanthanum or no drug. Conversely, no difference was observed among the different groups either in residual glomerular filtration rate, total weekly dialysis dose, total clearance, urine volume, protein catabolic rate, serum albumin or serum phosphate levels. Multiple linear regression analysis showed that none of these variables predicted plasma p-cresol concentrations that, instead, negatively correlated with the use of sevelamer. These results suggest that sevelamer could be an effective strategy to lower p-cresol circulating levels in peritoneal dialysis patients in which it could also favorably affect cardiovascular risk because of its anti-inflammatory effect.

  13. Lanthanum carbonate versus placebo for management of hyperphosphatemia in patients undergoing peritoneal dialysis: a subgroup analysis of a phase 2 randomized controlled study of dialysis patients

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    Hutchison Alastair J

    2013-02-01

    Full Text Available Abstract Background This short-term study assessed the efficacy and safety of lanthanum carbonate in the treatment of hyperphosphatemia in dialysis patients; here, we report a prespecified subgroup analysis of patients undergoing peritoneal dialysis. Methods Men and women (n = 39 who had received continuous ambulatory peritoneal dialysis for chronic kidney disease for 6 months or more were enrolled in eight renal medicine departments in the United Kingdom. A 2-week washout period was followed by a 4-week dose-titration phase during which patients received lanthanum carbonate titrated up to 2250 mg/day. This was followed by a 4-week, randomized, placebo-controlled, parallel-group phase during which patients continued to receive either lanthanum carbonate at the titrated dose, or a matched dose of placebo. The main outcome measure was control of serum phosphate levels (1.3-1.8 mmol/l at the end of the parallel-group phase. Results Serum phosphate was controlled in 3/39 (8% patients at the beginning of the dose-titration phase (after washout and in 18/31 (58% patients treated with lanthanum carbonate at its end. After the parallel-group phase, 60% of lanthanum carbonate-treated patients and 10% of those receiving placebo had controlled serum phosphate. There was no difference in mean (95% confidence interval serum phosphate levels between groups at randomization: lanthanum carbonate, 1.57 (1.34-1.81 mmol/l; placebo, 1.58 (1.40-1.76 mmol/l (p = 0.96. However, a difference was seen at the end of the parallel-group phase: lanthanum carbonate, 1.56 (1.33-1.79 mmol/l; placebo, 2.25 (1.81-2.68 mmol/l (p = 0.0015. There were no clinically important changes in nutritional parameters and no serious treatment-related adverse events were recorded. Conclusions At doses up to 2250 mg/day, lanthanum carbonate is well tolerated and controls hyperphosphatemia effectively. Treatment with higher doses of lanthanum carbonate may allow patients undergoing

  14. Correlation between visceral fat accumulation, leptin and eating disorder in peritoneal dialysis patients

    International Nuclear Information System (INIS)

    Eating disorder may be a major factor for protein-energy malnutrition occurs in patients with chronic renal failure (CRF). Some peritoneal dialysis (PD) patients demonstrate eating disorder in association with massive visceral fat accumulation. Markedly elevated leptin levels have been documented in CRF patients, especially in those who are treated with PD. Leptin is secreted by adipocytes, regulates both body composition and appetite behavior. This study evaluated the correlation between visceral fat accumulation, leptin and eating disorder in PD patients. Plasma leptin, albumin, insulin-like growth factor-1 (IGF-1), normalized protein catabolic rate (nPCR), C-reactive protein (CRP) and body composition were measured in 46 PD patients (27 males and 19 females; median age 62.7 years). Computed tomography was used for determination of visceral fat area (VFA) and subcutaneous fat area (SFA), at the initial state and during PD. The VFA and the SFA increased during PD treatment, and the ratio of increase in each fat area was significantly higher in VFA than in SFA (1.47±0.63 vs. 1.23±0.41 p<0.01, respectively). Serum leptin elevated (19.5±21.9 ng/mL), and correlated significantly with the percentage of body fat (r=0.584), body mass index (BMI: r=0.574), VFA (r=0.476) and SFA (r=0.684). Dietary intake correlated inversely with the visceral fat mass, and the low nPCR group had a higher VFA/BMI ratio (p<0.05). A negative correlation was found between nPCR and either serum leptin (r=-0.52), leptin/BMI (r=-0.44), or CRP (r=-0.55). Our data suggest that visceral fat accumulation and hyperleptinemia in PD patients are closely associated with eating disorder. Therefore, a new peritoneal solution containing an alternative osmotic agent instead of glucose may be useful to prevent accumulation of visceral fat in PD patients. (author)

  15. Risk factors associated with brachial–ankle pulse wave velocity among peritoneal dialysis patients in Macao

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    Kuang Ding-Wei

    2012-11-01

    Full Text Available Abstract Background Cardiovascular disease is the leading cause of mortality among peritoneal dialysis (PD patients in Macao. Increased arterial stiffness determined by pulse wave velocity (PWV has been established as an independent predictor of cardiovascular mortality in end-stage renal disease patients. The present study aims to investigate the relationship between arterial stiffness and its associated risk factors in chronic PD patients. Methods A total of 96 chronic PD patients (48 males/48 females were included in the cross-sectional study. Arterial stiffness was assessed by brachial-ankle PWV (baPWV. Patients were divided into two subgroups according to mean baPWV value. On enrollment, clinical characteristics and biochemical parameters were collected. Results Compared with low baPWV group patients, high baPWV group patients were significant older (pp=0.004 as well as previous CVD history (p=0.008. Serum albumin, pre-albumin levels and residual renal creatinine clearance (CCr were significantly lower but the serum ferritin level was significantly higher in high baPWV group patients than in low baPWV group patients (all pr=0.534, pr=0.350, pr=0.340, p=0.001. Meanwhile, baPWV negatively correlated with serum albumin (r=−0.479, pr=−0.320, p=0.003 and residual renal CCr (r=−0.177, p=0.048. Age-adjusted partial correlation test found a significant correlation between baPWV and CRP (r=0.462, ppp=0.015, CRP (p=0.019 and residual renal CCr (p=0.045. Conclusion Arterial stiffness, assessed by baPWV, had an independent correlation with age, serum albumin level, CRP level and residual renal CCr among PD patients in Macao.

  16. Patient characteristics and risk factors of early and late death in incident peritoneal dialysis patients.

    Science.gov (United States)

    Liu, Xinhui; Huang, Rong; Wu, Haishan; Wu, Juan; Wang, Juan; Yu, Xueqing; Yang, Xiao

    2016-01-01

    This study was conducted to identify key patient characteristics and risk factors for peritoneal dialysis (PD) mortality in terms of different time-point of death occurrence. The incident PD patients from January 1, 2006 to December 31, 2013 in our PD center were recruited and followed up until December 31, 2015. Patients who died in the early period (the first 3 months) were older, had higher neutrophil to lymphocyte ratio (N/L), serum phosphorus, and uric acid level, and had lower diastolic pressure, hemoglobin, serum albumin, and calcium levels. After adjustment of gender, age, and PD inception, higher N/L level [hazard ratio (HR) 1.115, P = 0.006], higher phosphorus lever (HR 1.391, P < 0.001), lower hemoglobin level (HR 0.596, P < 0.001), and lower serum albumin level (HR 0.382, P = 0.017) were risk factors for early mortality. While, presence of diabetes (HR 1.627, P = 0.001), presence of cardiovascular disease (HR 1.847, P < 0.001) and lower serum albumin level (HR 0.720, P = 0.023) were risk factors for late mortality (over 24 months). In conclusion, patient characteristics and risk factors associated with early and late mortality in incident PD patients were different, which indicated specific management according to patient characteristics at the initiation of PD should be established to improve PD patient survival. PMID:27576771

  17. Evaluation of hepatitis B vaccine responsiveness in hemodialysis and peritoneal dialysis patients

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    Salama Elsayed Farag

    2015-09-01

    Full Text Available Background: Hepatitis B Virus (HBV infection is considered as a major cause of liver cirrhosis and hepatocellular carcinoma. Patients with End Stage Renal Disease (ESRD are a risk group for HBV infection. The vaccine of hepatitis B has been recommended for prevention of HBV infection in ESRD patient especially on renal replacement therapy. Methods: Eighty seven patients with ESRD on peritoneal dialysis and hemodialysis requiring primary hepatitis B vaccination were enrolled in the study. Each of them received 40 and micro;g of recombinant hepatitis B vaccine in a four-dose schedule. Antibody response was determined by the levels of antibodies to the hepatitis B surface antigen (anti-HBs after last doses of the vaccination schedule. Results: We observed three response patterns to the immunizations in all patients after vaccination, the nonresponders (24.7% never reached the minimum protective titer of 10 mIU/mL, the poor responders (18.5% had titers between 10 and 100 mIU/mL, and the good responders (56.8% had antibody titers above 100 mIU/mL. Despite a reduction in anti-HBs over time, the good responders did not become unprotected during the observation period, especially those participants who had titers above 1000 mIU/mL after the initial immunization. Conclusions: We concluded that the immune response of the HBV vaccine was reduced in the HD and PD patients, which need yearly re-evaluation of seroconversion with booster doses of HBV vaccination if needed. [Int J Res Med Sci 2015; 3(9.000: 2259-2263

  18. Peritoneal dialysis for chronic cardiorenal syndrome:Lessons learned from ultrafiltration trials

    Institute of Scientific and Technical Information of China (English)

    Amir; Kazory

    2015-01-01

    The current models of cardiorenal syndrome(CRS) are mainly based on a cardiocentric approach; they assume that worsening renal function is an adverse consequence of the decline in cardiac function rather than a separate and independent pathologic phenomenon. If this assumption were true,then mechanical extraction of fluid(i.e.,ultrafiltration therapy) would be expected to portend positive impact on renal hemodynamics and function through improvement in cardio-circulatory physiology and reduction in neurohormonal activation. However,currently available ultrafiltration trials,whether in acute heart failure(AHF) or in CRS,have so far failed to show any improvement in renal function; they have reported no impact or even observed adverse renal outcomes in this setting. Moreover,the presence or absence of renal dysfunction seems to affect the overall safety and efficacy of ultrafiltration therapy in AHF. This manuscript briefly reviews cardiorenal physiology in AHF and concludes that therapeutic options for CRS should not only target cardio-circulatory status of the patients,but they need to also have the ability of addressing the adverse homeostatic consequences of the associated decline in renal function. Peritoneal dialysis(PD) can be such an option for the chronic cases of CRS as it has been shown to provide efficient intracorporeal ultrafiltration and sodium extraction in volume overloaded patients while concurrently correcting the metabolic consequences of diminished renal function. Currently available trials on PD in heart failure have shown the safety and efficacy of this therapeutic modality for patients with chronic CRS and suggest that it could represent a pathophysiologically and conceptually relevant option in this setting.

  19. Vitamin D Status Is an Independent Risk Factor for Global Cognitive Impairment in Peritoneal Dialysis Patients.

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    Gui-Ling Liu

    Full Text Available Vitamin D (VD deficiency is an independent risk factor for cognitive impairment (CI in the general population, but VD status in peritoneal dialysis (PD patients has not been investigated. In this study, we aimed to investigate the relationship between serum VD levels and global and specific cognitive functions in PD patients.Cross-sectional study, simultaneously conducted at two PD centers.Clinically stable patients (n = 273 undergoing PD for at least 3 months were enrolled over a period of one year.Demographic and comorbidity data were recorded, and routine biochemical parameters and serum 25-hydroxyvitamin D (25(OH D levels of overnight fasted patients were determined. Global cognitive function was assessed by the Modified Mini-Mental State Examination (3MS score; executive function, by the trail making tests (Trails A and B; and immediate memory, delayed memory, and language ability by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS sub-tests.In the univariate analysis, serum 25(OH D levels significantly correlated with 3MS scores (r = -0.139; P = 0.02, and Trail A (r = -0.188; P = 0.002 and B (r = -0.154; P = 0.01 completion times. In the multivariate analysis, 25(OH D was found to be independently associated with global CI, but not with executive dysfunction. Serum 25(OH D could not predict scores of immediate/delayed memory and language ability.VD deficiency is highly prevalent in PD patients and is an independent risk factor for global CI in this patient cohort.

  20. Percutaneous versus laparoscopic placement of peritoneal dialysis catheters: Simplicity and favorable outcome

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    Abdulla K Al-Hwiesh

    2014-01-01

    Full Text Available Implantation of peritoneal dialysis (PD catheters via the laparoscopic technique is expanding, but none of the studies concerning this technique have compared its outcome with the percutaneous insertion done by the nephrologist. We compared the technical survival and outcome of 52 PD catheters placed in 43 patients with end-stage renal disease (ESRD in our center from March 2006 to October 2007. Of these, 27 PD catheters were inserted percutaneously by a nephrologist (group 1 and 25 were placed by a surgeon using the conventional laparoscopic technique (group 2. Very obese patients, those with previous abdominal surgery, and those who refused local anesthesia were excluded from the study. All catheters were evaluated for mechanical and infectious complications and the overall technique survival was analyzed. The incidence of complications in PD catheters did not largely differ between the two groups. Early catheter-related infection episodes (within two weeks of catheter placement occurred in three of 22 (13.6% patients in group 1, versus three of 21 (14.3% patients in group 2 (P >0.05. The incidence of exit site leak was higher in group 2 (19.0% compared to (4.5% group 1 (P 0.05. We conclude that in our study, the percutaneous bedside placements of PD catheters done by nephrologists were comparable with the laparoscopic insertions performed by surgeons where the high-risk patients were avoided, and the former provided a safer and more reliable access that allowed a rapid initiation of PD.

  1. Clinical importance of intraperitoneal pressure in peritoneal dialysis and measures to counteract its effect on net ultrafiltration.

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    Flessner, M F

    1999-01-01

    Experiments in animals and in humans have shown that fluid loss from the peritoneal cavity to the body increases with large increments in the intraperitoneal hydrostatic pressure (IPP). We have demonstrated previously that much of this fluid loss occurs to the abdominal wall and is driven by the hydrostatic pressure gradient (i.p. pressure-skin pressure) that develops across the wall whenever therapeutic or pathologic volumes of fluid reside in the cavity. We hypothesized that eliminating the pressure difference across the wall by applying an equal and opposite pressure [abdominal counterpressure (ACP)] would decrease fluid movement into the wall and decrease fluid movement from the cavity. In addition, we hypothesized that net ultrafiltration or net fluid recovery would increase with ACP. To address these hypotheses, we dialyzed rats for 3 hours in the supine position at constant levels of IPP (4, 6, and 8 cmH2O) with isotonic or hypertonic dialysis solutions containing a protein marker of fluid movement. We measured total fluid loss, fluid marker concentration in the abdominal wall, and lymph flow. In separate animals, we repeated the experiments with ACP. Total fluid loss as determined by protein clearance and fluid marker deposition in the abdominal wall was decreased in all experiments. Lymph flow was unchanged by ACP. While ACP increased the net fluid recovery in isotonic dialysis, no change was observed in the hypertonic case. Analogous experiments were carried out in six dialysis patients with or without ACP during a 4-hour dialysis with 1.5% dextrose solution performed in the supine position at i.p. hydrostatic pressure of 4-6 cmH2O. No significant difference was noted in the measured net ultrafiltration between control and ACP studies. We conclude that the careful application of ACP does decrease fluid loss (particularly to the abdominal wall) during isotonic or hypertonic dialysis in the rat. However, ACP results in improved fluid recovery only with

  2. Efficacy and safety of Changfu peritoneal dialysis solution:a multi-center prospective randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-hui; NI Zhao-hui; MEI Chang-lin; YU Xue-qing; LIU Fu-you; MIAO Li-ning; LIU Zhi-hong

    2013-01-01

    Background A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis (PD) solutions.Some researchers believe that 6 L/d is enough for adequate dialysis,but there is no multi-center prospective study on Chinese population to confirm this.In this study,we evaluated the efficacy and safety of domestic PD solution (Changfu) and its difference between 6 L and 8 L dosage.Methods Adult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages,i.e.,6 L dose with Changfu dialysis solution,6 L dose with Baxter dialysis solution,8 L dose with Changfu dialysis solution,and 8 L dose with Baxter dialysis solution.After 48 weeks,the changes of primary and secondary efficacy indices were compared between different types and different dosages.We also analyzed the changes of safety indices.Results Changes of KW from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate (Ccr).Normalized protein catabolic rate (nPCR) from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume (nUF) and estimated glomerular filtration rate (eGFR).Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR.The decline of KW from baseline to 48 weeks in 6 L group was more than that in 8 L group.Change of Ccr was similar.During the 48-week period,the mean Kt/V was above 1.7/w,and mean Ccr was above 50 L·1.73 m-2·w-1.More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization,and the statistical differences disappeared after that.Conclusions The domestic PD solution (Changfu) was proven to be as effective as Baxter dialysis solution.During 48-week period,a dosage of 6 L/d was enough for

  3. [Nutritional and Functional assessment of peritoneal dialysis patients in the clinical practice: Report from MITO-DP Group].

    Science.gov (United States)

    Cupisti, Adamasco; D'Alessandro, Claudia; Caselli, Gian Marco

    2016-01-01

    Nutritional abnormalities and physical inactivity are risk factors of increased morbidity and mortality in patients with ESRD. Identify and define malnutrition, in particular protein-energy depletion (PEW), is an important task in the management of renal patients. The aim of this multicenter observational study was to implement the assessment of nutritional status and functional capacity in patients on peritoneal dialysis, including tests and validated methods which are relatively easy to apply in daily clinical practice. The study includes all the 133 prevalent patients (80 m, 53 f, age 65 14 years), in peritoneal dialysis treatment (vintage 26 19 months) in 9 centers in Tuscany. We performed anthropometry, bioimpedance (BIA), clinical biochemistry, evaluation of habitual physical activity (RAPA tests) and performance (Sit-To-Stand test), appetite-evaluation questionnaire, and indices including the Malnutrition Inflammation Score (MIS), Geriatric Nutrition Risk Index (GNRI), Charlson comorbidity index, Barthel and Karnowsky index. The latter showed a condition of dependence in 7.2% and 19.7% of cases, respectively. Poor appetite was recorded in 48.2%. The majority of patients fell within the overweight / obesity range (51%) with waist circumference values associated with increased cardiovascular risk in 51% of males and 60% of females. At the BIA analysis, a BCMI 11, indicative of PEW, took place in 12.7% of cases. The values of the MIS correlated directly with age and the degree of comorbidity and inversely with the sit-to-stand test, RAPA tests and appetite level. The data in this study show that single tests indicative of malnutrition disorders are frequent to be found in our series of peritoneal dialysis patients. However, a diagnosis of PEW is quite infrequent. A large percentage of patients are overweight with increased abdominal adiposity, and reduced cell mass and protein intake below recommended levels; the level of habitual physical activity is low, and

  4. Research Progress in Chronic Inflammatory State of Peritoneal Dialysis Patients%腹膜透析患者慢性炎症状态研究进展

    Institute of Scientific and Technical Information of China (English)

    白鸽

    2013-01-01

    Peritoneal dialysis is one of the effective treatment of end-stage renal disease,which can substitute parts of renal function.Because not all of the functions of the kidney can be substituted by peritoneal dialysis,many factors in vivo still affect the patients for long-term survival.Chronic inflammation is highly prevalent in long-term peritoneal dialysis population.The causes of inflammation are usually complex and multifactorial,involving both dialysis-related and dialysis-unrelated factors.The elevated inflammatory factors have negative influence on the peritoneal structure and function,cardiovascular system,nutritional status,residual renal function,dialysis sufficiency and quality of life.How to reduce inflammatory state and improve the peritoneal dialysis patients' survival rate are the research hotspots.%腹膜透析(PD)是终末期肾脏疾病治疗的有效方法之一,可替代肾脏的部分功能.由于PD不能代替肾脏的全部功能,体内仍然存在许多影响患者长期生存的因素.长期接受PD的患者体内普遍存在慢性炎症状态,其原因是复杂的、多种因素共同参与的,主要包括透析相关性及非透析相关性因素.体内炎性因子的增高对腹膜结构与功能、心血管系统、营养状况、残肾功能、透析充分性以及生存质量都有不利影响.如何减轻炎症状态,提高PD患者生存率是目前研究的热点.

  5. Automated system for high-throughput protein production using the dialysis cell-free method.

    Science.gov (United States)

    Aoki, Masaaki; Matsuda, Takayoshi; Tomo, Yasuko; Miyata, Yukako; Inoue, Makoto; Kigawa, Takanori; Yokoyama, Shigeyuki

    2009-12-01

    High-throughput protein production systems have become an important issue, because protein production is one of the bottleneck steps in large-scale structural and functional analyses of proteins. We have developed a dialysis reactor and a fully automated system for protein production using the dialysis cell-free synthesis method, which we previously established to produce protein samples on a milligram scale in a high-throughput manner. The dialysis reactor was designed to be suitable for an automated system and has six dialysis cups attached to a flat dialysis membrane. The automated system is based on a Tecan Freedom EVO 200 workstation in a three-arm configuration, and is equipped with shaking incubators, a vacuum module, a robotic centrifuge, a plate heat sealer, and a custom-made tilting carrier for collection of reaction solutions from the flat-bottom cups with dialysis membranes. The consecutive process, from the dialysis cell-free protein synthesis to the partial purification by immobilized metal affinity chromatography on a 96-well filtration plate, was performed within ca. 14h, including 8h of cell-free protein synthesis. The proteins were eluted stepwise in a high concentration using EDTA by centrifugation, while the resin in the filtration plate was washed on the vacuum manifold. The system was validated to be able to simultaneously and automatically produce up to 96 proteins in yields of several milligrams with high well-to-well reliability, sufficient for structural and functional analyses of proteins. The protein samples produced by the automated system have been utilized for NMR screening to judge the protein foldedness and for structure determinations using heteronuclear multi-dimensional NMR spectroscopy. The automated high-throughput protein production system represents an important breakthrough in the structural and functional studies of proteins and has already contributed a massive amount of results in the structural genomics project at the

  6. Influencia de la carga inicial de glucosa sobre los pacientes en diálisis peritoneal Influence of the initial glucose load on patients undergoing peritoneal dialysis

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    Francisco Cirera Segura

    2010-03-01

    Full Text Available Los objetivos del estudio fueron determinar si diferentes cargas de glucosa en el inicio de la diálisis peritoneal pueden ser negativas para la supervivencia de la técnica o de los pacientes y conocer qué factores les afectan y cómo puede actuar Enfermería al respecto. Se realizó un estudio retrospectivo desde 2004 a 2008. La muestra la constituyeron 63 pacientes, clasificados en 3 grupos según la concentración de glucosa. Se recogieron datos epidemiológicos, analíticos, transporte y aclaramiento peritoneal, comorbilidad y pauta de diálisis. Los resultados demuestran que los tres grupos se diferenciaban en el peso total de glucosa (p=0,001, en su concentración media (pThe aims of the study were to determine whether different glucose loads at the start of peritoneal dialysis could be negative for survival of the technique or of the patients, and to find out what factors affect them and how nursing staff can act in this regard. A retrospective study was carried out from 2004 to 2008. The sample comprised 63 patients, classified in 3 groups according to the glucose concentration. Epidemiological, analytical, peritoneal transport and rinsing, comorbility and dialysis dose data were compiled. The results show that the three groups were differentiated by the total glucose weight (p=0.001, average concentration (p<0.001, serum albumin (p<0.05, and the dialysate/creatinine plasma quotient (p=0.036. There were 15 deaths, with no significant differences found for the survival of the patients between the groups (p=0.163, although first-year survival was 95.2%, 94.1% and 78.4%. The factors that influenced survival were age, cardiovascular disease, total Kt/V, diuresis and albumin. Failure of the technique occurred in 8 patients and there were no differences between the groups (p=0.769, nor any independent factors affecting the survival of the technique. In conclusion, we have been unable to prove that a higher initial glucose load affects the

  7. Health-related quality of life as a predictor of mortality in patients on peritoneal dialysis1

    Science.gov (United States)

    de Oliveira, Marília Pilotto; Kusumota, Luciana; Haas, Vanderlei José; Ribeiro, Rita de Cássia Helú Mendonça; Marques, Sueli; Oller, Graziella Allana Serra Alves de Oliveira

    2016-01-01

    Objective: to characterize deaths that occurred, and the association between socio-demographic, clinical, laboratory variables and health-related quality of life and the outcome of death in patients on peritoneal dialysis, over a two year period after an initial assessment. Method: observational, prospective population study with 82 patients on peritoneal dialysis. The instruments used for the first stage of data collection were the mini-mental state examination, a sociodemographic, economic, clinical and laboratory questionnaire and the Kidney Disease and Quality of Life-Short Form. After two years, data for characterization and occurrence of death in the period were collected. The relative risk of death outcome was calculated through statistical analysis; the risk of death was estimated by the survival Kaplan-Meier curve, and determined predictors of death by the Cox Proportional Hazards Model. Results: of the 82 original participants, 23 had as an outcome death within two years. The increased risk for the outcome of death was associated with a lower mean score of health-related quality of life in the physical functioning domain. Conclusion: the worst health-related quality of life in the physical functioning domain, could be considered a predictor of death. PMID:27192413

  8. Expression of aquaporin-1 in the human peritoneum and the effect of peritoneal dialysis on its expression

    Institute of Scientific and Technical Information of China (English)

    方炜; 钱家麒; 余志远; 陈诗书

    2003-01-01

    Objective To investigate the expression of aquaporin-1 (AQP1) in the human peritoneum and to evaluate the effect of peritoneal dialysis (PD) on its expression.Methods Peritoneal biopsies were obtained from normal subjects (n=10), uremic nondialysis patients (n=12) at catheter insertion and PD patients (n=10) at the time of catheter removal, reinsertion or renal transplantation. Western blot, immuno-histochemical staining and reverse transcript-polymerase chain reaction (RT-PCR) techniques were used to investigate AQP1 expression.Results All peritoneal samples expressed AQP1 at both mRNA and protein levels. Western blot revealed a major band at 28 kD as well as more diffuse bands between 35 and 50 kD. The 28 kD band represents the nonglycosylated form of the protein while the 35-50 kD bands correspond to glycosylated AQP1. Immunohistochemical staining found the positive deposits were distributed in the mesothelial cells, endothelial cells of capillaries, venules and small veins, whereas no signal was detected in the arterioles. Semi-quantitative analysis showed that AQP1 expression was remarkably stable in all samples, whatever their origin (P>0.05).Conclusions Our findings suggested that AQP1 is the molecular counterpart of an ultra small pore during PD. Secondly, the peritoneal mesothelial cell might also be involved in peritoneal transcellular water transport. As regards whether or not the structural or distributional alterations of AQP1 in the peritoneum may be more obviously expressed during PD, further study is needed.

  9. Bioimpedancia: herramienta habitual en los cuidados de los pacientes de diálisis peritoneal (DP Bioimpedance: a common tool in the care of peritoneal dialysis (PD patients

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    Gema Vinagre Rea

    2011-09-01

    Full Text Available El estado de hidratación de los pacientes debe ser considerado como un indicador de diálisis adecuada, además de influir directamente en la calidad de vida del paciente. La Bioimpedancia es un método de valoración objetiva y de monitorización nutricional e hídrica de los pacientes. Las mediciones periódicas pueden ser complemento útil para la valoración clínica y la identificación de variaciones en la hidratación y nutrición, permitiendo alteraciones adecuadas de la conducta. En nuestra unidad, nos planteamos utilizar la bioimpedancia como herramienta para detectar el estado de hidratación y la composición corporal de los pacientes para elaborar un plan de cuidados individualizado. Se realizó en nuestro centro un estudio analizando en una muestra de 8 pacientes en programa de diálisis peritoneal, las mediciones por bioimpedancia que de forma rutinaria se realizaron en cada revisión. Las variables recogidas fueron edad, causa de enfermedad renal (ER, peso, altura, sexo, tiempo en diálisis, presión arterial (PA, filtrado glomerular (FG, nº de hipotensores, diuréticos y resultados obtenidos de las mediciones de bioimpedancia. Podemos concluir que la bioimpedancia detecta pacientes con hipertensión no dependiente de volumen. En estos casos es fundamental no forzar el aumento de UF para disminuir la PA, puesto que esto afectaría de forma adversa a la función renal residual. Por lo tanto, la bioimpedancia es una herramienta útil, práctica y fácil de manejar que aporta una información objetiva para el seguimiento del paciente en programa de diálisis peritoneal.The state of hydration of patients should be considered an indicator of adequate dialysis, as well as influencing directly on the patient's quality of life. Bioimpedance is an objective method for nutritional and hydric monitoring and assessment of patients. The regular measurements can be a useful aid to clinical assessment and the identification of variations in

  10. Estudo descritivo sobre a prática da diálise peritoneal em domicílio Descriptive study about the practice of home peritoneal dialysis

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    Sarah Silva Abrahão

    2010-03-01

    Full Text Available INTRODUÇÃO: A partir da vivência no atendimento de crianças/adolescentes portadores de doença renal crônica (DRC em tratamento dialítico no ambiente hospitalar pensou-se que aspectos seriam relevantes para a aplicação da diálise peritoneal domiciliar. O objetivo deste estudo foi descrever o nível de escolaridade e de informação do cuidador sobre a técnica de diálise peritoneal (DP, a renda familiar e condições gerais do local de realização da diálise e buscar associação com a realização inadequada da técnica. MÉTODO: Trata-se de um estudo descritivo do universo de 30 crianças e adolescentes com DRC assistidos pelo HC/UFMG no período de março de 2004 a maio de 2006. Os dados foram analisados utilizando-se o software SPSS versão 13.0. As seguintes variáveis foram testadas como possíveis fatores de risco para inadequação da técnica de diálise: escolaridade do cuidador, renda familiar, nível de informação do cuidador sobre a técnica de diálise, antissepsia das mãos, ausência de pia no quarto da diálise. RESULTADOS: A qualidade de aplicação da técnica de DP foi considerada inadequada em 18 (60% pacientes. Todos os valores de Odds Ratio estiveram dentro dos limites dos intervalos de confiança (95% e foram > 1, indicando a possibilidade de associação positiva entre a variável independente e a variável pesquisada, embora sem diferença estatística significativa. CONCLUSÕES: A análise estatística não mostrou associação entre as variáveis, entretanto acredita-se que elas exercem um papel positivo para o sucesso da aplicação da técnica dialítica.INTRODUCTION: As experienced with the assistance evaluation of children/adolescents with chronic kidney disease in dialysis treatment on hospital we thought about which aspects could be relevant to the peritoneal dialysis (PD application at home. The objective was to describe the level of schooling and information of the parents about the PD technique

  11. A Cost Evaluation of Peritoneal Dialysis and Hemodialysis in the Treatment of End-Stage Renal Disease in São Paulo, Brazil

    OpenAIRE

    de Abreu, Mirhelen Mendes; Walker, David R.; Sesso, Ricardo C; Ferraz, Marcos B

    2013-01-01

    ♦ Objective: Conventional hemodialysis (HD) predominates over peritoneal dialysis (PD) around the world. Prospective and comparative studies comparing the costs of these modalities are scarce. In the present prospective assessment, we describe the resources used and total patient costs for both HD and PD.

  12. Effects of starting hemodialysis with an arteriovenous fistula or central venous catheter compared with peritoneal dialysis: a retrospective cohort study

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    Coentrão Luis

    2012-08-01

    Full Text Available Abstract Background Although several studies have demonstrated early survival advantages with peritoneal dialysis (PD over hemodialysis (HD, the reason for the excess mortality observed among incident HD patients remains to be established, to our knowledge. This study explores the relationship between mortality and dialysis modality, focusing on the role of HD vascular access type at the time of dialysis initiation. Methods A retrospective cohort study was performed among local adult chronic kidney disease patients who consecutively initiated PD and HD with a tunneled cuffed venous catheter (HD-TCC or a functional arteriovenous fistula (HD-AVF in our institution in the year 2008. A total of 152 patients were included in the final analysis (HD-AVF, n = 59; HD-TCC, n = 51; PD, n = 42. All cause and dialysis access-related morbidity/mortality were evaluated at one year. Univariate and multivariate analysis were used to compare the survival of PD patients with those who initiated HD with an AVF or with a TCC. Results Compared with PD patients, both HD-AVF and HD-TCC patients were more likely to be older (pp = 0.017 and cardiovascular disease (p = 0.020. Overall, HD-TCC patients were more likely to have clinical visits (p = 0.069, emergency room visits (ppvs. 0.93 vs. 0.64, per patient-year; pvs. 0.07 vs. 0.14, per patient-year; p = 0.034 than HD-AVF and PD patients, respectively. The survival rates at one year were 96.6%, 74.5% and 97.6% for HD-AVF, HD-TCC and PD groups, respectively (pp = 0.024. Conclusion Our results suggest that HD vascular access type at the time of renal replacement therapy initiation is an important modifier of the relationship between dialysis modality and survival among incident dialysis patients.

  13. Successful Pregnancy in a 31-Year-Old Peritoneal Dialysis Patient with Bilateral Nephrectomy

    OpenAIRE

    Ahmed Abu-Zaid; Ahmed Nazer; Osama AlOmar; Al-Badawi, Ismail A

    2013-01-01

    Frequency of pregnancy among childbearing age women with end-stage renal disease (ESRD) undergoing long-term periodic dialysis ranges from 1% to 7%. Although pregnancy in dialysis women with ESRD is considered a largely high-risk pregnancy, occurrence of successful pregnancy is not impossible with success rates approaching 70%. Rates of successful pregnancy are greatly impacted by early pregnancy diagnosis and preserved residual renal functions. Herein, to the best of our knowledge, we report...

  14. Síndrome metabólico en diálisis peritoneal Metabolic syndrome in peritoneal dialysis

    OpenAIRE

    Francisco Cirera Segura; Jesús Lucas Martín Espejo

    2011-01-01

    Introducción: El síndrome metabólico es una agrupación de factores de riesgo cardiovascular de origen metabólico. Nos planteamos: • Determinar la prevalencia del síndrome metabólico en diálisis peritoneal y ver su evolución. • Valorar su influencia sobre la mortalidad. • Revisar las intervenciones de Enfermería destinadas a prevenirlo. Material y Métodos: Se realizó un estudio descriptivo retrospectivo de 5 años. Se utilizó la clasificación de criterios diagnósticos del síndrom...

  15. Bowel Obstruction and Peritoneal Dialysis: A Case Report of a Patient with Complications from a Broad Ligament Hernia

    Science.gov (United States)

    Otani-Takei, Naoko; Akimoto, Tetsu; Sadatomo, Ai; Saito, Osamu; Muto, Shigeaki; Kusano, Eiji; Nagata, Daisuke

    2016-01-01

    Abdominal hernias are a common cause of bowel obstruction. The major types of abdominal hernias are external or abdominal wall hernias, which occur at areas of congenital or acquired weakness in the abdominal wall. An alternative entity is internal hernias, which are characterized by a protrusion of viscera through the peritoneum or mesentery. We herein present the case of a female peritoneal dialysis patient with bowel obstruction due to an internal hernia. Although an initial work-up did not lead to a correct diagnosis, an exploratory laparotomy revealed that she had intestinal herniation due to a defect in the broad ligament of the uterus, which was promptly corrected by surgery. The concerns about the perioperative dialytic management as well as the diagnostic problems regarding the disease that arose in our experience with the present patient are also discussed.

  16. Transitory lupus anticoagulant antibodies leading to a quickly resolvable left ventricular thrombus in a young female patient on peritoneal dialysis.

    Science.gov (United States)

    Koch, M; Beckmann, R

    2009-05-01

    We present a 38-year-old female patient on peritoneal dialysis for 3 years due to mesangioproliferative glomerulonephritis since early adolescence and chronic failure of the right kidney transplants. In early 2006 she was treated with high-dose cortisone due to cryptogenic, organized pneumonia. During a routine echocardiographic examination performed because of occurrence of cerebral symptoms such as diminished visual and auditory acuity in the patient, we detected a mobile, left ventricular thrombus of unusual large size, along with serologically measured Lupus anticoagulant antibodies (LA). The thrombus could be completely lyzed within only 12 hours by urokinese and antithrombotic danaparoid sodium therapy without surgical intervention. Successful treatment was proven by negative LA antibody activity as well as by echocardiography. The general clinical health was greatly improved after rehabilitation 2 months after lysis. We assume that the patient may have had infection- or cortisone-triggered transitory LA antibodies causing the serious heart thrombus with hypokinesia in the apex cordis. PMID:19473621

  17. Metabolite Characterization in Peritoneal Dialysis Effluent Using High-resolution 1H and 1H-13C NMR Spectroscopy

    CERN Document Server

    Guleria, Anupam; Rawat, Atul; Khetrapal, C L; Prasad, Narayan; Kumar, Dinesh

    2014-01-01

    Metabolite analysis of peritoneal dialysis (PD) effluent may provide information regarding onset and progression of complications associated with prolonged PD therapy. In this context, the NMR detectable small metabolites of PD effluent samples were characterized using high resolution 1H and 1H-13C NMR spectroscopy. The various spectra were recorded (at 800 MHz proton frequency) on PD effluent samples obtained after 4 hour (intraperitoneal) dwell time from patients with end stage renal failure (ESRF) and continuing normally on PD therapy. Inspite of devastating spectral feature of PD effluent due to the presence of intense resonances from glucose and lactate, we were able to identify about 53 small endogenous metabolites (including many complex coupled spin systems) and more than 90 % of the total CH cross peaks of 1H-13C HSQC spectrum were identified specific to various metabolites of PD effluent. We foresee that the characteristic fingerprints of various metabolites of control PD effluent samples will be us...

  18. Association of Fetuin-A Levels with Carotid Intima Media Thickness and Valvular Calcification in Hemodialysis and Peritoneal Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Solak, Yalçın

    2013-01-01

    Full Text Available BACKGROUND: Fetuin-A is a negative acute-phase reactant which prevents vascular calcification. Coronary artery disease (CAD is the most important cause of mortality in patients undergoing renal replacement therapy (RRT. The key element of cardiovascular disease (CVD seen in end-stage renal disease patients who are on dialysis treatment is accelerated calcific atherosclerosis. There are a limited number of studies in which HD and PD is compared in terms of fetuin-A level.OBJECTIVE: We aimed to investigate the association of serum fetuin-A level with valvular calcification and predictors of CAD in hemodialysis (HD and peritoneal dialysis (PD patients.MATERIAL and METHODS: 39 HD (24 males, 15 females and 39 PD (25 males, 14 females patients were included in the study. We determined carotid artery intima media thickness (CIMT and evaluated heart valve calcification via echocardiography. We also measured serum fetuin-A level, CRP, ferritin, fibrinogen and serum albumin level. According to fetuin-A level, patients were stratified into quartiles.RESULTS: Fetuin-A level was significantly lower in HD patients when compared with that of PD patients (28.6±5.934 ng/ml, 32±4.8 ng/ml respectively p<0.001. There was a significant negative correlation between CIMT and fetuin-A level. CIMT was found to be lower in PD patients than in HD patients. We found a positive correlation between fetuin-A and dialysis adequacy and albumin level. There was a negative correlation of fetuin-A with age, fibrinogen, ferritin and CRP. Fetuin-A level was lower in patients with aortic calcification.CONCLUSION: Fetuin-A level was found to be lower in HD patients. Fetuin-A may be a novel marker for CVD in patients undergoing RRT.BACKGROUND: Fetuin-A is a negative acute-phase reactant which prevents vascular calcification. Coronary artery disease (CAD is the most important cause of mortality in patients undergoing renal replacement therapy (RRT. The key element of cardiovascular

  19. The Effectiveness of Local Hypothermia and Peritoneal Lavage-Dialysis in the Treatment of Patients with Acute Destructive Pancreatitis

    Directory of Open Access Journals (Sweden)

    Veniamin I. Shaposhnikov, PhD, ScD

    2012-12-01

    Full Text Available The aim of this study was to improve the principles of the pathogenetic therapy of acute pancreatitis and assess the effectiveness of local hypothermia of the pancreas, as well as peritoneal lavage-dialysis in the treatment of acute destructive pancreatitis. A total of 5889 patients with acute pancreatitis (AP were examined. The leading role played by the lesions of the pancreatic lymphatic system in the development of destructive processes was noted. In experiments done on eight dogs, the first day of experimental acute pancreatitis showed necrosis of the lumbar retroperitoneal lymph nodes with a violation of lymph drainage from the pancreas before the retroperitoneal fat necrosis was initiated. The effectiveness of local hypothermia of the pancreas was experimentally demonstrated. In 32 patients with AP, the perioperative local hypothermia of the pancreas for 20-25 minutes was followed by the reduction of the alpha-amylase activity in the peripheral blood and in the portal system, as well as a significant reduction in the edema of the pancreas, that delayed the progression of the destructive lesions. An effective method of performing lavage-dialysis of the omental bursa, by using a transversely perforated tube with a pollution control device in the lumen, was developed.

  20. The CT frequencies of various non-traumatic acute abdominal emergencies in hemodialysis, peritoneal dialysis patients and the general population

    International Nuclear Information System (INIS)

    Purpose: To investigate the frequency of non-traumatic acute abdominal emergencies in end-stage renal disease (ESRD) (peritoneal dialysis (PD) and haemodialysis (HD)) patients and in the general population as diagnosed by computed tomography (CT) imaging. Methods: The abdominal CT findings of ESRD patients with non-traumatic acute abdominal pain during the years 2001–2010 have been retrospectively evaluated. Thirty-three HD (14 females, 19 males, mean age: 62 ± 10.5) and 22 PD patients (12 females, 10 males, mean age: 59 ± 9.4) with acute abdominal pathology based on their CT scans have been included into the study. In addition, 127 individuals (68 females, 59 males, mean age: 40.7 ± 12.8) with normal renal functions who presented with non-traumatic acute abdominal pain diagnosed with an acute abdominal pathology based on their CT scans have been prospectively evaluated during the years 2009–2010. Results: While the most frequent etiology in PD patients was peritonitis (45.4%), acute pancreatitis (13.6%) and perforation (18.1), and in HD patients it was nonocclusive mesenteric ischemia (18.1%) and spontaneous intraabdominal bleeding (21.2%). The basic causes of acute abdomen in the general population were ureteral stone (34.6%) and appendicitis (18.1%). Conclusions: The causes of acute abdominal pain in ESRD patients is significantly different when compared to the general population. And within this special patient population the etiology of acute abdomen differs depending on the renal replacement therapy modality they are receiving. Thus, the causes of acute abdomen in PD patients are mostly peritonitis, acute pancreatitis, and perforation, while being mostly nonocclusive mesenteric ischemia and spontaneous intraabdominal bleeding in patients receiving HD therapy.

  1. 腹膜透析患者的营养管理%Management of nutrition in patients undergoing peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    李伟

    2015-01-01

    Patients undergoing peritoneal dialysis (PD)generally have malnutrition,which is the main reason for low survival,high hospitalization rate,and high mortality rate.The reasons for malnutrition are complex,including inflammation,inadequate dialysis,protein and calorie intake insufficiency,protein loss in the process of dialysis,high peritoneal transport,residual renal function (RRF)decline,chronic acidosis,high catabolism,and complications,that are all involved in the development and progression of malnutrition of PD patients. Malnutrition assessment requires a comprehensive judgement through a combination of history and examination indicators,such as subjective global assessment (SGA),protein nitrogen appearance rate (PNA),biochemical indicators,dual energy x-ray absorptiometry (DEXA),and bioimpedance analysis (BIA).It requires various comprehensive management to improve malnutrition in PD patients,including managing dietary intake,maintainning adequate dialysis dose,protecting RRF,and correcting acidosis;at the same time,attention should be paid to active prevention and treatment of peritonitis,maintainning the best balance of body fluids,using dialysate with good biocompatibility,and using drugs.%腹膜透析(PD)患者普遍存在营养不良,而营养不良是 PD 患者低生存率、高住院率、高死亡率的主要原因。PD 患者营养不良的原因复杂,炎症、透析不充分、蛋白与热量摄入不足、透析过程中蛋白质丢失、腹膜高转运、残余肾功能下降、慢性酸中毒、高分解代谢、各种并发症等,都参与了营养不良的发生发展。营养不良的评估需要结合病史和检查的各项指标来综合判定,如主观全面营养状态评价(SGA)、生化指标、蛋白质相当的总氮呈现率(PNA)、双能 X 射线吸收法(DEXA)、生物电阻抗分析(BIA)等。改善 PD 患者的营养不良需要进行多方面综合管理,如管理膳食摄入、保持足够的透

  2. Association between ambient carbon monoxide and secondary hyperparathyroidism in nondiabetic patients undergoing peritoneal dialysis

    OpenAIRE

    Weng CH; Hu CC; Yen TH; Huang WH

    2015-01-01

    Cheng-Hao Weng,1,2 Ching-Chih Hu,3 Tzung-Hai Yen,1,2 Wen-Hung Huang1,2 1Department of Nephrology, Division of Clinical Toxicology, Chang Gung Memorial Hospital, Linkou, 2College of Medicine, Chang Gung University, Taoyuan, 3Liver Research Unit, Department of Hepatogastroenterology, Chang Gung Memorial Hospital, Keelung, Taiwan Background: Secondary hyperparathyroidism (SHPT) is a major disorder in patients with chronic renal disease with or without dialysis. Air pollution has been confirmed...

  3. Key Factors for a High-Quality Peritoneal Dialysis Program — The Role of the PD Team and Continuous Quality Improvement

    Science.gov (United States)

    Fang, Wei; Ni, Zhaohui; Qian, Jiaqi

    2014-01-01

    The proportion of end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) has increased very fast in China over the last decade. Renji Hospital, affiliated with Shanghai Jiaotong University School of Medicine, is a recognized high-quality PD unit with a high PD utilization rate, excellent patient and technique survival (1-year and 5-year patient survival rate of 93% and 71%, and 1-year and 5-year technique survival of 96% and 82%, respectively), low peritonitis rate and a well-documented good quality of life of the treated patients. We believe that a dedicated and experienced PD team, a structured patient training program, continuous patient support, establishing and utilizing standardized protocols, starting PD with low dialysis dose, monitoring key performance indicators (KPIs), and continuous quality improvement (CQI) are the key factors underlying this successful PD program. PMID:24962961

  4. Key factors for a high-quality peritoneal dialysis program--the role of the PD team and continuous quality improvement.

    Science.gov (United States)

    Fang, Wei; Ni, Zhaohui; Qian, Jiaqi

    2014-06-01

    The proportion of end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) has increased very fast in China over the last decade. Renji Hospital, affiliated with Shanghai Jiaotong University School of Medicine, is a recognized high-quality PD unit with a high PD utilization rate, excellent patient and technique survival (1-year and 5-year patient survival rate of 93% and 71%, and 1-year and 5-year technique survival of 96% and 82%, respectively), low peritonitis rate and a well-documented good quality of life of the treated patients. We believe that a dedicated and experienced PD team, a structured patient training program, continuous patient support, establishing and utilizing standardized protocols, starting PD with low dialysis dose, monitoring key performance indicators (KPIs), and continuous quality improvement (CQI) are the key factors underlying this successful PD program. PMID:24962961

  5. Hemodialysis versus Peritoneal Dialysis: A Comparison of Survival Outcomes in South-East Asian Patients with End-Stage Renal Disease.

    Directory of Open Access Journals (Sweden)

    Fan Yang

    Full Text Available Studies comparing patient survival of hemodialysis (HD and peritoneal dialysis (PD have yielded conflicting results and no such study was from South-East Asia. This study aimed to compare the survival outcomes of patients with end-stage renal disease (ESRD who started dialysis with HD and PD in Singapore.Survival data for a maximum of 5 years from a single-center cohort of 871 ESRD patients starting dialysis with HD (n = 641 or PD (n = 230 from 2005-2010 was analyzed using the flexible Royston-Parmar (RP model. The model was also applied to a subsample of 225 propensity-score-matched patient pairs and subgroups defined by age, diabetes mellitus, and cardiovascular disease.After adjusting for the effect of socio-demographic and clinical characteristics, the risk of death was higher in patients initiating dialysis with PD than those initiating dialysis with HD (hazard ratio [HR]: 2.08; 95% confidence interval [CI]: 1.67-2.59; p<0.001, although there was no significant difference in mortality between the two modalities in the first 12 months of treatment. Consistently, in the matched subsample, patients starting PD had a higher risk of death than those starting HD (HR: 1.73, 95% CI: 1.30-2.28, p<0.001. Subgroup analysis showed that PD may be similar to or better than HD in survival outcomes among young patients (≤65 years old without diabetes or cardiovascular disease.ESRD patients who initiated dialysis with HD experienced better survival outcomes than those who initiated dialysis with PD in Singapore, although survival outcomes may not differ between the two dialysis modalities in young and healthier patients. These findings are potentially confounded by selection bias, as patients were not randomized to the two dialysis modalities in this cohort study.

  6. 品管圈活动在降低腹膜透析腹膜炎发生率中的应用%Application of quality control circle activity on reducing the incidence rate of peritoneal dialysis peritonitis

    Institute of Scientific and Technical Information of China (English)

    刘晓晨; 陈秀荣; 张兰

    2016-01-01

    目的:探讨品管圈在降低腹膜透析腹膜炎发生率中的应用效果.方法:选择2013年1~12月在肾内科住院后出院进行居家腹膜透析的患者70例为对照组,选择2014年1~12月在肾内科住院后出院进行居家腹膜透析的患者78例为观察组,两组患者均给予常规的护理措施,观察组在常规护理措施的基础上开展品管圈活动,即成立品管圈活动小组,确定活动主题,进行现状调查、分析原因、设定目标、制定对策并实施,比较两组患者腹膜透析腹膜炎的发生率.结果:观察组患者腹膜透析腹膜炎的发生率低于对照组(P<0.05).结论:将品管圈活动应用于腹膜透析患者的教育培训中,通过成员间的相互协作,找出问题发生的原因并进行分析,设定目标并制定对策进行实施,可以降低患者腹膜炎的发生率,促进护理工作质量的持续改进.%Objective:To discuss the application effect of quality control circle on reducing the incidence rate of peritoneal dialysis peritonitis. Methods:Se-lected 70 cases of patients taking house peritoneal dialysis after being hospitalized in nephrology department in January-December 2013 as control group;selected 78 cases of patients taking house peritoneal dialysis after being hospitalized in nephrology department in January- December 2014 as observation group. Two groups patients were given conventional nursing management. The observation group undertook quality control circle based on the conventional nursing management, namely,established quality control circle activity group,determined activity theme,made status survey, analyzed reason,set objec-tives,developed and carried measures and compared the incidence rate of peritoneal dialysis peritonitis of two groups patients. Results:The incidence rate of peritoneal dialysis peritonitis of observation group was lower than that of control group (P<0. 05). Conclusion:Through the mutual cooperation of members, finding and

  7. Meal phosphate variability does not support fixed dose phosphate binder schedules for patients treated with peritoneal dialysis: a prospective cohort study

    OpenAIRE

    Leung, Simon; McCormick, Brendan; Wagner, Jessica; Biyani, Mohan; Lavoie, Susan; Imtiaz, Rameez; Zimmerman, Deborah

    2015-01-01

    Background Removal of phosphate by peritoneal dialysis is insufficient to maintain normal serum phosphate levels such that most patients must take phosphate binders with their meals. However, phosphate ‘counting’ is complicated and many patients are simply prescribed a specific dose of phosphate binders with each meal. Therefore, our primary objective was to assess the variability in meal phosphate content to determine the appropriateness of this approach. Methods In this prospective cohort s...

  8. Continuous Ambulatory Peritoneal Dialysis Patients Show High Prevalence of Carotid Artery Calcification which is Associated with a Higher Left Ventricular Mass Index

    OpenAIRE

    Oh, Dong-Jin

    2005-01-01

    This study examined intima-media thickness and arterial plaque occurrence in the carotid and brachial arteries in continuous ambulatory peritoneal dialysis (CAPD) patients. The study compared 25 CAPD patients with 25 normotensive age- and sex-matched controls. Intima-media thickness and presence of plaque in carotid and brachial artery were measured three times using high-resolution B-mode echocardiography. Left ventricular mass was calculated using the Penn Convection equation. Blood samples...

  9. Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment

    OpenAIRE

    Tomaras V; Synodinou C; Theofilou P; Ginieri-Coccossis M; Soldatos C

    2008-01-01

    Abstract Background The study examines differences regarding quality of life (QoL), mental health and illness beliefs between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD/PD) patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods 144 End-Stage Renal Disease (ESRD) patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Pat...

  10. Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment

    OpenAIRE

    Ginieri-Coccossis, M; Theofilou, P; Synodinou, C; Tomaras, V; Soldatos, C

    2008-01-01

    Background The study examines differences regarding quality of life (QoL), mental health and illness beliefs between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD/PD) patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods 144 End-Stage Renal Disease (ESRD) patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients con...

  11. Lower Residual Renal Function is a Risk Factor for Depression and Impaired Health-Related Quality of Life in Korean Peritoneal Dialysis Patients

    OpenAIRE

    Park, Hayne Cho; Lee, Hajeong; Lee, Jung Pyo; Kim, Dong Ki; Oh, Kook-Hwan; Joo, Kwon Wook; Lim, Chun Soo; Kim, Yon Su; Ahn, Curie; Oh, Yun Kyu

    2011-01-01

    We retrospectively evaluated demographic and biochemical parameters associated with depression and health-related quality of life (HRQOL) in maintenance peritoneal dialysis (PD) patients. This study included 105 patients maintaining PD at Seoul National University Hospital. Data were collected from electronic medical record. Korean Beck's Depression Inventory and Korean version of Kidney Disease Quality of Life short form, version 1.3 were used to evaluate depression and HRQOL, respectively. ...

  12. Accumulation of epicardial fat rather than visceral fat is an independent risk factor for left ventricular diastolic dysfunction in patients undergoing peritoneal dialysis

    OpenAIRE

    Lin, Heng-Hsu; Lee, Jen-Kuang; Yang, Chung-Yi; Lien, Yu-Chung; Huang, Jenq-Wen; Wu, Cho-Kai

    2013-01-01

    Background Symptoms of heart failure with preserved left ventricular systolic function are common among patients undergoing peritoneal dialysis (PD). Epicardial fat (EpF) is an ectopic fat depot with possible paracrine or mechanical effects on myocardial function. The aim of our current study is to assess the association between EpF and Left ventricular diastolic dysfunction (LVDD) in patients undergoing PD and to clarify the relationships among EpF, inflammation, and LVDD in this population....

  13. Cost-effectiveness of hemodialysis and peritoneal dialysis: A national cohort study with 14 years follow-up and matched for comorbidities and propensity score.

    Science.gov (United States)

    Chang, Yu-Tzu; Hwang, Jing-Shiang; Hung, Shih-Yuan; Tsai, Min-Sung; Wu, Jia-Ling; Sung, Junne-Ming; Wang, Jung-Der

    2016-01-01

    Although treatment for the dialysis population is resource intensive, a cost-effectiveness analysis comparing hemodialysis (HD) and peritoneal dialysis (PD) by matched pairs is still lacking. After matching for clinical characteristics and propensity scores, we identified 4,285 pairs of incident HD and PD patients from a Taiwanese national cohort during 1998-2010. Survival and healthcare expenditure were calculated by data of 14-year follow-up and subsequently extrapolated to lifetime estimates under the assumption of constant excess hazard. We performed a cross-sectional EQ-5D survey on 179 matched pairs of prevalent HD and PD patients of varying dialysis vintages from 12 dialysis units. The product of survival probability and the mean utility value at each time point (dialysis vintage) were summed up throughout lifetime to obtain the quality-adjusted life expectancy (QALE). The results revealed the estimated life expectancy between HD and PD were nearly equal (19.11 versus 19.08 years). The QALE's were also similar, whereas average lifetime healthcare costs were higher in HD than PD (237,795 versus 204,442 USD) and the cost-effectiveness ratios for PD and HD were 13,681 and 16,643 USD per quality-adjusted life year, respectively. In conclusion, PD is more cost-effective than HD, of which the major determinants were the costs for the dialysis modality and its associated complications. PMID:27461186

  14. Characteristics of left ventricular hypertrophy estimated by MIBG and BMIPP cardiac scintigraphy in patients undergoing peritoneal dialysis

    Energy Technology Data Exchange (ETDEWEB)

    Ohashi, Hiroshige; Oda, Hiroshi; Ohno, Michiya; Watanabe, Sachirow; Kotoo, Yasunori; Matsuno, Yukihiko [Gifu Prefectural Hospital (Japan)

    2002-12-01

    Left ventricular hypertrophy (LVH) has been reported as a major factor in morbidity and mortality in chronic dialysis patients. However, cardiovascular mortality in peritoneal dialysis (PD) patients with LVH is substantially similar to that in hemodialysis (HD) patients. The present study sought to study whether sympathetic nerve activity and fatty acid metabolism of the myocardium estimated by {sup 123}I metaiodobenzylguanidine (MIBG) and {sup 123}I {beta}-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) myocardial scintigraphy are impaired or not in PD patients with LVH. The underlying disease of 45 PD patients enrolled in this study was chronic glomerulonephritis in all cases. Serum levels of natriuretic peptides (arterial natriuretic peptide (ANP), brain natriuretic peptide (BNP)) and free carnitine and MIBG, BMIPP myocardial scintigraphy and 2-dimensional echocardiography were measured in these 45 PD patients. The following results were obtained. The prevalence of increased left ventricular mass index (LVMI) was 84.4%. LVMI correlated with age, and serum levels of ANP and BNP, and inversely correlated with a heart-to-mediastinum ratio (H/M) estimated by MIBG and BMIPP myocardial scintigraphy. Percentages of the normal image of MIBG and BMIPP measured with a single photon emission computed tomography (SPECT) were 37.8% and 62.2%, respectively. The PD patients showing the diffuse defect of MIBG or BMIPP imaging had the decrease in left ventricular ejection fraction (LVEF). Especially, the serum level of free carnitine was reduced in the PD patients with diffuse defect of BMIPP SPECT. From these results, we concluded that PD patients with LVH showed impaired sympathetic nerve activity and fatty acid metabolism of the myocardium. Metabolic and functional disturbances of the myocardium may influence mortality in PD patients. (author)

  15. Characteristics of left ventricular hypertrophy estimated by MIBG and BMIPP cardiac scintigraphy in patients undergoing peritoneal dialysis

    International Nuclear Information System (INIS)

    Left ventricular hypertrophy (LVH) has been reported as a major factor in morbidity and mortality in chronic dialysis patients. However, cardiovascular mortality in peritoneal dialysis (PD) patients with LVH is substantially similar to that in hemodialysis (HD) patients. The present study sought to study whether sympathetic nerve activity and fatty acid metabolism of the myocardium estimated by 123I metaiodobenzylguanidine (MIBG) and 123I β-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) myocardial scintigraphy are impaired or not in PD patients with LVH. The underlying disease of 45 PD patients enrolled in this study was chronic glomerulonephritis in all cases. Serum levels of natriuretic peptides (arterial natriuretic peptide (ANP), brain natriuretic peptide (BNP)) and free carnitine and MIBG, BMIPP myocardial scintigraphy and 2-dimensional echocardiography were measured in these 45 PD patients. The following results were obtained. The prevalence of increased left ventricular mass index (LVMI) was 84.4%. LVMI correlated with age, and serum levels of ANP and BNP, and inversely correlated with a heart-to-mediastinum ratio (H/M) estimated by MIBG and BMIPP myocardial scintigraphy. Percentages of the normal image of MIBG and BMIPP measured with a single photon emission computed tomography (SPECT) were 37.8% and 62.2%, respectively. The PD patients showing the diffuse defect of MIBG or BMIPP imaging had the decrease in left ventricular ejection fraction (LVEF). Especially, the serum level of free carnitine was reduced in the PD patients with diffuse defect of BMIPP SPECT. From these results, we concluded that PD patients with LVH showed impaired sympathetic nerve activity and fatty acid metabolism of the myocardium. Metabolic and functional disturbances of the myocardium may influence mortality in PD patients. (author)

  16. Cerebral blood flow changes in hemodialysis and peritoneal dialysis patients: an arterial-spin labeling MR imaging.

    Science.gov (United States)

    Jiang, Xiao Lu; Wen, Ji Qiu; Zhang, Long Jiang; Zheng, Gang; Li, Xue; Zhang, Zhe; Liu, Ya; Zheng, Li Juan; Wu, Long; Chen, Hui Juan; Kong, Xiang; Luo, Song; Lu, Guang Ming; Ji, Xue Man; Zhang, Zong Jun

    2016-08-01

    We used arterial-spin labeling (ASL) MR imaging, a non-invasive technique to evaluate cerebral blood flow (CBF) changes in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis (PD) and hemodialysis (HD), and nondialysis ESRD patients compared with healthy cohort. Ninety seven ESRD patients including 32 PD patients (20 male, 12 female; mean age 33 ± 8 years), 33 HD patients (22 male, 11 female; mean age 33 ± 8 years) and 32 nondialysis patients (20 male, 12 female; mean age 35 ± 7 years) and 31 age- and gender-matched healthy controls (20 male, 11 female; mean age 32 ± 8 years) were included in this study. All subjects underwent ASL MR imaging, neuropsychologic tests, and ESRD patients underwent laboratory testing. CBF values were compared among PD, HD, nondialysis patients and control groups. Correlation analysis and multiple regression analysis were performed to investigate the association between CBF values and hemoglobin, neuropsychologic test results, serum creatinine, urea levels, disease duration, and dialysis duration. Elevated CBFs of whole brain region, gray matter, and white matter were found in all ESRD patient groups compared with healthy controls (all P differences for CBF between PD and HD patient groups. Negative correlations were observed between mean CBFs of whole brain region, gray matter, and white matter and the hemoglobin level in all ESRD patients. Multiple linear regression showed elevated CBF of multiple brain areas correlated with some neuropsychological tests in ESRD patients (all P differences of CBF change and cognitive function between PD and HD ESRD patients with long-term treatment. The degree of anemia may be a predominant risk factor for cognitive impairment in these ESRD patients. PMID:27167984

  17. Comparison of markers of oxidative stress, inflammation and arterial stiffness between incident hemodialysis and peritoneal dialysis patients – an observational study

    Directory of Open Access Journals (Sweden)

    Ratanjee Sharad

    2009-03-01

    Full Text Available Abstract Background Patients on peritoneal and hemodialysis have accelerated atherosclerosis associated with an increase in cardiovascular morbidity and mortality. The atherosclerosis is associated with increased arterial stiffness, endothelial dysfunction and elevated oxidative stress and inflammation. The aims of this study are to investigate the effects of peritoneal and hemodialysis on arterial stiffness, vascular function, myocardial structure and function, oxidative stress and inflammation in incident patients with end stage kidney disease. Methods This is an observational study. Eighty stage five CKD patients will be enrolled and followed for one-year. Primary outcome measures will be changes in 1 arterial stiffness measured by aortic pulse wave velocity, 2 oxidative stress assessed by plasma F2 isoprostanes and 3 inflammation measured by plasma pentraxin-3. Secondary outcomes will include additional measures of oxidative stress and inflammation, changes in vascular function assessed using the brachial artery reactivity technique, carotid artery intimal medial thickness, augmentation index and trans thoracic echocardiography to assess left ventricular geometry, and systolic and diastolic function. Patients will undergo these measures at baseline (6–8 weeks prior to starting dialysis therapy, then at six and 12 months after starting dialysis. Discussion The results of this study may guide the choice of dialysis modality in the first year of treatment. It may also lead to a larger study prospectively assessing the effect of dialysis modality on cardiovascular morbidity and mortality. Trial Registration ACTRN12609000049279

  18. Effects of Improving Physical Activity Level on Quality of Life and Functional Status of Patients Receiving Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Deran OSKA

    2014-01-01

    Full Text Available OBJECTIVE: The aim of this study was to determine whether patients receiving peritoneal dialysis (PD experience an improvement in physical activity, quality of life and functional status as a result of exercise training at home by motivation about benefi ts of exercising. MATERIAL and METHODS: Twenty-one PD patients of 46.7±14.1 years participated in the study. Participants were encouraged by a physiotherapist to walk for 30 minutes, 3 days a week and motivated by explaining benefi ts of exercising. We assessed quality of life by Kidney Disease Quality of Life Questionnaire-Turkish Version (KDQOL-SF, functional status by Six Minute Walk Test (SMW, physical activity level by International Physical Activity Questionnaire – Long Form (IPAQ-LF. The antropometric measurements were performed with the bioelectrical impedance. Assessments were done at the beginning and 3 months later. RESULTS: Total physical activity score of IPAQ-LF increased signifi cantly 3 months later (p0.05. Improvements in pain and emotional score of KDQOL-SF were statistically signifi cant (p<0.05. CONCLUSION: Regular exercise should be allocated in the PD standard care. Participation of the patient into such a program could be possible by explaining the benefi ts of exercising at the beginning of the treatment.

  19. Serum Hepcidin Levels and Reticulocyte Hemoglobin Concentrations as Indicators of the Iron Status of Peritoneal Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Aya Eguchi

    2012-01-01

    Full Text Available Hepcidin is the key mediator of renal anemia, and reliable measurement of serum hepcidin levels has been made possible by the ProteinChip system. We therefore investigated the iron status and serum hepcidin levels of peritoneal dialysis (PD patients who had not received frequent doses of an erythrocytosis-stimulating agent (ESA and had not received iron therapy. In addition to the usual iron parameters, the iron status of erythrocytes can be determined by measuring reticulocyte hemoglobin (RET-He. The mean serum hepcidin level of the PD patients (n=52 was 80.7 ng/mL. Their serum hepcidin levels were significantly positively correlated with their serum ferritin levels and transferrin saturation (TSAT levels, but no correlations were found between their serum hepcidin levels and RET-He levels, thereby suggesting that hepcidin has no effect on the iron dynamics of reticulocytes. Since low serum levels of CRP and IL-6, biomarkers of inflammation, were not correlated with the serum hepcidin levels, there is likely to be a threshold for induction of hepcidin expression by inflammation.

  20. Evaluation of the Relationship of Hepcidin Levels with Anemia and Inflammatory Markers in Patients on Peritoneal Dialysis: A Controlled Study

    Directory of Open Access Journals (Sweden)

    Zeki AYDIN

    2012-01-01

    Full Text Available OBJECTIVE: Hepcidin, a small peptide hormone synthesized in the liver, plays a central role in the regulation of iron metabolism. In addition, it acts as an intermediary in body defense and inflammation. Our aim in this study was to investigate the relationship of hepsidin levels with inflammation and iron indices in patients on peritoneal dialysis (PD.MATERIAL and METHODS: Nondiabetic PD patients were involved. Primary kidney disease, biochemical parameters, complete blood count, iron, total iron binding capacity (TIBC, ferritin, high sensitive C-reactive protein (hsCRP, fibrinogen, parathormone, interleukin (IL-6 and hepcidin levels were recorded as well as demographic parameters.RESULTS: Twenty-one PD patients (mean age 47.7±12.1 years and 17 healthy volunteers (mean age 54.0±7.2 years were involved. HepCidin levels were higher in the PD group (148.2±35.0 vs. 93.8±21.9; p<0.001. There was a positive correlation of hepcidin with urea, creatinine, phosphorus, ferritin, fibrinogen, IL-6 and parathormone; and a negative correlation with albumin, transaminases, calcium, TIBC, GFR, hemoglobin and hematocrit levels.CONCLUSION: Hepcidin levels increase with deepening anemia and show a positive correlation with inflammatory markers. Theurapeutic interventions regarding the effects of hepcidin on inflammatory status may play a role in the treatment of anemia due to inflammation. It may be beneficial to measure hepcidin levels together with ferritin, especially in patients with functional iron defficiency.

  1. Effect of Peritoneal Dialysis Treatment on Left Ventricular Systolic and Diastolic Functions in Patients with End-Stage Renal Disease

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    Feridun KAVUNCUOĞLU

    2014-09-01

    Full Text Available OBJECTIVE: To analyze the effect of peritoneal dialysis (PD treatment on left ventricular systolic and diastolic function in patients with end-stage renal disease (ESRD. MATERIAL and METHODS: The study population consisted of 51 patients with ESRD. Before a PD catheter was inserted, the patients were evaluated by echocardiography and Doppler tissue imaging (DTI. Then, a PD catheter was inserted. After 6 months, the second echocardiographic evaluations were performed. Left ventricular systolic and diastolic function parameters were compared. RESULTS: The mean age was 47 ± 13 years and 38 (74.5% of the patients were male. No significant difference was found in echocardiographic parameters including ejection fraction, fractional shortening, left ventricular mass, left ventricular mass index, left ventricular posterior wall thickness, inter ventricular septal thickness, left atrial diameter, early diastolic filling/late diastolic filling ratio before and after the period of PD. Left ventricular end-systolic diameter and left ventricular end-diastolic diameter values were significantly lower found in the period after PD. CONCLUSION: Our findings appear to reflect somewhat the favourable changes in LV diastolic and systolic functions in PD patients.

  2. Desenvolvimento e avaliação da esterilidade de sistema de diálise peritoneal pediátrico fechado Development and assessment of sterility of a closed-system pediatric peritoneal dialysis

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    Ana Paula Pereira Biazi

    2009-03-01

    Full Text Available OBJETIVO: Desenvolver um sistema de diálise peritoneal pediátrico totalmente fechado, de fácil manejo e avaliar o nível de garantia de esterilidade. MÉTODOS: No período de fevereiro a dezembro de 2008, foi idealizado e desenvolvido junto ao Setor de Bioengenharia da Braile Biomédica Indústria, Comércio e Representações S/A® um sistema de diálise peritoneal pediátrico fechado. Foram construídos 20 sistemas submetidos a testes quanto à garantia do nível de esterilidade, sendo divididos em grupo A (n=10, utilizando-se teste de esterilidade, e B (n=10, penetração do gás óxido de etileno. RESULTADOS: No grupo A, o teste de esterilidade foi negativo para a proliferação de bactérias e fungos em 14 dias, em todos os sistemas. No grupo B, o teste de penetração de gás demonstrou que houve penetração de gás em todos os pontos avaliados. CONCLUSÃO: Foi possível desenvolver um novo sistema de diálise peritoneal pediátrico fechado de fácil manuseio e garantir sua esterilização.OBJECTIVE: To develop an easy-handling totally closed pediatric peritoneal dialysis system and assess the sterility assurance level. METHODS: From February to December 2008 was designed and developed a closed-system pediatric peritoneal dialysis at the Bioengineering Division of Braile Biomédica Indústria, Comércio e Representações S/A®. Twenty systems were manufactured and submitted to sterility assurance level testing, and were divided into Group A (10 - using the sterility test - and B (10 - ethylene oxide gas penetration. RESULTS: In Group A, the sterility test was negative for bacteria and fungi proliferation within 14 days in all systems. In Group B, the gas penetration test showed that there was gas penetration in all points assessed. CONCLUSIONS: It was possible to develop a new easy-handling closed-system pediatric peritoneal dialysis and ensure its sterility.

  3. Hemodialysis versus peritoneal dialysis: a case control study of survival in patients with chronic kidney disease stage 5

    DEFF Research Database (Denmark)

    Maier, Alexandra; Stocks, Franziska; Pommer, Wolfgang;

    2009-01-01

    It is still controversial whether the mode of dialysis or preexisting comorbidities may influence the prognosis of patients with chronic kidney disease stage 5. Therefore, we performed a prospective case control study to evaluate whether the mode of dialysis may influence outcome. We found 25 cases...... dialysis, predicted death in patients with chronic kidney disease. It is concluded that age and comorbidities but not mode of dialysis are important to predict survival in patients with chronic kidney disease stage 5....

  4. Resorption and tolerance of the high doses of ferrous sulfate and ferrous gluconate in the patients on peritoneal dialysis

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    Laušević Mirjana

    2006-01-01

    Full Text Available Background/Aim. Iron supplementation plays a crucial role in peritoneal dialysis (PD patients. Oral iron substitution is more convenient than intravenous therapy in PD patients, but impaired absorption and adverse effects may be limiting factors for oral treatment. The aim of this study was to compare the absorption and side effects of high doses ferrous sulphate and ferrous gluconate in PD patients. Methods. Blood samples were taken from 29 PD patients at baseline, as well as 2, 4 and 8 hours after oral intake of 4 ferrous sulphate tablets (containing 105 mg elemental iron per tablet. The test was repeated using 8 ferrous gluconate drinkable ampoules (containing 50 mg elemental iron per ampoule. Results. The maximal increase in serum iron level during the test with iron sulphate was 113.51±103.37% versus the initial values of 183.87±37.38% during the ferrous gluconate test. The maximal values of serum iron after the intake of ferrous sulphate were 26.23±9.95 µmol/l versus 30.97±8.65 µmol/l after the intake of ferrous gluconate. There was a statistically significant difference between these two groups. Six patients showed an increase in serum iron of more than 300% after a high ferrous gluconate dose, while in 15 of the patients serum iron increased between 100% and 300%, and in 8 of the patients serum iron levels increased by less than 100%. Side effects occurred more frequently after the intake of ferrous sulphate than ferrous gluconate. Conclusion. High doses of oral iron were well absorbed and tolerated in PD patients. Ferrous gluconate was better absorbed and tolerated than ferrous sulphate, thus we recommend it for oral iron supplementation in PD patients.

  5. The influence of simvastatin in induced peritoneal fibrosis in rats by peritoneal dialysis solution with glucosis 4.25% Influência da sinvastatina na fibrose peritoneal induzida em ratos pelo uso de solução de diálise peritoneal com glicose a 4,25%

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    Gilberto Baroni

    2012-04-01

    Full Text Available PURPOSE: To investigate the influence of using simvastatin on the peritoneal fibrosis induced in rats using peritoneal dialysis solution with glucoses 4.25%. METHODS: Prospective controlled study in 20 non-uremic Wistar rats. The animals received a peritoneal infusion of 10 ml/100 g of peritoneal dialysis solution glucose 4.25% on a daily basis. The animals were divided in two groups: experimental and control. The experimental group received simvastatin 4 mg/kg/d, by a gastric tube. The control group did not receive any drug. The follow-up was 21 and 49 days. At the end, one surgical procedure was performed to get histological samples of visceral and parietal peritoneum. The samples were analyzed using Hematoxylin Eosin and Sirius Red, to evaluate the severity of the fibrosis. RESULTS: The analysis showed that the intensity of the fibrosis, the peritoneal thickness and the cell number in experimental and control groups were not statistically significant different in experimental and control groups. CONCLUSION: The simvastatin do not decrease the intensity of fibrosis on the peritoneal membrane that happens on rats on peritoneal dialysis.OBJETIVO: Investigar a influência do uso da sinvastatina na fibrose peritoneal induzida em ratos pelo uso de solução de diálise peritoneal rica em glicose. MÉTODOS: Estudo prospectivo controlado, em ratos Wistar não urêmicos. Foram estudados 20 animais. Os animais foram submetidos diariamente à punção abdominal, sendo infundida solução de diálise peritoneal com glicose a 4,25% na dose de 10 ml/100 g de peso. Os animais foram divididos em dois grupos: experimental e controle. O grupo experimental recebeu sinvastatina na dose de 4 mg/kg/dia por gavagem. O grupo controle não recebeu nenhuma droga. Foram acompanhados por 21 e 49 dias. Ao final do período foram submetidos à procedimento cirúrgico para retirada de peritônio parietal e visceral. As amostras obtidas foram analisadas histologicamente

  6. Periton Diyalizi Hastasında Kolonoskopi Sonrası Gelişen Peritonit

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    Ali TAMER

    2012-01-01

    Full Text Available Peritonitis in peritoneal dialysis patients after colonoscopy is a rare complication. We present a peritoneal dialysis patient who developed peritonitis shortly after colonoscopy together with a discussion on diagnosis, management and the current literature.

  7. Relationship between Kt/V urea-based dialysis adequacy and nutritional status and their effect on the components of the quality of life in incident peritoneal dialysis patients

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    Chen Jin-Bor

    2012-06-01

    Full Text Available Abstract Background It is well known that the quality of life of patients with chronic kidney disease can be improved by dialysis. While previous studies have used retrospective designs and adhered to a standard target prescribed by clinical guidelines, our study prospectively investigates the association between the adequacy of peritoneal dialysis (PD and measures of nutritional status on quality-of-life domains in a cohort of incident PD patients. Methods It was a prospective 6-month observational study. Eighty incident PD participants who were treated in a hospital-based PD center were enrolled. The period of enrollment was January 2009–June 2010; follow-up continued until December 2010. PD adequacy indices, including Kt/V urea, weekly Ccr (WCcr, measures of nutritional status (albumin, BMI, and nPCR were measured at 1 month and 6 months after PD initiation. SF-36 health survey questionnaires were used to measure the quality of life. The outcomes were used to measure the changes in the domains of the SF-36 after 6 months of PD therapy. Results Seventy-seven incident patients who underwent PD for 6 months were included in the study. The mean age was 47.3 years, and the male-to-female ratio was 38:39. A peritoneal Kt/V urea value of 1.2, which was also the baseline cutoff value, was found to have the highest influence on SF-36 domains. Patients with baseline peritoneal Kt/V urea value of Limitations A small cohort and a short observation period. Conclusions The baseline level of peritoneal Kt/V urea affected the components of the quality of life after PD initiation. In contrast, a lower baseline nPCR level was associated with deterioration in the quality of life after PD therapy.

  8. Factors Associated with the Serum Myostatin Level in Patients Undergoing Peritoneal Dialysis: Potential Effects of Skeletal Muscle Mass and Vitamin D Receptor Activator Use.

    Science.gov (United States)

    Yamada, Shunsuke; Tsuruya, Kazuhiko; Yoshida, Hisako; Tokumoto, Masanori; Ueki, Kenji; Ooboshi, Hiroaki; Kitazono, Takanari

    2016-07-01

    Myostatin is a member of the transforming growth factor-β family, which regulates synthesis and degradation of skeletal muscle proteins and is associated with the development of sarcopenia. It is up-regulated in the skeletal muscle of chronic kidney disease patients and is considered to be involved in the development of uremic sarcopenia. However, serum myostatin levels have rarely been determined, and the relationship between serum myostatin levels with clinical and metabolic factors remains unknown. This cross-sectional study investigated the association between serum myostatin level and clinical factors in 69 outpatients undergoing peritoneal dialysis. Serum myostatin level was determined by commercially available enzyme-linked immunosorbent assay (ELISA). Univariable and multivariable analysis were conducted to determine factors associated with serum myostatin levels. The factors included age, sex, diabetes mellitus, dialysis history, body mass index, residual kidney function, peritoneal dialysate volume, serum biochemistries, and the use of vitamin D receptor activators (VDRAs). Mean serum myostatin level was 7.59 ± 3.37 ng/mL. There was no association between serum myostatin level and residual kidney function. Serum myostatin levels were significantly and positively associated with lean body mass measured by the creatinine kinetic method and negatively associated with the use of VDRAs after adjustment for potential confounding factors. Our study indicated that serum myostatin levels are associated with skeletal muscle mass and are lower in patients treated with VDRAs. Further studies are necessary to determine the significance of measuring serum myostatin level in patients undergoing peritoneal dialysis. PMID:26895008

  9. Spontaneous retroperitoneal hemorrhage presenting as hemoperitoneum secondary to renal cyst rupture in a peritoneal dialysis patient with acquired cystic kidney disease.

    Science.gov (United States)

    Biyik, Z; Solak, Y; Gaipov, A; Ozbek, O; Esen, H; Turk, S

    2015-01-01

    Spontaneous retroperitoneal hemorrhage (SRH) is a rare and potentially fatal condition. Acquired cystic kidney disease (ACKD) may cause SRH in hemodialysis patients. However, presentation of retroperitoneal hematoma as hemoperitoneum in peritoneal dialysis (PD) patients is exceedingly rare. We report a 44-year-old male PD patient who presented with hemoperitoneum secondary to retroperitoneal hematoma. The reason of SRH was rupture of the cysts of ACKD. The patient underwent unilateral nephrectomy with subsequent disappearance of hemoperitoneum. The importance of this case lies in the fact that the patients who have been receiving dialysis for a long time should be under surveillance in terms of ACKD development and potential associated complications such as cyst hemorrhage and malignancy. PMID:26199480

  10. The Influence Factors Analysis of Itchy Skin for Peritoneal Dialysis Patients%腹膜透析患者皮肤瘙痒影响因素分析

    Institute of Scientific and Technical Information of China (English)

    翁文娟; 陈东晓

    2015-01-01

    目的:探讨腹膜透析患者皮肤瘙痒影响因素。方法:选取2013年1月-2015年1月广东省汕头大学医学院第二附属医院肾内科住院部腹膜透析随访患者126例,采用问卷调查方式采集临床资料,采用单因素与Logistic多因素回归分析腹膜透析患者皮肤瘙痒影响因素。结果:皮肤瘙痒累及全身各个部位,常见的受累部位为背部、腹部、头部、四肢,分别占69.84%、46.03%、43.65%、42.86%,对称性皮肤瘙痒占84.92%,泛发性皮肤瘙痒(累及全身皮肤≥50%)占25.40%。皮肤瘙痒持续时间(t)<1个月、1个月≤t<6个月、6个月≤t<1年、t≥1年分别占7.14%、42.86%、10.32%、39.68%。126例腹膜透析患者中皮肤瘙痒发生率为61.11%(77/126),单因素分析结果显示,腹膜透析患者皮肤瘙痒与年龄、糖尿病、腹膜透析时间、皮肤干燥、城市居民、睡眠质量、家务劳动、合并不良情绪及血磷、钙磷乘积及血清PTH水平相关(P<0.05)。Logistic多因素回归分析显示,年龄≥50岁、糖尿病、腹膜透析时间和血清PTH水平是腹膜透析患者皮肤瘙痒患者的独立危险因素(P<0.001)。结论:腹膜透析患者皮肤瘙痒主要受年龄、腹膜透析时间及血清PTH水平等多种因素影响。%Objective:To investigate the influence factors of itchy skin for peritoneal dialysis patients. Method:126 peritoneal dialysis patients in the nephrology department of the Second Affiliated Hospital of Shantou University Medical College from January 2013 to January 2015 were selected,the clinical data were collected by questionnaire survey method,the influence factors analysis of itchy skin for peritoneal dialysis patients were analyzed by the single factor and Logistic multifactor regression analysis.Result:Itchy skin were dragged in whole body each place, affected areas to back,abdomen,the head,limbs,were respectively commonly accounted for 69

  11. The comparison of exit-site care with normal saline and povidone-iodine in preventing exit-site infection and peritonitis in children on chronic peritoneal dialysis treatment

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    Onder Yavascan

    2011-01-01

    Full Text Available Peritonitis and catheter exit- site infections (ESI are important causes of hospitalization and catheter loss in patients undergoing chronic peritoneal dialysis (CPD. The frequency of infection can be reduced by scrupulous exit- site care with or without topical antiseptics. There are no studies showing any benefit in the use of povidone-iodine or normal saline for care of exit- sites in long- term CPD patients. In this study, we aimed to determine the potential effectiveness of the application of povidone-iodine or normal saline at the catheter exit- site in preventing ESI and peritonitis in children on CPD. A total of 98 patients treated with either povidone-iodine or normal saline were included in this study. Group I (34 patients used povidone-iodine and group II (64 patients simply cleansed the exit- site with normal saline (0.9% NaCl. Dressings were changed 2 to 3 times in a week. The total cumulative follow- up time was 3233 patient- months. ESIs occurred in 10 (29.4% of 34 patients using povidone-iodine and in 10 (15.6% of 64 patients using normal saline. The frequency of ESI was significantly high in group I (povidone-iodine patients. The mean rate of ESI was 1 episode/60.8 patient- months for group I versus 1 episode/144 patient- months for group II (P 0.05. In conclusion, exit- site care with normal saline is an effective strategy in reducing the incidence of ESI in children on CPD. It can thus significantly reduce morbidity, catheter loss, and the need to transfer patients on peritoneal dialysis to hemodialysis.

  12. Rationale and design of the balANZ trial: A randomised controlled trial of low GDP, neutral pH versus standard peritoneal dialysis solution for the preservation of residual renal function

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    Clarke Margaret

    2010-09-01

    Full Text Available Abstract Background The main hypothesis of this study is that neutral pH, low glucose degradation product (GDP peritoneal dialysis (PD fluid better preserves residual renal function in PD patients over time compared with conventional dialysate. Methods/Design Inclusion criteria are adult PD patients (CAPD or APD aged 18-81 years whose first dialysis was within 90 days prior to or following enrolment and who have a residual GFR ≥ 5 ml/min/1.73 m2, a urine output ≥ 400 ml/day and an ability to understand the nature and requirements of this trial. Pregnant or lactating patients or individuals with an active infection at the time of enrolment, a contra-indication to PD or participation in any other clinical trial where an intervention is designed to moderate rate of change of residual renal function are excluded. Patients will be randomized 1:1 to receive either neutral pH, low GDP dialysis solution (Balance® or conventional dialysis solution (Stay.safe® for a period of 2 years. During this 2 year study period, urinary urea and clearance measurements will be performed at 0, 3, 6, 9, 12, 18 and 24 months. The primary outcome measure will be the slope of residual renal function decline, adjusted for centre and presence of diabetic nephropathy. Secondary outcome measures will include time from initiation of peritoneal dialysis to anuria, peritoneal small solute clearance, peritoneal transport status, peritoneal ultrafiltration, technique survival, patient survival, peritonitis rates and adverse events. A total of 185 patients has been recruited into the trial. Discussion This investigator-initiated study has been designed to provide evidence to help nephrologists determine the optimal dialysis solution for preserving residual renal function in PD patients. Trial Registration Australian New Zealand Clinical Trials Registry Number: ACTRN12606000044527

  13. One Example Peritoneal Dialysis Concurrent Peritonitis Patient's Nursing ExperienceAbstract%1例腹膜透析并发腹膜炎患者的护理体会

    Institute of Scientific and Technical Information of China (English)

    蓝辉娆

    2012-01-01

      本文报告1例腹膜透析并发腹膜炎患者护理体会,并取得了较好的效果。腹膜透析并发腹膜炎的护理范围涉及用药指导、生活护理、心理和行为问题的干预等多方面。通过对本患者的护理,笔者体会到本病的全面康复,不仅需要有效的药物治疗,更要发挥健康的家庭功能支持作用,对疾病伴发的心理、行为问题进行护理干预。%  This text reports a peritoneum dialysis sufferer's nursing erupting peritonitis realizes, and obtained better effect.The range that the peritoneum is dialysis to erupt the nursing of peritonitis involves to guide with the medicine, live nursing, mental state and behavior question of multiaspects like interruption,etc.Pass the nursing to this sufferer, the writer realizes completely recovering from ilness of this disease and not only needs an useful medicine treatment, but also wants to develop healthy home function to favor an action, vs the mental state, behavior question of the disease companion hair progress nursing interruption.

  14. Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment

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    Tomaras V

    2008-11-01

    Full Text Available Abstract Background The study examines differences regarding quality of life (QoL, mental health and illness beliefs between in-centre haemodialysis (HD and continuous ambulatory peritoneal dialysis (CAPD/PD patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods 144 End-Stage Renal Disease (ESRD patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients consisted of: a 77 in-centre haemodialysis (HD and 58 continuous ambulatory peritoneal dialysis (CAPD/PD patients, all currently being treated by dialysis for varied length of time. Patients were compared for differences after being grouped into those who recently commenced treatment ( 4 years. Next, cases were selected as to form two equivalent groups of HD and CAPD/PD patients in terms of length of treatment and sociodemographic variables. The groups consisted of: a 41 in-centre haemodialysis (HD and b 48 continuous ambulatory peritoneal dialysis (CAPD/PD patients, fitting the selection criteria of recent commencement of treatment and similar sociodemographic characteristics. Patient-reported assessments included: WHOQOL-BREF, GHQ-28 and the MHLC, which is a health locus of control inventory. Results Differences in mean scores were mainly observed in the HD patients with > 4 years of treatment, providing lower mean scores in the QoL domains of physical health, social relationships and environment, as well as in overall mental health. Differences in CAPD/PD groups, between those in early and those in later years of treatment, were not found to be large and significant. Concerning the analysis on equivalent groups derived from selection of cases, HD patients indicated significantly lower mean scores in the QoL domain of environment and higher scores in the GHQ-28 subscales of anxiety/insomnia and severe depression, indicating more symptoms in these areas

  15. 腹膜透析患者死亡危险因素分析%Analysis of risk factors of death in patients with peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    黄群; 李德天

    2016-01-01

    目的:分析腹膜透析患者的死亡危险因素,指导临床诊治。方法回顾性分析该院2008年6月—2013年9月收治的并在该院初次行腹膜透析、随访3个月以上的患者143例,其中死亡35例,存活108例,存活患者中肾移植6例,拔管12例,失访2例,采用多变量 COX 回归分析方法分析患者接受腹膜透析前各项临床指标对其预后的影响。结果原发病中,以慢性肾小球肾炎为主,63例(44.06%),糖尿病肾病46例(32.17%),高血压肾损伤21例(14.68%),马兜铃酸肾病5例(3.5%),止痛剂肾病3例(2.1%),多囊肾2例(1.4%),血管炎肾损伤、梗阻性肾病各1例(0.7%),原因不明的患者1例(0.7%)。死亡患者中,死于心血管疾病10例(28.57%),脑血管疾病7例(20%),腹膜炎5例(14.29%),肺内感染4例(11.43%),消化道出血2例(5.71%),原因不明4例(11.43%),肿瘤、营养不良、多器官功能衰竭各1例(2.86%)。总体透析时间(28.3±16.42)个月,死亡组平均透析时间(24.53±17.13)个月。单因素分析显示,进入腹膜透析时的年龄大、既往脑血管疾病病史为腹膜透析患者死亡的危险因素,再进行多因素 COX 回归,结果显示透析前高龄、高磷为腹膜透析患者死亡的独立危险因素。结论(1)腹膜透析患者原发病仍是以慢性肾小球肾炎为主(44.06%),符合我国目前慢性肾功能不全原发病构成;(2)该透析中心腹膜透析患者死亡疾病构成、生存率与国际报道接近;(3)腹膜透析前患者高龄、血磷升高为腹膜透析患者死亡的独立危险因素。%Objective Analysis of risk factors of death in patients with peritoneal dialysis to guide the clinical diagnosis and treat-ment.Methods 143 cases who recived first row of peritoneal dialysis, admitted in

  16. 甘草酸二胺对腹膜透析大鼠腹膜纤维化的影响%Effect of diammonium glycyrrhizinate on peritoneal fibrosis in rats receiving peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    卫志锋; 李多; 陆继芳; 刘圣君; 李素敏

    2013-01-01

    Objective To investigate the effect of diammonium glycyrrhizinate on peritoneal fibrosis in rats receiving peritoneal dialysis. Methods The male SD rats ( clean grade ) were randomly divided into 5 group, the rats in normal control group were not given any intervention ; the rats in NS group were given 0 9% sodium chloride injection 20ml by intraperitoneal injection daily ;the rats in model group were given 4. 25% peritoneal dialysis solution 20ml daily, meanwhile, were given lipopolysaccharide (LPS) 0. 6mg/kg,3 times a week by intraperitoneal injection; the rats in pentoxifylline treatment group , on the basis of model group , were given pentoxifylline 6mg/kg daily by intraperitoneal injection ;the rats in diammonium glycyrrhizinate treatment group ,on the basis of model group , were given diammonium glycyrrhizinate 10mg/kg daily by intraperitoneal injection The trial was performed for continuous 28 days, at the 30th day, 2h peritoneal equilibration test was adopted to determine the rats'peritoneum function ,and the partial peritoneum tissues of rats were collected and the changes of pathological morphous were observed under light microscope . The experimental data were analyzed with SPSS 13. 0. Results There were no significant changes in peritoneum function and structure in normal control group and NS group, however , which in model group were severely damaged ( P 0.05). Conclusion The 4. 25% peritoneal dialysis solution can cause peritoneal fibrosis in rats, however, diammonium glycyrrhizinate can improve peritoneal fibrosis and relieve the aggravation of peritoneum structure and function.%目的 探讨甘草酸二铵对腹膜透析大鼠腹膜纤维化的影响.方法 将清洁级雄性SD大鼠随机分成正常对照组,不给采取干预措施;生理盐水组,每日腹腔注射0.9%氯化钠注射液20 ml;模型组,每日腹腔注射4.25%腹膜透析液20 ml,同时腹腔内注射脂多糖(lipopolysaccharide,LPS)0.6 mg/kg,3次/周;已酮可可碱治疗组,除

  17. Nutrition and Peritoneal Dialysis

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  18. Visión enfermera de las necesidades psicosociales de los cuidadores de personas en tratamiento con Diálisis Peritoneal Nursing view of the psychosocial needs of carers of people undergoing Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Lola Andreu Periz

    2007-03-01

    Full Text Available Debido a la edad o a patologías interrecurrentes muchas personas en programa de Diálisis Peritoneal Ambulatoria, necesitan total o parcialmente de la ayuda de un cuidador por lo que la visión de los profesionales respecto al cuidador y sus necesidades es fundamental para ofrecer unos cuidados de salud adecuados. Con el objetivo de identificar y describir la visión de la enfermería responsable de los programas de diálisis peritoneal respecto a las necesidades psicosociales de los cuidadores principales de las personas sometidas a esta forma de tratamiento se realizó a 7 profesionales de enfermería nefrológica entrevistas semiestructuradas con un guión previo con preguntas abiertas. El análisis cualitativo de sus respuestas sugiere que para poder implementar eficazmente la participación familiar en los cuidados es imprescindible la organización personalizada y el soporte institucional; que la atención a la familia es una de las actividades de enfermería que no se suele valorar y para la que los responsables de la DP se sienten en ocasiones solos y faltos de recursos. Para los grandes problemas, como el cansancio del cuidador, se apuntan soluciones como buscar lugares fuera del hogar donde se le pueda realizar al paciente la técnica temporalmente.Due to age and recurrent pathologies, many people on the Ambulatory Peritoneal Dialysis programme need the full or part-time assistance of a carer, and therefore the view of professionals in relation to the carer and his or her needs is fundamental in order to offer adequate healthcare. In order to identify and describe the view of nursing staff responsible for the peritoneal dialysis programmes with regard to the psychosocial needs of the main carers of people who undergo this form of treatment, semi-structured interviews of 7 renal nursing professionals were carried out, using a guideline with open questions. The qualitative analysis of their responses suggests that in order to implement

  19. Relación entre la presión intrabdominal en diálisis peritoneal con las hernias y fugas The link between intra-abdominal pressure in peritoneal dialysis and hernias and fugues

    Directory of Open Access Journals (Sweden)

    Concepción Blasco Cabañas

    2012-06-01

    ±253 ml/m². Un 23.5 % tenían una presión intrabdominal mayor a 20 cm. de H2O. En sedestación la media fue de 28±5.5 cm. de H2O y en bipedestación de 43.7±5.3 cm. de H2O. Los enfermos con presión intrabdominal > 20 cm. H2O tenían más porcentaje de hernias (50% vs 12 % y fugas pericatéter (37 % vs. 12 %. Como principales conclusiones, podemos destacar que los niveles de presión intrabdominal de nuestros pacientes son algo más elevados que en otras series. A mayor edad, mayor comorbilidad y mayor índice de masa corporal, la presión intrabdominal es más elevada. Los enfermos con presión intrabdominal elevada presentaron más episodios de hernias y fugas.Normal intra-abdominal pressure is equal to atmospheric pressure (zero. In peritoneal dialysis the introduction of intra-peritoneal liquid increases intra-abdominal pressure. In various studies it is recommended that this does not exceed 16-20cm H2O. In addition to possible abdominal discomfort, high intra-abdominal pressure can be linked to problems with the abdominal wall, such as hernias and fugues, and have implications for peritoneal transport and ultrafiltration deficit. The aims of this study were the following: to find out the intra-abdominal pressure levels in the prevalent type of patients in peritoneal dialysis, to assess the factors influencing the values for this pressure and to study the relationship between intra-abdominal pressure and the development of hernias and fugues, retrospectively. A transversal, observational and retrospective study was conducted to measure intra-abdominal pressure in the prevalent, stable patients who had been on peritoneal dialysis for more than three months. Intra-abdominal pressure was measured using the method described by Durand: patient in a supine position, with diurnal peritoneal volume. The final intra-abdominal pressure is the average of the measurements taken during inspiration and expiration, is expressed in cm H2O and the volume drained is

  20. Choosing to live with home dialysis-patients' experiences and potential for telemedicine support: a qualitative study

    Directory of Open Access Journals (Sweden)

    Rygh Ellen

    2012-03-01

    Full Text Available Abstract Background This study examines the patients' need for information and guidance in the selection of dialysis modality, and in establishing and practicing home dialysis. The study focuses on patients' experiences living with home dialysis, how they master the treatment, and their views on how to optimize communication with health services and the potential of telemedicine. Methods We used an inductive research strategy and conducted semi-structured interviews with eleven patients established in home dialysis. Our focus was the patients' experiences with home dialysis, and our theoretical reference was patients' empowerment through telemedicine solutions. Three informants had home haemodialysis (HHD; eight had peritoneal dialysis (PD, of which three had automated peritoneal dialysis (APD; and five had continuous ambulatory peritoneal dialysis (CAPD. The material comprises all PD-patients in the catchment area capable of being interviewed, and all known HHD-users in Norway at that time. Results All of the interviewees were satisfied with their choice of home dialysis, and many experienced a normalization of daily life, less dominated by disease. They exhibited considerable self-management skills and did not perceive themselves as ill, but still required very close contact with the hospital staff for communication and follow-up. When choosing a dialysis modality, other patients' experiences were often more influential than advice from specialists. Information concerning the possibility of having HHD, including knowledge of how to access it, was not easily available. Especially those with dialysis machines, both APD and HHD, saw a potential for telemedicine solutions. Conclusions As home dialysis may contribute to a normalization of life less dominated by disease, the treatment should be organized so that the potential for home dialysis can be fully exploited. Pre-dialysis information should be unbiased and include access to other patients

  1. Do the outcomes of living donor renal allograft recipients differ with peritoneal dialysis and hemodialysis as a bridge renal replacement therapy?

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    Narayan Prasad

    2014-01-01

    Full Text Available This study was undertaken to compare the outcomes of living donor renal transplant recipients using peritoneal dialysis (PD and hemodialysis (HD as a bridge modality for renal replacement therapy till renal transplantation. The demographic profiles of the recipients and donors, the patients′ native kidney disease (diabetic versus non-diabetic, duration on dialysis, requirement of anti-hypertensive drugs, number of blood transfusions, human leukocyte antigen (HLA mismatch status, pre- and post-transplant infectious complications, and post-transplant outcomes of patients were compared between the two groups. The demographic features of the study patients were similar in the two groups. The duration of dialysis prior to transplant was significantly longer in the PD group than in the HD group of patients. The anti-hypertensive drug requirement was lower and the hemoglobin level and residual urine volume at the time of transplant were relatively better in the PD patients compared to the HD patients. The number of acute rejection episodes, delayed graft function, surgical complications, glomerular filtration rate at one month and at the last follow-up, were also similar in both groups. The short-term and long-term graft survival was similar in both groups of patients. The one-, two-, five-, and eight-year death-censored graft survival rates of the PD patients were 98, 95, 85, and 73%, respectively, and in the HD group of patients, they were 100, 93, 84, and 79%, respectively. The one-, two-, five-, and eight-year patient survival rates in the PD group were 97, 92, 77, and 66%, respectively, and in the HD group, they were 97, 92, 79, and 69%, respectively. Our study suggests that the outcomes of the living donor renal allograft recipients did not differ between the groups of patients who used PD or HD as renal replacement therapy prior to renal transplantation.

  2. Scintigraphic diagnosis of infectious complications in renal failure patients undergoing hemodialysis, continuous ambulatory peritoneal dialysis or renal transplant

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Vicente, Ana Maria; Ruiz Solis, Sebastian; Soriano Castrejon, Angel; Poblete Garcia, Victor Manuel; Talavera Rubio, Maria del Prado; Rodado Marina, Sonia; Cortes Romera, Montserrat [Ciudad Real General Hospital (Spain). Dept. of Nuclear Medicine

    2005-10-15

    Patients with end-stage renal disease have two therapeutic options, dialysis and renal transplantation. Infectious complications occurring in such patients will not only condition the effectiveness of such treatments, but are among the main causes of morbidity and mortality in such cases. Knowledge of the advantages and limitations of nuclear techniques is essential for management of these conditions. (author)

  3. Relationship between Plasma Fibroblast Growth Factor-23 Concentration and Bone Mineralization in Children with Renal Failure on Peritoneal Dialysis

    OpenAIRE

    Wesseling-Perry, Katherine; Pereira, Renata C.; Wang, Hejing; Elashoff, Robert M.; Sahney, Shobha; Gales, Barbara; Jüppner, Harald; Salusky, Isidro B.

    2008-01-01

    Context: Fibroblast growth factor (FGF)-23 is produced in bone, and circulating levels are markedly elevated in patients with end-stage kidney disease, but the relationship between plasma levels of FGF-23 and bone histology in dialysis patients with secondary hyperparathyroidism is unknown.

  4. Vivendo entre o pesadelo e o despertar: o primeiro momento no enfrentamento da diálise peritoneal Viviendo entre la pesadilla y el despertar: el primer enfrentamiento de la diálisis peritoneal Living between the nightmare and the awakening: the first time in dealing with peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Felipe Kaezer dos Santos

    2011-03-01

    idea de muerte y haciendo una clara distinción entre la enfermedad renal crónica y la diálisis. Si antes, las dos percepciones parecían solo una, el despertar presenta la diálisis peritoneal como el "anti-muerte", como un renacer para la vida.This article originates from a dissertation whose object was the significance of facing the customer carrier of chronic kidney disease by initiating peritoneal dialysis. The study subjects were considered from the perspective of symbolic interactionism, which emphasizes the significance of the elements of the world as determinants for the interaction. Following the methodological procedures of Grounded Theory were established paradigms of the five elements of analysis: Causes, Context, Factors Actors, Strategies for Action/Interaction and Consequences. The purpose of this discussion is finding ways by which the customer carrier faces chronic kidney disease on peritoneal dialysis, on the verge of realizing this method. Facing this new situation, the customer goes to a wake, abandoning the idea of death and making a clear distinction between chronic kidney disease and dialysis. If before, the two perceptions seemed to be just one, the awakening has peritoneal dialysis as the "anti-death" like a rebirth for life.

  5. Motivo de "escolha" de diálise peritoneal: exaustão de acesso vascular para hemodiálise? Reason for "choosing" peritoneal dialysis: exhaustion of vascular access for hemodialysis?

    Directory of Open Access Journals (Sweden)

    Paulo Novis Rocha

    2010-03-01

    Full Text Available INTRODUÇÃO: Pouco se conhece sobre a evolução de pacientes que iniciam DP como única alternativa. OBJETIVOS: Descrever o perfil clínico-demográfico e a ocorrência de peritonite em uma amostra de pacientes convertidos de HD para DP por exaustão de acesso vascular. MÉTODOS: Revisão dos prontuários de todos os pacientes do programa de DP do HGRS. RESULTADOS: Foram estudados 22 pacientes com idade mediana de 47,9 anos, 54,5% de homens, 84,2% de negros ou mulatos, 68,2% procedentes do interior da Bahia. DP foi a modalidade inicial de TRS em apenas quatro pacientes. Os 18 pacientes restantes iniciaram TRS através de HD; neste grupo, predominou o início de HD de forma emergencial e através de cateter duplo-lúmen (CDL. Em uma mediana de 7,7 meses em HD, a maioria dos pacientes (64,7% usou mais de quatro CDL. Em apenas 7/18 (39% pacientes, a conversão de HD para DP foi feita por escolha do paciente; na maioria dos casos, 11/18 (61%, o motivo de conversão foi exaustão de acesso vascular para HD. Peritonite foi mais frequente nos pacientes que entraram em HD por exaustão de acesso vascular que no restante do grupo. CONCLUSÕES: O início de TRS de forma emergencial através de HD utilizando CDL pode levar a uma rápida exaustão de acesso vascular, deixando a DP como única alternativa viável. Este modo inadequado de "seleção" de pacientes para DP está associado a maiores chances de ocorrência de peritonite.INTRODUCTION: Little is known about the prognosis of patients beginnig peritoneal dialysis (PD as their last alternative. OBJECTIVES: To describe the clinical-demographic profile of patients switching from hemodialysis (HD to PD, due to exhaustion of the HD vascular access, and the occurrence of peritonitis among them. METHODS: Review of the medical records of all patients in the PD program of the Hospital Roberto Santos in the city of Salvador, state of Bahia, Brazil. RESULTS: The study comprised 22 patients (median age, 47

  6. Repercussões cardiorrespiratórias da diálise peritoneal em crianças graves Cardiorespiratory repercussions of the peritoneal dialysis in critically ill children

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    Patrícia Gombai Barcellos

    2008-03-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A diálise peritoneal (DP é um procedimento freqüentemente indicado para crianças graves com insuficiência renal aguda, sua finalidade é substituir a filtração glomerular e melhorar o controle do equilíbrio hidroeletrolítico e ácido-básico. Entretanto, podem ocorrer alterações cardiorrespiratórias durante o procedimento. Desta forma, o objetivo deste estudo foi descrever as repercussões cardiorrespiratórias da DP em Pediatria e o nível de evidência dos estudos que abordam as repercussões. MÉTODO: Revisão bibliográfica de artigos que abordassem as repercussões cardiorrespiratórias da DP em Pediatria. Pesquisa nos bancos de dados Medline, Ovid e Lilacs, analisando artigos publicados entre 1990 e 2007, com as seguintes palavras-chave, nos idiomas português, inglês e espanhol, respectivamente: diálise peritoneal, efeitos hemodinâmicos, complicações respiratórias, complicações cardíacas, Pediatria; peritoneal dialysis, hemodynamic effects, respiratory complications, cardiac complications, Pediatric; peritoneal diálisis, efecto hemodinámico, complicaciones respiratorias, complicaciones cardiacas, Pediatria. Os artigos encontrados foram classificados em nível de evidências segundo Cook e col. 1992. RESULTADOS: Foram encontrados 13 artigos, sendo que oito deles abordaram as repercussões cardiocirculatórias e cinco abordaram as repercussões no sistema respiratório da DP. Esses estudos avaliaram pacientes na faixa etária de recém-nascidos a adolescentes graves, totalizando 178 crianças. Dentre as complicações respiratórias mais freqüentes durante a DP encontrou-se a redução da complacência pulmonar e da pressão parcial arterial de oxigênio, aumento da resistência das vias aéreas e da pressão parcial arterial de gás carbônico; após a infusão de fluído na DP os estudos demonstraram um aumento da relação entre a pressão parcial e a fração inspirada de oxig

  7. Association of Fetuin-A Levels with Carotid Intima Media Thickness and Valvular Calcification in Hemodialysis and Peritoneal Dialysis Patients

    OpenAIRE

    Yalçın SOLAK; Ali İNAL; Hüseyin ATALAY; Kayrak, Mehmet; Bıyık, Zeynep; Kültigin TÜRKMEN; Yeksan, Mehdi; Süleyman TÜRK

    2013-01-01

    BACKGROUND: Fetuin-A is a negative acute-phase reactant which prevents vascular calcification. Coronary artery disease (CAD) is the most important cause of mortality in patients undergoing renal replacement therapy (RRT). The key element of cardiovascular disease (CVD) seen in end-stage renal disease patients who are on dialysis treatment is accelerated calcific atherosclerosis. There are a limited number of studies in which HD and PD is compared in terms of fetuin-A level.OBJECTIVE: We aimed...

  8. The relationship between apelin and cardiac parameters in patients on peritoneal dialysis: is there a new cardiac marker?

    OpenAIRE

    Karadag, Serhat; Ozturk, Savas; Gursu, Meltem; Gurdal, Ahmet; Basinoglu, Filiz; Yigit, Servet; Zeki AYDIN; Uzun, Sami; Sumnu, Abdullah; Oflaz, Huseyin; Kazancioglu, Rumeyza

    2014-01-01

    Background Many markers have been proposed for CVD risk assessment in dialysis population. Apelin is a peptide that has roles in cardiovascular functions and volume regulation namely vasodilation, decreased blood pressure (BP), positive inotropic effect and inhibition of antidiuretic hormone release. The aim of this study was to examine relationship of apelin levels with echocardiographic findings and laboratory parameters related with cardiovascular function and bone mineral metabolism among...

  9. Home Dialysis: A Dutch Perspective

    NARCIS (Netherlands)

    E.W. Boeschoten; W.M. Michels

    2011-01-01

    For patients with end-stage renal disease who are not (yet) eligible for renal transplantation, treatment with dialysis is mandatory for survival. Home dialysis modalities (home hemodialysis or peritoneal dialysis) offer patients more flexibility compared with in-center treatment and have been advoc

  10. Effect of sulodexide on peritoneal morphology and function of peritoneal dialysis rats%舒洛地特对腹膜透析大鼠腹膜结构和功能的作用

    Institute of Scientific and Technical Information of China (English)

    韦永光; 林沁; 戢晴; 郑丰

    2011-01-01

    Objective To investigate the effect of sulodexide on the peritoneal morphology and function of long-term peritoneal dialysis rats. Methods Adult male Sprague-Dawley rats were randomly divided into the following four groups:control group(n= 6), model group(n= 10), low-dose sulodexide group (n= 10) and high-dose sulodexide group(n = 10). A 1 hour peritoneal equilibration test was performed after an eight-week peritoneal dialysis in each group. The dialysate samples were subjected to examination by hemocytometer for determination of 1 h dialysate urea(Durea ), dialysate protein(Dtp ), initial dialysate glucose(D0 ) and 1 h dialysate glucose( D1 ), plasma urea nitrogen(Purea )and total plasma protein(Ptp ); and the D/P (parameter for clearance rate of urea nitrogen), D/Ptp (parameter for total protein loss in dialysate), and D1/D0 (parameter for peritoneal ultrafiltration)were calculated. The parietal peritoneum tissues of rats were harvested and stained by Hematoxylineosin and Masson trichrome for observation of the peritoneal structure. The vessels and leukocytes in peritoneum tissue were counted (n/mm2) using stained sections. Leukocytes in dialysate samples were evaluated using hemocytometer. The levels of inflammatory cytokine (MCP-1, TNFα) in dialysate samples were measured by enzyme-linked immunosorbent assay(ELISA)and the expression of TGF-β1 in parietal peritoneum was detected by immunohistoehemistry assay. Results Compared with the control group, rats in the model group had decreased peritoneal mesothelial cells, thickened sub-mesothelial matrix, increased inflammatory cells, and angiogenesis (P<0.05). The ultrafilitration volume (UF) and glucose reabsorption (D1 /D0 ) were significantly lower and the dialysate-to-plasma urea ratio (D/Purea) and dialysate-to-plasma total protein ratio(D/Ptp ) were significantly higher in model group than those in the control group (P<0.05). Counts of leukocytes and levels of MCP-1 and TNFα in dialysate samples were

  11. Application of authorized education in enhancing the compliance of patients accepting peritoneal dialysis%授权教育在提高腹膜透析病人依从性中的应用

    Institute of Scientific and Technical Information of China (English)

    张慧; 林征

    2011-01-01

    [目的]探讨授权教育在提高腹膜透析病人依从性中的应用.[方法]选择2006年1月-2010年6月在苏州市立医院接受过治疗的60例腹膜透析的病人,对其实施3个月授权教育,观察教育前后饮食依从性、服药依从性、透析依从性及自我效能感的改变.[结果]授权教育后,60例腹膜透析病人饮食依从性、服药依从性、透析依从性、自我效能感均有明显提高.[结论]授权教育有助于提高腹膜透析病人的治疗依从性,增强其自我效能及自我管理能力.%Objective:To probe into applying authoriged education in enhan cing the compliance of patients accepting peritoneal dialysis. Method:A to tal of 60 cases accepted peritoneal dialysis in municipal hospital of Suzhou city from Jan. 2006 to Jun 2010 were selected. They had been carried out authoriged education for 3 months. They had been carried out authoriged education for 3 months. Then changes of diet compliance, medicine taking compliance,and self - efficacy feeling of all patients were observed before and after the education. Result: After the authoriged education, the diet compliance,medicine taking compliance and self -efficacy feeling of all 60 cases accepted peritoneal dialysis bad enhanced remarkably. Conclusion: Authoriged education can help to enhance the treatment compliance of pa tients accepting peritoneal dialysis and to streng then their self- efficacy and self - management ability.

  12. Geografia da diálise peritoneal no Brasil: análise de uma coorte de 5.819 pacientes (BRAZPD Geography of peritoneal dialysis in Brazil: analysis of a cohort of 5,819 patients (BRAZPD

    Directory of Open Access Journals (Sweden)

    Natália Maria da Silva Fernandes

    2010-09-01

    Full Text Available INTRODUÇÃO: O Brasil é um país continental com grande diversidade demográfica, social e cultural. Esse fator pode determinar diferenças demográficas, clínicas e no desfecho apresentado por pacientes portadores de doença renal crônica em diálise peritoneal (DP. OBJETIVO: Avaliar as características clínicas e os desfechos apresentados por pacientes em DP nas diversas regiões do Brasil, analisando uma coorte de pacientes (BRAZPD no período de dezembro de 2004 a outubro de 2007. PACIENTES E MÉTODOS: Os dados foram coletados mensalmente e os pacientes foram acompanhados até o desfecho (óbito, transplante renal, recuperação da função renal, transferência para hemodiálise ou perda de seguimento. RESULTADOS: Avaliados 5.819 pacientes incidentes e prevalentes. A maioria dos pacientes realizava terapia renal substitutiva (TRS no Sudeste, onde a média de tempo de acompanhamento foi maior (12,3 meses e há maior percentual de idosos (36,4%. A prevalência de diabetes mellitus é maior no Sudeste e Sul do país (38,1% e 37%, respectivamente. A maioria dos pacientes da região Norte realizou hemodiálise previamente, 66,2%. A taxa de saída por óbito foi maior na região Norte (30,1%, assim como por falência da técnica (22,3%. CONCLUSÃO: Os dados revelam diferenças demográficas, clínicas e em taxas de mortalidade e falência da técnica de DP refletindo as peculiaridades demográficas e sociais do Brasil. A geografia da DP no Brasil demonstra ser um espelho da geografia do Brasil. Portanto, políticas de saúde devem levar em conta as características de cada região para que possamos melhorar a sobrevida dos pacientes e da técnica em diálise peritoneal.INTRODUCTION: Brazil is a continental country with great diversity of population, social and cultural. This factor may determine different demographic, clinical and outcome presented by patients with chronic kidney disease on peritoneal dialysis (PD. OBJECTIVE: To evaluate the

  13. Anaemia management with subcutaneous epoetin delta in patients with chronic kidney disease (predialysis, haemodialysis, peritoneal dialysis: results of an open-label, 1-year study

    Directory of Open Access Journals (Sweden)

    Kwan Jonathan TC

    2009-02-01

    Full Text Available Abstract Background Anaemia is common in patients with chronic kidney disease (CKD and can be managed by therapy with erythropoiesis-stimulating agents (ESAs. Epoetin delta (DYNEPO®, Shire plc is the only epoetin produced in a human cell line. The aim of this study was to demonstrate the safety and efficacy of subcutaneously administered epoetin delta for the management of anaemia in CKD patients (predialysis, peritoneal dialysis or haemodialysis Methods This was a 1-year, multicentre, open-label study. Patients had previously received epoetin subcutaneously and were switched to epoetin delta at an identical dose to their previous therapy. Dose was titrated to maintain haemoglobin at 10.0–12.0 g/dL. The primary endpoint was mean haemoglobin over Weeks 12–24. Secondary analyses included long-term haemoglobin, haematocrit and dosing levels. Safety was assessed by monitoring adverse events, laboratory parameters and physical examinations. Results In total 478 patients received epoetin delta, forming the safety-evaluable population. Efficacy analyses were performed on data from 411 of these patients. Mean ± SD haemoglobin over Weeks 12–24 was 11.3 ± 1.1 g/dL. Mean ± SD weekly dose over Weeks 12–24 was 84.4 ± 72.7 IU/kg. Haemoglobin levels were maintained for the duration of the study. Epoetin delta was well tolerated, with adverse events occurring at rates expected for a CKD patient population; no patient developed anti-erythropoietin antibodies. Conclusion Subcutaneously administered epoetin delta is an effective and well-tolerated agent for the management of anaemia in CKD patients, irrespective of dialysis status. Trial registration http://www.controlled-trials.com ISRCTN68321818

  14. 丙酮酸盐在腹膜透析液中优于乳酸盐%Advantages of pyruvate over lactate in peritoneal dialysis solutions

    Institute of Scientific and Technical Information of China (English)

    周方强

    2001-01-01

    This review discusses effects of both lactate and pyruvate, and high glucose in peritoneal dialysis solutions (PDS) on leukocytes, mainly on intracellular pH ( [pH]i ), glucose metabolic pathways, and apoptosis.Lactate-based PDS (L-PDS) are bioincompatible primarily due to the low pH, high lactate, and glucose excess in both individual and combination. High lactate in an acidi milieu would induce severe intracellular acidosis of leukocytes, and high glucose may disturb glucose metabolic pathways and activate protein kinase C (PKC) and nuclear factor-kappa B (NF-κ B) of the cells, leading to apoptosis. Pymvate-based PDS (P-PDS) are novel experimental PDS. Evidence shows that P-PDS are superior in biocompatibility. Pyruvate protection of cells has been confirmed in many fields besides the PDS area.Although the underlying mechanism whereby P-PDS preserve cell function is not fully understood, it may be associated with the maintenance of [ pH ]i close to physiological, due to its low buffering capacity, improvement of cellular glucose metabolic pathways and redox state,and sustainment of intracellular calcium ([ Ca2+ ]i )homeostasis in high glucose concentrations. It may also inhibit PKC and NF-c B activation in high glucose. In addition, pyruvate is a strong antioxidant, a scavenger of hydrogen peroxide (H2O2). However, exogenous pyruvate in PDS could not be an energy source for cells and also the Crabtree effect might not occur in neutrophils.Pyruvate is a hopeful candidate of buffers in PDS in the near future. Further observation of P-PDS is strongly needed with peritoneal cells to verify the cell protection both in vitro and in vivo before clinic trials.

  15. The experience of nursing for 82 cases of peritoneal dialysis patients%82例腹膜透析患者的护理

    Institute of Scientific and Technical Information of China (English)

    李娜; 邱新华

    2013-01-01

    This paper summarizes the nursing experience of 82 cases of peritoneal dialysis (PD) patients. Primary nursing methods in-clude: setting up full-time PD nursing system, carrying out a variety of nursing education activities, following up PD patients regularly, teaching them with PD knowledge, dynamic tracking and analysis of patients' nursing issues in order to take the appropriate nursing methods to solve the problems. Implement the nurse responsibility system, which is managed by PD treatment team, can effectively promote the social rehabilitation of PD patients and improve their life quality and satisfaction.%总结了82例腹膜透析(PD)患者的护理体会。主要护理措施有设立专职PD护士,开展多种形式的护理教育活动,定期随访患者,对其进行PD知识的宣教,并从中动态跟踪分析患者的护理问题,从而采取相应护理措施解决问题。认为实行PD治疗团队管理下的护士责任制,可有效促进PD患者的社会回归,提高他们的生活质量和生活满意度。

  16. Quantification of reactive carbonyl compounds in icodextrin-based peritoneal dialysis fluids by combined UHPLC-DAD and -MS/MS detection.

    Science.gov (United States)

    Gensberger-Reigl, Sabrina; Huppert, Jochen; Pischetsrieder, Monika

    2016-01-25

    During heat sterilization of peritoneal dialysis (PD) fluids, the glucose component is partially degraded. The formed glucose degradation products impair biocompatibility and limit the long-term application of PD fluids. As an alternative to glucose, icodextrin, a polyglucose, is used as osmotic agent in PD fluids. After targeted screening for reactive carbonyl compounds, NMR- and MS-analyses very recently revealed 4-deoxyglucosone (4-DG), 3-deoxyglucosone (3-DG), 3-deoxygalactosone (3-DGal), 3,4-dideoxypentosone (3,4-DDPS), and 5-hydroxymethylfurfural (5-HMF) as main polyglucose degradation products (pGDPs) in icodextrin-based PD fluids. Now, the present study established and validated a UHPLC method with DAD as well as a UHPLC-MS/MS method for the first-time quantification of those five major pGDPs in commercial icodextrin PD fluids after derivatization with o-phenylenediamine. Thus, 4-DG was identified to be the main degradation product (in concentrations up to 20 μM). In contrast to the values measured in glucose-based products, the concentration of 3-DGal (≤ 16 μM) was higher than the concentration of 3-DG (≤ 7 μM) indicating different reaction pathways starting from polyglucose compared to glucose. The compounds 3,4-DDPS and 5-HMF were present in minor quantities (≤ 0.3 μM each). PMID:26540628

  17. Effect of traveling abroad for a short period on peritoneal dialysis patients' health status%短期出国旅行对腹膜透析病人健康状况的影响

    Institute of Scientific and Technical Information of China (English)

    聂建东; 张枫; 韩庆烽; 汪涛; 苏春燕

    2009-01-01

    目的 探讨腹膜透析病人集体短期出国旅行的可行性,以及出国旅行对腹膜透析病人健康状况的影响.方法 组织11例腹膜透析稳定的病人进行为期4 d的出国旅行,对旅行前后病人的主、客观生活质量,生活满意度评分,康复状况,躯体症状及超滤量、尿量、血压的变化进行观察.结果 旅行前后病人的主、客观生活质量,生活满意度方面评分提高,但差异无统计学意义(P>0.05);病人的超滤量、尿量等变化差异无统计学意义(P>0.05),但血压控制更为理想.结论 透析稳定的腹膜透析病人可以耐受短期集体出国旅行,而且旅行可以增强病人对生活的自信心,提高自我管理能力,是一种很好的康复干预方式.%Objective To explore the feasibility of traveling abroad for a short period, and analyze the effect on peritoneal dialysis patients' health status. Methods A four-day long travel to Jeju island was organized. Eleven peritoneal dialysis patients whose health status was stable participated in this activity. Their dialysis regimen, total fluid removal, clinical symptoms, quality of life and rehabilitation status were evaluated before and after the travel. Results Three patients had some clinical symptoms, such us edema and nausea before travel, and all of them eased or disappeared after travel. Their dialysis doses and total fluid removal unchanged between pre-and post-travel, hut volume status improved and hypertension was better controlled (P 0. 05), and rehabilitation status improved. Conclusions The stable dialyzed peritoneal dialysis patients can endure short period travel abroad. And their self management capacity improved after travel. Travd outside is an effective way to promote peritoneal dialysis patients rehabilitation.

  18. A Case of Fulminant Sclerosing Peritonitis Presented Like Acute Culture-Negative Peritonitis and Successfully Treated with Corticosteroid Therapy

    OpenAIRE

    Jung, Ji Yun; Cho, Jong Tae

    2013-01-01

    Sclerosing peritonitis is an uncommon complication of peritoneal dialysis. It is characterized by peritoneal fibrosis and sclerosis. The most common clinical presentations of sclerosing peritonitis in peritoneal dialysis patients are ultrafiltration failure and small bowel obstruction. The prognosis and response to immunosuppressive therapy of sclerosing peritonitis presenting with ultrafiltration failure or small bowel obstruction are poor. Here, we describe the case of a 28-yr-old man with ...

  19. Los indicadores del manejo del régimen terapéutico y su relación con la evolución de la información adquirida durante el entrenamiento en diálisis peritoneal Therapeutic regimen management indicators and their relationship to the evolution of the information acquired during peritoneal dialysis training

    Directory of Open Access Journals (Sweden)

    Antonia Concepción Gómez Castilla

    2011-06-01

    Full Text Available Los pacientes de diálisis peritoneal son sometidos a la intervención enfermera enseñanza individual para la obtención de conocimientos básicos, con el objetivo de efectuar el tratamiento en domicilio en condiciones de seguridad, que minimicen los riesgos que conlleva el proceso de diálisis peritoneal. La adecuación de los objetivos esperados a las características y/o capacidad del paciente/familia, consigue individualizar las actividades propias de la intervención enseñanza, así como el nivel de conocimientos adquiridos. Los indicadores relacionados con el manejo del proceso, la infección, la hidratación y la dieta, sirven para conocer el nivel de conocimientos del paciente/familia, y así poder dar desde la unidad de diálisis peritoneal, apoyo y o seguimiento individualizado en el domicilio, según las necesidades del paciente. La evolución del manejo del régimen terapéutico, es un hecho que siempre preocupa a la enfermería de diálisis peritoneal; el cumplimiento tanto de las normas aprendidas durante el entrenamiento como de los procedimientos descritos, son de suma importancia para minimizar las complicaciones intrínsecas al proceso terapéutico que nos ocupa. La necesidad de establecer pautas para un reentrenamiento estructurado, hemos pretendido conocerla a través de los indicadores relacionados con los criterios de resultados que describimos a continuación: • Conocimiento del manejo del régimen terapéutico (1813. • Conducta de cumplimiento (1601. • Control del riesgo (1902. • Control de síntomas (1608. Los criterios de resultados esperados corresponden al diagnóstico estandarizado en nuestro medio de 0082 Manejo efectivo del régimen terapéutico y 00162 Disposición para el manejo efectivo del régimen terapéutico, que son las etiquetas diagnósticas por excelencia al alta tras el entrenamiento para efectuar la diálisis peritoneal en el domicilio.Patients undergoing peritoneal dialysis receive

  20. Intervenciones de enfermería para la conservación de la función renal residual en diálisis peritoneal Nursing intervention for the conservation of residual kidney function in peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Jesús Lucas Martín Espejo

    2007-12-01

    de la función renal residual.The conservation of residual kidney function is an important factor to take into account in patients undergoing dialysis. In this work we have set the following goals: to study the factors that influence the deterioration of residual kidney function in our PD patients, to define the Nursing Diagnostics and Collaboration Problems in which our interventions contribute to slowing down this process. The sample was made up of 67 patients, with diuresis in excess of 300 ml/day at the beginning in PD.The evolution of the residual kidney function and its relationship with the quantity of glucose and weekly volume of peritoneal liquid used, use of icodextrine, technique used and other related variables were observed. We selected the nursing diagnostics (Kidney-ineffective tissular perfusion, Ineffective handling of therapeutic regime, Risk of imbalance in volume of liquids, Risk of nutritional imbalance by deficiency or excess, outcomes and intervention criteria with the activities applied of interrelated NANDA, NIC and NOC taxonomies, and collaboration problems. In the results obtained, the glucose and volume of weekly peritoneal liquid were lower in patients who maintained residual kidney function. We did not find differences in the residual kidney function according to the PD technique or use of icodextrine. Patients who conserve diuresis use lower weekly volumes and glucose, nutritional parameters are better, we did not find any different in the maintenance of the residual kidney function depending on the type of technique, between diabetic and non-diabetic patients. Nursing interventions on diagnostics related to imbalance in the volume of liquid that achieve normal weight,blood pressure, absence of oedemas, adequate use of glucose in the dialysis patient, etc.can favour maintenance of residual kidney function.

  1. 持续性不卧床腹膜透析相关性腹膜炎的影响因素研究%Risk Factors for Continuous Ambulatory Peritoneal Dialysis-Related Peritonitis

    Institute of Scientific and Technical Information of China (English)

    杨军; 张燕; 许清玉

    2012-01-01

    目的 探讨持续性不卧床腹膜透析(CAPD)相关性腹膜炎(CAPD-related peritonitis,CAPDrp)发生的影响因素.方法 从患者的文化程度、发病季节、基础疾病、1年内复诊次数、营养状况及致病菌种类6个方面,回顾性分析我科近7年来收治的136例次CAPDrp的可能原因.结果 高中和高中以上文化程度者CAPDrp发生的年平均例次明显低于高中以下文化者(P<0.05);每年5~9月发病者CAPDrp发生的年平均例次明显高于其他月份发病者(P<0.05);1年内复诊≥6次的患者CAPDrp发生的年平均例次低于<6次的患者(P<0.05).血红蛋白≤80 g/L者与血红蛋白> 80 g/L比较,清蛋白≤28 g/L者与清蛋白>28 g/L者比较,CAPDrp发生的年平均例次间差异均有统计学意义(P< 0.05).革兰阴性杆菌和真菌的感染率有上升趋势.结论 CAPDrp的发生与患者文化程度、发病季节、基础疾病、1年内复诊次数、营养状况关系密切;与终末期肾病(ESRD)的基础疾病关系不明显.%Objective To investigate the risk factors for continuous ambulatory peritoneal dialysis ( CAPD ) - related peritonitis ( CAPDrp ). Methods The clinical data of 136 patients who suffered from CAPDrp in our center during the past 7 years were retrospectively analyzed in terms of education background, disease - onset season, underlying diseases, visits per year, nutritional status, and pathogen species. Results Patients with a higher education background ( high school or higher ) tended to have lower incidence of CAPDrp ( P 80g/Lvs. ≤80 g/L ) and serum albumin > 28 g/L vs. ≤28 g/L ( bothP <0. 05 ). In addition, it also showed an increasing tendency after tuberculous bacillus and fungus infections. Conclusion CAPDrp is closely related with the patients' education background, disease - onset seasons, underlying diseases, visits per year, and nutritional status; however, it shows no correlation with the underlying diseases of offend - stage ESRD.

  2. Rationale and design of the oral HEMe iron polypeptide Against Treatment with Oral Controlled Release Iron Tablets trial for the correction of anaemia in peritoneal dialysis patients (HEMATOCRIT trial

    Directory of Open Access Journals (Sweden)

    Isbel Nicole M

    2009-07-01

    Full Text Available Abstract Background The main hypothesis of this study is that oral heme iron polypeptide (HIP; Proferrin® ES administration will more effectively augment iron stores in erythropoietic stimulatory agent (ESA-treated peritoneal dialysis (PD patients than conventional oral iron supplementation (Ferrogradumet®. Methods Inclusion criteria are peritoneal dialysis patients treated with darbepoietin alpha (DPO; Aranesp®, Amgen for ≥ 1 month. Patients will be randomized 1:1 to receive either slow-release ferrous sulphate (1 tablet twice daily; control or HIP (1 tablet twice daily for a period of 6 months. The study will follow an open-label design but outcome assessors will be blinded to study treatment. During the 6-month study period, haemoglobin levels will be measured monthly and iron studies (including transferring saturation [TSAT] measurements will be performed bi-monthly. The primary outcome measure will be the difference in TSAT levels between the 2 groups at the end of the 6 month study period, adjusted for baseline values using analysis of covariance (ANCOVA. Secondary outcome measures will include serum ferritin concentration, haemoglobin level, DPO dosage, Key's index (DPO dosage divided by haemoglobin concentration, and occurrence of adverse events (especially gastrointestinal adverse events. Discussion This investigator-initiated multicentre study has been designed to provide evidence to help nephrologists and their peritoneal dialysis patients determine whether HIP administration more effectively augments iron stores in ESP-treated PD patients than conventional oral iron supplementation. Trial Registration Australia New Zealand Clinical Trials Registry number ACTRN12609000432213.

  3. 腹膜透析患者自我管理行为及健康状况的相关性研究%Study on the relationship between self-management behavior and health status of peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    刘鹏飞; 骆素萍

    2010-01-01

    目的 了解目前国内腹膜透析患者自我管理行为的状况和健康状况,探讨患者自我管理行为与其健康状况的关系.方法 采用问卷调查的方法,结合实验室检查,对151例腹膜透析患者的自我管理行为和健康状况进行调查,分析自我管理行为与健康状况的关系,提出提高患者自我管理行为的护理措施.结果 腹膜透析患者自我管理行为得分为(28.8±5.32)分,患者自我管理行为与其生理和心理的健康状况密切相关.自我管理行为与Karnofsky活动指数、白蛋白水平呈正相关(P<0.01),与躯体症状、舒张压、血磷和抑郁水平呈负相关(P<0.01).结论 腹膜透析患者自我管理行为与其生理和心理的健康状况密切相关,自我管理行为的提高,有助于健康状况的改善.%Objective To explore the status of self-management behavior and health among peritoneal dialysis patients and their relationship. Methods A total of 151 cases with peritoneal dialysis were investigated with questionnaire for their self-management behavior and health status, in order to analyze the relationship between them and propose the nursing measurements of improving the nursing measurements. Results The self-management behavior score for peritoneal dialysis patient was (28. 8±5. 32), their self-management behavior was correlated with physical and mental health. There showed pisitive correlation between self-management behavior and Kamofsky activity index, albumin levels ( P < 0. 01), while negtive correlation with somatic symptoms, diastolic blood pressure, blood phosphorus and the level of depression (P <0. 01). Conclusions Self management behaviors among peritoneal dialysis patients are closely related to their physical and mental health. The improvement of self management behavior is helpful to the improvement of health.

  4. Processo de cuidar do idoso em Diálise Peritoneal Ambulatorial Contínua no domicílio Proceso de cuidar del anciano, que hace Diálisis Peritoneal Ambulatorial Contínua en el domicilio Home care for the elderly undergoing Continuous Ambulatory Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Daniele Favaro Ribeiro

    2009-12-01

    DPAC.Objectives: To describe the elders with end stage renal disease (ESRD undergoing continuous ambulatory peritoneal dialysis (CAPD, their caregivers, and the care the caregivers provide to the elders. Methods: This was a qualitative study with 9 caregivers. Data were collected through oral history. Data analysis consisted of thematic content analysis. Results: The sample consisted of 5 male and 4 female elders and all them were dependent on caregivers to change the dialysis collection bag. The mean age of the participants was 70 years. Among the caregivers, 8 of them were female with a mean age of 41.5 years and they provided 8 hours of care to the elders daily. The main theme emerging from the content analysis was "home care for the elderly undergoing continuous ambulatory peritoneal dialysis." Conclusion: Caregivers need support for the development of knowledge and skills to deal with the elders' demand of care, particularly in regard to the management of CAPD.

  5. Peritoneal Dialysis Dose and Adequacy

    Science.gov (United States)

    ... campuses in Maryland and Arizona Research Resources Protocols, repositories, mouse models, plasmids, and more Technology Advancement & Transfer ... through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, ...

  6. 腹膜透析患者的转归及其危险因素分析%The analysis of outcome and the risk factors for mortality in peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    周巍; 王葳; 韩国锋; 孙晶; 张金元

    2012-01-01

    Objective To analyze the outcome and the risk factors for mortality in the peritoneal dialysis (PD) patients in a single peritoneal dialysis in a period of 27 years, and to discuss the approaches to obtain a better prognosis. Methods We retrospectively analyzed patients on PD for more than one month during the period from January 1985 to December 2011 in this hospital. We collected and analyzed their outcomes, the cause of dropout from PD, demographic characteristics, laboratory data, dialysis adequacy, residual renal function, peritoneal transport characteristics, and nutritional status. Results A total of 841 patients were enrolled, of whom 431 were females (51.2%). The mean age at the begining of PD was 58.53 + 16.67 years. The primary diseases for end stage renal disease were glomerulonephritis (52.3%), hypertension (16.6%), and diabetes (15.3%), in which glomerulonephritis was the most important primary disease. The mean peritoneal dialysis duration was 18.63 + 20.35 months. Up to December 2011, the patients remained on PD in 246 cases (29.2%), died in 296 cases (35.2%), changed to hemodialysis in 152 cases (18.1%), treated with kidney transplant in 64 cases (7.6%), and lost for follow-up in 83 cases (9.9%). The main cause of death was cardiovascular events (41.6%), followed by infection (33.0%) including pulmonary infection (23.2%) and peritonitis (9.8%), and cerebral vascular accident (9.5%). The major reason (59.2%)changing from PD to hemodialysis was the PD associated infection, followed by functional abnormalities of peritoneal catheter (25.7%) such as occlusion and drift, and insufficient peritoneal dialysis (7.2%). Cox proportional hazards model analysis indicated that the risk factors for mortality were age (HR: 1.06, P < 0.01), diabetes (HR: 1.88, P< 0.01), change of hemodialysis to PD (HR: 1.49, P< 0.01), lower serum albumin (HR: 2.44, P < 0.01), higher C-reaction protein (HR: 2.07, P< 0.01), lower creatinine clearance rate (HR: 1.89, P < 0.05), and

  7. Evaluación global subjetiva y escala de malnutrición-inflamación para valorar el estado nutricional de pacientes en diálisis peritoneal con hipoalbuminemia Subjective global assessment and malnutrition-inflammation scale to assess the nutritional status of patients on peritoneal dialysis with hypoalbuminaemia

    Directory of Open Access Journals (Sweden)

    Sagrario Jiménez Jiménez

    2012-06-01

    Full Text Available Los pacientes con insuficiencia renal crónica en diálisis peritoneal con frecuencia están mal nutridos o en riesgo de desnutrición, por sus especiales características y favorecido por múltiples factores, como otras patologías asociadas, diálisis inadecuada, estado inflamatorio, pérdida de nutrientes por el dializado, etc. Se han descrito numerosos métodos para evaluar el estado nutricional, siendo las medidas antropométricas y determinaciones de laboratorio las más utilizadas, pero cuando las aplicamos a pacientes renales los resultados obtenidos son muy variables, además algunos de ellos plantean problemas a la hora de su aplicación, por las especiales características de los pacientes en diálisis. Una forma de prevenir la malnutrición es identificar a aquellos pacientes en riesgo de desnutrición y evitar su deterioro progresivo. Nuestro objetivo, es evaluar el estado nutricional de los pacientes en diálisis peritoneal con hipoalbuminemia. Hemos seleccionado 21 pacientes con más de 3 meses en diálisis peritoneal y con tendencia a tener hipoalbuminemia Patients with chronic renal deficiency on peritoneal dialysis are often poorly nourished or at risk of malnutrition due to their special characteristics, and this is exacerbated by a range of factors, including other associated pathologies, unsuitable dialysis, inflammatory state, loss of nutrients due to the dialysate, etc. Numerous methods for assessing nutritional status have been described, among which anthropometric measurements and laboratory determinations are the most widely-used. However, when these are applied to renal patients the results obtained are highly variable, and moreover problems arise with putting some of them into practice, due to the special features of dialysis patients. One way of preventing malnutrition is to identify the patients at risk and avoid their gradual deterioration. The aim here is to assess the nutritional status of patients on peritoneal

  8. Systematic barriers to the effective delivery of home dialysis in the United States: a report from the Public Policy/Advocacy Committee of the North American Chapter of the International Society for Peritoneal Dialysis.

    Science.gov (United States)

    Golper, Thomas A; Saxena, Anjali B; Piraino, Beth; Teitelbaum, Isaac; Burkart, John; Finkelstein, Fredric O; Abu-Alfa, Ali

    2011-12-01

    Home dialysis, currently underused in the United States compared with other industrialized countries, likely will benefit from the newly implemented US prospective payment system. Not only is home dialysis less expensive from the standpoint of pure dialysis costs, but overall health system costs may be decreased by more subtle benefits, such as reduced transportation. However, many systematic barriers exist to the successful delivery of home dialysis. We organized these barriers into the categories of educational barriers (patient and providers), governmental/regulatory barriers (state and federal), and barriers specifically related to the philosophies and business practices of dialysis providers (eg, staffing, pharmacies, supplies, space, continuous quality improvement practices, and independence). All stakeholders share the goal of delivering home dialysis therapies in the most cost- and clinically effective and least problematic manner. Identification and recognition of such barriers is the first step. In addition, we have suggested action plans to stimulate the kidney community to find even better solutions so that collectively we may overcome these barriers. PMID:21903316

  9. Is Dialysis Modality a Factor in the Survival of Patients Initiating Dialysis After Kidney Transplant Failure?

    OpenAIRE

    Perl, Jeffrey; Dong, James; Rose, Caren; Jassal, Sarbjit Vanita; Gill, John S.

    2013-01-01

    ♦ Background: Kidney transplant failure (TF) is among the leading causes of dialysis initiation. Whether survival is similar for patients treated with peritoneal dialysis (PD) and with hemodialysis (HD) after TF is unclear and may inform decisions concerning dialysis modality selection.

  10. 血管生成素及其受体在腹膜透析腹膜组织中的表达%Expression of angiopoietin and its receptor in peritoneum of peritoneal dialysis rats

    Institute of Scientific and Technical Information of China (English)

    庄薇; 陈红; 施敏; 钟爱民

    2011-01-01

    目的 分析并研究尿毒症腹膜透析大鼠腹膜血管生成素(Ang)及其受体(Tie)的表达情况及影响因素.方法 SD雄性大鼠5/6肾切除术建立尿毒症模型,成模后腹腔内植入腹透管,随机分为尿毒症组(NS组)及腹透组(PD组).尿毒症组每日给予20 ml生理盐水腹腔灌注,腹透组每日给予20 ml 4.25%百特腹透液腹腔灌注,持续6周.对照组(C组)行假手术且不予液体灌注.实验结束取大鼠腹膜组织,观察腹膜血管新生情况;行免疫组化及RT-PCR检测腹膜组织血管生成素及其受体的表达变化.结果 实验表明PD组相对其他两组新生血管数明显增多,NS组新生血管数较C组为多(P均<0.05).免疫组化显示Ang2及其Tie2阳性细胞数PD组相对于C组和NS组明显增加,NS组较C组亦有增加(P均<0.05).RT-PCR显示PD组Ang2 mRNA和Tie2 mRNA表达较NS组和C组明显上调,而NS组高于C组(P均<0.05).结论 尿毒症本身及腹膜透析液均会上调腹膜的血管生成素及其受体表达,且与血管新生密切相关.%Purpose Long-term peritoneal dialysis ( PD ) can induce ultrafiltration failure , and one of its main factors is angiogenesis.For understanding the cause of peritoneum angiogenesis, the aim of this study was to investigate the change of angiopoietin and its receptor in peritoneum of peritoneal dialysis rats. Methods Uremic rats were established by subtotal nephrectomy in which the rat was implanted a peritoneal dialysis tube. The rats were treated with daily injection of 20 ml physiological saline ( NS group ) and 20 ml 4. 25% peritoneal dialysate ( PD groups ) by transcatheter, respectively, for 6 weeks. Rats with sham operation without peritoneal dialysate were used as control group. The peritoneum was obtained when the experiment was finished. Vessel density of the peritoneum was detected, and the expression levels of angiopoietin and its receptor were examined in the peritoneum by immunohistochemistry and RT-PCR. Results

  11. Encapsulating peritoneal sclerosis: experience of a tertiary referral center.

    LENUS (Irish Health Repository)

    Phelan, P J

    2010-05-01

    Encapsulating peritoneal sclerosis (EPS) is arguably the most serious complication of chronic peritoneal dialysis (PD) therapy with extremely high mortality rates. We aimed to establish the rates of EPS and factors associated with its development in a single center.

  12. The cause of dropout in peritoneal dialysis patients%腹膜透析患者退出原因分析

    Institute of Scientific and Technical Information of China (English)

    高妍婷; 段斌; 王晓明; 侯冰

    2009-01-01

    目的 探讨持续性非卧床腹膜透析患者退出腹膜透析的原因及其影响因素,为改善持续性非卧床腹膜透析患者的预后提供依据.方法 分析在我院进行持续性非卧床腹膜透析的终末期肾脏病患者的临床资料,统计退出腹膜透析患者例数并分析其原因.结果 95例入选患者中有39例患者退出腹膜透析,退出率为41.1%,退出原因死亡为56.4%(22/39)、改血液透析为20.5%(8/39)和肾移植为15.4%(6/39).患者死亡的主要原因为心力衰竭(54.5%)和肺部感染(27.3%).死亡组患者高龄、开始透析时的残余肾功能差、营养不良及贫血程度较重;此外死亡组患者原发病为糖尿病比例与对照组比较差异有统计学意义(P<0.05),且使用血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体拮抗剂控制血压与对照组比较差异也有统计学意义(P<0.05).腹膜炎是导致患者改血液透析的主要原因.结论 死亡是持续性非卧床腹膜透析患者退出腹膜透析的主要原因,患者死亡的主要原因为心血管疾病和感染、高龄、糖尿病、残余肾功能差、贫血和营养不良是影响患者生存的危险因素,早期肾脏替代治疗、积极改善贫血和营养状况以及使用血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体拮抗剂可改善持续性非卧床腹膜透析患者的预后.%Objective To investigate the cause of dropout in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods Ninety - five CAPD patients were enrolled. Their dropout was reviewed. Results Among the 39 patients who dropped out, 22 cases died, 8 cases switched to hemodialysis, 6 cases received renal transplantation. The major cause of death was heart failure (54.5%) and lung infec-lion (27.3%). The death cases had older age, lower lever residual renal function(RRF), more serious mal-nutrition and anemia (P <0.05). Besides, diabetic patients were more general in the death cases (P <0

  13. Estudio sobre el cambio de elección de tratamiento renal sustitutivo en pacientes que han optado por diálisis peritoneal Study on the change in choice of renal replacement treatment in patients who have opted for peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    María del Valle Garrido López

    2006-03-01

    Full Text Available La elección de tratamiento renal sustitutivo es una decisión crucial en los pacientes con insuficiencia renal crónica. De ahí la importancia de la información que les ofrecemos en la consulta de prediálisis. Dentro del grupo de pacientes que optan por diálisis peritoneal (DP como terapia renal sustitutiva (TRS, existen algunos, que por propia voluntad, cambian esta decisión y pasan a hemodiálisis (HD, ya sea en situación de prediálisis, o incluso estando ya en diálisis peritoneal. Hemos analizado la elección de TRS en nuestra área de salud, características de los pacientes, la prevalencia y variables que influyen en el cambio de técnica (desde DP a HD, determinando el perfil del paciente más susceptible de cambiar su decisión. Los resultados ponen de manifiesto que la familia tiene una elevada influencia en el cambio de opción. La principal preocupación de todos los pacientes que eligen DP, es el miedo a la peritonitis, tanto si posteriormente cambian su elección como si no lo hacen. Una queja común es la falta de espacio para almacenar el material. Otras características importantes son: el hecho de que consideran la técnica complicada (36.4%, que precisan colaboración de alguien para realizarla (27.3% y que tienen una presión familiar negativa hacia la técnica (27.3%.The choice of renal replacement treatment is a crucial decision in patients with chronic renal failure. Hence the importance of the information we offer them in the pre-dialysis consultation. Within the group of patients who opt for peritoneal dialysis (PD as a renal replacement therapy (RRT, there are some who at their own choice change this decision and move onto haemodialysis (HD, either at the pre-dialysis phase or even after having started peritoneal dialysis. We have analysed the choice of RRT in our health area, patient characteristics, prevalence and the variables that influence the decision to change technique (from PD to HD, determining the

  14. 不同超滤功能的持续不卧床腹膜透析患者腹膜液体转运功能评估%Ultrafiltration capacity and peritoneal fluid kinetics in continuous ambulatory peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    者星炜; 罗洁; 刘振华; 白云凯; 熊丽炎; 单亦升; 程磊; 田信奎; 汪涛

    2012-01-01

    目的 容量控制对于腹膜透析至关重要.腹膜平衡实验(peritoneal equilibration test,PET)可以评估腹膜小分子溶质转动功能,对优化腹膜透析存腹时间提供依据,但是不能预测腹膜液体转运功能.所以,本研究使用计算机拟合对不同超滤功能腹膜透析患者的腹膜液体转运功能进行评估.方法 纳入研究患者包括每天使用3~4袋2.5%葡萄糖透析液者(为腹膜超滤功能差组)和使用3~4袋1.5%葡萄糖透析液者(为腹膜功能好组),两组患者在上述透析处方下都能达到足够的液体清除.所有入组的患者都要求详细记录自己每天的腹膜透析换液情况,以评估腹膜液体转运功能.结果 本研究包括了17名持续不卧床腹膜透析患者(continuous ambulatory peritoneal dialysis,CAPD),其中9名为超滤功能差组,8名为超滤功能好组.与超滤功能好组相比,超滤功能差组的患者每天更多的处于高葡萄糖(P<0.01)环境中,透析液/血浆肌酐比值(D/Pcre)更高(P<0.05),有更高的腹膜液体吸收率(Ke)(P<0.01). 结论 与超滤功能好的患者相比超滤功能差的患者的腹膜小分子溶质转运率更高,更为重要的是,超滤能力差的患者腹膜液体吸收率更高.%Objective Volume control is critical for peritoneal dialysis. Although peritoneal equilibration test (PET) has been used to clarify the peritoneal membrane characteristics, it is unable to adequately predict peritoneal fluid removal and appropriately optimize the dwelling time. In the present study, we applied computer simulation and performed a more detailed evaluation of the fluid kinetics in patients with different ultrafiltration (UF) capacity. Methods Patients who used three to four exchanges of 2.5% glucose dialysate per day (poor UF capacity group) and patients who used three to four exchanges of 1.5% glucose dialysate per day (good UF capacity group) to achieve adequate amount of peritoneal fluid removal were

  15. Patients' experiences of peritoneal dialysis at home: a phenomenological approach La experiencia vivida por pacientes en diálisis peritoneal domiciliaria: un abordaje fenomenológico A experiência vivida pelos pacientes em diálise peritoneal domiciliar: uma abordagem fenomenológica

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Araújo Sadala

    2012-02-01

    Full Text Available The aim of this study was to highlight the meaning of home dialysis as experienced by patients with chronic renal failure. The research design was influenced by Ricoeur´s phenomenology. Nineteen patients from a Brazilian public hospital were interviewed, from May to September 2009. Interviews were guided by the question: "Tell me about your experiences lived undergoing PD". Findings unveiled the patients' perception of the drastic changes in their existence, consequent to disease and treatment; and the perception of themselves in that process. The feeling of anguish, physical pain and deprivations were part of living that condition. They foresee an uncertain future, depending on the expertise of health care providers and the demands on support of significant others. Findings suggest that individual aspects of patients' experiences must be considered if health care providers are to facilitate positive health outcomes.El objetivo de este estudio fue comprender la experiencia de la diálisis peritoneal domiciliaria, a partir de la narración de los pacientes. El abordaje del estudio se inspiró en la fenomenología hermenéutica de Paul Ricoeur. Fueron entrevistados 19 pacientes en la unidad de hemodiálisis de un hospital público brasileño, de marzo a septiembre de 2009. Las entrevistas fueron orientadas por la pregunta: describa su experiencia en la diálisis peritoneal. Los resultados revelaron la percepción de los participantes sobre el significado de la enfermedad en sus vidas y las drásticas transformaciones personales sufridas en ese proceso. Sentimientos de angustia y dolor física fueron acompañados por importantes limitaciones personales y sociales, impuestas por el tratamiento. Ellos esperan un futuro desconocido, reconociendo su dependencia de la ayuda de los familiares y de los profesionales de la salud. Los resultados revelan las dificultades y la falta de perspectivas experimentadas por los pacientes en diálisis, demostrando

  16. Ultrafiltration and Dialysis Adequacy with Various Daily Schedules of Dialysis Fluids

    OpenAIRE

    Paniagua, Ramón; Debowska, Malgorzata; Ventura, María-de-Jesús; Ávila-Díaz, Marcela; Prado-Uribe, Carmen; Mora, Carmen; García-López, Elvia; Lindholm, Bengt; Waniewski, Jacek

    2012-01-01

    Dialysis regimens for continuous ambulatory peritoneal dialysis (CAPD) patients vary with the need for fluid removal, but also because of concerns about the local and systemic consequences of high glucose exposure. The implications of various regimens for dialysis adequacy—that is, fluid and small-solute removal—are not always clear. We therefore analyzed ultrafiltration (UF) and adequacy indices for 4 different combinations of dialysis fluid.

  17. Relación entre la presión intrabdominal en diálisis peritoneal con las hernias y fugas The link between intra-abdominal pressure in peritoneal dialysis and hernias and fugues

    OpenAIRE

    Concepción Blasco Cabañas; Esther Ponz Clemente; Loreley Betancourt Castellanos; Sol Otero López; Dolores Marquina Parra; Carmen Gran Pueyo; Carmen Moya Mejía

    2012-01-01

    La presión intrabdominal normal es igual a la atmosférica (cero). En Diálisis Peritoneal con la introducción del líquido intraperitoneal, la presión intrabdominal aumenta. En varios estudios se aconseja que esta no supere los 16-20 cm. H2O. Además de las posibles molestias abdominales, una presión intrabdominal elevada puede tener relación con los problemas de la pared abdominal, como hernias y fugas y tener implicaciones en el transporte peritoneal y el déficit de ultrafiltración. Los objeti...

  18. Visión enfermera de las necesidades psicosociales de los cuidadores de personas en tratamiento con Diálisis Peritoneal Nursing view of the psychosocial needs of carers of people undergoing Peritoneal Dialysis

    OpenAIRE

    Lola Andreu Periz; Paqui Gruart Armangué; Lia Tamar Sánchez-Salido

    2007-01-01

    Debido a la edad o a patologías interrecurrentes muchas personas en programa de Diálisis Peritoneal Ambulatoria, necesitan total o parcialmente de la ayuda de un cuidador por lo que la visión de los profesionales respecto al cuidador y sus necesidades es fundamental para ofrecer unos cuidados de salud adecuados. Con el objetivo de identificar y describir la visión de la enfermería responsable de los programas de diálisis peritoneal respecto a las necesidades psicosociales de los cuidadores pr...

  19. Trabalho e qualidade de vida relacionada à saúde de pacientes em diálise peritoneal Trabajo y Calidad de Vida Relacionada a la Salud de pacientes en Diálisis Peritoneal Work and health-related quality of life of patients on peritoneal dialysis

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    Marília Pilotto de Oliveira

    2012-01-01

    pacientes y merece la atención de los profesionales de la salud en la búsqueda de estrategias que favorezcan e incentiven su manutención y reinserción en el mercado de trabajo.OBJECTIVE: To describe and compare Health Related Quality of Life (HRQoL of patients on peritoneal dialysis (PD who had and who did not have paid work. METHODS: A cross-sectional and populational study with 82 patients from the two PD services in Ribeirão Preto (SP, Brazil. Data collection was conducted by interviews between December/2009 and March/2010. The questionnaires for the characterization of patients, the Mini Mental State Examination and the Kidney Disease and Quality of Life-Short Form were used. Analyses were performed using exploratory univariate and bivariate statistics, and the confirmatory bivariate among the independent variables and the dimensions of HRQoL. RESULTS: Patients with paid work presented higher mean scores reflecting better HRQoL for the majority of the dimensions of the instrument used. CONCLUSION: Work is an important facet of life for these patients and merits the attention of health professionals in the search for strategies that promote and incentivize its maintenance and the reintegration of patients into the labor market.

  20. Dialysis and contrast media

    International Nuclear Information System (INIS)

    In a previous survey we revealed uncertainty among responders about (a) whether or not to perform hemodialysis in patients with severely reduced renal function who had received contrast medium; and (b) when to perform hemodialysis in patients on regular treatment with hemodialysis or continuous ambulatory dialysis who received contrast medium. Therefore, the Contrast Media Safety Committee of The European Society of Urogenital Radiology decided to review the literature and to issue guidelines. The committee performed a Medline search. Based on this, a report and guidelines were prepared. The report was discussed at the Ninth European Symposium on Urogenital Radiology in Genoa, Italy. Hemodialysis and peritoneal dialysis safely remove both iodinated and gadolinium-based contrast media. The effectiveness of hemodialysis depends on many factors including blood and dialysate flow rate, permeability of dialysis membrane, duration of hemodialysis and molecular size, protein binding, hydrophilicity, and electrical charge of the contrast medium. Generally, several hemodialysis sessions are needed to removal all contrast medium, whereas it takes 3 weeks for continuous ambulatory dialysis to remove the agent completely. There is no need to schedule the dialysis in relation to the injection of iodinated or MR contrast media or the injection of contrast agent in relation to the dialysis program. Hemodialysis does not protect poorly functioning kidneys against contrast-medium-induced nephrotoxicity. Simple guidelines are given. (orig.)

  1. Dialysis and contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Morcos, Sameh K. [Department of Diagnostic Imaging, Northern General Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield S5 7AU (United Kingdom); Thomsen, Henrik S. [Department of Diagnostic Radiology 54E2, Copenhagen University Hospital at Herlev, Herlev Ringvej 75, 2730 Herlev (Denmark); Webb, Judith A.W. [Department of Diagnostic Imaging, St Bartholomew' s Hospital, London EC1A 7BE (United Kingdom)

    2002-12-01

    In a previous survey we revealed uncertainty among responders about (a) whether or not to perform hemodialysis in patients with severely reduced renal function who had received contrast medium; and (b) when to perform hemodialysis in patients on regular treatment with hemodialysis or continuous ambulatory dialysis who received contrast medium. Therefore, the Contrast Media Safety Committee of The European Society of Urogenital Radiology decided to review the literature and to issue guidelines. The committee performed a Medline search. Based on this, a report and guidelines were prepared. The report was discussed at the Ninth European Symposium on Urogenital Radiology in Genoa, Italy. Hemodialysis and peritoneal dialysis safely remove both iodinated and gadolinium-based contrast media. The effectiveness of hemodialysis depends on many factors including blood and dialysate flow rate, permeability of dialysis membrane, duration of hemodialysis and molecular size, protein binding, hydrophilicity, and electrical charge of the contrast medium. Generally, several hemodialysis sessions are needed to removal all contrast medium, whereas it takes 3 weeks for continuous ambulatory dialysis to remove the agent completely. There is no need to schedule the dialysis in relation to the injection of iodinated or MR contrast media or the injection of contrast agent in relation to the dialysis program. Hemodialysis does not protect poorly functioning kidneys against contrast-medium-induced nephrotoxicity. Simple guidelines are given. (orig.)

  2. 黄芪注射液对高通透性腹膜透析大鼠透析效能及腹膜结构的影响%Huangqi Injection's Effect on the Dialysis Efficiency and Structure of Peritoneal Dialysis Rat with High Permeable Perineum

    Institute of Scientific and Technical Information of China (English)

    刁金囡; 盛梅笑; 朱萱萱; 王宁皎; 朱长乐; 何伟明

    2011-01-01

    目的 探讨不同浓度黄芪注射液对高通透性腹膜透析大鼠透析效能及腹膜结构的影响.方法 40只SD雄性大鼠,分空白对照组(A组)、单纯腹透组(B组)、黄芪注射液低浓度组(C组)与黄芪注射液高浓度组(D组).除A组外,余3组分别腹腔注射4.25%葡萄糖腹透液、低浓度黄芪腹透液、高浓度黄芪腹透液25mL/d,连续10d.于第11天进行腹膜功能试验,观察各组大鼠透析液留腹0、30、60 、90、120 min尿素氮D/P值(D/P urea)、肌酐D/P值(D/P Cr)、葡萄糖D/D0值(D/D0Glu)的变化,以及透析液留腹120min时尿素清除率(Curea)、肌酐清除率(CCr)、透析超滤量(UF)、净超滤量(NetUF),并采集腹膜组织观察腹膜形态结构的改变.结果 ①各透析组(B、C、D组)各时点D/P Cr高于A组、D/D0Glu低于A组(P<0.05),B组UF、NetUF 低于A组(P<0.05);②C、D组D/P urea留腹60min后各时点均高于B组(P<0.05),D组D/P Cr 留腹60、90min较B组高(P<0.05)、D/D0 Glu留腹60min较B组低(P<0.05);③D组与C组比较,D/P urea、D/P Cr(30、60、90min)与D/D0Glu(30、60min)的变化更明显(P<0.05);④D组Curea、CCr、UF、NetUF均高于 B组(P<0.05);⑤C、D组腹膜增厚及间皮细胞脱落情况较B组改善.结论 4.25%葡萄糖腹透液可造成腹膜间皮层损伤,腹膜的通透性增高,超滤量减少,腹透液中加入黄芪可以保护腹膜间皮层,提高腹膜对尿素、肌酐的清除,提高透析效能,但不增加腹膜对葡萄糖的吸收,高浓度含黄芪腹透液尚能提高腹膜对水的清除,增加透析超滤量.%OBJECTIVE To explore Huangqi injection of different concentration and their dialysis efficiency and structure effect on peritoneal dialysis rat with high permeable perineum. METHODS 40 male SD rats were divided into control group (Group A), simple peritoneal dialysis group (Group A), Huangqi injection with low concentration (Group C) and Huangqi injection with high concentration

  3. 居家腹膜透析操作者规范洗手现状及原因分析%A survey and analysis of the practice of hand hygiene among operators of home peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    芦丽霞; 乔捷; 赵慧萍

    2011-01-01

    Objective This study aimed to investigate the practice of hand-washing before bag changing among the operators who did home peritoneal dialysis (PD) and analyze the factors that influenced adherence to hand hygiene protocols. Methods During the month of April 2010, 76 operators, who did home peritoneal dialysis for PD patients in PD center of Peking University People's Hospital, received the survey. A self-designed questionnaire survey on normative hand hygiene before operating and grading standard was used for this study. Results Among peritoneal dialysis operators, the majority are females (64.5%), 65.8% are retirees and most of the dialysis operations were conducted by the patients themselves (73.7%). Only 5 of the operators (6.6%) passed when they were observed the procedures of hand washing. The average time of hand washing was 8 seconds. 57.8% of the operators omitted two parts during washing procedures, and 81.6% of the operators omitted two or more parts. The parts acconnts for higher omission rate in order were: knuckles, fingerwebs, fingertips. 14 operators passed the bacterial colony counts after hand washing, with the pass rate was 18%. The bacterial colony counts were negatively correlated with the hand washing scores, that is, the lower scores of hand washing, the higher colony counts. The operator's age, dialysis duration, education level, occupation, gender, relationship with patients and other factors were not associated with hand washing scores. Conclusion The hand washing practice of the peritoneal dialysis operators are not normative. The professional PD nurses should pay attention to give the PD operators more training about the importance and the procedures of normative hand washing,so as to improve the hand hygiene status.%目的 了解居家腹膜透析操作者操作前规范洗手的现状及其影响因素.方法 采用自行设计的操作前规范洗手调查问卷、规范洗手评分标准,对2010年4月份期间北京

  4. Diálisis peritoneal automática adaptada: un método de prescripción eficaz, eficiente y seguro

    Directory of Open Access Journals (Sweden)

    Sergi Aragó Sorrosal

    2014-09-01

    Full Text Available El objetivo del trabajo es analizar los resultados obtenidos tras la introducción de la modalidad de diálisis peritoneal automática adaptada, usando bicarbonato puro como agente tampón, en un grupo de pacientes en programa de diálisis peritoneal automática convencional. Estudio de diseño cuasi experimental, que se realizó entre los meses de febrero y diciembre de 2013, en la unidad de diálisis peritoneal del Hospital Clínic de Barcelona. Los sujetos de estudio fueron 12 pacientes, 7 mujeres y 5 hombres, de dicha unidad en modalidad de diálisis peritoneal automática convencional. Edad media 58±12 años (rango: 34-71. El estudio consistió en comparar dos modalidades de diálisis peritoneal automática. Se inició el estudio con prescripción de diálisis convencional, durante tres meses, para cambiar a modalidad de diálisis adaptada durante el mismo intervalo de tiempo. Y finalizarlo, con tres meses de pauta de diálisis convencional. Se prescribió el mismo volumen total de líquido de diálisis y tiempo de sesión, para cada paciente en ambas modalidades, variando los volúmenes y tiempos de permanencia en función de la modalidad. Se utilizó solución de diálisis con bicarbonato puro y glucosa 1,5%. Todos los pacientes, con día seco. Se monitorizaron las variables al inicio del estudio, y en cada cambio de prescripción. Los resultados obtenidos en diálisis convencional: Kt/v=2,3±0,2, aclaramiento de creatinina=63±8litros/semana, y ultrafiltración=842±110ml. En diálisis adaptada, Kt/v=2,8±0,2, aclaramiento de creatinina=74±9litros/semana, y ultrafiltración=982±123ml. La diálisis adaptada permite obtener una adecuada eficacia de tratamiento, mejora los parámetros de adecuación de diálisis y ultrafiltración; siendo segura y cómoda para el paciente.

  5. Application of King’s interactive and goal attainment theory in self-care agency of peritoneal dialysis patients%King互动达标理论对腹膜透析患者自护能力的影响

    Institute of Scientific and Technical Information of China (English)

    田瑞杰; 苗金红; 田喜梅; 樊少磊; 孙莉莉

    2013-01-01

    Objective To evaluate the effects of self-care agency of peritoneal dialysis patients by applying King’s interactive and goal attainment theory. Methods 60 peritoneal dialysis patients who were discharged from the first affiliated hospital of Zhengzhou university, department of Nephrology, were assigned into the experimental group (30 cases) and the control group (30 cases). The control group was given general nursing, the experimental group was given interactive and goal attainment intervention. 3 months after the intervention, compared the intervention effects of two groups by the scores of self-care agency scale (ESCA) and investigate the percentage before discharge. Results The scores of self-care agency of two groups have no significant difference (P>0.05) at the time of admission. After the implementation of interactive and goal attainment intervention, the self-care agency scores of the experimental group compared with the control group, the difference was statistical y significant (P﹤0.05). Results Application of King’s interactive and goal attainment theory in peritoneal dialysis patients by nursing intervention can significantly improve the self-care agency of patients, it is worthy of clinical application.%目的:探讨King互动达标理论对腹膜透析患者自我护理能力的影响。方法采用便利抽样法,选择郑州大学第一附属医院肾内科腹膜透析患者60例,随机分为对照组和实验组,每组各30例。对照组患者实施一般护理,实验组患者实施King互动达标护理。干预后3个月,采用自我护理能力测定量表(ESCA)比较两组干预效果。在出院前进行达标率调查。结果两组患者自护能力得分在入院时差异无统计学意义(P>0.05),实验组患者在实施King互动达标护理后,其自护能力得分与对照组相比,差异具有统计学意义(P<0.05),且达标率显著高于对照组(P<0.05)。结论运用King互动达

  6. Effect of reform of perioperative nursing process in peritoneal dialysis%腹膜透析围手术期护理流程改革的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    王青尔; 孙慧敏; 周婷婷; 李晴; 李韬彧; 吕桂兰

    2011-01-01

    目的 探讨对腹膜透析围手术期护理进行流程改革,分析其临床效果.方法 选择行腹膜透析治疗的160例患者为研究对象,按照住院顺序分为实验组和对照组各80例,对照组采用传统护理工作模式管理,实验组采用改进的护理流程,并比较两组患者的临床效果.结果 实验组患者平均住院日缩短(P<0.01),住院费用降低(P<0.05),患者的健康知识评分和满意度提高(P<0.01),术后1个月依从性提高(P<0.01或P<0.05).结论 采用改进的护理流程明显优于常规护理流程,可供临床围手术期护理管理借鉴.%Objective To discuss the effect of reform of perioperative nursing process in peritoneal dialysis. Methods According to the admission order, 160 new peritoneal dialysis patients were divided into observation group and the control group,with 80 cases in each group. The observation group used the reformed nursing process, and the control group used the traditional model of nursing. Then the effects of the two groups were compared after treatment. Results Compared to the control group,the average length of stay was significantly shorter (P<0.01) ,and the hospitalization costs were less (P<0.05) ,and the score of disease -related knowledge and the satisfaction rate of patients were significantly higher in the observation group (P <0. 01 ) ,the improvement of compliance after one month (P < 0. 01 or P < 0.05 ) . Conclusion The reformed nursing process is superior to the traditional model of nursing. So it is worthy of using widely in clinical perioperative nursing management.

  7. Peritonitis due to Rhizobium radiobacter

    OpenAIRE

    Marta, R; Dâmaso, C; Silva, JE; M.De Almeida

    2011-01-01

    Rhizobium radiobacter (Agrobacterium radiobacter) is an aerobic Gram-negative rod belonging to Agrobacterium genus, a group of phytopathogenic bacteria present in the soil that has been implicated in human opportunistic infections. We report a clinical case of bacterial peritonitis in a 5-year-old child with chronic renal disease in peritoneal dialysis, who had a history of direct soil contact identified. The infection was treated with ceftazidime and piperaciline+tazobactam without relapses ...

  8. Elevated levels of procoagulant plasma microvesicles in dialysis patients.

    Directory of Open Access Journals (Sweden)

    James O Burton

    Full Text Available Cardiovascular (CV death remains the largest cause of mortality in dialysis patients, unexplained by traditional risk factors. Endothelial microvesicles (EMVs are elevated in patients with traditional CV risk factors and acute coronary syndromes while platelet MVs (PMVs are associated with atherosclerotic disease states. This study compared relative concentrations of circulating MVs from endothelial cells and platelets in two groups of dialysis patients and matched controls and investigated their relative thromboembolic risk. MVs were isolated from the blood of 20 haemodialysis (HD, 17 peritoneal dialysis (PD patients and 20 matched controls. Relative concentrations of EMVs (CD144(+ ve and PMVs (CD42b(+ ve were measured by Western blotting and total MV concentrations were measured using nanoparticle-tracking analysis. The ability to support thrombin generation was measured by reconstituting the MVs in normal plasma, using the Continuous Automated Thrombogram assay triggered with 1µM tissue factor. The total concentration of MVs as well as the measured sub-types was higher in both patient groups compared to controls (p0.3. Dialysis patients have higher levels of circulating procoagulant MVs than healthy controls. This may represent a novel and potentially modifiable mediator or predictor of occlusive cardiovascular events in these patients.

  9. Elevated levels of procoagulant plasma microvesicles in dialysis patients.

    Science.gov (United States)

    Burton, James O; Hamali, Hassan A; Singh, Ruchir; Abbasian, Nima; Parsons, Ruth; Patel, Amit K; Goodall, Alison H; Brunskill, Nigel J

    2013-01-01

    Cardiovascular (CV) death remains the largest cause of mortality in dialysis patients, unexplained by traditional risk factors. Endothelial microvesicles (EMVs) are elevated in patients with traditional CV risk factors and acute coronary syndromes while platelet MVs (PMVs) are associated with atherosclerotic disease states. This study compared relative concentrations of circulating MVs from endothelial cells and platelets in two groups of dialysis patients and matched controls and investigated their relative thromboembolic risk. MVs were isolated from the blood of 20 haemodialysis (HD), 17 peritoneal dialysis (PD) patients and 20 matched controls. Relative concentrations of EMVs (CD144(+ ve)) and PMVs (CD42b(+ ve)) were measured by Western blotting and total MV concentrations were measured using nanoparticle-tracking analysis. The ability to support thrombin generation was measured by reconstituting the MVs in normal plasma, using the Continuous Automated Thrombogram assay triggered with 1µM tissue factor. The total concentration of MVs as well as the measured sub-types was higher in both patient groups compared to controls (p0.3). Dialysis patients have higher levels of circulating procoagulant MVs than healthy controls. This may represent a novel and potentially modifiable mediator or predictor of occlusive cardiovascular events in these patients. PMID:23936542

  10. 维持性血液透析与腹膜透析患者血压变异性比较%A comparative study on variability of blood pressure in patients treated by maintenance hemodialysis or continuous peritoneal dialysis.

    Institute of Scientific and Technical Information of China (English)

    王刚; 尹乐; 刘文虎

    2013-01-01

    Objective To explore the difference in variability of blood pressure ( BPV ) in patients treated by maintenance hemodialysis ( MHD ) compared with continuous peritoneal dialysis ( CAPD). Methods Thirty patients with MHD and thirty patients with CAPD in this hospital were recruited for this cross - sectional study. The ambulatory blood pressure ( ABP ) monitoring was proceeded in patients with MHD for 44 hours and in patients with CAPD for 24hours. The mean value of systolic blood pressure ( SBP ),diastolic blood pressure ( DBP ), the declining percentage of nocturnal SBP, the mean value of standard deviation ( SD ) and coefficient of variation ( CV ) were compared between patients with MHD and CAPD. These parameters were also compared between dialysis day and non - dialysis day in patients with MHD. Results The mean value of blood pressure of patients with MHD in non - dialysis day was significantly higher than that of patients with CAPD(SBP, 148. 9 ±20. 6 mm-Hg vs. 129.9±16.4 mmHg, P <0.001; DBP, 89.9±12.5 mmHg vs. 82.9±11.5 mmHg, P =0.028 ). The cases of dipper pattern blood pressure in patients with MHD in dialysis day were much higher than those in patients with CAPD ( 5/30 vs. 0, P =0. 029 ). There was no significant difference on both SD and CV between patients with MHD or CAPD. However, the SD level of DBP in non - dialysis day was larger than that in dialysis day, 10.4±2.9 vs. 12.5±5.0, P -0.031. Conclusion The blood pressure of patients with MHD in non - dialysis day is higher than that of patients with CAPD. There are dipper pattern blood pressure in some patients with MHD after hemodialysis. The variability of blood pressure in patients with MHD is larger in non - dialysis day.%目的 对比维持性血液透析(MHD)和连续性非卧床腹膜透析(CAPD)患者血压变异性,观察不同透析方式血压变化的特点.方法 选择MHD和CAPD治疗的非糖尿病尿毒症患者各30例,对MHD患者进行非透析期间的44 h动态

  11. 浙江省腹膜透析医疗服务网络构建的SWOT分析%SWOT Analysis on Medical Service Network Building of Peritoneal Dialysis in Zhejiang Province

    Institute of Scientific and Technical Information of China (English)

    胡丹; 王峦; 张璐莹; 程晓明

    2011-01-01

    Objective: Further analysis the building of peritoneal dialysis medical network in Zhejiang, and provide reference for relevant decision-making departments. Methods: SWOT analysis is used to understand its strcngth, weakness, opportunity and threat. Results: There coexist strength, weakness, opportumty and challenge. Conclusion: Relevant departments should make full use ofits strength and opportunity,develop strategies to meet challenge, and eliminate or reduce the adverse effects of disadvantage to avoid or rcsolve existing threat.%目的:进一步对浙江省腹膜透析医疗服务网络构建进行分析,为相关部门决策提供参考依据.方法:采用SWOT分析方法,了解该医疗服务网络构建的优势、劣势、机会和威胁.结果:浙江省腹膜透析医疗服务网络构建的优势、劣势、机遇和挑战并存.结论:相关部门在构建腹膜透析医疗服务网络时,要充分利用内部优势,抓住外部机遇,制定相应策略迎接挑战,消除或减弱劣势带来的不利影响,规避或解决现有威胁.

  12. Sclerosing encapsulating peritonitis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Candido, Paula de Castro Menezes; Werner, Andrea de Freitas; Pereira, Izabela Machado Flores; Matos, Breno Assuncao; Pfeilsticker, Rudolf Moreira; Silva Filho, Raul, E-mail: paulacmcandido@yahoo.com.br [Hospital Felicio Rocho, Belo Horizonte, MG (Brazil)

    2015-01-15

    Sclerosing encapsulating peritonitis, a rare cause of bowel obstruction, was described as a complication associated with peritoneal dialysis which is much feared because of its severity. The authors report a case where radiological findings in association with clinical symptoms have allowed for a noninvasive diagnosis of sclerosing encapsulating peritonitis, emphasizing the high sensitivity and specificity of computed tomography to demonstrate the characteristic findings of such a condition. (author)

  13. 利用三级医疗体系推广腹膜透析社区化管理模式的初步研究%Promotion of Community Management Mode of Peritoneal Dialysis based on Third-level Medical System

    Institute of Scientific and Technical Information of China (English)

    刘旭; 张东亮; 王刚; 尹乐; 郭王; 刘文虎

    2012-01-01

    Objective To promote the community management mode of peritoneal dialysis based on the Third - Level medical system. Methods On the basis of academic strength of the Third - Level hospital to help to establish community center for peritoneal dialysis in primary medical institutions and to train professional medical care technicians of peritoneal dialysis. According to relative occupational documents on standardized operating specifications of peritoneal dialysis issued by the Ministry of Health, to formulate operating and managing procedures suitable for primary medical institutions, as well as the procedures and standards of patient referral with the Third - Level hospital. A preliminary evaluation of the model was carried out through the therapeutic effect for the patients, and the feedback from investigation of patients and their family members, and medical staff. Results The duration of this study was one month. All together 10 peritoneal dialysis professionals were trained for primary medical institutions, and the community person - times for clinic visit went up about 500, and 30 uremia patients were treated with peritoneal dialysis. The patients' conditions after the treatment were good, and it is convenient for the patients to seek medical care, the patients' costs were reduced, and the satisfaction rate reached 100%. Conclusion The community management mode of peritoneal dialysis based on Third - Level medical system can promote reasonable disposition and utilization of medical resources , which brings on great social and economic benefits, therefore it is worth popularizing.%目的 利用三级医疗体系推广腹膜透析社区化管理模式.方法 依托三级医院学术力量,协助基层医疗单位建立社区化腹膜透析分中心、培训腹膜透析专业医疗护理技术人员.参照卫生部腹膜透析标准化操作规范等行业文件,制定适合基层医疗单位操作的工作、管理流程,以及三级医疗机构间患者双向

  14. MEK 1/2 inhibitors for the treatment of peritoneal fibrosis

    OpenAIRE

    Pozo Barriuso, Miguel Ángel del; López Cabrera, Manuel; Strippoli, Raffaele

    2008-01-01

    [EN] Drugs useful in the prevention and treatment of fibrosis of the peritoneal membrane (peritoneal opacification, tanned peritoneum syndrome, mural fibrosis and sclerosing peritonitis syndrome), which arises as a consequence of long-term peritoneal dialysis, method for selecting such dmgs and method for collecting data that are useful in the diagnosis of said disease.

  15. 持续不卧床腹膜透析患者需要状况的质性研究%The qualitative research on needs of continuous ambulatory peritoneal dialysis patients.

    Institute of Scientific and Technical Information of China (English)

    洪菲菲; 孟繁洁

    2011-01-01

    目的:了解持续不卧床腹膜透析患者的需要状况,为临床护理措施实施提供依据.方法:运用现象学的方法,对13例实施持续性不卧床腹膜透析3个月以上患者进行深入访谈.采用类属分析法将收集到的资料依据马斯洛人类基本需要层次论进行整理、归类和分析.结果:持续性不卧床腹膜透析患者存在各种需要无法满足的状况,随着透析时间的延长这种状况更加突出.结论:护理人员应针对持续性不卧床腹膜透析患者不同阶段实施个性化护理,以最大限度地满足患者的各种需要,提高其生活质量.%Objective:To know about the needs of continous ambulatory peritoneal dialysis patients,in order to provide basis for clinical nursing. Methods: A total of 13 CAPD patients were investigated in depth by adopting phenomenology mothd. And data collected from them were sorted out, categorized and analyzed by abraham maslow requirement layer theory in analysis on classifications. Results:There are various un - satisfied conditions in CAPD patients. And this conditions is becoming increasingly conspicuous as time prolonging. Conclusion:Nursing staff should provide personalization services at different stage of CAPD to meet needs of patients in maximum and improve their quality of life.

  16. Relevância do estado de hidratação na interpretação de parâmetros nutricionais em diálise peritoneal Relevance of hydration status on the interpretation of nutritional parameters in peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Aline de Araujo Antunes

    2011-02-01

    determinants of the hydration status of chronic peritoneal dialysis patients and investigated the effects of fluid overload on their nutritional status. METHODS: A cross-sectional study was conducted in 2006 to evaluate 27 chronic peritoneal dialysis patients from the Dialysis Center of the Medical School Hospital of Botucatu (SP, considering clinical, dialytic, laboratory, anthropometric and bioimpedance parameters. A linear multiple regression model was used to evaluate the influence of these parameters on hydration status. The sample was stratified according to hydration status, given by the ratio between extracellular water and total body water (0.47 for males and 0.52 for females, obtained by bioelectrical impedance. Analysis of covariance, Mann-Whitney test, chi-square test, and Fisher's exact test were used for making comparisons. The significance level was set at 5% (p≤0.05. RESULTS: Patients with greater urine volume and receiving automatic dialysis presented better hydration status. Patients with higher fluid overload, compared with those with lower overload, presented lower phase angle (M=4.2, SD=0.9 vs. M=5.7, SD=0.7º; p=0.006, lower albumin levels (M=3.06, SD=0.46 vs. M=3.55, SD=0.52g/dL; p=0.05, and higher percentage of triceps skinfold thickness (M=75.3, SD=36.9 vs. M= 92.1, SD=56.9; p=0.058. No other anthropometric differences were observed. CONCLUSION: Low levels of albumin and phase angle in patients with higher fluid overload were not related to worse nutritional status. This result suggests that one must consider the set of variables obtained by many methods and relate and interpret them comprehensively in order to obtain a reliable nutritional diagnosis of patients with fluid overload.

  17. 循证护理在预防腹膜透析并发症中的应用%The application of evidence-based nursing in the prevention of peritoneal dialysis-related complications

    Institute of Scientific and Technical Information of China (English)

    廖周谊; 文艳秋; 陈凤

    2012-01-01

    Objective To investigate the efficacy of application of evidence-base nursing in peritoneal dialysis (PD) patients to prevent PD-related complications. Methods A series of 83 PD patients enrolled in 2007 were set as the routine nursing groupCRN group). Another 82 PD patients enrolled in 2008 were set as the evidence-based nursing group (EBN group) , with PD-related complications assessed and then managed according to evdience-based nursing principles. Clinical outcomes were analyzed. Results Hemorrhagic complicatons occurred in 6 patients in the RN group and 4 4 in the EBN group. In addition, the ratio of abdominal pain/distention, dialysate leakage, inadequate drainage of peritoneal fluid, catheter exit and tunnel infection and peritonitis between the RN group and the ENB group was 8 to 4, 2 to 0, 14 to 6, 4 to 1 and 6 to 2 respectively. The incidence of complications between these two groups was statistically different (P< 0. 05). Conclusion The application of evidence-based nursing could effectively reduce the incidence of PD-related complications. Evidence-based nursing is helpful to modify routine modality of nursing, to solve problems in clinical practices and to improve the quality of nursing.%目的 探讨循证护理在预防腹膜透析并发症中的应用价值.方法 将2007年83例行腹膜透析的患者设为常规护理组,2008年82例行腹膜透析的患者设为循证护理组,对出现的并发症进行临床评估,应用循证护理思维加以具体指导,制定护理干预措施,并对干预结果进行分析.结果 常规组/循证组中出血者6例/4例,腹痛腹胀者8例/4例,腹透管周围漏液者2例/0例,腹膜透析液引流不畅者14例/6例,皮肤出口及隧道感染者4例/1例,腹膜炎者6例/2例,两组患者并发症发生率比较具有统计学差异(P<0.05).结论 采取循证护理能有效减少腹膜透析并发症的发生,改变了护理人员经验式的护理观念和传统护理模式,解决了临床护理

  18. 可溶性酪氨酸激酶2融合蛋白对尿毒症腹膜透析大鼠腹膜形态和功能的影响%Soluble tyrosine kinase 2 fusion protein ameliorates peritoneal morphologic and functional changes in uremic peritoneal dialysis rats

    Institute of Scientific and Technical Information of China (English)

    严豪; 方炜; 李振元; 林爱武; 曹励欧; 袁江姿; 倪兆慧; 钱家麒

    2010-01-01

    目的 研究可溶性酪氨酸激酶2融合蛋白(sTie-2-Fc)对尿毒症腹膜透析大鼠腹膜血管新生、溶质转运和超滤功能的影响.方法 32只雄性Wistar大鼠按数字随机法分为假手术组、尿毒症组、尿毒症腹透组和sTie-2-Fc干预组(均n=8).尿毒症腹透组和sTie-2-Fc干预组大鼠经腹透管每天2次腹腔灌注4.25%葡萄糖透析液(3 ml/100 g体质量)共4周,sTie-2-Fc干预组大鼠每次灌注时在透析液中加入1μg sTie-2-Fc.各组大鼠处死前行腹膜平衡试验,检测腹膜转运和超滤功能,取大网膜标本行抗CD31免疫组化染色并计血管数.结果 与假手术组大鼠相比,尿毒症组大鼠的2 h腹透液和血肌酐比值(D/Pcr)增高(0.78±0.05比0.70±0.09,P=0.028),腹透液2 h与0 h葡萄糖比值(D/D0)降低(0.69±0.05比0.76±0.07,P=0.033),腹膜超滤量(UF,ml)减少(2.29±0.50比4.58±1.64,P=0.005),腹膜血管数量增加[(5.8±3.0)/HP比(1.6±0.5)/HP,P<0.01].尿毒症腹透组大鼠的溶质转运较尿毒症组大鼠进一步增高(D/Pcr:0.89±0.05比0.78±0.05,P<0.01;D/D0:0.47±0.09比0.69±0.05,P<0.01),UF(ml)减少(0.40±0.59比2.29±0.50,P=0.005),腹膜血管数量增多[(16.7±1.2)/HP比(5.8±3.0)/HP,P<0.01].干预组大鼠使用sTie-2-Fc后,UF(ml)较尿毒症腹透组大鼠显著增加(1.56±0.48比0.40±0.59,P=0.014),腹膜血管数量显著减少[(9.2±1.2)/HP比(16.7±1.2)/HP,P<0.01],但两组大鼠的D/Pcr和D/DO差异均无统计学意义.结论 sTie-2-Fc使尿毒症腹透大鼠腹膜血管新生减少,超滤增加,有利于保护腹膜结构和功能,可能是防治腹透后腹膜结构和功能改变的另一靶点.%Objective To explore the effect of soluble tyrosine kinase 2 fusion protein (sTie-2-Fc) on peritoneal angiogenesis, solute transport and ultrafi]tration capacity in uremic rats undergoing peritoneal dialysis (PD). Methods Thirty-two male Wistar rats were randomly divided into sham-operation group, uremic group, uremic PD group, and sTie-2-Fc group

  19. Dialysis - hemodialysis

    Science.gov (United States)

    Artificial kidneys - hemodialysis; Dialysis; Renal replacement therapy - hemodialysis; End-stage renal disease - hemodialysis; Kidney failure - hemodialysis; Renal failure - hemodialysis; Chronic kidney disease - hemodialysis

  20. Peritoneal mesothelioma.

    OpenAIRE

    Anderson, J H; Stewart, C. J.; Hansell, D T; Anderson, J. R.

    1993-01-01

    We report two patients who presented with small bowel obstruction secondary to peritoneal mesothelioma. The difficulties in establishing this diagnosis at an early stage are illustrated. Recent advances in the management of peritoneal mesothelioma are reviewed.

  1. Comportamiento del orificio de implantación del catéter en pacientes en diálisis peritoneal en relación a los cuidados Behaviour of the catheter wound in peritoneal dialysis patients in relation to care

    Directory of Open Access Journals (Sweden)

    A. Concepción Gómez Castilla

    2007-12-01

    Full Text Available Las infecciones del orificio de salida en diálisis peritoneal son la causa de morbilidad más frecuente en los pacientes sometidos a esta técnica. Existen numerosos procedimientos para los cuidados del orificio y no resulta fácil definir un único método que garantice el buen estado del orificio. Con el fin de valorar el comportamiento del orificio relacionado con el procedimiento utilizado en sus cuidados estudiamos a 306 pacientes durante 24 meses, recogiendo variables sociodemográficas y clínicas. Hemos encontrado una alta incidencia de infecciones del orificio producidas por gérmenes gram positivos de piel y mucosas, con una correlación fuerte con el hecho de que el paciente/familiar cuidador sea portador nasal de estafilococo áureo y que aparecen con mayor frecuencia en los pacientes que no retiran el apósito para la ducha. Así mismo hemos detectado un aumento en infecciones por pseudomona cuando el paciente no procede al secado del orificio con secador.Infections of the catheter wound in peritoneal dialysis are the most frequent cause of morbility in patients who undergo this technique. There are a number of procedures for the care of the wound and it is not easy to define a single method that will guarantee good condition of the wound. In order to evaluate the behaviour of the wound related to the procedure used in their care, we studied 306 patients over 24 months, compiling socio-demographic and clinical variables. We found a high incidence of infections caused by gram-positive skin and mucous germs, with a strong correlation with the fact that the patient/family carer is a nasal carer of staphylococcus aureus and that they appear more frequently in patients who do not remove the wound dressing in the shower. We also detected an increase in pseudomonas infections when the patient does not dry the wound with a hair-dryer.

  2. QOL Comparison between Hemodialysis and Peritoneal Dialysis Patients and Its Influencing Factors%血液透析和腹膜透析患者的生命质量对比及影响因素研究

    Institute of Scientific and Technical Information of China (English)

    热娜; 赵新; 张豫; 刘健

    2013-01-01

    目的 比较新疆血液透析(血透)和腹膜透析(腹透)患者的生命质量,探讨透析患者生命质量的影响因素.方法 采用多中心调查法.282例患者选自新疆7所医院,血透患者215例(血透组),腹透患者67例(腹透组),用简明健康调查量表(SF-36)、自制人口学问卷对两组患者进行现场调查.结果 (1) 腹透患者的SF-36的总分及躯体疼痛、社会功能及精神健康维度的得分均高于血透患者,差异有统计学意义(P<0.05);其他维度的得分比较,差异均无统计学意义(P>0.05).(2)无论是血透组还是腹透组,汉族和少数民族患者的SF-36总分及各维度得分比较,差异均无统计学意义(P>0.05);原发病为糖尿病的患者其SF-36总分及生理功能、生理职能、躯体疼痛、精力维度得分均低于非糖尿病患者,差异有统计学意义(P<0.05);就业患者的SF-36总分及生理职能、总体健康、社会功能、情感职能、精神健康维度的得分均高于失业患者,差异有统计学意义(P<0.05).(3)多元线性回归分析结果显示,透析方式、年龄、文化程度、工作状态、原发病对SF-36得分的影响有统计学意义(P<0.05).结论 (1)新疆血透患者的生命质量总分低于腹透患者,透析早期可优先考虑腹透.(2)汉族、少数民族透析患者生命质量无差异;糖尿病患者的生命质量低于非糖尿病患者,失业患者的生命质量低于就业患者.(3)透析方式、年龄、文化程度、工作状态、原发病多因素影响透析患者的生命质量.%Objective To compare the quality of life ( QOL ) of hemodialysis ( HD ) and peritoneal dialysis ( PD ) patients in Xinjiang and to explore its influencing factors. Methods Short Form - 36 ( SF - 36 ) and self - made demographic questionnaire were used to cany out an on - site investigation in 215 HD and 67 PD patients. Results ( 1 ) The SF -36 total score and scores of bodily pain ( BP ), social function ( SF

  3. Effect of nursing interventions on quality of life for patients undergoing continuous ambulatory peritoneal dialysis: A Meta-analysis%护理干预对腹膜透析患者生活质量影响的Meta分析

    Institute of Scientific and Technical Information of China (English)

    庞建红; 汪小华; 刘永琴; 鞠阳; 许义

    2014-01-01

    Objective To evaluate the effect of nursing interventions on the quality of life of patients undergoing continuous ambulatory peritoneal dialysis (CAPD).Methods Randomized controlled trials (RCTs) involving nursing interventions were collected from the databases of Cochrane,PubMed,Elsevier Science Direct,VIP,CNKI and WanFang.Data were analyzed with RevMan 5.1 software.Results 8 articles met the inclusion criteria.The results of Meta-analysis showed that there was considerable heterogeneity across the analysis,which might be resulted from length of intervention and patients of different ages according to subgroup analysis,and that gender was not the factor causing heterogeneity.In the experimental group,both physical and emotional aspects after receiving nursing interventions were significantly improved than the control group.Conclusions Nursing interventions can improve the quality of life of patients with CAPD.%目的 评价护理干预对持续非卧床腹膜透析(CAPD)患者生活质量的影响.方法 计算机检索Cochrane、PubMed、Elsevier Science Direct、VIP、CNKI、万方数据库并辅以互联网络检索.收集对CAPD患者进行护理干预的随机对照试验(RCT),采用RevMan 5.1软件进行统计处理.结果 共纳入RCT文献8篇.Meta分析结果显示,本组资料存在一定的异质性,其中干预时间和年龄是导致异质性的主要原因,以性别分组进行亚组分析显示异质性未能明显消除.干预组患者在情感职能维度得分高于对照组;在躯体疼痛和心理健康维度得分明显高于对照组;在生理功能、生理职能、总体健康、生命活力和社会功能维度得分显著高于对照组.结论 护理干预可以提高CAPD患者的生活质量.

  4. Practice of self-care ability test in patients on domestic peritoneal dialysis therapy%居家腹膜透析患者自我护理能力考核的实践

    Institute of Scientific and Technical Information of China (English)

    郭玲玲; 胡雁; 费剑英; 应茉薇; 李爱夏

    2012-01-01

    Objective To improve self-care ability and health condition of homebased peritoneal dialysis (PD) patients. Methods A total of 86 PD patients were randomly divided into a control group and an observation group of 43 according to their even or odd admission numbers. Patients in the control group were given conventional health education, while their counterparts in the observation group received self-care ability test and stratified education. Results Compared with the control group, the incidence rate of PD-re-lated infections was significantly lower in the observation group after 3 months, and the total score and dimension scores of knowledge, attitude, and behavior of self-care ability were significantly higher (P<0. 05,P<0. 01). The scores of PD-related knowledge and skills in the observation group were significantly improved after the intervention (P<0. 01 for both). Conclusion Self-care ability test and stratified education applied to PD patients can improve their self-care ability and health condition.%目的 提高居家腹膜透析(PD)患者自我护理能力及改善其健康状况.方法 将86例居家PD患者按门诊就诊奇偶数分为对照组与观察组各43例.对照组进行常规健康教育;观察组进行自我护理能力考核和分层次健康教育.结果 3个月后观察组PD相关感染并发症发生率显著低于对照组,自我护理能力中知识、态度、行为维度及总分显著高于对照组(P<0.05,P<0.0l),观察组知识及技能评分较干预前显著提高(均P<0.01).结论 对PD患者开展自我护理能力考核及分层次教育,能提高患者的自我护理能力,从而改善患者的健康状况.

  5. Peritoneal carcinosis

    International Nuclear Information System (INIS)

    Abdominal CT yields several pieces of information for the diagnosis of secundary neoplastic involvement of the peritoneum (peritoneal car-cinosis). Peritoneal carcinosis may be the first clinical sign of an occult primary tumor. CT scans of 120 patients with peritoneal car-cinosis confirmed by pre/peri-operative biopsy or at autopsy, were retrospectively reviewed. The CT patterns of peritoneal carcinosis were detected in 20 of 44 patients with an occult malignancy. In 16 of 76 cases with a known malignancy there was no evidence of secondary peritoneal involvement. The incidence of CT findings and their correlation with the primary tumor are critically discussed. The authors have assessed the utility of CT in detecting peritoneal carcinosis, even though in their experience CT findings of secondary neoplastic peritoneal involvement could not be correlated with a primary tumor

  6. Intelligent predicting approach of peritoneal fluid absorption rate based-on neural network

    Institute of Scientific and Technical Information of China (English)

    Mei ZHANG; Yueming HU; Tao WANG

    2003-01-01

    This paper addresses the important intelligent predicting problem of peritoneal absorption rate in the peritoneal dialysis treament process of renal failure. As the index of dialysis adequacy, KT/V and Ccr are widely used and accepted. However,growing evidence suggests that the fluid balance may play a critical role in dialysis adequacy and patient outcome. Peritoneal fluid absorption decreases the peritoneal fluid removal. Understanding the peritoneal fluid absorption rate will help clinicians to opthnize the dialysis dwell time. The neural network approach is applied to the prediction of peritoneal absorption rate. Compared with multivariable regression method, the experimental results showed that neural network method has an advantage over multivariable regression. The application of this predicting method based-on neural network in clinic is instructive.

  7. Update on dialysis economics in the UK.

    Science.gov (United States)

    Sharif, Adnan; Baboolal, Keshwar

    2011-03-01

    The burgeoning population of patients requiring renal replacement therapy contributes a disproportionate strain on National Health Service resources. Although renal transplantation is the preferred treatment modality for patients with established renal failure, achieving both clinical and financial advantages, limitations to organ donation and clinical comorbidities will leave a significant proportion of patients with established renal failure requiring expensive dialysis therapy in the form of either hemodialysis or peritoneal dialysis. An understanding of dialysis economics is essential for both healthcare providers and clinical leaders to establish clinically efficient and cost-effective treatment modalities that maximize service provision. In light of changes to the provision of healthcare funds in the form of "Payment by Results," it is imperative for UK renal units to adopt clinically effective and financially accountable dialysis programs. This article explores the role of dialysis economics and implications for UK renal replacement therapy programs. PMID:21364210

  8. A Qualitative ResearCh of Tiredness Related to Poor Sleep in Peritoneal Dialysis Patients%腹膜透析患者睡眠相关疲乏的质性研究

    Institute of Scientific and Technical Information of China (English)

    田兴; 娄小平; 刘畅; 李争艳; 罗静; 田瑞杰

    2015-01-01

    [AbstraCt] ObjeCtive To understand the experience of tiredness related to poor sleep in peritoneal dialysis( PD) patients. Methods A qualitative method was used to conduct in _ depth interviews with 13 PD patients receiving peritoneal dialysis in the First Affiliated Hospital of Zhengzhou University from December,2012 to August,2013 recruited by purposive sampling. Data were analyzed by Colaizzi phenomenotogical research method. Results The tiredness feelings fell into 3 themes, including patientsˊ perception of fatigue:mental and physical tiredness,sleepiness;the results of the fatigue:having such negative emotions as shame,concern,irritability,anxiety and loneliness,inactive,less creative and less concentrated, fragile;self fatigue _ adapting abilities and strategies:fighting for tiredness,being more obedient and indifferent,accepting and adapting to fatigue. ConClusion Constant tiredness makes PD patients have different feelings and physiological perception. Negative responses like perplexity and sleepiness confine their physical activity,awareness of their physical function and normal social activity,causing them under corresponding psychological burden. In their fight for tiredness,they finally accept or become obedient and indifferent. The medical workers should pay more attention to the problem of tiredness,evaluate their sleep quality and daily activities in time,take appropriate measures to change patientsˊ awareness of PD so as to help them reduce their tiredness and improve their sleep quality.%目的:了解腹膜透析患者睡眠相关疲乏的感受和经历。方法采用目的抽样法,于2012年12月—2013年8月选取在郑州大学第一附属医院行腹膜透析治疗的患者13例为本研究对象。应用质性研究方法,对13例因睡眠质量差而致疲乏的腹膜透析患者进行深度访谈,采用 Colaizzi 描述性现象学研究法分析资料。结果腹膜透析患者睡眠相关疲乏的感受

  9. Iron inhibits respiratory burst of peritoneal phagocytes in vitro

    DEFF Research Database (Denmark)

    Gotfryd, Kamil; Jurek, Aleksandra; Kubit, Piotr;

    2011-01-01

    Objective. This study examines the effects of iron ions Fe(3+) on the respiratory burst of phagocytes isolated from peritoneal effluents of continuous ambulatory peritoneal dialysis (CAPD) patients, as an in vitro model of iron overload in end-stage renal disease (ESRD). Material and Methods. Res...

  10. Mycobacterium avium complex-associated peritonitis with CAPD after unrelated bone marrow transplantation.

    Science.gov (United States)

    Miyashita, Emiko; Yoshida, Hisao; Mori, Daisuke; Nakagawa, Natsuki; Miyamura, Takako; Ohta, Hideaki; Seki, Masafumi; Tomono, Kazunori; Hashii, Yoshiko; Ozono, Keiichi

    2014-12-01

    Peritonitis remains an important complication of peritoneal dialysis and is mostly caused by aerobic enteric bacteria. Non-tuberculous mycobacteria (NTM)-associated peritonitis is an unusual but serious infection, requiring special culture techniques to avoid delay in diagnosis. We report the case of an 11-year-old girl with aplastic anemia on ambulatory peritoneal dialysis who had Mycobacterium avium complex-associated peritonitis after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This case emphasizes that we should be constantly cautious about NTM infection in allo-HSCT recipients, especially when standard cultures are negative and the infection is refractory to empirical antibiotic therapy. PMID:25521993

  11. Sclerosing peritonitis: an unusual cause of ascites in a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Pepels, M J A E; Peters, F P J; Mebis, J J I R; Ceelen, Th L; Hoofwijk, A G M; Erdkamp, F L G

    2006-10-01

    Sclerosing peritonitis is a rare condition characterised by fibrosis and adhesion of the peritoneum to loops of the small intestine. It is generally associated with continuous peritoneal dialysis, peritoneo-venous shunts or &beta-adrenergic blocking agents. In this case we report a female patient with idiopathic sclerosing peritonitis and systemic lupus erythematosus. PMID:17057274

  12. Treatment Methods for Kidney Failure: Peritoneal Dialysis

    Science.gov (United States)

    ... campuses in Maryland and Arizona Research Resources Protocols, repositories, mouse models, plasmids, and more Technology Advancement & Transfer ... through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, ...

  13. Treatment Methods for Kidney Failure: Peritoneal Dialysis

    Science.gov (United States)

    ... and water in foods such as fruits, vegetables, ice cream, gelatin, soup, and ice pops. You need water ... for Scientists Current Funding Opportunities Funded Grants & Grant History Funding Process Research Programs & Contacts Research Training & Career ...

  14. When to initiate renal replacement therapy: The trend of dialysis initiation

    OpenAIRE

    Lin, Ze-Hua; Zuo, Li

    2015-01-01

    The timing of renal replacement therapy for patients with end-stage renal disease has been subject to considerable variation. The United States Renal Data System shows an ascending trend of early dialysis initiation until 2010, at which point it decreased slightly for the following 2 years. In the 1990s, nephrologists believed that early initiation of dialysis could improve patient survival. Based on the Canadian-United States Peritoneal Dialysis study, the National Kidney Foundation Dialysis...

  15. Sclerosing Encapsulating Peritonitis; Review

    Directory of Open Access Journals (Sweden)

    Norman O. Machado

    2016-05-01

    Full Text Available Sclerosing encapsulating peritonitis (SEP is a rare chronic inflammatory condition of the peritoneum with an unknown aetiology. Also known as abdominal cocoon, the condition occurs when loops of the bowel are encased within the peritoneal cavity by a membrane, leading to intestinal obstruction. Due to its rarity and nonspecific clinical features, it is often misdiagnosed. The condition presents with recurrent episodes of small bowel obstruction and can be idiopathic or secondary; the latter is associated with predisposing factors such as peritoneal dialysis or abdominal tuberculosis. In the early stages, patients can be managed conservatively; however, surgical intervention is necessary for those with advanced stage intestinal obstruction. A literature review revealed 118 cases of SEP; the mean age of these patients was 39 years and 68.0% were male. The predominant presentation was abdominal pain (72.0%, distension (44.9% or a mass (30.5%. Almost all of the patients underwent surgical excision (99.2% without postoperative complications (88.1%.

  16. 血液透析和腹膜透析患者生活质量评价%The evaluation of quality of life in hemodialysis and peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    王小琳

    2012-01-01

    Objective:The study investigated the differences of hemodialysis ( HD) and peritoneal dialysis ( PD) patients in quality of life (QoL). Methods: 75 HD patients and 46 PD patients were employed to our investigation from January 2010 to December 2011. Patient - reported assessments included: WHOQOL - BREF inventory of World Health Organization, General Health Questionnaire ( GHQ - 28 ) of Goldberg, State - Trait Anxiety Inventory, Center for Epidemiologic Studies Depression Scale ( CES - D) and Multidimensional Health Locus of Control ( MHLC) , then the data were analyzied statistically. Results:Indicated that HD patients reported lower QoL in the environment and social relationships domains,more symptoms were also reported in the GHQ - 28 subscales of anxiety/insomnia and severe depression. Conclusion: The findings confirm the differences between the two treatment modalities, indicating that HD patients have poorer QoL in several aspects of their environment and their social relationships. Both groups reported elevated depression. However, HD patients reported more suicidal thoughts and sleep problems compared to PD patients.%目的:研究血液透析患者和腹膜透析患者生活质量的差异.方法:对我院2010年1月~2011年12月血液透析患者75例,腹膜透析患者46例进行问卷调查,调查工具为世界卫生组织生存质量测定简式量表(WHOQOLBREF)、一般健康问卷(CHQ - 28)、状态-特质焦虑问卷(STAI 1/STAI 2)、流行病调查中心抑郁量表(CES - D)、多纬度健康状况心理控制源量表(MHLC),并进行统计学分析.结果:血液透析患者在环境和社会关系方面生活质量较低,并且在GHQ -28表中显示更易焦虑/失眠和严重抑郁,在CES-D与STAI 1/STAI 2中两者无统计学差异,在MHLC量表中,血液透析患者求助医师方面低于腹膜透析患者.结论:血液透析和腹膜透析两种治疗模式存在差异性,血液透析患者比腹膜透析患者生活质量

  17. Association between diet and arterial stiffness in patients with continuous ambulatory peritoneal dialysis%腹膜透析患者饮食成分与大动脉僵硬度的关系

    Institute of Scientific and Technical Information of China (English)

    张聪; 邵凤民; 鲁新红; 田顺利; 范晓红

    2010-01-01

    目的 探讨持续性非卧床腹膜透析(CAPD)患者饮食营养成分与大动脉僵硬度的关系.方法 选取同一中心92例饮食状况稳定的CAPD患者为研究对象.采用自动脉搏波速度分析仪测定脉搏波速度(PWV),由专业的营养师计算患者饮食组成部分,与PWV进行相关和多元回归分析,筛选出大动脉僵硬度的影响因素.结果 Pearson分析发现PWV与尼克酸 (r=-0.148,P<0.05)、维生素C(r=-0.125,P<0.05)、维生素E(r=-0.181,P<0.05)、碳水化合物(r=-0.181,P<0.05)、能量(r=-0.147,P<0.05)、蛋白质(r=-0.154,P<0.05)相关.多元回归分析结果显示,饮食中维生素E(β=-0.163,P=0.022)及碳水化合物(β=-0.284,P=0.025)是PWV的独立相关因素,二者一起决定了PWV变化的5%.结论 腹膜透析患者饮食维生素E、碳水化合物与PWV密切相关.维生素E、碳水化合物是腹膜透析患者大动脉僵硬度的独立影响因素.%Objective To investigate the association between dietary nutritive composition and pulse wave velocity (PWV)in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods CAPD patients (n=92) of stable dietary habits in one single center were included.Carotid-femoral PWV was measured with a validated automatic device and was used as an index of large arterial stiffness.Dietary nutritive composition of these patients were calculated by a professional nutritionist. Pearson's correlation and multiple regression analysis were performed to identify the relationship between nutritive composition and PWV.Results PWV was closely associated with nicotinic acid (r=-0.148,P<0.05),vitamin C(r=-0.125,P<0.05),vitamin E (r=-0.181,P<0.05),carbohydrates (r=-0.181,P<0.05),energy (r=-0.147,P<0.05),protein(r=-0.154,P<0.05), respectively.Multiple regression analysis showed that PWV was independently determined by vitamin E (β=-0.163,P=0.022)and Carbohydrates (β=-0.284,P=0.025).They accounted for 5% of the total variance.Conclusions Dietary vitamin E and

  18. 内皮功能障碍评估对腹膜透析患者预后价值的研究%Prognostic value of endothelial dysfunction assessment in patients on peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    吴桂艳; 刘阳; 邬明阳; 孙洪芹; 李金芝; 李金玲; 吴虹娟

    2015-01-01

    Objective To explore the value of endothelial dysfunction assessment in predicating major adverse cardiac and cerebrovascular events (MACCE) in peritoneal dialysis (PD) patients.Methods A prospective cohort study included 136 end stage renal disease (ESRD) patients from Jan 1,2009 to Dec 31,2011 was conducted.Endothelial function was assessed by flowmediated dilation (FMD) of brachial artery.Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared by the log-rank test.Multivariate Cox proportional hazards regression was used to determine the independent risk factors of MACCE.Results In the follow-up period,18 patients in low FMD (FMD≤2.7%) group occurred MACCE,and 13 patients in high FMD (FMD > 2.7%) group occurred MACCE.Compared with high FMD group,MACCE-free survival rate in the low FMD group had a significantly decreased (x2=4.190,P=0.041).Multivariate Cox proportional hazards regression analysis showed that higher level of total cholesterol,lower FMD,longer PD time and higher levels of hs-CRP were all independent predictors of MACCE.Conclusion Reduced brachial artery FMD is an independent risk factor of MACCE,and the application of FMD contributes to the risk stratification of cardiac and cerebrovascular disease in PD patients.%目的 探讨血管内皮功能障碍对腹膜透析(PD)患者主要不良心脑血管事件(MACCE)的预测价值.方法 前瞻性队列研究,以2009年1月1日至2011年12月31日期间行腹膜透析的136例终末期肾病患者为研究对象.内皮功能指标采用超声测量的肱动脉血流介导的舒张功能(FMD),随访以电话随访为主,辅以住院随访、门诊随访.生存率估算应用Kaplan-Meier法,组间生存率比较采用log-rank检验,应用多变量Cox比例风险回归分析MACCE的独立危险因素.结果 在随访期内,低FMD (FMD≤2.7%)组有18例出现MACCE,高FMD(FMD> 2.7%)组有13例出现MACCE.Kaplan-Meier曲线表明,与

  19. Cross-sectional study and influencing factors of self-management ability in patients undergoing continuous ambulatory peritoneal dialysis%腹膜透析患者自我管理能力的横断面研究及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    庞建红; 汪小华; 王菲; 陈月琴; 鞠阳; 许义; 马珊珊

    2014-01-01

    Objective To investigate the status quo and influencing factors of self-management ability in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).Methods Totally 339 CAPD patients with clinical follow-up regularly were investigated for the situation of self-management with general information questionnaire and Self-management Scale for CAPD.Results The total score of patients' self-management ability was (66.03±15.57).Multiple linear regression analysis showed that education level,marital status,occupation and duration of dialysis were influencing factors of patients' self-management ability.Conclusions Patients undergoing CAPD have certain degree of self-management ability.Nurses should promote their self-management ability according to different education level,marital status,occupation and duration of dialysis.%目的 了解持续非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者自我管理能力现状,并探讨其影响因素.方法 采用一般资料调查表和CAPD患者自我管理量表,对339例常规门诊随访的CAPD患者进行调查,并对调查结果进行分析.结果 本组患者自我管理总分为(66.03±15.57)分,多元线性回归分析显示,影响患者自我管理能力的主要因素有文化程度、婚姻状况、工作状态和透析龄.结论 本次受调查的患者具有一定的自我管理能力,临床护理人员可针对不同文化程度、婚姻状况、工作状态及透析龄的患者采取差异性的健康教育方式,促进患者自我管理能力的提高.

  20. Source of peritoneal proteoglycans. Human peritoneal mesothelial cells synthesize and secrete mainly small dermatan sulfate proteoglycans.

    OpenAIRE

    Yung, S; Thomas, G. J.; Stylianou, E; Williams, J D; Coles, G. A.; Davies, M.

    1995-01-01

    This study describes experiments that compare the proteoglycans (PGs) extracted from the dialysate from patients receiving continuous peritoneal ambulatory dialysis (CAPD) with those secreted by metabolically labeled human peritoneal mesothelial cells in vitro. The PGs isolated from both sources were predominantly small chondroitin sulfate/dermatan sulfate PGs. Western blot of the core proteins obtained after chondroitin ABC lyase treatment with specific antibodies identified decorin and bigl...

  1. Augmentation index's change and its influencing factor in patients on continuous ambulatory peritoneal dialysis%持续性非卧床腹膜透析患者增强指数的变化及影响因素

    Institute of Scientific and Technical Information of China (English)

    孙特; 林洪丽; 张瑜; 于长青; 孙红艳

    2010-01-01

    目的 应用增强指数(AI)检测持续性非卧床腹膜透析(CAPD)患者的动脉弹性,分析影响AI的因素,评估CAPD患者的动脉弹性功能状况.方法 测量46例CAPD患者(CAPD组)及42例健康者(对照组)的身高、体重、血压,检测血液指标,应用桡动脉压力波形分析仪测定AI,分析影响AI的因素.结果 CAPD组患者的收缩压、舒张压、脉压、中心动脉压和心率换算成75次/min的AI值(AIP75)明显高于对照组.CAPD患者女性的AIP75明显高于男性[(96.67±8.95)%比(89.89±6.46)%,P=0.022].简单相关分析显示,CAPD患者的AI与性别、年龄、收缩压、舒张压、脉压、中心动脉压呈正相关,与身高、体重、体重指数呈负相关,与各项血液指标及透析龄无相关性.多元线性回归分析显示,CAPD患者的AI与性别、年龄、身高、舒张压及中心动脉压存在线性回归关系.结论 CAPD患者动脉弹性降低,动脉硬度增加,其AI与年龄、身高、舒张压及中心动脉压密切相关,是部分反映动脉弹性的一个无创指标.中心动脉压与动脉弹性、僵硬度密切相关,临床测定中心动脉压对于预防心血管事件具有重要意义.%Objective To analyze the factors influencing augmentation index (AI) by examining the AI changes in patients who received continuous ambulatory peritoneal dialysis (CAPD) therapy, and evaluate the artery elastic function situation. Methods The height, weight, blood pressure, blood indicators were detected in 46 CAPD patients (CAPD group) and 42 controls (control group). AI was managed by OMRON HEM-90OOAI, and the influencing factor was analyzed. Results Systolic blood pressure(SBP),diastolic blood pressure(DBP), pulse pressure, central aortic pressure and AIp75 (AI value, when pulse was 75 beats/min) in CAPD group were significantly higher than those in control group. Within CAPD patients,the AIp75, in female was significantly higher than that in nude [(96.67±8.95 )% vs (89.89±6

  2. Peritoneal carcinomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Raptopoulos, V. [Dept. of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (United States); Gourtsoyiannis, N. [Dept. of Radiology, Medical School of Crete, Heraklion, Crete (Greece)

    2001-11-01

    The peritoneum is a mesothelial lining of the abdominal cavity (parietal) and intraperitoneal viscera (visceral). The cavity contains a small amount of fluid, which circulates from cephalad to caudal to cephalad, influenced by negative pressure under the diaphragm during exhalation, gravity, and bowel peristalsis. Peritoneal reflections and mesenteries divide the cavity into various compartments (supramesocolic, inframesocolic, and pelvis). These reflections support the peritoneal organs and provide vascular and nervous connections while within the cavity they influence pathway of intraperitoneal fluid circulation. Capillary force over convex surfaces influence stasis of fluid and promotes peritoneal seeding; thus, there are numerous areas in which peritoneal masses are seen more commonly. These areas include the undersurface of the diaphragm (negative pressure and capillary force), the omentum (bathed in fluid), the right lower quadrant (oblique course from left superior to right inferior of the small bowel mesentery), the left lower quadrant (transverse course of the sigmoid), and the pelvis (gravity). Peritoneal carcinomatosis may be either primary (mesothelioma) or metastatic. The mode of spread is by direct invasion, lymphatic permeation, peritoneal seeding or hematogenous. The imaging patterns include fibronodular stranding, nodules, plaques, and masses. Mesenteric thickening may produce pleated or stellate patterns. Spiral CT is the most useful modality in diagnosis and follow-up of peritoneal tumors. (orig.)

  3. Peritoneal carcinomatosis

    International Nuclear Information System (INIS)

    The peritoneum is a mesothelial lining of the abdominal cavity (parietal) and intraperitoneal viscera (visceral). The cavity contains a small amount of fluid, which circulates from cephalad to caudal to cephalad, influenced by negative pressure under the diaphragm during exhalation, gravity, and bowel peristalsis. Peritoneal reflections and mesenteries divide the cavity into various compartments (supramesocolic, inframesocolic, and pelvis). These reflections support the peritoneal organs and provide vascular and nervous connections while within the cavity they influence pathway of intraperitoneal fluid circulation. Capillary force over convex surfaces influence stasis of fluid and promotes peritoneal seeding; thus, there are numerous areas in which peritoneal masses are seen more commonly. These areas include the undersurface of the diaphragm (negative pressure and capillary force), the omentum (bathed in fluid), the right lower quadrant (oblique course from left superior to right inferior of the small bowel mesentery), the left lower quadrant (transverse course of the sigmoid), and the pelvis (gravity). Peritoneal carcinomatosis may be either primary (mesothelioma) or metastatic. The mode of spread is by direct invasion, lymphatic permeation, peritoneal seeding or hematogenous. The imaging patterns include fibronodular stranding, nodules, plaques, and masses. Mesenteric thickening may produce pleated or stellate patterns. Spiral CT is the most useful modality in diagnosis and follow-up of peritoneal tumors. (orig.)

  4. Spectrum of abdominal pathologies detected with CT in long term dialysis patients

    Energy Technology Data Exchange (ETDEWEB)

    Ulu, Esra Meltem Kayahan [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak cad. No.: 45, Bahcelievler/Ankara (Turkey)], E-mail: emkayahanulu@yahoo.com; Tarhan, N. Cagla [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak cad. No.: 45, Bahcelievler/Ankara (Turkey); Hocaoglu, Elif [Bakirkoy Dr Sadi Konuk Training and Research Hospital, Department of Radiology, Zuhurat Baba mah, Bakirkoy/Istanbul (Turkey); Akman, Beril [Department of Nephrology, Fevzi Cakmak cad. No.: 45, Bahcelievler/Ankara (Turkey); Basaran, Ceyla; Donmez, Fuldem Yildirim; Niron, Emin Alp [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak cad. No.: 45, Bahcelievler/Ankara (Turkey)

    2009-11-15

    As a consequence of the expanded use of long term hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) treatments and extended life spans, complications of end-stage renal disease and dialysis treatments are being encountered with increasing frequency in these patients. Computed tomography can accurately depict many of the potential complications of end-stage renal disease on dialysis. This article presents the abdominal CT findings of 429 end-stage renal disease patients who are on either hemodialysis or continuous ambulatory peritoneal dialysis treatment.

  5. Spectrum of abdominal pathologies detected with CT in long term dialysis patients

    International Nuclear Information System (INIS)

    As a consequence of the expanded use of long term hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) treatments and extended life spans, complications of end-stage renal disease and dialysis treatments are being encountered with increasing frequency in these patients. Computed tomography can accurately depict many of the potential complications of end-stage renal disease on dialysis. This article presents the abdominal CT findings of 429 end-stage renal disease patients who are on either hemodialysis or continuous ambulatory peritoneal dialysis treatment.

  6. 成年男性持续非卧床腹膜透析患者性生活状况的质性研究%A qualitative research on the sexual life situation of adult males with continuous ambulatory peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    庞建红; 李琳; 汪小华; 仇静波; 许义; 鞠阳; 蒋青

    2013-01-01

    目的 探索成年男性持续非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者的性生活现状.方法 运用深度访谈法,收集12例男性CAPD患者对性生活的感受,应用类属分析法进行分析.结果 男性CAPD患者性生活状况的5个主题:性欲望下降、获得和维持勃起的自信度下降、性生活的克制、性生活满意度和婚姻美满度的改变、对性知识的强烈渴求.结论 成年男性CAPD患者存在不同程度的性功能障碍,护理人员应重视并提供性教育.%Objective The aim of the study is to explore the sexual life situation of adult males with continuous ambulatory peritoneal dialysis (CAPD).Methods Data of experience about sexual life of 12 male CAPD patients was collected using in-depth interview and were analyzed with category approach.Results Five themes were sublimated:declined sexual desire,decreased self-confidence to get and to maintain an erection,restraint of sexual life,changes in sexual and marriage satisfaction,and urgent desire for sexual knowledge.Conclusions There are varying degrees of sexual dysfunction in adult male CAPD patients.Nurses should pay attention to and supply the education of sexual knowledge.

  7. Peritoneal Disorders

    Science.gov (United States)

    Your peritoneum is the tissue that lines your abdominal wall and covers most of the organs in your abdomen. ... the surface of this tissue. Disorders of the peritoneum are not common. They include Peritonitis - an inflammation ...

  8. Peritoneal mesothelioma

    International Nuclear Information System (INIS)

    Previous imaging reports of peritoneal mesothelioma have described a variety of radiologic appearances, but have not included its pathologic classification. We retrospectively reviewed 10 cases of peritoneal mesothelioma representing the following histologic categories: 7 epithelial, 2 sarcomatoid, and one biphasic. By imaging, epithelial mesotheliomas demonstrated diffuse thickening of the peritoneum and mesentery and/or multiple small nodules. The sarcomatoid-type appeared as a mass and the biphasic-type had radiologic and gross pathologic features of both sarcomatoid and epithelial types. We conclude that peritoneal mesothelioma presents with a wide spectrum of radiographic appearances and should therefore be included in the differential diagnoses of diffuse as well as localized peritoneal processes. (orig.)

  9. Benign Multicystic Peritoneal Mesothelioma

    Science.gov (United States)

    ... Center (GARD) Print friendly version Benign multicystic peritoneal mesothelioma Table of Contents Overview Treatment Prognosis Living With ... Names for this Disease BMPM Benign cystic peritoneal mesothelioma Multilocular peritoneal inclusion cysts Multilocular peritoneal cysts About ...

  10. 腹膜透析患者门诊随访频率与生存率关系的研究%Relationship between follow-up frequency at the outpatient clinic and their survival in peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    杨桂鲜; 韩庆烽; 周晓玲; 孙庆华; 聂建东; 孙玲华; 史均宝; 何培丽

    2012-01-01

    Objective To investigate the relationship between follow-up frequency at the outpatient clinic and their survival in peritoneal dialysis (PD) patients. Method We recruited 202 incident patients who started PD between September 2006 and September 2008. They were divided into two groups according to the follow-up frequency: once a month in a group (one month group), and once more than a month in another group (more than one month group). Their general information and clinical data including laboratory examinations, nutrition status, complications and outcome after PD for 3 months and at the endpoint of the study were analyzed. Results At the beginning of PD, there were no significant differences in these parameters between the two groups, except that patients from rural area were different in the two groups (X2 = 10.629, P=0.005). At the end-point of the study, patients in the more than one month group had higher rate of hypertension (X2=15.561, P=0.000), lower serum albumin (t=2.219, P=0.028), higher serum phosphorus (t=-3366, P=0.001), and higher rate of malnutrition evaluated by SGA (X2=3.859, P=0.046), as compared with those in the one month group. Kaplan-Meier survival analysis demonstrated that survival rate and technical survival rate were significantly higher in the one month group than in the more than one month group (P=0.001 and P-0.002, respectively). Cox regression analysis showed that age, serum albumin, Kt/V and CCI were the independent factors affecting survival in PD patients, and that the follow-up frequency at the outpatient clinic was not included in the independent factors for survival (X2 = 40.673, P= 0.000). Conclusion The follow-up frequency at the outpatient clinic was unrelated to survival of PD patients. However, lower follow-up frequency at outpatient clinics may associate with malnutrition and more complications leading to poorer prognosis. We recommend the follow-up frequency of once a month for PD patients.%目的 探讨腹膜透析患

  11. A Comparison of Clinical Characteristics and Survival Between Diabetic Nephropathy Patients and Non-diabetic Nephropathy Patients Undergoing Peritoneal Dialysis%糖尿病肾病腹膜透析患者的临床特点和预后

    Institute of Scientific and Technical Information of China (English)

    钟慧; 刘芳; 付平; 沙朝晖; 唐晓红; 秦敏; 周雪丽; 任英

    2012-01-01

    目的 分析和探讨糖尿病肾病腹膜透析患者的临床特征和预后.方法 人选2009年1月至2011年8月于我中心进行腹膜透析的患者,根据原发病分为糖尿病肾病腹膜透析组和非糖尿病腹膜透析组,收集比较两组患者的基本资料、生化结果和透析相关指标,应用Kaplan-Meier法和Cox回归进行生存分析.结果 460例随访腹膜透析患者中,糖尿病肾病患者64例(13.9%).糖尿病肾病患者平均年龄高于非糖尿病者,分别为(63±13)岁和(45±16)岁(P<0.001).糖尿病肾病腹膜透析患者的高敏C反应蛋白(hsCRP)高于非糖尿病腹膜透析患者,而血清白蛋白水平及前白蛋白水平低于非糖尿病腹膜透析患者(P<0.01).糖尿病肾病腹膜透析患者的甘油三酯和标准蛋白分解率(nPCR)也低于非糖尿病腹膜透析组(P<0.05).两组患者的血红蛋白、甲状旁腺激素、钙磷水平、胆固醇水平、随访时间、透析充分性和残余肾功能差异无统计学意义.糖尿病肾病和非糖尿病腹膜透析患者第1年累计生存率分别为73.3%和90.7%(P<0.05),第2年分别为61.8%和82.5% (P<0.05).糖尿病肾病腹膜透析患者的平均生存时间低于非糖尿病腹膜透析患者,分别为24.6月和30.1月(P<0.05).糖尿病肾病腹膜透析患者死亡风险为非糖尿病腹膜透析患者的2.449倍.在多因素Cox回归分析中年龄和血清白蛋白是糖尿病肾病腹膜透析患者死亡的危险因素.结论 糖尿病肾病腹膜透析患者透析开始时的年龄大,易发生营养不良和微炎症状态.年龄和营养不良是影响腹膜透析患者生存的危险因素.糖尿病肾病腹膜透析患者生存率明显低于非糖尿病患者.%Objective To investigate clinical characteristics and survival of diabetic patients with end-stage renal disease on peritoneal dialysis (PD). Methods The clinical data were collected from the patients who initiated PD in our PD Center from Jan

  12. Long-term survival and relative factors on peritoneal dialysis patients: Data analysis of single center on registration system%腹膜透析患者长期生存及相关因素分析——单中心登记系统数据分析

    Institute of Scientific and Technical Information of China (English)

    俞雨生; 周岩; 周婷婷; 陈伊文; 李世军; 唐政; 刘志红

    2011-01-01

    Objective: To analyze the current situation of peritoneal dialysis in our country and the factors influencing the long - term prognosis by review of single peritoneal dialysis center registration data system. Methodology: Patients on maintenance PD were retrospectively studied from February 2002 to November 2010. The Kaplan Meier method for measuring patient survival rate and technique survival rate were applied. We also analyzed the risk factors and calculated their hazard ratio (HR) for patient mortality and PD technique failure using multivariate regression of the Cox proportional hazards method. Results:A total of 681 patients were recruited. Among them,398 (58.5% ) were males,and the mean age at the start of PD was (45. 68 ± 15. 69) years old, Chronic glomerulonephritis (CGN) was the main cause of end stage renal disease ( ESRD ), and followed by diabetes mellitus ( 11.8%) .Mean PD duration was ( 13.94 ± 16.40) months. There were 604 cases (88.1% ) receiving day ambulatory peritoneal dialysis ( DAPD) , while 77 (11. 3% ) got continuous ambulatory peritoneal dialysis ( CAPD ) . The 1,3,5 and 8 years of technical survival rates were 87.0% , 74.4% ,61. 85% and 53. 0% .respectively. While the 1,3,5 and 8 years of patient survival rates were 94.2% ,80.8%, 75. 3% and 64. 5% .respectively. Excluded patients giving up treatment due to economic factors,the causes of quit PD were dialysis inadequacy ( 35. 2% ) , cardiovascular diseases ( 33. 8% ) , peritonitis (12.6% ). catheters complications (8. 5% ) and pleural effusion (4. 2% ). The main causes of death were cardiovascular events ( 37. 7% ) , infection ( 10.4% ) and cerebrovascular events (7. 8% ). The predictors of patient drop-out in our study were anemia [ relative risk ( RR ) 0. 53, P < 0. 01 ] , protein energy malnutrition ( RR 0. 77, P < 0. 05 ), low serum albumin level ( RR 9. 49, P < 0. 01 )uponstarting PD. Conclusion; The patients with PD in our center had a good technical survival rate. The main factor

  13. 腹透患者营养不良-微炎症状态对腹膜炎及死亡风险的影响%Malnutrition-Inflammation Status Increased the Risk of Peritonitis and Hospitalization/death in Chinese Peritoneal Dialysis Patients

    Institute of Scientific and Technical Information of China (English)

    桂志红; 许烨; 王会玲; 张金元

    2010-01-01

    目的:探讨腹膜透析(peritoneal dialysis,PD)患者营养不良-炎症复合体综合征(malnutrition inflammation complex syndrome,MICS)对腹膜炎发生率、住院频率及死亡风险的影响.方法:对符合纳入标准的98例PD患者,采用营养不良-炎症评分(malnutrition inflammation score,MIS)评估MICS,按MIS分值分为轻度(1~8分)、中度(9~18)、重度(>18);观察患者人体测量学指标、尿素清除率(KT/V)和标化蛋白分解代谢率(nPCR),检测生化指标、微炎症指标[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、24 h腹透液中丢失的蛋白量;随访6个月内患者腹膜炎发生率、住院频率及死亡率,运用多元Logistic回归分析、COX比例风险分析MIS对腹膜炎发生率、住院及死亡风险等预后的影响.结果:所纳入的98例PD患者中,MICS患者56例,占57%,其中MIS轻、中、重度平均分值分别为5、12、19.5(各占53.06%、39.80%、7.14%);MIS分值越高,患者年龄越大,人体测量学指标包括BMI、MAC和TSF下降,与营养相关的生化指标包括Alb、BUN和Ser水平明显降低(P<0.05);炎症因子hs-CRP和IL-6水平明显升高(P<0.05),但TNF-α水平在各组间差异无统计学意义.各组KT/V、nPCR和24 h腹透液蛋白丢失量差异无统计学意义.MIS与腹膜炎发病频次、住院频次、住院总天数显著正相关(P<0.01),MIS每增加1分则患腹膜炎的相对风险为1.185(1.036~1.355 P<0.05),死亡风险为1.242(1.102~1.401,P<0.01).结论:57%的维持性腹膜透析患者可并发MICS;MICS惠者具有高龄的特点;MICS可增加PD患者患腹膜炎、住院频次以及死亡风险;MIS可预测患者腹膜炎和死亡风险.

  14. Peritoneal mesothelioma

    International Nuclear Information System (INIS)

    The definitive diagnosis of peritoneal mesothelioma and its differentiation from metastatic peritoneal carcinomatosis may be difficult because of the clinical, macroscopic, and microscopic variability of the tumor. To this purpose, a combination of criteria, including the clinical picture, the gross pathologic findings, the exclusion of other primary neoplasms, and the microscopic findings, must be taken into consideration. Conventionally, these criteria may be established only after surgical exploration and extensive sampling. Experience with patients with peritoneal mesothelioma and metastatic peritoneal carcinomatosis, as well as a review of the recent imaging literature, shows excellent correlation between computed tomography or ultrasound and the operative or autopsy findings. These imaging modalities showed soft-tissue masses or nodules; thickened omentum (omental cake), peritoneum, mesentery, and bowel wall; pleural plaques; and usually disproportionally small, if any, ascites. The latter two observations may be useful in differentiating mesothelioma from carcinomatosis macroscopically. Furthermore, fine-needle aspiration biopsy, after performing wide sampling of the tumors in different locations under ultrasonic or computed tomographic guidance, produced diagnostic cytologic specimens. Thus, the need for exploratory surgery may be alleviated, and the diagnosis of peritoneal mesothelioma may be made prospectively and relatively noninvasively with the use of computed tomography or ultrasound and fine-needle aspiration biopsy. Since epidemiologic studies predict increasing incidence of this neoplasm, especially among asbestos workers, it is suggested that these techniques be seriously considered as screening methods for high-risk populations.67 references

  15. Influence of Astragalus Combined With Telmisartan on the Insulin Resistance of Nondiabetic Peritoneal Dialysis Patients%黄芪联合替米沙坦对非糖尿病腹膜透析患者胰岛素抵抗的影响研究

    Institute of Scientific and Technical Information of China (English)

    官继超; 龚淑文; 吴秀娟

    2015-01-01

    Objective To investigate the clinical effect of astragalus combined with telmisartan on the insulin resistance of nondiabetic peritoneal dialysis patients.Methods Enrolled 81 nondiabetic patients with stable condition who underwent continuous ambulatory peritoneal dialysis ( CAPD ) in Shaoxing People′s Hospital for more than three months from January 2012 to June 2014.Using random number table method , the patients were divided into control group , telmisartan group and combined group , with 27 patients in each group.Control group was given antihypertensive drugs apart from ACEI and ARB;telmisartan group was given oral administration of telmisartan tablets by 80 mg/d; combined group was given telmisartan tablets plus the oral administration of astragalus granules by 4 g/time and 2 times/day.All patients were treated with 1.5% or 2.5%glucose peritoneal dialysate produced by Baxter.A series of indicators of the three groups were recorded , including age , BMI, triacylglycerol , total cholesterol level , time of peritoneal dialysis , peritoneal dialysis solution dosage , exposure value of peritoneal dialysis solution and urine amount.Blood pressure , Hb, hs-CRP, iPTH, Kt/V, Ccr and HOMA-IR were determined at baseline , 3 months and 6 months during treatment.Results The three groups were not significantly different in gender, the usage rate of statins, age, BMI, triacylglycerol, total cholesterol level, time of peritoneal dialysis, peritoneal dialysis dosage, the exposure value of peritoneal dialysis and urine amount (P>0.05) .There was no interaction effect between the treatment methods of systolic pressure , diastolic blood pressure , Hb, iPTH, Kt/V and Ccr and treatment duration ( P>0.05);the three groups were not significantly different in systolic pressure , diastolic pressure , Hb, iPTH, Kt/V and Ccr ( P>0.05);systolic pressure, diastolic pressure, Hb and iPTH changed significantly with different time points (P0.05) .There was intervention effect between the

  16. INDUCTION OF CHRONIC KIDNEY FAILURE IN A LONG-TERM PERITONEAL EXPOSURE MODEL IN THE RAT: EFFECTS ON FUNCTIONAL AND STRUCTURAL PERITONEAL ALTERATIONS

    NARCIS (Netherlands)

    F. Vrtovsnik; A. Coester; D. Lopes-Barreto; D.R. de Waart; A. van der Wal; D.G. Struijk; R. Krediet; M. Zweers

    2010-01-01

    Background: A long-term peritoneal exposure model has been developed in Wistar rats. Chronic daily exposure to 3.86% glucose based, lactate buffered, conventional dialysis solutions is possible for up to 20 weeks and induces morphological abnormalities similar to those in long-term peritoneal dialys

  17. Technique of Peritoneal Catheter Placement under Fluoroscopic Guidance

    International Nuclear Information System (INIS)

    Peritoneal catheters are mainly used for peritoneal dialysis in patients with end-stage renal disease. Other uses of this catheter include intraperitoneal chemotherapy and gene therapy for ovarian cancer and draining of uncontrolled refractory ascites in patients with liver cirrhosis. Traditionally, surgeons place most of these peritoneal catheters either by laparoscopy or open laparotomy. We detail our percutaneous approach to placing peritoneal catheters using fluoroscopic guidance. We emphasize the use of additional ultrasound guidance, including gray scale and color Doppler ultrasound, to determine the safest puncture site and to guide the initial needle puncture in order to avoid bowel perforation and injury to epigastric artery. We present our experience in placing peritoneal catheters using this technique in 95 patients with various indications. Fluoroscopic guided percutaneous placement of peritoneal catheters is a safe, minimally invasive, and effective alternative to open surgical or laparoscopic placement.

  18. New Insights into Therapeutic Strategies for the Treatment of Peritoneal Fibrosis: Learning from Histochemical Analyses of Animal Models

    OpenAIRE

    Kitamura, Mineaki; Nishino, Tomoya; Obata, Yoko; Ozono, Yoshiyuki; Koji, Takehiko; Kohno, Shigeru

    2014-01-01

    Encapsulating peritoneal sclerosis (EPS) is a fatal complication that can occur in patients undergoing long-term peritoneal dialysis. It is characterized by bowel obstruction and marked sclerotic thickening of the peritoneal membrane. Although the mechanisms underlying the development of EPS are complex, angiogenesis, inflammation, and peritoneal fibrosis are known to be essential factors. Now, several animal models that exhibit EPS have pathophysiology similar to that of human EPS and have b...

  19. Peritoneal Hydatidosis

    Directory of Open Access Journals (Sweden)

    Daniela Costamagna

    2010-01-01

    Full Text Available Secondary peritoneal hydatidosis is caused by spontaneous or iatrogenic rupture of hepatic echinococcal cysts. We describe the case of a 65-year-old Tunisian male patient with previous history of liver hydatidosis who presented to our attention with subocclusive status. Imaging revealed a retrovesical hydatid cyst, adherent to the sigmoid colon. The treatment of choice was surgical removal of the cyst and the sigmoid colon. The patient is now being closely followed up.

  20. Comparison of peritoneal equilibration test(PET) with Tc99m-DTPA excretion in the assessment of peritoneal permeability

    International Nuclear Information System (INIS)

    Aim: Assessment of peritoneal permeability is necessary for successful management of End Stage Renal Disease (ESRD) patients by Continuous Ambulatory Peritoneal Dialysis (CAPD). Twardowski in 1987 described for the first time a method know as Peritoneal Equilibration Test (PET ) to determine peritoneal membrane characteristics. However, this test is not only cumbersome but is associated with several limitations. The objective of this study was to develop an alternative method of assessing the peritoneal permeability and compare this method with the conventional PET. Method: Twenty patients under going regular CAPD were included in this study. Before starting the peritoneal dialysis 370 MBq (10 mCi) 99mTc-DTPA was injected intravenously in the same standard precondition as for PET evaluation. A standard dose of same quantity was kept and used later for calculations. At the end of four hours a dialysate fluid sample (1 ml) was collected and the total dialysis effluent fluid volume was measured. Excretion of 99mTc-DTPA into the dialysate fluid as percentage of injected dose was calculated. Simultaneously standard PET values were recorded for comparison. Results: Peritoneal excretion of 99mTc-DTPA ranged from 8 % to 16 % of the injected dose depending upon the peritoneal membrane permeability. Depending upon the DTPA excretion the patients were divided into 4 groups: High Transporter (15% and above; High Average (12 to 15 %); Low Average (10 to 12%); Low Average (10% and less). When the results were compared with the conventional PET values, a good correlation (r=0.79) could be found. Conclusion: Determining the excretion of 99mTc-DTPA in the dialysate fluid after 4 hrs as percentage of the injected dose is a simple and convenient method to assess the peritoneal membrane permeability and can be used as an alternative technique to conventional PET which is very cumbersome and associated with many limitations

  1. Historical Study (1986-2014): Improvements in nutritional status of dialysis patients

    DEFF Research Database (Denmark)

    Koefoed, Mette; Kromann, Charles Boy; Hvidtfeldt, Danni;

    2016-01-01

    OBJECTIVE: Malnutrition is common in dialysis patients and is associated with adverse clinical outcomes. Despite an increased focus on improved nutrition in dialysis patients, it is claimed that the prevalence of malnutrition in this group of patients has not changed during the last decades. Direct...... historical comparisons of the nutritional status of dialysis patients have never been published. To directly compare the nutritional status of past and current dialysis patients, we implemented the methodology of a study from 1986 on a population of dialysis patients in 2014. DESIGN: Historical study...... comparing results of two cross-sectional studies performed in 1986 and 2014. SETTING: We compared the nutritional status of hemodialysis (HD) and peritoneal dialysis (PD) patients attending the dialysis center at Roskilde Hospital, Denmark, in February to June 2014, with that of HD and PD patients treated...

  2. Dialysis Facility Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Dialysis Facility Compare helps you find detailed information about Medicare-certified dialysis facilities. You can compare the services and the quality of care...

  3. Restless legs syndrome in patients on dialysis

    Directory of Open Access Journals (Sweden)

    Al-Jahdali Hamdan

    2009-01-01

    Full Text Available Restless legs syndrome (RLS is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG. This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH, Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC, Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG′s RLS Questionnaire (RLSQ. Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 ± 17.2 years and mean duration on dialysis 40.4 ± 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM, coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively. Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS (P= < 0.001 and 0.001, respectively. Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis

  4. Restless legs syndrome in patients on dialysis

    International Nuclear Information System (INIS)

    Restless legs syndrome (RLS) is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG). This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD) on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH), Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC), Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG's RLS Questionnaire (RLSQ). Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 + - 17.2 years and mean duration on dialysis 40.4 + - 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM), coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively). Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS) (P= < 0.001 and 0.001, respectively). Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis and

  5. Comportamiento del orificio de implantación del catéter en pacientes en diálisis peritoneal en relación a los cuidados Behaviour of the catheter wound in peritoneal dialysis patients in relation to care

    OpenAIRE

    A. Concepción Gómez Castilla; J. Lucas Martín Espejo; Carmen Trujillo Campos; Ángela Laguillo de Castro; Mercedes Tejuca Marenco; Encarnación López Bermúdez; Cristina Ortega Cuadro; Julia Rodríguez Pérez; Piedad González de la Peña García; Flora López González

    2007-01-01

    Las infecciones del orificio de salida en diálisis peritoneal son la causa de morbilidad más frecuente en los pacientes sometidos a esta técnica. Existen numerosos procedimientos para los cuidados del orificio y no resulta fácil definir un único método que garantice el buen estado del orificio. Con el fin de valorar el comportamiento del orificio relacionado con el procedimiento utilizado en sus cuidados estudiamos a 306 pacientes durante 24 meses, recogiendo variables sociodemográficas y clí...

  6. Adherence to treatment, emotional state and quality of life in patients with end-stage renal disease undergoing dialysis

    OpenAIRE

    García-Llana, Helena; Remor, Eduardo; Selgas, Rafael

    2013-01-01

    A low rate of adherence to treatment is a widespread problem of great clinical relevance among dialysis patients. The objective of the present study is to determine the relationship between adherence, emotional state (depression, anxiety, and perceived stress), and healthrelated quality of life (HRQOL) in renal patients undergoing dialysis. Method: Two patient groups (30 in hemodialysis and 31 in peritoneal dialysis) participated in this study. We evaluated aspects of adhere...

  7. Multicystic transformation of the kidneys in dialysis patients

    DEFF Research Database (Denmark)

    Frifelt, J J; Larsen, C; Elle, Birgitte;

    1989-01-01

    In a dialysis population patients who had been treated merely with haemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) were examined with ultrasound. The occurrence of multicystic transformation of the kidney was 4/15 in HD patients and 8/25 in CAPD patients with no significant...... difference between the two groups. There was a significant association between the occurrence of multicystic transformation and the patient age while there was no significant association to the duration of dialysis or the duration of the uraemic state. No tumour or any other complication to cystic...... transformation was found. In 582 persons without renal disease examined as controls we found 44 with cystic change. This material does not support the recommendation of regular ultrasound examination of our dialysis patients. However, until these results can be confirmed by prospective studies we must recommend...

  8. The Effect of Continuous Quality Improvement(CQI) on Disorders of Calcium and Phosphorus Metabolism Management in Continuous Ambulatory Peritoneal Dialysis(CAPD) Patients%持续质量改进对老年腹膜透析患者钙磷代谢紊乱的作用

    Institute of Scientific and Technical Information of China (English)

    郑设锋; 刘金女; 卢蝉; 毛红; 孙维文; 赵瑞育; 赵章健; 陈法东; 缪初升; 宋瑞芳

    2012-01-01

    Objective: To evaluate the effect of continuous quality improvement CQI ) on management of calcium and phos-phorus metabolism disorders in elderly patients undergoing peritoneal dialysis . Methods: With the use of PDCA four - step( plan, do, check and act), we designed and carried out treatments to improve calcium and phosphorus metabolism in ederly patients undergoing peritoneal dialysis. Results :45 elderly patients dialyzed for more than 3 months participated in the study. The overall incidence of calcium and phosphorus metabolism disorders got down from 82. 22% to 42. 22% after CQI. In details, the level of serum calcium reduced from ( 2. 71 ± 0. 25 )mmol/L to( 2. 52 ± 0. 31 )mmol/L in hypercalcemia group( P 3个月的老年患者参与了此项研究.经9个月CQI,各种钙磷代谢紊乱总发生率由82.22%降至42.22%(P<0.05).其中高钙血症组血钙由(2.71±0.25)mmol/L降至(2.52±0.31)mmol/L(P<0.05),低钙血症组血钙由(1.78±0.42)mmol/L升至(2.11±0.24)mmol/L(P<0.05),血磷水平由(2.13±0.62)mmol/L降至(1.67±0.53)mmol/L(P<0.05),钙磷乘积由(80.22±16.61)mg2/dl2降至(54.58±15.93)mg2/dl2(P<0.05),继发性甲状旁腺功能亢进患者的血清全段甲状旁腺素(iPTH)由(488.12±227.31)pg/ml降至(290.3±171.15)pg/ml(P<0.01),血清碱性磷酸酶水平由(108.75±35.31)U/L降至(88.75±38.14)U/L(P<0.05).有残肾功能较无残肾功能组,虽KT/V差异不大,在CQI后纠正高磷血症、高钙血症、甲状旁腺功能亢进上差异均有统计学意义(P<0.05).结论:持续质量改进措施显著改善了老年腹膜透析患者的钙磷代谢紊乱.

  9. Retrospective analysis of the relationship between the protein nutrition index and survival rate in patients with peritoneal dialysis%腹膜透析患者蛋白质营养指数与生存率关系的回顾性分析

    Institute of Scientific and Technical Information of China (English)

    黄静雅; 谢雪锋; 李小梅; 杨素琼; 贾磊; 郑桂琼

    2014-01-01

    目的 回顾性分析腹膜透析(peritoneal dialysis,PD)患者蛋白营养指数(PNI)与生存情况的关系.方法 回顾性分析本院2003年1月至2014年1月进行PD治疗的慢性肾脏疾病患者各项临床和检验指标.PNI评分由ALB、nPNA、LBM 3项指标决定.根据PNI评分将PD患者分成4组:营养状态良好、营养状态一般、营养状态较差、蛋白能量消耗(PEW)状态.采用线性回归分析法分析PNI的决定因素,Kaplan-Meier分析PD患者蛋白营养状态与生存率的关系,Cox回归法分析PD患者的生存危险因素.结果 年龄、并发症指数、血清Cr、K-Kt/V、T-Kt/V都与患者PNI有线性关系.4组的5年生存率分别为95%、92%、65%、23%.PD患者生存危险因素有年龄、并发症指数、PNI.结论 根据PNI评分评估PD患者的蛋白营养状态是可以预测患者的生存情况的,PNI评分越高其生存率越高.%Objective To analyze retrospectively the relationship between protein nutrition index (PNI) and survival conditions in patients with peritoneal dialysis (PD).Methods Various clinical and laboratory indexes of patients with chronic kidney disease from January 2004 to January 2014 were analyzed retrospectively.PNI score was determined by serum albumin (ALB),normalized protein nitrogen presentation rate (nPNA),lean body mass (LBM).According to PNI score,PD patients were divided into four groups:good nutrition status,nutrition status in general,poor nutrition,PEW status.Linear regression analysis was used to analyze determine factors of PNI;analysis of Kaplan-Meier was applied to examine relationship between the protein nutrition status and survival rate;COX regression analysis was used to analyze the risk factors for survival in patients with PD.Results All the indexes,age,complications index,serum Cr,K-Kt/V,T-Kt/V had a linear relationship with PNI.5-year survival rate in the four groups were respectively 95%,92%,65%,23%.Age,complications,PNI index were the

  10. Tamoxifen is associated with lower mortality of encapsulating peritoneal sclerosis: results of the Dutch Multicentre EPS Study

    NARCIS (Netherlands)

    M.R. Korte; M.W. Fieren; D.E. Sampimon; H.F. Lingsma; W. Weimar; M.G.H. Betjes

    2011-01-01

    Background. Encapsulating peritoneal sclerosis (EPS) is a serious complication of peritoneal dialysis (PD) with an increasing incidence. There is no clear consensus on the treatment of EPS, but anecdotal reports indicate improvement in EPS patients treated with tamoxifen. At present, there is no evi

  11. The effect of dialysis on radiocaesium in man

    International Nuclear Information System (INIS)

    Dialysis is used for cleaning the blood in patients with end-stage renal disease. The most common methods are hemodialysis (HD) and peritoneal dialysis (PD). Dialysis patients might constitute a critical group because of poor elimination of radioactive elements ingested. On the other hand dialysis may be a useful decontamination method for radioactivity. The effect of dialysis on the turnover of radiocaesium was studied in 10 HD patients and 4 PD patients. The dialysis fluid, which contains electrolytes and the metabolic waste products, was analyzed for radiocaesium. In this connection the patients were whole-body counted for radiocaesium and 40K. The results show that HD patients generally have a lower body burden of radiocaesium than normal subjects, while PD patients show normal levels. At steady state both dialysis methods eliminate slightly less radiocaesium than normal kidneys do, but in the case of HD during a much shorter time. The calculated effective half-life for radiocaesium was normal in the HD patients, and somewhat longer in the PD patients. Considering that HD is performed only for 12-15 h weekly, the elimination rate of radiocaesium by HD is much higher compared with that by normal kidneys. Thus, HD might constitute an important method for decontamination of radiocaesium after accidental internal contamination

  12. Survey on Self-management of Continuous Ambulatory Peritoneal Dialysis Patients under New Rural Cooperative Medical System in Hunan Province%湖南省新农合维持性腹膜透析患者自我管理的调查分析与对策

    Institute of Scientific and Technical Information of China (English)

    蒋娟; 张浩; 丁四清; 曹薇

    2013-01-01

    [目的]调查维持性腹膜透析(C A PD )患者自我管理所存在的问题,探讨提高患者自我管理能力的方法。[方法]通过问卷调查的方法对本院50例新农合CAPD患者进行一般资料和自我管理情况调查。[结果]50例新农合C A PD患者自我管理在六个大项,十三个分项的平均得分值显示患者在透析操作,服药,水盐控制三方面得分较高,各项得分良好率均在30%~40%;在透析知识,饮食摄入,心理健康等三项得分偏低,各项得分良好率均低于20%。[结论]新农合C A PD患者自我管理情况普遍较差,医护人员应对其加强透析前健康教育,指导患者严格遵守饮食原则,改善心理自我管理,帮助其提高自我管理能力。%[Objective]To investigate the problems in self-management of continuous ambulatory peritoneal di-alysis(CAPD) patients ,and to explore how to improve self-management skills .[Methods]Questionnaire survey method was used to investigate general information and self-management situation of 50 CAPD patients under new rural cooperative medical system in our hospital .[Results]The average scores of 6 main items and 13 sub-items of self-management showed that the scores of dialysis procedure ,drug administration and the controlling of water and salt in 50 CAPD patients under new rural cooperative medical system were higher ,and the good rates of scores of each item were 30% ~40% .The scores of dialysis knowledge ,diet intake and mental health were lower ,and the good rates of scores of each item were less than 20% .[Conclusion]The situation of self-management in CAPD pa-tients under new rural cooperative medical system is generally poor .Health care workers should strengthen health education before dialysis ,guide patients to strictly abide by diet principle and improve mental self-management in order to increase self-management skills .

  13. Peritoneal fluid culture

    Science.gov (United States)

    Culture - peritoneal fluid ... sent to the laboratory for Gram stain and culture. The sample is checked to see if bacteria ... based on more than just the peritoneal fluid culture (which may be negative even if you have ...

  14. Peritoneal Fluid Analysis

    Science.gov (United States)

    ... Home Visit Global Sites Search Help? Peritoneal Fluid Analysis Share this page: Was this page helpful? Formal name: Peritoneal Fluid Analysis Related tests: Pleural Fluid Analysis , Pericardial Fluid Analysis , ...

  15. Tratamento laparoscópico dos cateteres de diálise peritoneal obstruídos Laparoscopic treatment of catheters with obstruction in peritoneal dialisis

    Directory of Open Access Journals (Sweden)

    Orlando Ribeiro Prado Filho

    2000-06-01

    Full Text Available The success of peritoneal dialysis in the treatment of patients with chronic renal failure depends on a proper performance of peritoneal catheter. This study shows the experience from the Service of Surgery from Departament of Medicine of State University of Maringá and the Service of Nephrology from Maria Auxiliadora Hospital, Maringá, in the laparoscopic approach of catheters with obstruction.

  16. Dialysis centers - what to expect

    Science.gov (United States)

    ... what to expect; Renal replacement therapy - dialysis centers; End-stage renal disease - dialysis centers; Kidney failure - dialysis ... swells and the hand on that side feels cold Your hand gets cold, numb, or weak Also ...

  17. Assessment and clinical aspects of health-related quality of life in dialysis patients and patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Molsted, Stig; Prescott, Lotte; Heaf, James;

    2007-01-01

    BACKGROUND/AIMS: It is relevant to investigate health-related quality of life (HRQOL) in dialysis and chronic kidney disease (CKD) patients in order to optimise treatment. The aim of this study was to investigate HRQOL in dialysis and CKD patients, to compare results from patients treated with...... control parameters were measured and the patients completed the questionnaire Kidney Disease Quality Of Life. RESULTS: PD patients rated Dialysis Staff Encouragement and Patient Satisfaction better than HD patients (p< or = 0.05). Dialysis patients scored significant lower than the general population in...... hemodialysis (HD) and peritoneal dialysis (PD) and to investigate the prediction of dialysis quality control parameters (blood hemoglobin, plasma albumin, and Kt/V) and tobacco smoking in disease-specific HRQOL. METHODS: Seventy-one HD, 59 PD, and 63 CKD patients participated in the study. Dialysis quality...

  18. The effect of different dialysis modalities on pruritus in patients with uremia

    Institute of Scientific and Technical Information of China (English)

    金东华

    2013-01-01

    Objective To study the effects of different dialysis modalities on pruritus in patients with uremia.Methods There were 19 hemodialysis (HD) patients,17 hemodialysis combined with hemodiafiltration (HD+HDF) patients and 20 peritoneal dialysis (PD) patients enrolled in for study.All patients were suffering from skin pruritus.Plasmaβ2-microglobulin (β2-MG) and intact parathyroid hormone (iPTH) were measured by using radio immunoassay before and 4 weeks,8 weeks after the initia-

  19. Is hemodialysis a reason for unresponsiveness to hepatitis B vaccine? Hepatitis B virus and dialysis therapy

    OpenAIRE

    Sit, Dede; ESEN, Bennur; Atay, Ahmet Engin; Kayabaşı, Hasan

    2015-01-01

    Impaired renal function is associated with a high risk of chronicity of hepatitis B virus (HBV) infection. Patients on hemodialysis (HD) or peritoneal dialysis are at an increased risk of viral transmission due to frequent necessity of blood product transfer as well as use of contaminated dialysate or dialysis materials. Additionally, health professionals may cause viral spread via contaminated hands and carelessness against hygiene rules. The frequency of chronic HBV infection may be as high...

  20. Imaging of the peritoneal cavity in CAPD.

    Science.gov (United States)

    Wankowicz, Z; Pietrzak, B; Skrobowska, E

    1996-01-01

    The aim of our study was the use of the optimal imaging of the peritoneal cavity (PC) for continuous ambulatory peritoneal dialysis (CAPD)-related problems. Ultrasonography (USG), direct abdominal radiography (DAR), peritoneoscintigraphy (PSG), and standard peritoneo-computed tomography (PCT) with reconstruction (R-PCT) were performed in 25 patients on CAPD from three to 44 months. Studies were done at the beginning of CAPD (1-3 months) as well as in the noncomplicated and complicated course of CAPD. Group 1 comprised 17 patients in whom 77 PC images were taken in the non-complicated course of CAPD. Group II comprised 15 patients in whom 65 images were taken during or after complications. For USG and DAR we used standard equipment, PSG was done with sulfur colloid labeled with technetium 99m (Tc 99m), PCT, and R-PCT were done with Omnipaque and Somatom HiQ Siemens unit. In PCT, two- and three dimensional reconstruction were done by our own computer program. USG was recommended for imaging of tunnel infections, exit-site infection (ESI), and adhesion. PSG was useful in almost all observed complications of CAPD except thickening of the peritoneal membrane (PM). Standard PCT with R-PCT was more useful than PCT because of a more legible image of the peritoneal cavity, which gives the possibility of monitoring fluid distribution and measuring of intraperitoneal fluid volume. PMID:8728239

  1. Complications after placement of peritoneal catheter

    Directory of Open Access Journals (Sweden)

    Đurđević-Mirković Tatjana

    2011-01-01

    Full Text Available Introduction. Peritoneal dialysis is one of the modalities used for treatment of end-stage chronic kidney failure. Nowadays, this method is complementary to haemodialysis and renal transplantation. Owing to the rich vascularization of the peritoneum, it is used in the processes of osmosis and diffusion, enabling the removal of uremic material from the body. The procedure includes introduction of peritoneal fluid via the peritoneal catheter. Complications. The catheter is placed through the anterior abdominal wall with its tip positioned in the small pelvis. There are several techniques for catheter placement considered minimally invasive, which, however, may be associated with various complications. These complications can be divided into mechanical (catheter dysfunction, cuff protrusion, hernia, dialysate leaks, visceral perforation and infectious (early peritonitis, exit site or tunnel infection, surgical wounds. In most cases, such complications are rare and can be successfully managed using conservative therapy; however, in some situations severe complications can endanger the life of the patient. On-time recognition of complications, particularly in patients at risk, is of paramount importance for an effective treatment. The development of complications can increase the morbidity and the chance of treatment failure, and therefore transfer to haemodialysis. Conclusion. The preoperative evaluation and determination of the risk factors as well as the early recognition and adequate management of complications are essential in their prevention.

  2. Peritoneal tuberculosis: radiographic diagnosis

    Directory of Open Access Journals (Sweden)

    Carolina Ospina-Moreno

    2014-12-01

    Full Text Available Peritoneal tuberculosis (TB is an extrapulmonary form of presentation of tuberculosis. HIV infection is a primary risk factor for this condition. Diagnosis requires microbiological or histopathological confirmation in addition to supporting radiological imaging studies. Abdominal ultrasonography and CT are useful to obtain a radiographic diagnosis, with typical findings including diffuse peritoneal thickening, presence of ascites in varying volumes, adenopathies, and caseating nodes. We report 2 cases of patients with ascites and nodular peritoneal thickening on diagnostic images, as well as high CA-125 levels in laboratory tests. In both patients, a diagnosis of peritoneal tuberculosis was reached following a US-guided peritoneal biopsy.

  3. Quality of life in dialysis: A Malaysian perspective.

    Science.gov (United States)

    Liu, Wen J; Musa, Ramli; Chew, Thian F; Lim, Christopher T S; Morad, Zaki; Bujang, Adam

    2014-04-01

    There is a growing interest to use quality of life as one of the dialysis outcome measurement. Based on the Malaysian National Renal Registry data on 15 participating sites, 1569 adult subjects who were alive at December 31, 2012, aged 18 years old and above were screened. Demographic and medical data of 1332 eligible subjects were collected during the administration of the short form of World Health Organization Quality of Life questionnaire (WHOQOL-BREF) in Malay, English, and Chinese language, respectively. The primary objective is to evaluate the quality of life among dialysis patients using WHOQOL-BREF. The secondary objective is to examine significant factors that affect quality of life score. Mean (SD) transformed quality of life scores were 56.2 (15.8), 59.8 (16.8), 58.2 (18.5), 59.5 (14.6), 61.0 (18.5) for (1) physical, (2) psychological, (3) social relations, (4) environment domains, and (5) combined overall quality of life and general health, respectively. Peritoneal dialysis group scored significantly higher than hemodialysis group in the mean combined overall quality of life and general health score (63.0 vs. 60.0, P cerebral vascular accident and leg amputation. Subjects on peritoneal dialysis modality achieved higher combined overall quality of life and general health score than those on hemodialysis. Religion and cerebral vascular accident were significantly associated with all domains and combined overall quality of life and general health. PMID:26820998

  4. Peritoneal adhesion: it can be life-threatening, and life-saving

    Directory of Open Access Journals (Sweden)

    Huang Jiun-Chi

    2012-09-01

    Full Text Available Abstract Background The inevitable post-inflammatory fibrosis and adhesion often compromises future treatment in peritoneal dialysis patients. Here, we describe a patient who experienced an unusual form of peritoneal adhesion that made her give up peritoneal dialysis. However, its unique pattern also saved her from infection caused by bowel perforation. Case presentation The female patient discontinued peritoneal dialysis due to gradual dialysis inadequacy. Two months after shifting to hemodialysis with generally improved sense of well-being and no sign of abdominal illness, she was admitted to remove the Tenckhoff catheter. The procedure was smooth, but fever and abdominal pain not at the site of operation developed the next day. Abdominal ultrasound showed the presence of ascites and aspiration revealed slimy, green-yellowish pus that gave a negative result on bacterial culture. Abdominal computed tomography (CT with oral contrast medium was performed, but failed to demonstrate the suspected bowel perforation. The examination, however, did show accumulation of pus inside the abdomen but outside the peritoneal cavity. We drained the pus with two 14-F Pig-tail catheters and the total amount of drainage approached 4000 ml. The second CT was performed with double dose of the contrast medium and found a leak of the contrast from the jejunum. She then received laparotomy and had the perforation site closed. Conclusions In summary, this uremic patient suffered from pus accumulation inside her abdomen without obvious systemic toxic effect. The bowel perforation and pus formation might be caused by repeated peritonitis, but the peritoneal adhesion itself might also isolate her peritoneal cavity from the anticipated toxic injuries of bowel perforation.

  5. Amyloidosis associated with dialysis

    International Nuclear Information System (INIS)

    Amongst the complications of dialysis, amyloid osteopathy is getting increasingly significant. It is due to deposition of β2-microglobulin. To determine the incidence and time of development of this complication, the skeletal radiographs of 185 patients undergoing dialysis, some for up to ten years, were analysed retrospectively. In about 10% of patients, the presence of β2-microglobulin osteopathy may be expected. The radiological features, sites of predilection and differential diagnosis of amyloid osteopathy and of other skeletal changes due to dialysis are discussed. (orig.)

  6. A report of the Malaysian dialysis registry of the National Renal Registry, Malaysia.

    Science.gov (United States)

    Lim, Y N; Lim, T O; Lee, D G; Wong, H S; Ong, L M; Shaariah, W; Rozina, G; Morad, Z

    2008-09-01

    The Malaysian National Renal Registry was set up in 1992 to collect data for patients on renal replacement therapy (RRT). We present here the report of the Malaysian dialysis registry. The objectives of this papar are: (1) To examine the overall provision of dialysis treatment in Malaysia and its trend from 1980 to 2006. (2) To assess the treatment rate according to the states in the country. (3) To describe the method, location and funding of dialysis. (4) To characterise the patients accepted for dialysis treatment. (5) To analyze the outcomes of the dialysis treatment. Data on patients receiving dialysis treatment were collected at initiation of dialysis, at the time of any significant outcome, as well as yearly. The number of dialysis patients increased from 59 in 1980 to almost 15,000 in 2006. The dialysis acceptance rate increased from 3 per million population in 1980 to 116 per million population in 2006, and the prevalence rate from 4 to 550 per million population over the same period. The economically advantaged states of Malaysia had much higher dialysis treatment rates compared to the less economically advanced states. Eighty to 90% of new dialysis patients were accepted into centre haemodialysis (HD), and the rest into the chronic ambulatory peritoneal dialysis (CAPD) programme. The government provided about half of the funding for dialysis treatment. Patients older than 55 years accounted for the largest proportion of new patients on dialysis since the 1990s. Diabetes mellitus has been the main cause of ESRD and accounted for more than 50% of new ESRD since 2002. Annual death rate averaged about 10% on HD and 15% on CAPD. The unadjusted 5-year patient survival on both HD and CAPD was about 80%. Fifty percent of dialysis patients reported very good median QoL index score. About 70% of dialysis patients were about to work full or part time. There has been a very rapid growth of dialysis provision in Malaysia particularly in the older age groups. ESRD

  7. Myofibroblastic Conversion and Regeneration of Mesothelial Cells in Peritoneal and Liver Fibrosis.

    Science.gov (United States)

    Lua, Ingrid; Li, Yuchang; Pappoe, Lamioko S; Asahina, Kinji

    2015-12-01

    Mesothelial cells (MCs) form a single epithelial layer and line the surface of body cavities and internal organs. Patients who undergo peritoneal dialysis often develop peritoneal fibrosis that is characterized by the accumulation of myofibroblasts in connective tissue. Although MCs are believed to be the source of myofibroblasts, their contribution has remained obscure. We determined the contribution of peritoneal MCs to myofibroblasts in chlorhexidine gluconate (CG)-induced fibrosis compared with that of phenotypic changes of liver MCs. CG injections resulted in disappearance of MCs from the body wall and the accumulation of myofibroblasts in the connective tissue. Conditional linage tracing with Wilms tumor 1 (Wt1)-CreERT2 and Rosa26 reporter mice found that 17% of myofibroblasts were derived from MCs in peritoneal fibrosis. Conditional deletion of transforming growth factor-β type II receptor in Wt1(+) MCs substantially reduced peritoneal fibrosis. The CG treatment also induced myofibroblastic conversion of MCs in the liver. Lineage tracing with Mesp1-Cre mice revealed that Mesp1(+) mesoderm gave rise to liver MCs but not peritoneal MCs. During recovery from peritoneal fibrosis, peritoneal MCs, but not liver MCs, contribute to the regeneration of the peritoneal mesothelium, indicating an inherent difference between parietal and visceral MCs. In conclusion, MCs partially contribute to myofibroblasts in peritoneal and liver fibrosis, and protection of the MC layer leads to reduced development of fibrous tissue. PMID:26598235

  8. Dialysis Extraction for Chromatography

    Science.gov (United States)

    Jahnsen, V. J.

    1985-01-01

    Chromatographic-sample pretreatment by dialysis detects traces of organic contaminants in water samples analyzed in field with minimal analysis equipment and minimal quantities of solvent. Technique also of value wherever aqueous sample and solvent must not make direct contact.

  9. Dialysis Facility Compare Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Dialysis Facility Compare Website provided by the Centers for Medicare and Medicaid Services. These data...

  10. Applied peritoneal anatomy

    International Nuclear Information System (INIS)

    The peritoneal cavity is a complex anatomical structure with multiple attachments and connections. These are better understood with reference to the embryological development of this region. Armed with this knowledge, the diagnosis and assessment of a wide range of common intra-abdominal diseases becomes straightforward. This article will review and simplify the terminology, complex embryological development, and anatomy of the peritoneum, peritoneal attachments, and the reflections forming the peritoneal boundaries. Normal anatomy will be described using schematic diagrams with corresponding computed tomography (CT) and magnetic resonance imaging (MRI) images, including CT peritoneograms. The relevance of intra- and extra-peritoneal anatomy to common pathological processes will be demonstrated

  11. Baxter Aurora dialysis system.

    Science.gov (United States)

    Kelly, Thomas D

    2004-01-01

    With the recent focus on the benefits of more frequent dialysis, the Baxter Aurora dialysis system provides maximum flexibility for therapy prescription, including short daily treatments, long nocturnal treatments, hemodialysis, hemofiltration, and online hemodiafiltration, all in a compact, reliable, easy to use system. A self-prompting touch screen user interface mounted on a movable arm provides for comfortable operation, whether sitting and standing. An automatic treatment setup mode facilitates easy treatment setup. Complex menus are eliminated by the use of a hardware key that automatically selects only the prescribed options during power up, eliminating all menus associated with nonprescribed functions and modalities. This prevents the user from becoming confused or accidentally altering the dialysis treatment. Prior to dialysis the instrument goes through an automatic self-test that confirms the operation of internal systems. The screen will dim when there is no action that the patient needs to attend to on the instrument. After dialysis, press the disinfect button and the instrument disinfects itself and shuts off. For patient safety, the "disinfect" menus are not available during dialysis. The instrument can also be programmed to automatically start and rinse at a set time. For remote treatment monitoring, the instrument connects to the Internet. The Aurora records information about the machine's technical status, providing a record of instrument history for easy servicing. The Aurora is a flexible platform that provides the desired renal therapy with ease of use and proper support for the hemodialysis patient when combined with Baxter's 24-hour infrastructure and support. PMID:15043620

  12. Effect of isoflavones on atherosclerosis in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Fatih sahpaz

    2016-03-01

    Conclusion: Finally; it can be supplied useful effects on inflammatory and atherosclerotic process by using of isoflavones which has antilipogenic, antihypertensive and improving vascular health properties in end stage renal disease. [Cukurova Med J 2016; 41(1.000: 112-120

  13. Hookworm Anemia in a Peritoneal Dialysis Patient in China.

    Science.gov (United States)

    Wu, Fuquan; Xu, Ying; Xia, Min; Ying, Guanghui; Shou, Zhangfei

    2016-06-01

    Hookworm infections as well as other intestinal nematodiases are endemic in China. In this case, a 70-year-old male showed symptoms of chest tightness, shortness of breath, and both lower extremities edema. The diagnostic result was chronic renal insufficiency, chronic kidney disease (5th stage), and renal anemia at first. Then, he received treatment with traditional drugs. However, this treatment did not help to alleviate the symptoms of the patient significantly. The results of gastroendoscopy showed hookworms in the duodenum, also confirmed by pathology examination. Anemia was markedly ameliorated after eliminating the parasites. The results mentioned above suggested that ancylostomiasis was the leading causes of anemia in this patient, and the etiology of anemia in uremic patients should be systematically considered. Especially when anemia could not be cured by regular treatments, rare diseases should be investigated. PMID:27417086

  14. The kampo medicine Daikenchuto inhibits peritoneal fibrosis in mice.

    Science.gov (United States)

    Kitamura, Mineaki; Nishino, Tomoya; Obata, Yoko; Oka, Satoru; Abe, Shinichi; Muta, Kumiko; Ozono, Yoshiyuki; Koji, Takehiko; Kohno, Shigeru

    2015-01-01

    Long-term peritoneal dialysis therapy causes inflammation and histological changes in the peritoneal membrane. Inflammation generally activates fibroblasts and results in fibroblast-myofibroblast differentiation. Heat-shock protein 47 (HSP 47), a collagen-specific molecular chaperone, is localized in myofibroblasts and is involved in the progression of peritoneal fibrosis. Daikenchuto (DKT), a Kampo medicine, is used to prevent postoperative colon adhesion. It inhibits inflammation and HSP 47 expression in the gastrointestinal tract. We examined the effect of DKT on chlorhexidine gluconate (CG)-induced peritoneal fibrosis in mice injected with 0.1% CG dissolved in 15% ethanol. DKT was dissolved in the drinking water. Histological changes were assessed using Masson trichrome staining. Cells expressing α-smooth muscle actin (α-SMA), HSP 47, phospho-Smad 2/3, F4/80, and monocyte chemotactic protein-1 were examined immunohistochemically. Compared with the control group, the peritoneal tissues of the CG group were markedly thickened, and the number of cells expressing α-SMA, HSP 47, phospho-Smad 2/3, F4/80, and monocyte chemotactic protein-1 was significantly increased. However, these changes were inhibited in the DKT-treated group. These results indicate that DKT can prevent peritoneal fibrosis by inhibiting inflammation and HSP 47 expression. PMID:25747978

  15. [Management of color-Doppler imaging in dialysis patients].

    Science.gov (United States)

    Battaglia, Yuri; Granata, Antonio; Zamboli, Pasquale; Lusenti, Tiziano; Di Lullo, Luca; Floccari, Fulvio; Logias, Franco; D'Amelio, Alessandro; Fiorini, Fulvio

    2012-01-01

    In recent decades, the survival of dialysis patients has gradually increased thanks to the evolution of dialysis techniques and the availability of new drug therapies. These elements have led to an increased incidence of a series of dialysis-related diseases that might compromise the role of dialysis rehabilitation: vascular disease, skeletal muscle disease, infectious disease, cystic kidney disease and cancer. The nephrologist is therefore in charge of a patient group with complex characteristics including the presence of indwelling vascular and/or peritoneal catheters, conditions secondary to chronic renal failure (hyperparathyroidism, anemia, amyloid disease, etc.) and superimposed disorders due to old age (cardiac and respiratory failure, cancer, type 2 diabetes mellitus, etc.). Early clinical and organizational management of such patients is essential in a modern and ''economic'' vision of nephrology. The direct provision of ultrasound services by the nephrologist responds to these requirements. A minimum level of expertise in diagnostic ultrasonography of the urinary tract and dialysis access should be part of the nephrologist's cultural heritage, acquired through theoretical and practical training programs validated by scientific societies, especially for those who choose to specialize in these procedures and become experts in imaging or interventional ultrasonography. PMID:23229666

  16. Peritoneal lymphomatosis: case report

    International Nuclear Information System (INIS)

    Peritoneal lymphomatosis is a rare manifestation of high grade lymphomas. Although it is difficult to differentiate peritoneal lymphomatosis from other peritoneal diseases such as peritoneal carcinomatosis and leiomyomatosis clinically and radiologically, it should be included in differential diagnosis because the disease is curable with chemotherapy. Consequently, radiologic diagnosis plays a very important role in the detection of this disease. We experienced two cases of peritoneal lymphomatosis with primary gastrointestinal lymphomas in the distal ileum. The two patients were 25 and 50-year-old males. Abdominal CT, ultrasound and barium study were performed on both patients. Both patients had non-Hodgkin's lymphoma confirmed with open or sonographically guided biopsies. Although radiologic appearances overlapped, characteristic findings of long-segmental circumscribed annular mass, aneurysmal luminal dilatation, small to moderate amount of ascites without septation or loculation, diffuse involvement of mesentery, omentum and peritoneum, and enlarged lymph nodes were helpful in narrowing the range of possible diagnoses

  17. Prevalence of sleep apnea and excessive day time sleepiness in patients with end-stage renal disease on dialysis

    OpenAIRE

    Hamdan Al-Jahdali

    2012-01-01

    Sleep apnea (SA) and excessive daytime sleepiness (EDS) are common sleep disorders among patients with end-stage renal disease (ESRD). This cross-sectional study, carried out in two dialysis centers in Saudi Arabia, assessed the prevalence of sleep apnea and sleepiness in Saudi patients with ESRD who are on maintenance dialysis with either peritoneal or hemodialysis. We used questionnaires to assess the prevalence of SA and EDS. The association between sleep apnea, EDS, and other sleep disord...

  18. Draining Fluids through a Peritoneal Catheter in Newborns after Cardiac Surgery Helps to Control Fluid Balance

    Directory of Open Access Journals (Sweden)

    Elisa Ruano Cea

    2010-01-01

    Full Text Available Dialysis can be used in severe cases, but may not be well tolerated. In such patients, peritoneal drainage could be an alternative option for fluid removal. We report the case of a newborn with a truncus arteriosus who developed postoperatively a complicated clinical course with right ventricular dysfunction, prerenal condition as well as fluid overload despite diuretic therapy. Dialysis was indicated for fluid removal. Peritoneal dialysis was started using a surgically placed Tenckhoff catheter and stopped due to inefficacy and leaks and no other modalities of dialysis were used. However, the catheter was left in place over a period of two months for fluid drainage and removed because of unexplained fever. In order to determine the effect of peritoneal drainage, we selected a period of one week before and one week after the removal of the drain to compare daily clinical data, urine electrolytes and renal function and found a positive effect on fluid balance control. We conclude that the fluid removal by continuous peritoneal drainage is a simple and safe alternative that can be used to control fluid balance in infants after cardiac surgery.

  19. Draining Fluids through a Peritoneal Catheter in Newborns after Cardiac Surgery Helps to Control Fluid Balance.

    Science.gov (United States)

    Ruano Cea, Elisa; Jouvet, Philippe; Vobecky, Suzanne; Merouani, Aicha

    2010-01-01

    Dialysis can be used in severe cases, but may not be well tolerated. In such patients, peritoneal drainage could be an alternative option for fluid removal. We report the case of a newborn with a truncus arteriosus who developed postoperatively a complicated clinical course with right ventricular dysfunction, prerenal condition as well as fluid overload despite diuretic therapy. Dialysis was indicated for fluid removal. Peritoneal dialysis was started using a surgically placed Tenckhoff catheter and stopped due to inefficacy and leaks and no other modalities of dialysis were used. However, the catheter was left in place over a period of two months for fluid drainage and removed because of unexplained fever. In order to determine the effect of peritoneal drainage, we selected a period of one week before and one week after the removal of the drain to compare daily clinical data, urine electrolytes and renal function and found a positive effect on fluid balance control. We conclude that the fluid removal by continuous peritoneal drainage is a simple and safe alternative that can be used to control fluid balance in infants after cardiac surgery. PMID:20379389

  20. 肾移植与腹膜透析患者生活质量比较的病例对照研究%Comparison of quality of life in renal transplantation and peritoneal dialysis patients: a case-control study

    Institute of Scientific and Technical Information of China (English)

    金三丽; 庞冬; 杨萍; 胡晶敏; 王晓玥; 张卨; 耿妍; 路潜

    2012-01-01

    目的 比较肾移植患者与腹膜透析患者的生活质量.方法 采用病例对照的研究方法,以性别、年龄、文化程度、工作与否、付费方式、肾替代治疗时间作为匹配条件,选择肾移植和腹膜透析患者各58例,以健康相关生活质量问(Short Form 36 Health Survey Questionnaire,SF-36)评估其生活质量.结果 肾移植与腹膜透析患者的生理综合得分和精神综合得分均无显著性差异,在涉及的8个维度中,肾移植患者的生理机能(t=3.060,P=0.003)、一般健康状况(t=2.579,P = 0.011)和精力(t=2.610,P=0.011)高于腹膜透析患者,而生理职能(Z=3.917,P=0.000)低于腹膜透析患者.结论 肾移植与腹膜透析患者总体生活质量无差异,仅个别维度有差异;良好的疾病管理能改善患者生活质量,应加强肾替代治疗患者的管理.%Objective To compare the quality of life between renal transplantation (RT) and peritoneal dialysis (PD) patients. Methods A case-control study was used, matching sex, age, education level, employment, means of payment and renal replacement therapy duration in two groups. 58 pairs were selected to fill out Short Form 36 Health Survey Questionnaire (SF-36) which was used to evaluate their quality of life. Results There were no significant differences in physical component summary and mental component summary between two groups. Physical functioning (t=3.060, P=0.003), general health (£=2.579, /=0.011) and vitality (t=2.610, P= 0.011) of RT patients were higher than those of PD patients, whereas role-physical(Z=3.917, P=0.000) was lower than PD patients. Conclusions There was no significant difference in total quality of life between two groups. High-quality disease management would benefit to improve the quality of life. We should pay more attention to the disease management, especially for RT patients.

  1. 中文版腹膜透析患者自我管理量表的编制与信度效度检验%Development of self-management scale for peritoneal dialysis patients and the test of its validity and reliability

    Institute of Scientific and Technical Information of China (English)

    庞建红; 汪小华; 赵黎; 傅雪琴; 姜小梅; 仇静波; 许义; 汪年松

    2014-01-01

    Objective: To develop and evaluate the scale of self-management for continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: The item pool was formulated based on literature review and in-depth interviews. An initial scale containing 5 dimensions and 44 items was constructed through two rounds of Delphi expert consultation and preliminary test. Totally 313 CAPD patients from Jiangsu-Zhejiang-Shanghai area were investigated to test the reliability and validity of the scale. Results: Five factors, including technical operations of liquid replacement, solution for unusual situation, diet management, complications monitoring, emotional regulation and social participation, were extracted by exploratory factor analysis; the 28 items could explain 64.567% of the total variance. The content validity index, Cronbach's α coefifcient, split-half coefifcient and test-retest reliability was 0.963, 0.926, 0.960 and 0.937 respectively. Conclusion: The scale is supported to be a reliable and valid tool for the self-management assessment of CAPD patients.%目的:发展适用于持续非卧床腹膜透析(CAPD)患者自我管理的测评量表并进行信、效度检验。方法:查阅文献并结合患者访谈,发展条目池;经两轮德尔菲(Delphi)专家评定和预试验,形成包含5个因子44个条目的初始量表;调查江浙沪地区“三甲”医院的313例CAPD患者,评价量表的信、效度。结果:探索性因素分析得到含有28个条目的5个公因子:换液技术操作、操作中异常情况的处理、饮食管理、并发症监测、情绪管理及社会回归。累积解释变异率为64.567%,量表内容效度指数为0.963,Cronbach’sα系数为0.926,奇偶折半系数为0.960,重测信度系数为0.937。结论:本量表具有良好的信、效度,适用于CAPD患者自我管理能力的评价。

  2. Peritoneal dialysis in 30 infants and children with acute renal insufficiency after complex congenital heart disease surgery%腹膜透析治疗婴幼儿复杂先天性心脏病术后急性肾功能不全30例

    Institute of Scientific and Technical Information of China (English)

    卢琳; 吴锡阶; 陈良万

    2013-01-01

    Objective To analyse peritoneal dialysis(PD) in 30 infants and children with acute renal insufficiency after complex congenital heart disease surgery,sum up the clinical experience of PD therapy infants and children with acute renal insufficiency after complex congenital heart disease surgery.Methods The clinical records of 30 infants and children during January 2010 to June 2012 were analysed retrospectively,with 23 male and 7 female,aged from 7 days to 18 months[average (8.28 ± 5.17) months],weight 2.5-14 kg[average (5.15 ± 3.89) kg].The reasons for PD:7 cases because of oliguria (urine < 1 ml · h-1 · kg-1,duration > 4 h) and the other 23 cases because of anuria.Results One case with total anomalous pulmonary venous connection(TAPVC) died of left heart failure,1 case with transposition of the great arteries died of multiple organ failure,and the other 28 cases were all cured,cure rate 93.33%.Conclusion PD is easy,safe and low-cost,has definite curative effect in infants and children with acute renal insufficiency after complex congenital heart disease surgery,worth to popularize.%目的 回顾性分析30例婴幼儿复杂先天性心脏病术后合并急性肾功能不全行腹膜透析治疗的资料,总结腹膜透析治疗婴幼儿复杂先心病术后合并肾功能不全的临床经验.方法 分析2010年1月至2012年6月,30例复杂先天性心脏病术后合并急性肾功能不全行腹膜透析治疗患婴(儿)的的临床资料,男23例,女7例;年龄7天~18个月,平均(8.28±5.17)个月;体质量2.5 ~14.0 kg,平均(5.15 ±3.89) kg.7例因少尿(每小时尿量<1ml/kg,持续时间>4h)、组织水肿行腹膜透析,23例因无尿行腹膜透析.结果 死亡2例,1例完全型肺静脉异位引流患儿因左心室小、左心衰竭而死亡,1例完全型大动脉转位因多器官功能衰竭而死亡;28例(93.33%)治愈.结论 腹膜透析操作简单方便、安全性高、费用低,治疗复杂先天性心脏病术后合

  3. Osteoarthropathy in dialysis amyloidosis

    International Nuclear Information System (INIS)

    Many long-term (>60 months) hemodialysis patients develop a severe osteoarticular disease, called 'dialysis arthropathy', which is characterized by the deposition in bone and synovia of a new type of amyloid made mainly of β2-microglobulin. In the present study, 31 patients (17 males, 14 females; age 54.1±13 years) undergoing chronic hemodialysis arthropathy by means of clinics and of radiological investigations (conventional radiography and computed tomography). Sixteen patients (51.6%) had radiographic evidence of dialysis arthropathy: geodes (shoulders, 12 cases; wrists, 11; hips, 2; knees, 2) and/or destructive arthropathies (cervical spine, 13 cases; dorsolumbar spine, 2; hands, 2; hips, 1). Within 24 months, these lesions were found to progress slowly in the majoriry of cases. In the diagnostic process, CT should be employed in the study of spine, shoulders and hips when the lesions have not been sufficiently demonstrated by conventional radiography in the presence of evident clinical signs. Patients with dialysis arthropathy had undergone dialysis for longer periods than those without it (p<0.005) and showed a significantly higher incidence of both carpal tunnel syndrome (p<0.0005) and shoulder pain (p<0.005). Our findings confirm the high incidence and clinical importance of dialysis arthropathy in long-term hemodialysis patients end the value of diagnostic imaging in screening such patients for those lesions

  4. Relationship between Chinese Medicine Syndromes of Malnutrition and Insulin Resistance and Analysis on Correlative Factors for the Patients Undergoing Peritoneal Dialysis%腹膜透析营养不良患者中医证型与胰岛素抵抗的关系及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李建英; 梁青; 黄克基; 刘先英

    2011-01-01

    Objective To discuss the relationship between Chinese medicine syndromes of malnutrition and insulin resistance( IR )for the patients undergoing maintenance peritoneal dialysis( MPD )as well as the correlative factors of IR, and explore the law on the syndrome differentiation and treatment of this disease in Chinese medicine.Methods 60 cases of uremia undergoing MPD were selected.The cases in compliance with malnutrition according to the Subjective Global Assessment( SGA )were differentiated into different types of Chinese medicine in terms of chronic kidney failure.Besides, a health control group( 30 cases )is set up.The serum fasting insulin( FINS )and fasting blood sugar( FBG )were detected in two groups.The homeostasis model assessment for insulin resistance( HOMA -IR )was calculated as the indicator of IR.Meanwhile, the serum albumin( ALB ), prealbumin( PA ), hemoglobin( HB ), the total urea clearance rate( KT/Vt )and the residual kidney urea clearance( KT/Vr )were detected for MPD patients.The relationship of different syndromes of Chinese medicine with each IR parameter, as well as between HOMA - IR and every indicator was investigated.Results The levels of FBG,FINS and HOMA - IR in MPD group were all higher than those in the healthy control group( P < 0.01 or P < 0.05 ).For the main syndromes such as spleen and kidney yang deficiency and yin and yang deficiency, as well as the associated syndrome such as turbid damp syndrome, the levels of the serum FBG, FINS and HOMA - IR were all higher apparently than those in the other three groups( P < 0.01 or 0.05 ).The correlative analysis displayed that the serum ALB, PA, KT/Vt and KT/Vr were positively correlated to HOMA - IR.Conclusions Insulin resistance presents universally in the patients with malnutrition undergoing MPD,which is much predominated in spleen and kidney yang deficiency syndrome, yin and yang deficiency syndrome and turbid damp syndrome.There is a close correlation of IR with nutrition,dialysis

  5. Diabetic Muscle Infarction: A Rare Cause of Acute Limb Pain in Dialysis Patients

    Directory of Open Access Journals (Sweden)

    G. De Vlieger

    2013-01-01

    Full Text Available Diabetic muscle infarction is a rare microangiopathic complication occurring in patients with advanced diabetes mellitus. Diabetic patients with chronic kidney disease stage Vd are prone to develop this complication. The presenting symptom is a localized painful swelling of the affected limb. Symptoms usually resolve spontaneously during the following weeks, but frequent relapse can occur and in some cases swelling may lead to compartment syndrome. Biochemical blood analyses show an elevated C-reactive protein, but creatine kinase is often normal. Diagnosis can be made on clinical presentation and imaging, with magnetic resonance imaging as the gold standard. Histology is often not contributive. Treatment consists of rest, analgesics, rigorous glycemic control and low-dose aspirin. Severe cases of compartment syndrome require fasciotomy. In the current paper, we present two diabetic patients with cystic fibrosis, who are treated with automated peritoneal dialysis and suffered from episodic lower limb infarction. We subsequently review 48 episodes of diabetic muscle infarction previously reported in the literature in patients with end-stage renal disease.

  6. Survival by Dialysis Modality-Who Cares?

    Science.gov (United States)

    Lee, Martin B; Bargman, Joanne M

    2016-06-01

    In light of the recent emphasis on patient-centered outcomes and quality of life for patients with kidney disease, we contend that the nephrology community should no longer fund, perform, or publish studies that compare survival by dialysis modality. These studies have become redundant; they are methodologically limited, unhelpful in practice, and therefore a waste of resources. More than two decades of these publications show similar survival between patients undergoing peritoneal dialysis and those receiving thrice-weekly conventional hemodialysis, with differences only for specific subgroups. In clinical practice, modality choice should be individualized with the aim of maximizing quality of life, patient-reported outcomes, and achieving patient-centered goals. Expected survival is often irrelevant to modality choice. Even for the younger and fitter home hemodialysis population, quality of life, not just duration of survival, is a major priority. On the other hand, increasing evidence suggests that patients with ESRD continue to experience poor quality of life because of high symptom burden, unsolved clinical problems, and unmet needs. Patients care more about how they will live instead of how long. It is our responsibility to align our research with their needs. Only by doing so can we meet the challenges of ESRD patient care in the coming decades. PMID:26912541

  7. Peritoneal Dialysate Glucose Load and Systemic Glucose Metabolism in Non-Diabetics: Results from the GLOBAL Fluid Cohort Study

    OpenAIRE

    Mark Lambie; James Chess; Jun-Young Do; Hyunjin Noh; Hi-Bahl Lee; Yong-Lim Kim; Angela Summers; Paul Ford Williams; Sara Davison; Marc Dorval; Nick Topley; Simon John Davies

    2016-01-01

    Background and Objectives Glucose control is a significant predictor of mortality in diabetic peritoneal dialysis (PD) patients. During PD, the local toxic effects of intra-peritoneal glucose are well recognized, but despite large amounts of glucose being absorbed, the systemic effects of this in non-diabetic patients are not clear. We sought to clarify whether dialysate glucose has an effect upon systemic glucose metabolism. Methods and Materials We analysed the Global Fluid Study cohort, a ...

  8. Dialysis modality choice in diabetic patients with end-stage kidney disease

    DEFF Research Database (Denmark)

    Couchoud, Cecile; Bolignano, Davide; Nistor, Ionut;

    2015-01-01

    BACKGROUND: Diabetes is the leading cause of end-stage kidney disease (ESKD). Because of conflicting results in observational studies, it is still subject to debate whether in diabetic patients the dialysis modality selected as first treatment (haemodialysis or peritoneal dialysis) may have a major...... on diabetes, end-stage kidney disease and dialysis modality. Selection of relevant studies, data extraction and analysis were performed by two independent reviewers. RESULTS: Twenty-five observational studies (23 on incident and 2 on prevalent cohorts) were included in this review. Mortality was the only main...... outcome addressed in large cohorts. When considering patient survival, results were inconsistent and varied across study designs, follow-up period and subgroups. We therefore found no evidence-based arguments in favour or against a particular dialysis modality as first choice treatment in patients...

  9. Giant peritoneal loose bodies

    Directory of Open Access Journals (Sweden)

    Chris van Zyl

    2015-03-01

    Full Text Available Giant peritoneal loose bodies are rare lesions, originating from auto-amputated appendices epiploicae. They may cause urinary or gastrointestinal obstruction and, should the radiologist not be familiar with the entity, can potentially be confused with malignant or parasitic lesions.Familiarity with their characteristic computed tomographic features is essential to prevent unnecessary surgery in the asymptomatic patient. We present a case of a 70-year-old man diagnosed with two giant peritoneal loose bodies.

  10. Depression in dialysis patients.

    Science.gov (United States)

    King-Wing Ma, Terry; Kam-Tao Li, Philip

    2016-08-01

    Depression is the most common psychiatric illness in patients with end-stage renal disease (ESRD). The reported prevalence of depression in dialysis population varied from 22.8% (interview-based diagnosis) to 39.3% (self- or clinician-administered rating scales). Such differences were attributed to the overlapping symptoms of uraemia and depression. Systemic review and meta-analysis of observational studies showed that depression was a significant predictor of mortality in dialysis population. The optimal screening tool for depression in dialysis patients remains uncertain. The Beck Depression Inventory (BDI), Patient Health Questionnaire (PHQ) and Center for Epidemiologic Studies Depression Scale (CESD) have been validated for screening purposes. Patients who scored ≥14 using BDI should be referred to a psychiatrist for early evaluation. Structured Clinical Interview for DSM disorders (SCID) remains the gold standard for diagnosis. Non-pharmacological treatment options include cognitive behavioural therapy and exercise training programs. Although frequent haemodialysis may have beneficial effects on patients' physical and mental well-being, it cannot and should not be viewed as a treatment of depression. Selective serotonin reuptake inhibitors (SSRIs) are generally effective and safe in ESRD patients, but most studies were small, non-randomized and uncontrolled. The European Renal Best Practice (ERBP) guideline suggests a trial of SSRI for 8 to 12 weeks in dialysis patients who have moderate-major depression. The treatment effect should be re-evaluated after 12 weeks to avoid prolonging ineffective medication. This review will discuss the current understanding in the diagnosis and management of depression in dialysis patients. PMID:26860073

  11. Renal cell carcinoma in dialysis patients. A single center experience

    International Nuclear Information System (INIS)

    Renal cell carcinoma (RCC) is a life-threatening complication of end-stage renal disease with an unclear pathogenesis. We evaluated RCC developing in patients undergoing dialysis. In 2624 patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis at our hospital between July 1993 and March 2004, we performed annual screening for RCC using abdominal computed tomography and ultrasonography. Patients diagnosed with RCC underwent radical nephrectomy as well as clinical and pathologic evaluation. RCC was detected in 44 patients (1.68%; 31 males and 13 females). The age of RCC patients was 55.5±11.1 years. Dialysis duration before RCC diagnosis was 11.2±7.2 years. Most RCC were early stage and low stage by TNM classification, 43 patients had N0M0 RCC, whereas one had N1M0. Tumor size was 2.9±1.9 cm. The predominant histological type of RCC was common or conventional cell-type carcinoma (clear cell carcinoma and granular cell carcinoma). Of patients, 5 (11.4%) had bilateral RCC, and satellite tumor lesions in RCC were detected in 13 (29.5%). In 36 patients (81.8%) RCC was accompanied by acquired cystic disease of the kidney. These patients had longer dialysis durations (P=0.01) and smaller tumors (P=0.048). RCC metastasized postoperatively in 4 patients (9.1%), while one (2.3%) died of cancer. Our dialysis patients showed a higher incidence of RCC than the general population. Prognosis was favorable because tumors were detected by screening when they were small. Therefore, periodical screening for RCC seems very important in dialysis patients. (author)

  12. Symptomatic treatment of ascites with a peritoneo-vesical automated fluid shunt system in a dog.

    Science.gov (United States)

    Venzin, C; Kook, P; Jenni, S; Wilhelm, S; Degen, T; Braun, A; Rütten, M; Glaus, T M

    2012-02-01

    A six-year-old Rottweiler with chronic ascites and moderate panhypoproteinaemia that had been treated with large volume paracentesis over several months duration was diagnosed with a large bi-atrial mass and hepatic fibrosis. For palliative treatment, a peritoneo-vesical automated fluid shunt system with an integrated chargeable battery and an integrated computer to control pump function and to transmit data transcutaneously was implanted by coeliotomy. The pump was left in place for 10 weeks, eliminating the need for further paracentesis during this time. At the end of this period, no ascites was discernible and serum protein concentrations had returned to their respective reference intervals. As a complication, decubitus with skin perforation had developed above the pump. Besides palliative treatment of chronic refractory ascites, this pump may have application in other conditions characterised by chronic cavity effusion or in peritoneal dialysis. PMID:22106956

  13. Peritonitis: laparoscopic approach

    Directory of Open Access Journals (Sweden)

    Agresta Ferdinando

    2006-03-01

    Full Text Available Abstract Background Laparoscopy has became as the preferred surgical approach to a number of different diseases because it allows a correct diagnosis and treatment at the same time. In abdominal emergencies, both components of treatment – exploration to identify the causative pathology and performance of an appropriate operation – can often be accomplished via laparoscopy. There is still a debate of peritonitis as a contraindication to this kind of approach. Aim of the present work is to illustrate retrospectively the results of a case-control experience of laparoscopic vs. open surgery for abdominal peritonitis emergencies carried out at our institution. Methods From January 1992 and January 2002 a total of 935 patients (mean age 42.3 ± 17.2 years underwent emergent and/or urgent surgery. Among them, 602 (64.3% were operated on laparoscopically (of whom 112 -18.7% – with peritonitis, according to the presence of a surgical team trained in laparoscopy. Patients with a history of malignancy, more than two previous major abdominal surgeries or massive bowel distension were not treated Laparoscopically. Peritonitis was not considered contraindication to Laparoscopy. Results The conversion rate was 23.2% in patients with peritonitis and was mainly due to the presence of dense intra-abdominal adhesions. Major complications ranged as high as 5.3% with a postoperative mortality of 1.7%. A definitive diagnosis was accomplished in 85.7% (96 pat. of cases, and 90.6% (87 of these patients were treated successfully by Laparoscopy. Conclusion Even if limited by its retrospective feature, the present experience let us to consider the Laparoscopic approach to abdominal peritonitis emergencies a safe and effective as conventional surgery, with a higher diagnostic yield and allows for lesser trauma and a more rapid postoperative recovery. Such features make Laparoscopy a challenging alternative to open surgery in the management algorithm for abdominal

  14. Racial and Ethnic Disparities in Use of and Outcomes with Home Dialysis in the United States.

    Science.gov (United States)

    Mehrotra, Rajnish; Soohoo, Melissa; Rivara, Matthew B; Himmelfarb, Jonathan; Cheung, Alfred K; Arah, Onyebuchi A; Nissenson, Allen R; Ravel, Vanessa; Streja, Elani; Kuttykrishnan, Sooraj; Katz, Ronit; Molnar, Miklos Z; Kalantar-Zadeh, Kamyar

    2016-07-01

    Home dialysis, which comprises peritoneal dialysis (PD) or home hemodialysis (home HD), offers patients with ESRD greater flexibility and independence. Although ESRD disproportionately affects racial/ethnic minorities, data on disparities in use and outcomes with home dialysis are sparse. We analyzed data of patients who initiated maintenance dialysis between 2007 and 2011 and were admitted to any of 2217 dialysis facilities in 43 states operated by a single large dialysis organization, with follow-up through December 31, 2011 (n =: 162,050, of which 17,791 underwent PD and 2536 underwent home HD for ≥91 days). Every racial/ethnic minority group was significantly less likely to be treated with home dialysis than whites. Among individuals treated with in-center HD or PD, racial/ethnic minorities had a lower risk for death than whites; among individuals undergoing home HD, only blacks had a significantly lower death risk than whites. Blacks undergoing PD or home HD had a higher risk for transfer to in-center HD than their white counterparts, whereas Asians or others undergoing PD had a lower risk than whites undergoing PD. Blacks irrespective of dialysis modality, Hispanics undergoing PD or in-center HD, and Asians and other racial groups undergoing in-center HD were significantly less likely than white counterparts to receive a kidney transplant. In conclusion, there are racial/ethnic disparities in use of and outcomes with home dialysis in the United States. Disparities in kidney transplantation evident for blacks and Hispanics undergoing home dialysis are similar to those with in-center HD. Future studies should identify modifiable causes for these disparities. PMID:26657565

  15. The application of peritoneal dialysis ( PD ) in the children with complex congenital heart disease after surgery%腹膜透析时机对先天性心脏病患者术后临床效果的影响

    Institute of Scientific and Technical Information of China (English)

    梁林宝; 程国栋; 凌国生; 朱春磊

    2012-01-01

    Objective To investigate the efficacy of peritoneal dialysis(PD) in the children with complex congenital heart disease after surgery.Methods 65 children with complex congenital heart disease were divided into group A(33 cases) and group B(32 cases).Group A was given PD when diuretics or urine output was less than 0.5ml per hour,while group B was given PD when urine output was less than 0.5ml per hour after 6h.The survival effect and indicators of PD before and after treatment were observed.Results The effective rate of group A (84.85% ) was significantly better than group B ( 53.12% ) ( x2 =5.18,P < 0.05 ).The fatality rate of group A (9.09% ) was significantly lower than group B ( 18.75% ) ( x2 =5.32,P < 0.05 ).The renal function was significantly improved.Urine output increased to the normal level,serum potassium,blood urea nitrogen,serum creatinine concentration were effectively controlled,the changes of indicators had significant differences before and after PD (t =5.22,3.46,46,4.89,4.77,all P < 0.05).Conclusion PD was an effective support method for heart,renal insufficiency after the surgery of complex congenital heart disease,and it had good clinical effect for early application.%目的 探讨复杂先天性心脏病术后腹膜透析(PD)的应用时机.方法 65例复杂性先天性心脏病患儿随机分为A组(33例)与B组(32例),A组术后于使用利尿药效果差或尿量<0.5ml·kg-1·h-1时即采用PD,B组于尿量<0.5 ml·kg-1·h-1持续6h后采用PD,观察比较两组患儿的生存效果和PD前后各项指标的变化.结果 PD治疗l-15 d后,65例患儿PD前尿量(1.03±0.43)ml·kg-1·h-1、血钾(5.52±0.94) mmol/L、血尿素氮(19.54±3.73) mmol/L、血肌酐(143.77±42.89) mmol/L,PD后分别为(2.85±0.61)ml· kg-1· h-1、(4.32±0.57) mmol/L、(9.54±3.42) mmol/L、(120.01±49.22)mmol/L,PD前后各项指标变化差异均有统计学意义(t =5.22、3.46、4.89、4.77,均P<0.05).A组患儿尿量逐渐改善及恢复28

  16. Dialysis disequilibrium syndrome

    OpenAIRE

    Harris, C. P.; Townsend, J J

    2012-01-01

    The dialysis disequilibrium syndrome is a rare but serious complication of hemodialysis. Despite the fact that maintenance hemodialysis has been a routine procedure for over 50 years, this syndrome remains poorly understood. The signs and symptoms vary widely from restlessness and headache to coma and death. While cerebral edema and increased intracranial pressure are the primary contributing factors to this syndrome and are the target of therapy, the precise mechanisms for their development ...

  17. Ultrasound-guided biopsy of the thickened peritoneal reflections: efficacy and diagnostic role in the differential diagnosis of peritoneal tuberculosis and peritoneal carcinomatosis

    International Nuclear Information System (INIS)

    To evaluate the accuracy and safety of ultrasound-guided biopsy of the thickened peritoneal reflections and to determine the efficacy and diagnostic role of this procedure in the differential diagnosis of peritoneal tuberculosis and peritoneal carcinomatosis. Twenty-seven patients with only mildly thickened (25 mm or less) peritoneal reflections without apparent mass formations, and in whom imaging findings were not diagnostic, underwent ultrasound-guided biopsy. Five-MHz linear or convex linear array transducers were used for ultrasound guidance, and an automated gun with 18-gauge (n=3D23) or 20-gauge (n=3D4) needles for tissue sampling. biopsies were performed on the thickened parietal peritoneum (n=3D9), greater omentum (n=3D11), and small bowel mesentery (n=3D7), and the results were compared with the final diagnosis determined by radiologic/clinical follow-up (n=3D17) or laparoscopic biopsy (n=3D10). Complications and changes in hemoglobin and hematocrit levels after the procedure were evaluated. Specimens adequate for pathologic examination were obtained in all 27 patients. The histopathologic results were metastatic carcinomatosis (n=3D15), peritoneal tuberculosis (n=3D8), and chronic granulomatous inflammation (n=3D4). Specific pathologic diagnosis was obtained in all patients except the four with chronic granulomatous inflammation. Differentiation between benignancy and malignancy was possible in all patients and the histopathologic specific accuracy rate was 100%. No clinically significant complications were observed. In 24 patients with ascites at the site of the biopsy, transient bleeding was observed immediately after the procedure, but this stopped spontaneously within a few minutes. Post-procedural hemoglobin and hematocrit levels were only minimally lower (mean values of 0.9 g/dL and 3.0%, respectively) than pre-procedurally. Ultrasound-guided biopsy of thickened peritoneal reflections is a safe and effective diagnostic procedure and is useful in

  18. Disease: H01164 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available en identified as an unusual etiologic opportunistic agent in patients with cardiac transplant, automated peritoneal dialysis...opportunistic bacterium in ambulatory peritoneal dialysis. Int J Infect Dis 14:e173-4 (2010) PMID:15243119 (

  19. Peritoneal manifestations of parasitic infection.

    Science.gov (United States)

    Kim, So Yeon; Ha, Hyun Kwon

    2008-01-01

    The purpose of this study was to describe of peritoneal manifestations of parasitic infection at CT. A broad spectrum of CT findings can be seen in the peritoneal cavity, including a varying degree of omental or mesenteric infiltration, single or multiple peritoneal mass or nodule, and peritoneal thickening or stranding. Recognition of these findings are crucial for establish an early diagnosis and helps avoid unnecessary surgery. PMID:17924162

  20. Food-starch granulomatous peritonitis.

    OpenAIRE

    Davies, J D; Ansell, I D

    1983-01-01

    Two cases of peritoneal granulomatous reactions to food starch are described. They followed bowel perforation and clinically mimicked tuberculous and glove-powder starch peritonitis. Their histological differences from corn-starch peritonitis warrant attention in the absence of previous documentation of starch as a component of peritoneal food granulomas. Food-starch granules tend to be larger than those of glove powder, are often oval, and may be extremely resistant to salivary diastase dige...