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Seminars in Nephrology

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https://www.readbyqxmd.com/read/28153198/encapsulating-peritoneal-sclerosis
#1
REVIEW
Helen Alston, Stanley Fan, Masaaki Nakayama
Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of peritoneal dialysis. In this review, we describe the clinical picture and histologic changes to the peritoneal membrane that are associated with EPS and provide an update on current diagnosis and management. We also discuss the recent studies that have suggested that the use of more biocompatible solutions containing lower concentrations of glucose degradation product that often are pH neutral in combination with a change in clinical practice (reducing glucose exposure and monitoring peritoneal membrane function) might ameliorate peritoneal degeneration, reduce the incidence of EPS, and minimize the severity of the disease...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153197/peritoneal-membrane-preservation
#2
REVIEW
M Auxiliadora Bajo, Gloria Del Peso, Isaac Teitelbaum
Peritoneal dialysis (PD) is a successfully used method for renal replacement therapy. However, long-term PD may be associated with peritoneal fibrosis and ultrafiltration failure. The key factors linked to their appearance are repeated episodes of inflammation associated with peritonitis and long-term exposure to bioincompatible PD fluids. Different strategies have been proposed to preserve the peritoneal membrane. This article reviews the functional and structural alterations related to PD and strategies whereby we may prevent them to preserve the peritoneal membrane...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153196/peritoneal-dialysis-related-peritonitis-atypical-and-resistant-organisms
#3
REVIEW
Yeoungjee Cho, Dirk Gijsbert Struijk
Peritoneal dialysis (PD)-related peritonitis remains to be one of the most frequent and serious complications of PD. In this study, existing literature has been reviewed on PD peritonitis caused by atypical organisms and antibiotic resistant organisms and their impact on patient outcomes. Although uncommon, delay in recognition of PD peritonitis caused by atypical organisms can lead to poor patient outcomes if there is a delay in diagnosis and implementation of appropriate treatment. There is also a large difference in prevalence of antibiotic-resistant infections across the world with variable impact on reported patient-level outcomes...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153195/inflammation-and-peritoneal-dialysis
#4
REVIEW
Philip Kam-Tao Li, Jack Kit-Chung Ng, Christopher William Mcintyre
Inflammation is one of the well-recognized nontraditional risk factors that contributes to the excessive cardiovascular mortality in peritoneal dialysis (PD) patients. Serum C-reactive protein and interleukin-6 levels are common surrogate markers used to measure inflammatory burden and predict adverse clinical outcomes in PD patients. Causes of inflammation are complex and can be categorized into factors related to a decrease in renal function and factors related to dialysis. They interact with each other and finally result in systemic and intraperitoneal inflammation...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153194/fluid-overload-in-peritoneal-dialysis-patients
#5
REVIEW
Yong-Lim Kim, Wim Van Biesen
Volume management in peritoneal dialysis patients is of importance, as both volume overload and dehydration are associated with worse outcomes. When assessing volume status, it is important to understand that different techniques measure different fluid compartments (intracellular vs extracellular vs circulating volume) and the impact of cardiac function. Attention to salt restriction and diuretics can help to maintain euvolemia without need for hypertonic bags. Glycaemia should be monitored to avoid thirst...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153193/low-gdp-solution-and-glucose-sparing-strategies-for-peritoneal-dialysis
#6
REVIEW
Cheuk Chun Szeto, David W Johnson
Long-term exposure to a high glucose concentration in conventional peritoneal dialysis (PD) solution has a number of direct and indirect (via glucose degradation products [GDP]) detrimental effects on the peritoneal membrane, as well as systemic metabolism. Glucose- or GDP-sparing strategies often are hypothesized to confer clinical benefits to PD patients. Icodextrin (glucose polymer) solution improves peritoneal ultrafiltration and reduces the risk of fluid overload, but these beneficial effects are probably the result of better fluid removal rather than being glucose sparing...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153192/current-challenges-and-opportunities-in-pd
#7
REVIEW
Philip Kam-Tao Li, Vickie Wai-Ki Kwong
Despite the gradual increased use of peritoneal dialysis (PD) globally around the world, it is recognized that a number of areas in PD as a renal-replacement therapy require attention and improvements. The current challenges in PD include how to tackle technique failure and sustain long-term PD, manage and prevent peritoneal infections, malnutrition and inflammation, cardiovascular mortality, volume overload, glucose exposure, adequacy of solute removal, peritoneal access, peritoneal physiology and changes with long-term PD, patient fatigue, psychosocial issues, and care of elderly patients on PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153191/peritoneal-dialysis-catheter-insertion
#8
REVIEW
John H Crabtree, Kai-Ming Chow
The success of peritoneal dialysis as renal-replacement therapy depends on a well-functioning peritoneal catheter. Knowledge of best practices in catheter insertion can minimize the risk of catheter complications that lead to peritoneal dialysis failure. The catheter placement procedure begins with preoperative assessment of the patient to determine the most appropriate catheter type, insertion site, and exit site location. Preoperative preparation of the patient is an instrumental step in facilitating the performance of the procedure, avoiding untoward events, and promoting the desired outcome...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153190/acute-pd-evidence-guidelines-and-controversies-%C3%A2
#9
REVIEW
Daniela Ponce, Andre Balbi, Brett Cullis
Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited and PD now frequently is used in developing countries because of its lower cost and minimal infrastructural requirements. Studies from these countries have shown that, with careful thought and planning, critically ill patients can be treated successfully using PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153189/components-of-a-successful-peritoneal-dialysis-program
#10
REVIEW
Xueqing Yu, Rajnish Mehrotra, Xiao Yang
Although varying widely among different countries and geographic regions, the development of peritoneal dialysis invariably requires a well-established program. Key ingredients for the successful delivery of this therapy include adequate chronic kidney disease education, governmental or nongovernmental reimbursement, qualified physicians and nurses trained in the principles and practice of peritoneal dialysis, clinical management that incorporates an excellent and well-trained peritoneal dialysis team, a feasible and well-designed program for catheter insertion, a sound patient training and follow-up scheme, and continuous quality improvement...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153188/introduction-advancing-global-pd-knowledge
#11
EDITORIAL
Philip K T Li
No abstract text is available yet for this article.
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/27987550/back-to-the-future-paving-the-way-for-the-next-generation-of-renal-therapeutics
#12
REVIEW
Louis Brenner
No abstract text is available yet for this article.
November 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27987549/genetics-of-diabetic-kidney-disease
#13
EDITORIAL
Jose C Florez
No abstract text is available yet for this article.
November 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27987548/genetics-of-kidney-diseases
#14
EDITORIAL
Friedhelm Hildebrandt
No abstract text is available yet for this article.
November 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27987547/genetics-of-familial-fsgs
#15
EDITORIAL
Martin Pollak
No abstract text is available yet for this article.
November 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27987546/tales-of-personalized-cancer-treatment
#16
EDITORIAL
George Demetri
No abstract text is available yet for this article.
November 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27987545/podocyte-targeted-treatment-for-proteinuric-kidney-disease
#17
EDITORIAL
Peter Mundel
No abstract text is available yet for this article.
November 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27987544/clinical-trials-in-fsgs-past-challenges-and-new-trial-designs
#18
EDITORIAL
Deb Gipson
No abstract text is available yet for this article.
November 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27987543/personalized-comments-on-challenges-and-opportunities-in-kidney-disease-therapeutics-the-glom-next-symposium
#19
EDITORIAL
Anna Greka, Deb Gibson, Peter Mundel, George Demetri, Friedhelm Hildebrandt, Martin Pollak, Jose Florez
In the face of ever-increasing incidence and prevalence of kidney disease worldwide, the unmet need for new treatments is unprecedented. Precision medicine is defined as the use of modern technologies to identify mechanisms of diseases in individual patients, and thus deploy treatment using tailored, targeted approaches, in the hopes of avoiding unnecessary toxicities and complications. Is there a place for kidney disease therapeutics in this space? If so, what is required to make significant progress toward precision nephrology? To answer these critical questions, we present a series of personalized comments corresponding to the responses offered to these very questions during the Inaugural Glom-NExT Symposium held at Harvard Medical School on October 23, 2014, a national meeting focused exclusively on kidney disease therapeutics...
November 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27987542/an-introduction-to-the-glom-next-inaugural-symposium-toward-precision-medicine-in-nephrology
#20
EDITORIAL
Anna Greka
No abstract text is available yet for this article.
November 2016: Seminars in Nephrology
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