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Advances in Peritoneal Dialysis

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https://www.readbyqxmd.com/read/26714393/mortality-comparison-of-hemodialysis-and-peritoneal-dialysis-patients-at-a-single-japanese-center
#1
COMPARATIVE STUDY
Shoji Koga, Hiroyuki Ito
To investigate whether peritoneal dialysis (PD) is useful as a first modality in Japan, where hemodialysis (HD) is used in 97% of all patients on maintenance dialysis, we used intention-to-treat (ITT) and as-treated analyses to examine patient survival at our center, where HD and PD are used almost equally. In the ITT analysis, survival was significantly better in the PD group than in the HD group (p = 0.009). Meanwhile, the as-treated analysis did not reveal any significant differences in survival between the HD and PD groups...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714392/offering-patients-therapy-options-in-unplanned-start-development-and-implementation-of-an-education-program-for-unplanned-start-patients
#2
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Peter Rutherford
Unplanned start of dialysis is still a common and important problem for dialysis units in Europe and across the world: 30%-50% of patients can commence therapy in that way. Such patients are known to experience increased morbidity and mortality, to make greater demands on health care resources, and to be less likely to receive their dialysis modality choice. We therefore aimed to meet the specific needs of unplanned-start patients by developing and implementing an Unplanned Start Educational Programme in dialysis units...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714391/impact-of-peritoneal-dialysis-catheter-insertion-by-a-nephrologist-results-of-a-questionnaire-survey-of-patients-and-nurses
#3
Naoki Washida, Kayoko Aikawa, Shuji Inoue, Takahiro Kasai, Keisuke Shinozuka, Kohkichi Morimoto, Kozi Hosoya, Koichi Hayashi, Hiroshi Itoh
Peritoneal dialysis (PD) is an excellent dialysis mo- dality, but it is underutilized in the United States and Japan. In the present study, we evaluated the impact of interventional nephrology in PD on the impres- sions held by patients and nurses about selection of a renal replacement therapy and the complications associated with PD therapy. Over aperiod of 7 years, PD catheter insertion in 120 patients with end-stage renal disease (age: 63.0 ± 13.3 years) was performed by nephrologists at Keio University Hospital or Saitama Medical Center...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714390/hypotension-in-infants-on-chronic-peritoneal-dialysis-mechanisms-complications-and-management
#4
REVIEW
Enrico Vidal, Franz Schaefer
Hypotension represents a very serious clinical problem in patients receiving renal replacement therapy, and it is associated with a significant increase in mortality risk. Infants on chronic peritoneal dialysis (CPD) can be particularly prone to chronic hypotension because of the hyponatremic hypovolemia risk related to their primary renal disease, their nutritional needs, and their peritoneal membrane characteristics. In this setting, if an acute clinical event leads to a further decline in systolic blood pressure, the counteract and perfusion pressure autoregulatory mechanisms can both be impaired, leading to severe complications...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714389/association-between-residual-kidney-function-and-visit-to-visit-blood-pressure-variability-in-peritoneal-dialysis-patients
#5
Kei Yokota, Tsutomu Sakurada, Kenichiro Koitabashi, Yugo Shibagaki, Kazuomi Kario, Kenjiro Kimura
Visit-to-visit blood pressure (BP) variability has recently been recognized as an important risk factor for decline of residual kidney function (RKF) in patients with chronic kidney disease. However little is known about the impact of visit-to-visit BP variability on RKF in peritoneal dialysis (PD) patients. We retrospectively studied the association between RKF and visit-to-visit BP variability in 42 patients who started on PD between February 2006 and March 2012. Residual kidney function was defined as the mean of the urea and creatinine clearances in the patients...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714388/relationship-of-normalized-protein-catabolic-rate-with-nutrition-status-and-long-term-survival-in-peritoneal-dialysis-patients
#6
Paul A Fein, Stacey Weiss, Morrell M Avram, Francis Ramos, Priyanka Singh, Sein Yin See, Madeeha Shahzadi, Jyotiprakas Chattopadhyay
The normalized protein catabolic rate (nPCR) reflects daily dietary protein intake in stable dialysis patients. In peritoneal dialysis (PD) patients, reports about the importance of nPCR as marker of nutrition and outcome have been inconsistent. The objective of the present study was to investigate the relationships of nPCR with body composition parameters, micronutrient electrolytes, and long-term survival in PD patients. From November 2000 to May 2008, 57 PD patients were enrolled in the study. On enrollment, demographic, clinical, and biochemical data were recorded...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714387/association-between-home-blood-pressure-and-body-composition-by-bioimpedance-monitoring-in-patients-undergoing-peritoneal-dialysis
#7
Naho Kurasawa, Takefumi Mori, Eri Naganuma, Emiko Sato, Kenji Koizumi, Shinichi Sato, Ikuko Oba, Mihoko Tsuchikawa, Sadayoshi Ito
Home blood pressure (HBP) is an independent predictor of cardiovascular and renal function. However, no particular guidelines have been established for optimal HBP in peritoneal dialysis (PD) patients. Bioelectrical impedance analysis (BIA) is a beneficial tool for determining body composition. In the present study, we used BIA to determine body composition parameters that might play a role in the regulation of HBP in PD patients, and we compared HBP with office blood pressure (BP). Our study enrolled 15 patients (11 men, 4 women) receiving PD at Tohoku University Hospital, who, for 1 year, agreed to monitor HBP and to undergo body composition analysis...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714386/a-comparison-study-of-glucose-fluctuation-during-automated-peritoneal-dialysis-and-continuous-ambulatory-peritoneal-dialysis
#8
COMPARATIVE STUDY
Eri Okada, Daisuke Oishi, Tsutomu Sakurada, Takashi Yasuda, Yugo Shibagaki
In recent years, it has become possible to examine an individual's daily glucose profile with a continuous glucose monitoring system (CGMS). The aim of the present study was to use a CGMS to evaluate the difference in glucose fluctuation between diabetic patients on automated peritoneal dialysis (APD) and those on continuous ambulatory peritoneal dialysis (CAPD). We retrospectively studied 20 diabetic patients on peritoneal dialysis (16 men, 4 women; mean age: 55 ± 10 years) who used a CGMS a total of 23 times (12 times by APD users, 11 times by CAPD users)...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714385/the-vasopressin-2-receptor-antagonist-tolvaptan-improves-nutrition-and-inflammatory-states-in-peritoneal-dialysis-patients-with-diabetes-mellitus
#9
Takeyuki Hiramatsu, Kazuki Asai, Akiko Ozeki, Marie Saka, Akinori Hobo, Shinji Furuta
Previously, we reported that, in peritoneal dialysis (PD) patients, tolvaptan preserves residual renal function and ameliorates left ventricular hypertrophy. Here, we evaluated the effect of tolvaptan in terms of nutrition and inflammatory states. Of 24 incident PD patients with diabetes, 12 were assigned to a control group that did not receive tolvaptan, and 12, to a group that, 2 weeks after initiation of PD, received tolvaptan 15 mg daily for 12 months. At baseline and at 6 and 12 months after initiation of PD, we evaluated serum C-reactive protein (CRP), albumin, urine volume, peritoneal ultrafiltration (UF), phosphate elimination, protein uptake, left ventricular mass index (LVMI), and the diameter of the inferior vena cava (IVC)...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714384/european-training-and-research-in-peritoneal-dialysis-a-network-to-deliver-scientific-peritoneal-dialysis-training-to-a-new-generation-of-researchers
#10
Anna Machowska, Tanja van Wier, Christoph Aufricht, Rob Beelen, Peter Rutherford
Peritoneal dialysis (PD) utilization varies across countries, and of the factors that explain the variation, the scientific and clinical knowledge of health care professionals is potentially important. In this paper, we describe a European collaboration--between 8 academic PD research programs, a small-to-medium-sized enterprise, and a large PD product manufacturer--that received significant research funding from the EU commission to establish a training network. European Training and Research in Peritoneal Dialysis (EuTRiPD) is providing training to 12 PhD students who have moved within the European Union and are completing research training...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714383/lymphangiogenesis-and-lymphatic-absorption-are-related-and-increased-in-chronic-kidney-failure-independent-of-exposure-to-dialysis-solutions
#11
Carmen A Vlahu, Marijke de Graaff, Jan Aten, Dirk G Struijk, Raymond T Krediet
Increased lymphatic absorption might contribute to ultrafiltration failure in peritoneal dialysis (PD). Lymphangiogenesis develops during PD, but little is known about the relationship between its morphologic and functional parameters. The relationships between lymph vessel density, the effective lymphatic absorption rate (ELAR), and fibrosis were investigated in a rat model of chronic kidney failure (CKD) with exposure to dialysis solutions. Wistar rats (n = 44) were allocated to these groups: NKF (normal kidney function), CKD (70% nephrectomy), CKDD [CKD, with daily intraperitoneal (i...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714382/using-a-peritoneal-dialysis-access-simulator-in-surgical-training-for-nephrologists
#12
Tsutomu Sakurada, Yasuhiro Taki, Shigeki Kojima, Daisuke Oishi, Kenichiro Koitabashi, Shina Sueki, Nagayuki Kaneshiro, Yugo Shibagaki
In Japan, peritoneal dialysis (PD) catheter insertion has been performed by both nephrologists and surgeons. However, nephrologists have fewer opportunities to train in the insertion procedure. We therefore used a PD access simulator to provide training in this operative technique for nephrologists. A PD access simulator developed by Terumo Medical Corporation was used for the training. The simulator uses a mannequin made of acrylic resin. The abdominal wall of a pig is attached to the abdominal area, and a plastic bag represents the abdominal cavity...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714381/glucose-and-insulin-response-to-peritoneal-dialysis-fluid-in-diabetic-and-nondiabetic-peritoneal-dialysis-patients
#13
Ikuko Oba, Takefumi Mori, Makiko Chida, Naho Kurasawa, Eri Naganuma, Emiko Sato, Kenji Koizumi, Shinichi Sato, Mihoko Tsuchikawa, Sadayoshi Ito
A postprandial increase in blood glucose in peritoneal dialysis (PD) patients with diabetes was observed in our previous study using continuous blood glucose monitoring. The response was observed in diabetic but not in nondiabetic PD patients. In addition, the response was reduced when patients used icodextrin; glucose absorbed from the peritoneum was responsible for the postprandial increase in blood glucose. Because our PD patients often change their PD fluid before meals, the present study aimed to determine the blood glucose and insulin responses to PD fluid...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714380/relationship-between-peritoneal-transport-characteristics-and-natriuretic-peptides-in-peritoneal-dialysis-patients
#14
MULTICENTER STUDY
Shigeki Kojima, Tsutomu Sakurada, Masahiro Uehara, Takeshi Okamoto, Nagayuki Kaneshiro, Yusuke Konno, Yugo Shibagaki
Few studies have attempted to evaluate the relationship between peritoneal permeability and fluid status in peritoneal dialysis (PD). The aim of the present study was to clarify the relationship between change in the dialysate-to-plasma ratio of creatinine (D/P Cr) and change in fluid status as evaluated by natriuretic peptides. We studied 49 PD patients (29 men, 62 ± 11 years, 36.7% with diabetes) who underwent a peritoneal equilibration test at least twice after PD initiation. We evaluated correlations between the rate of change in the D/P Cr (R C-D/P Cr), the rate of change in a human atrial natriuretic polypeptide (RC-αhANP), and the rate of change in brain natriuretic peptide (RC-BNP)...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/26714379/can-plasma-hyaluronan-and-hyaluronidase-be-used-as-markers-of-the-endothelial-glycocalyx-state-in-patients-with-kidney-disease
#15
REVIEW
Carmen A Vlahu, Raymond T Krediet
Hyaluronan (HA) is widely spread in the body and is an important component of the extracellular matrix, including the endothelial glycocalyx (EG). Essential for its vasculoprotective function, HA is involved in vascular permeability and many other processes. In patients with kidney disease, plasma HA is higher than expected, but the extent to which plasma HA and its degrading enzyme hyaluronidase can be used as markers for the state of the EG has not yet been determined. In the first part of this review, we describe HA synthesis and degradation; we then focus on the involvement of the kidney in the process...
2015: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/25338434/telemedicine-the-slow-revolution
#16
Jack W Moncrief
The use of interactive video has been recognized as a means of delivering medical support to isolated areas since the 1950s. The Department of Defense recognized early the capacity of telemedicine to deliver medical care and support to front-line military personnel. In 1989, the Texas Telemedicine Project received grants and support from the then American Telephone and Telegraph Company (now AT&T) and the Meadows Foundation of Dallas, Texas, to establish and evaluate telemedicine delivery in central Texas. That project had 6 connected telemedicine sites: 3 in Austin, Texas, and 3 in Giddings, Texas (a small community 55 miles to the southeast of Austin)...
2014: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/25338433/favorable-outcome-of-fournier-gangrene-in-two-patients-with-diabetes-mellitus-on-continuous-peritoneal-dialysis
#17
Darlene Vigil, Anil Regmi, Reuben Last, Brenda Wiggins, Yijuan Sun, Karen S Servilla, Joanna R Fair, Larry Massie, Antonios H Tzamaloukas
Fournier gangrene (FG), a form of necrotizing fasciitis of the perineum and genitals, with high morbidity and mortality in the general population, carries the additional risk of involvement of the peritoneal catheter tunnel and peritoneal cavity in patients on chronic peritoneal dialysis (PD). We describe two men with diabetes who developed FG in the course of PD. Computed tomography showed no extension of FG to the abdominal wall, and spent peritoneal dialysate was clear in both patients. Broad-spectrum antibiotic therapy with anaerobic coverage and early aggressive debridement followed by negative-pressure wound therapy and repeated debridement led to improvements in clinical status in both cases...
2014: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/25338432/a-review-of-diuretic-use-in-dialysis-patients
#18
REVIEW
Ruchi Kumra, Joanne M Bargman
Diuretics are commonly prescribed to manage various conditions in the general population. They can continue to play a role in dialysis patients to manage extracellular fluid volume and hypertension and to reduce the tendency to hyperkalemia. Nevertheless, diuretics are often stopped when patients commence dialysis. Several studies have shown that preserved residual renal function in dialysis patients is associated with improved patient survival. Although the association between diuretic use and preserved residual renal function is still controversial, the numerous clinical benefits offered by diuretics render those agents valuable in dialysis patients with urine output...
2014: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/25338431/impact-of-hydration-and-nutrition-status-on-the-watson-formula-in-peritoneal-dialysis-patients
#19
Masahide Furusho, Junxiong Weng, Takefumi Mori, Tao Wang
Urea clearance (Kt/V urea), adjusted for total body water (TBW) using the Watson formula (TBW(Watson)), is widely used to guide peritoneal dialysis (PD) prescription and to ensure dialysis adequacy. The impact of body composition on the determination of TBW(Watson) is well established, but the effect of hydration and nutrition status on TBW(Watson) is not understood. We therefore studied the effects of hydration and nutrition status on TBW(Watson) in PD patients. Our study enrolled 195 PD patients and 33 healthy control subjects...
2014: Advances in Peritoneal Dialysis
https://www.readbyqxmd.com/read/25338430/molecular-mechanisms-of-peritoneal-dialysis-induced-microvascular-vasodilation
#20
El Rasheid Zakaria, Asma Althani, Ashraf A Fawzi, Omar M Fituri
Peritoneal dialysis (PD) solutions dilate microvessels by undefined mechanisms. This vasodilation directly affects ultrafiltration and solute exchange during a PD dwell and is thought to account for the variable mass transfer area coefficient for small solutes during a glucose-based hypertonic dwell. We hypothesized that PD-mediated vasodilation occurs by endothelium-dependent mechanisms that involve endothelium energy-dependent K+ channels (K(ATP)), adenosine A1 receptor activation, and NO release. We used intravital videomicroscopy to study 3 levels of microvessels (A1 inflow arterioles about 100 microm diameter to pre-capillary A3 arterioles 10 - 15 microm diameter) in the terminal ileum of anesthetized rats under control conditions in vivo in a tissue bath...
2014: Advances in Peritoneal Dialysis
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