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Peritoneal dialysis access

Edwina A Brown, Frederic O Finkelstein, Osasuyi U Iyasere, Alan S Kliger
Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities...
October 20, 2016: Kidney International
Michael A Kraus, Sheru Kansal, Michael Copland, Paul Komenda, Eric D Weinhandl, George L Bakris, Christopher T Chan, Richard J Fluck, John M Burkart
Although intensive hemodialysis (HD) can address important clinical problems, increasing treatment also introduces risks. In this review, we assess risks pertaining to 6 domains: vascular access complications, infection, mortality, loss of residual kidney function, solute balance, and patient and care partner burden. In the Frequent Hemodialysis Network (FHN) trials, short daily and nocturnal schedules increased the incidence of access complications, although the incidence of access loss was not statistically higher...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Malcolm G Coulthard
Most babies with chronic renal failure are identified antenatally, and over half that are treated with peritoneal dialysis receive kidney transplants before school age. Most infants that develop acute renal failure have hypotension following cardiac surgery, or multiple organ failure. Sometimes the falls in glomerular filtration and urine output are physiological and reversible, and sometimes due to kidney injury, but (illogically) it is now common to define them all as having 'acute kidney injury'. Contrary to widespread opinion, careful interpretation of the plasma creatinine concentrations can provide sensitive evidence of early acute renal failure...
September 25, 2016: Early Human Development
Laure Peyro Saint Paul, Maxence Ficheux, Danièle Debruyne, Magalie Loilier, Nicolas Bouvier, Rémy Morello, Jean-Jacques Parienti, Renaud Verdon, François Fournel, Vincent Cattoir, Thierry Lobbedez
♦ Background: Antibiotics are preferentially delivered via the peritoneal route to treat peritoneal dialysis-related peritonitis (PDRP) to ensure that maximal concentrations are delivered to the site of infection. Our study focused on the pharmacokinetics of daptomycin (DAP) administered via the intraperitoneal (IP) route in patients with PDRP. ♦ Methods: According to the DaptoDP protocol (Clinical Trial No. 2012-005699-33), IP DAP was administered daily, i.e., during the 6-h Nutrineal (Baxter Healthcare Corporation, Deerfield, IL, USA) dwell time period, for 14 days, in addition to administration of the antibiotics used for the usual care of patients with PDRP...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Ana Maria Cusumano, Guillermo Javier Rosa-Diez, Maria Carlota Gonzalez-Bedat
In 2015, 634387 million people (9% of the world's population) resided in Latin America (LA), with half of those populating Brazil and Mexico. The LA Dialysis and Transplant Registry was initiated in 1991, with the aim of collecting data on renal replacement therapy (RRT) from the 20 LA-affiliated countries. Since then, the Registry has revealed a trend of increasing prevalence and incidence of end-stage kidney disease on RRT, which is ongoing and is correlated with gross national income, life expectancy at birth, and percentage of population that is older than 65 years...
September 6, 2016: World Journal of Nephrology
Dr Charlotte Ratcliff, Miss Monica Hansrani
INTRODUCTION: This case report intends to highlight the Haemodialysis Reliable Outflow (HeRO) graft as a potential long term option for ongoing dialysis in patients with central venous stenosis. PRESENTATION OF CASE: A 55year old patient, who developed end stage renal failure (ESRF) after chemotherapy treatment for breast cancer, presented at the limit of her dialysis access after a 15year haemodialysis history causing central vein stenosis. The patient was initially started on peritoneal dialysis but after repeated peritonitis was switched to haemodialysis...
2016: International Journal of Surgery Case Reports
Timmy Lee, Mae Thamer, Yi Zhang, Qian Zhang, Michael Allon
BACKGROUND AND OBJECTIVES: Few studies have evaluated vascular access use after transition from peritoneal dialysis to hemodialysis. Our study characterizes vascular access use after switch to hemodialysis and its effect on patient mortality and evaluates whether a peritonitis event preceding the switch was associated with the timing of permanent vascular access placement and use. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The US Renal Data System data were used to evaluate the establishment of a permanent vascular access in 1165 incident Medicare-insured adult patients on dialysis who initiated peritoneal dialysis between July 1, 2010 and June 30, 2011 and switched to hemodialysis within 1 year...
August 30, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Dirk G Struijk
BACKGROUND: Peritoneal dialysis (PD) for the treatment of end-stage renal failure was introduced in the 1960s. Nowadays it has evolved to an established therapy that is complementary to hemodialysis (HD), representing 11% of all patients treated worldwide with dialysis. Despite good clinical outcomes and similar results in patient survival between PD and HD, the penetration of PD is decreasing in the Western world. SUMMARY: First the major events in the history of the development of PD are described...
December 2015: Kidney Diseases
Anna Rita Liuzzi, Ann Kift-Morgan, Melisa Lopez-Anton, Ida M Friberg, Jingjing Zhang, Amy C Brook, Gareth W Roberts, Kieron L Donovan, Chantal S Colmont, Mark A Toleman, Timothy Bowen, David W Johnson, Nicholas Topley, Bernhard Moser, Donald J Fraser, Matthias Eberl
The antimicrobial responsiveness and function of unconventional human T cells are poorly understood, with only limited access to relevant specimens from sites of infection. Peritonitis is a common and serious complication in individuals with end-stage kidney disease receiving peritoneal dialysis. By analyzing local and systemic immune responses in peritoneal dialysis patients presenting with acute bacterial peritonitis and monitoring individuals before and during defined infectious episodes, our data show that Vγ9/Vδ2(+) γδ T cells and mucosal-associated invariant T cells accumulate at the site of infection with organisms producing (E)-4-hydroxy-3-methyl-but-2-enyl pyrophosphate and vitamin B2, respectively...
September 15, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
Michael J Fischer, Kevin T Stroupe, James S Kaufman, Ann M O'Hare, Margaret M Browning, Min-Woong Sohn, Zhiping Huo, Denise M Hynes
BACKGROUND: Predialysis nephrology care is associated with lower mortality and rates of hospitalization following chronic dialysis initiation. Whether more frequent predialysis nephrology care is associated with other favorable outcomes for older adults is not known. METHODS: Retrospective cohort study of patients ≥66 years who initiated chronic dialysis in 2000-2001 and were eligible for VA and/or Medicare-covered services. Nephrology visits in VA and/or Medicare during the 12-month predialysis period were identified and classified by low intensity (<3 visits), moderate intensity (3-6 visits), and high intensity (>6 visits)...
2016: BMC Nephrology
Louise M Moist, Ahmed A Al-Jaishi
Patients with Stages 4 and 5 CKD are optimally managed within a multidisciplinary care setting. This provides an opportunity to create a "patient centered" approach to renal replacement modality options and conservative care. The care team engages with the patient and caregivers to assist with the understanding of their health status, modality and vascular access selection, and overall living with the comorbidity of chronic illness. A systematic approach to provision of education, modality, and access selection, are in part, driven by the patient's expected survival and need for dialysis, the risks and benefits with different modalities, and access and adaptation to their preferences and home situations...
July 2016: Advances in Chronic Kidney Disease
Gregor Novljan, Rina R Rus, Vladimir Premru, Rafael Ponikvar, Nina Battelino
When peritoneal dialysis is inapplicable, chronic hemodialysis (HD) becomes the only available treatment option in small children. Due to small patient size, central venous catheters (CVC) are mainly used for vascular access. Over the past 4 years, four children weighing less than 15 kg received chronic HD in our unit. A total of 848 dialysis sessions were performed. Altogether, 21 catheters were inserted. In all but one occasion, uncuffed catheters were used. Catheter revision was performed 15 times during the study period, either due to infection or catheter malfunction...
June 2016: Therapeutic Apheresis and Dialysis
Jadranka Buturović-Ponikvar, Jakob Gubenšek, Miha Arnol, Tone Adamlje, Zlata Ceglar, Gabriela Damevska, Mateja Globokar, Senka Černe, Andrej Čufer, Andrej Drozg, Robert Ekart, Bojan Knap, Aljoša Kandus, Sonja Kapun, Simona Kralj-Lopert, Dimitrij Klančič, Natalija Kunc-Rešek, Stojan Kralj, Marko Malovrh, Marjan Močivnik, Gregor Novljan, Karmen Romozi, Igor Rus, Silvan Saksida, Bojan Vujkovac, Rafael Ponikvar
This report provides a summary of the 2013 Slovenian renal replacement therapy (RRT) data, obtained from 24 renal centers: 23 dialysis and one transplant center, referring from 31 December 2013, with 100% response rate to individual patient questionnaires. Slovenia had a population of 2 061 085 on 1 January 2014. The total number of patients treated by RRT was 2077, i.e. 1008.3 per million of population (pmp); 1349 (65%) were treated by hemodialysis, 52 (2.5%) by peritoneal dialysis, and 676 (32.5%) had a functioning kidney graft...
June 2016: Therapeutic Apheresis and Dialysis
Leyat Tal, Joseph R Angelo, Ayse Akcan-Arikan
Peritoneal dialysis (PD) is generally considered the preferred extracorporeal therapy for neonates with acute kidney injury (AKI). However, there are situations when PD is not suitable, such as in patients with previous abdominal surgery, hyperammonemia and significant ascites or anasarca. Additionally, with a need to start PD soon after catheter placement, there is increased risk of PD catheter leak and infection. Extracorporeal continuous renal replacement therapy (CRRT) is challenging in severely ill neonates as it requires obtaining adequately sized central venous access to accommodate adequate blood flow rates and also adaptation of a CRRT machine meant for older children and adults...
November 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Belén Marrón, Janusz Ostrowski, Marietta Török, Delia Timofte, Attila Orosz, Andrzej Kosicki, Alicja Całka, Daniela Moro, Dezider Kosa, Jenö Redl, Abdul Rashid Qureshi, Jose Carolino Divino-Filho
INTRODUCTION: Integrated Care Settings (ICS) provide a holistic approach to the transition from chronic kidney disease into renal replacement therapy (RRT), offering at least both types of dialysis. OBJECTIVES: To analyze which factors determine type of referral, modality provision and dialysis start on final RRT in ICS clinics. METHODS: Retrospective analysis of 626 patients starting dialysis in 25 ICS clinics in Poland, Hungary and Romania during 2012...
2016: PloS One
Julie Y Chen, Edmond P H Choi, Eric Y F Wan, Anca K C Chan, Joyce P Y Tsang, Karina H Y Chan, W K Lo, S L Lui, W L Chu, Cindy L K Lam
AIM: The aim of this study was to evaluate the validity, reliability and sensitivity of the disease-specific items of the Kidney Disease Quality of Life-36 (KDQOL-36) in Chinese patients undergoing maintenance dialysis. METHODS: The content validity was assessed by content validity index (CVI) in ten subjects. 356 subjects were recruited for pilot psychometric testing. The internal construct validity was assessed by corrected item-subscale total correlation. Confirmatory factor analysis (CFA) was used to confirm the factor structure...
2016: PloS One
Ünal Bıçakcı, Gürkan Genç, Burak Tander, Mithat Günaydın, Dilek Demirel, Ozan Özkaya, Rıza Rızalar, Ender Arıtürk, Ferit Bernay
INTRODUCTION: The aim of this study was to evaluate patients with end stage renal failure (ESRD) who underwent chronic peritoneal dialysis (CPD). The clinical outcomes of laparoscopic and open placements of catheters were compared. MATERIALS AND METHODS: We reviewed 49 (18 male and 31 female) children with CPD according to age, sex, cause of ESRD, catheter insertion method, kt/V rate, complications, presence of peritonitis, catheter survival rate between January 2002 and February 2014...
April 2016: Journal of Minimal Access Surgery
Virginia Wang, Matthew L Maciejewski, Cynthia J Coffman, Linda L Sanders, Shoou-Yih Daniel Lee, Richard Hirth, Joseph Messana
OBJECTIVE: To examine the relationship between distance to dialysis provider and patient selection of dialysis modality, informed by the absolute distance from a patient's home and relative distance of alternative modalities. DATA SOURCES: U.S. Renal Data System. STUDY DESIGN: About 70,131 patients initiating chronic dialysis and 4,795 dialysis facilities in 2006. The primary outcome was patient utilization of peritoneal dialysis (PD). Independent variables included absolute distance between patients' home and the nearest hemodialysis (HD) facility, relative distance between patients' home and nearest PD versus nearest HD facilities, and their interaction...
April 7, 2016: Health Services Research
Marisa Cristiane Cardoso de Oliveira, Adriano Luis Ammirati, Maria Claudia Andreolli, Marco Antonio Justo Nadalleto, Camila Barbosa Silva Barros, Maria Eugênia Fernandes Canziani
INTRODUCTION: Anemia is a common complication in dialysis patients, scare studies have evaluated anemia in patients undergoing peritoneal dialysis (PD). OBJECTIVE: This study aimed to investigate the prevalence of anemia and its associated factors in patients undergoing PD in a single center where patients have free access to agents stimulating erythropoiesis (ESA) and intravenous iron supplementation. METHODS: Cross-sectional study analyzing the demographic, clinical and laboratory variables of 120 patients...
March 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Ricardo Cintra Sesso, Antonio Alberto Lopes, Fernando Saldanha Thomé, Jocemir Ronaldo Lugon, Carmen Tzanno Martins
INTRODUCTION: National chronic dialysis data have had impact in the treatment planning. OBJECTIVE: To report data of the annual survey of the Brazilian Society of Nephrology about chronic kidney disease patients on dialysis in July 2014. METHODS: A survey based on data of dialysis units from the whole country. The data collection was performed by using a questionnaire filled out on-line by the dialysis units. RESULTS: Three hundred twelve (44%) of the dialysis units in the country answered the questionnaire...
March 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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