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Peritoneal dialysis access

Brendan Bowman, Sijie Zheng, Alex Yang, Brigitte Schiller, José A Morfín, Melvin Seek, Robert S Lockridge
Dialysis care in the United States continues to move toward an emphasis on continuous quality improvement and performance benchmarking. Government- and industry-sponsored programs have evolved to assess and incentivize outcomes for many components of end-stage renal disease care. One aspect that remains largely unaddressed at a systemic level is the high-risk transition period from chronic kidney disease and acute kidney injury to permanent dialysis dependence. Incident dialysis patients experience disproportionately high mortality and hospitalization rates coupled with high costs...
March 3, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Tania Huria, Suetonia Palmer, Lutz Beckert, Jonathan Williman, Suzanne Pitama
BACKGROUND: In Aotearoa/New Zealand, Māori, as the indigenous people, experience chronic kidney disease at three times the rate of non-Māori, non-Pacific New Zealanders. Māori commence dialysis treatment for end-stage kidney disease at three times the rate of New Zealand European adults. To examine for evidence of inequity in dialysis-related incidence, treatment practices, and survival according to indigeneity in Aotearoa/New Zealand, utilising a Kaupapa Māori approach. METHODS: We conducted a retrospective cohort study involving adults who commenced treatment for end-stage kidney disease in Aotearoa/New Zealand between 2002 and 2011...
February 20, 2018: International Journal for Equity in Health
Liliana Simões-Silva, Ricardo Araujo, Manuel Pestana, Isabel Soares-Silva, Benedita Sampaio-Maia
Chronic kidney disease (CKD) is associated with an imbalanced human microbiome due not only to CKD-associated factors such as uremia, increased inflammation and immunosuppression, but also to pharmacological therapies and dietary restrictions. End-stage renal disease patients require renal replacement therapies commonly in the form of hemodialysis (HD) or peritoneal dialysis (PD). HD implies the existence of a vascular access, such as an arteriovenous fistula/graft or a venous catheter, whereas PD implies a long-term peritoneal catheter and the constant inflow of peritoneal dialysate...
February 11, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Anna Mathew, Jody-Ann McLeggon, Nirav Mehta, Samuel Leung, Valerie Barta, Thomas McGinn, Gihad Nesrallah
Background: Survival and hospitalization are critically important outcomes considered when choosing between intensive hemodialysis (HD), conventional HD, and peritoneal dialysis (PD). However, the comparative effectiveness of these modalities is unclear. Objective: We had the following aims: (1) to compare the association of mortality and hospitalization in patients undergoing intensive HD, compared with conventional HD or PD and (2) to appraise the methodological quality of the supporting evidence...
2018: Canadian Journal of Kidney Health and Disease
Javier Uceda Fernandez, David Millrine, Simon A Jones
Anti-microbial host defence is dependent on the rapid recruitment of inflammatory cells to the site of infection, the elimination of invading pathogens, and the efficient resolution of inflammation so as to minimise damage to the host. The peritoneal cavity provides an easily accessible and physiologically relevant system where the delicate balance of these processes may be studied. Here, we describe murine models of peritoneal inflammation that enable studies of both competent anti-microbial immunity and inflammation associated tissue damage as a consequence of recurrent bacterial challenge...
2018: Methods in Molecular Biology
Marcela Lara Mendes, Camila Albuquerque Alves, Edwa Maria Bucuvic, Dayana Bitencourt Dias, Daniela Ponce
Most patients with stage 5 CKD start RRT of unplanned manner. Unplanned dialysis, also known as urgent start, may be defined as hemodialysis (HD) started without permanent vascular access, i.e., using a central venous catheter (CVC), or as peritoneal dialysis (PD) started within seven days after implantation of the catheter, without family training. Although few studies have evaluated the PD as an immediate treatment option for patients starting urgent RRT, theirs results suggest that it is a feasible and safe alternative, with infectious complications and survival similar to patients treated with unplanned HD...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Jurij Janež
Peritoneal dialysis (PD) is a generally accepted method for treatment of patients with the end-stage renal disease. A larger proportion of PD patients transfer to haemodialysis every year than the converse. Many of the underlying causes of transfer to haemodialysis are preventable. Infectious complications still remain the most common reason for transfer of PD patients to haemodialysis, catheter-related problems are the second most common cause. For PD to be effective it is very important to provide a quality peritoneal access with the insertion of PD catheter with minimum complications...
January 10, 2018: Journal of Minimal Access Surgery
Rajnish Mehrotra
Peritoneal dialysis is the most common modality for home dialysis and to ensure patients have access to dialysis at home, training programs have to ensure that the fellows attain clinical competency in the care of such patients. The limited data available however are sobering; about 10 years ago, 44% of nephrologists reported that they did not feel competent in the care of patients undergoing peritoneal dialysis. There are recognizable challenges in ensuring clinical competency of trainees that may need creative solutions...
January 4, 2018: Seminars in Dialysis
Jose J Perez, Bo Zhao, Samaya Qureshi, Wolfgang C Winkelmayer, Kevin F Erickson
BACKGROUND: Many patients in the United States have limited or no health insurance at the time they develop end-stage renal disease (ESRD). We examined whether health insurance limitations affected the likelihood of peritoneal dialysis (PD) use. STUDY DESIGN: Retrospective cohort analysis of patients from the US Renal Data System initiating dialysis therapy in 2006 through 2012. SETTING & PARTICIPANTS: We identified socioeconomically similar groups of patients to examine the association between health insurance and PD use...
December 22, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Bethany Roehm, Amanda R Vest, Daniel E Weiner
Left ventricular assist devices (LVADs) improve survival in patients with advanced heart failure. As LVAD use increases, so do the number of patients with LVADs who also have kidney disease. However, there are only sparse data on how best to care for these patients. This review provides an overview of LVAD principles and indications, including blood pressure assessment and criteria for receipt of both destination and bridge to transplantation LVADs. Following LVAD implantation, kidney function may improve in the short term, particularly if cardiorenal physiology was present; in the longer term, data remain limited...
February 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Wen-Yi Li, Yi-Cheng Wang, Shang-Jyh Hwang, Shih-Hua Lin, Kwan-Dun Wu, Yung-Ming Chen
BACKGROUND: The clinical consequences of starting chronic peritoneal dialysis (PD) after emergent dialysis via a temporary hemodialysis (HD) catheter has rarely been evaluated within a full spectrum of treated end-stage renal disease (ESRD). We investigated the longer-term outcomes of patients undergoing emergent-start PD in comparison with that of other practices of PD or HD in a prospective cohort of new-onset ESRD. METHODS: This was a 2-year prospective observational study...
December 11, 2017: BMC Nephrology
Mohd Rizal Abdul Manaf, Naren Kumar Surendra, Abdul Halim Abdul Gafor, Lai Seong Hooi, Sunita Bavanandan
End-stage renal disease (ESRD) is managed by either lifesaving hemodialysis (HD) and peritoneal dialysis (PD) or a kidney transplant. In Malaysia, the prevalence of dialysis-treated ESRD patients has shown an exponential growth from 504 per million population (pmp) in 2005 to 1155 pmp in 2014. There were 1046 pmp patients on HD and 109 pmp patients on PD in 2014. Kidney transplants are limited due to lack of donors. Malaysia adopts public-private financing model for dialysis. Majority of HD patients were treated in the private sector but almost all PD patients were treated in government facilities...
2017: International Journal of Nephrology
Dinesh Bansal, Vijay Kher, Krishan Lal Gupta, Debasish Banerjee, Vivekanand Jha
INTRODUCTION: Despite the growing number of haemodialysis (HD) patients in India, little is known about vascular access practice. We investigated the use and cost of different vascular accesses by Indian nephrologists. METHODS: An online survey was emailed to 920 Indian nephrologists and 388 (42.1%) responded; 98.5% of whom were responsible for managing dialysis patients, 98% in hospitals. RESULTS: Sixty-four percent of patients initiated renal replacement therapy with HD, 7% with peritoneal dialysis, 10% kidney transplantation and 19% conservative care...
November 25, 2017: Journal of Vascular Access
Haijiao Jin, Zhaohui Ni, Shan Mou, Renhua Lu, Wei Fang, Jiaying Huang, Chunhua Hu, Haifen Zhang, Hao Yan, Zhenyuan Li, Zanzhe Yu
BACKGROUND: Patients with end-stage renal disease (ESRD) frequently require urgent-start dialysis. Recent evidence suggests that peritoneal dialysis (PD) might be a feasible alternative to hemodialysis (HD) in these patients, including in older patients. METHODS: This retrospective study enrolled patients aged > 65 years with ESRD who underwent urgent dialysis without functional vascular access or PD catheter at a single center, from January 2011 to December 2014...
November 21, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Susan Bridger
Providing care and education for a patient on peritoneal dialysis (PD) requires that the nephrology nurse have knowledge and expertise in the PD access. This article provides information on types and placement of PD catheters, pre-placement and post-placement education and care, how to assess PD catheter exit site healing, and initial use of the PD catheter for access.
September 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Alejandra Molano-Triviño, Benjamin Wancjer, Mauro M Neri, Akash N Karopadi, Mitchell Rosner, Claudio Ronco
INTRODUCTION: Hemodialysis (HD) is an expensive therapy in economic and in ecological terms, owing to a high carbon footprint and significant consumption of natural sources, especially water. Our aim was to review strategies to diminish waste of water in maintenance dialysis, exploring previously described water reuse trends and less known strategies for reducing the dialysate flow. METHODS: We conducted a systematic review of water-sparing strategies, including the reuse of reverse osmosis rejected water and the reduction of dialysate flux...
November 8, 2017: International Journal of Artificial Organs
Nosratollah Nezakatgoo, Albert Ndzengue, Manhunath Ramaiah, Elvira O Gosmanova
Peritoneal dialysis (PD) interruption requiring hemodialysis (HD) is not uncommon and its frequently abrupt nature prevents timely creation of permanent HD access and avoidance of central venous catheters (CVC). We retrospectively studied a cohort of 24 end-stage renal disease (ESRD) patients (mean age 50.7 years, 83.3% African-Americans, 58.3% females, time on dialysis interquartile range [IQR] 0 - 65 days) who had simultaneous PD catheter insertion and backup arteriovenous fistula (AVF) creation between January 1, 2012, and December 31, 2013...
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Ricardo Cintra Sesso, Antonio Alberto Lopes, Fernando Saldanha Thomé, Jocemir Ronaldo Lugon, Carmen Tzanno Martins
INTRODUCTION: National chronic dialysis data are important for 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 2016. METHODS: A survey based on data of dialysis centers from the whole country. The data collection was performed by using a questionnaire filled out on-line by the dialysis centers. RESULTS: 309 (41%) of the dialysis units in the country answered the questionnaire...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Victoria Briggs, Ivonne Solis-Trapala, Allan Wailoo, Keith McCullough, Mark Lambie, Fergus J Caskey, James Fotheringham, Simon J Davies, Martin Wilkie
BACKGROUND: High-quality peritoneal dialysis (PD) catheter insertion pathways are essential for optimal access to the therapy. Dialysis outcomes are influenced by a range of patient and center-related factors, and there is a need to better understand these so that catheter insertion pathways can be better matched to individual circumstances. OBJECTIVES: To examine how patient- and center-related factors influence the choice of catheter insertion pathways for a PD patient, and the impact of such factors and pathways on patient outcomes, and specifically, to compare the occurrence of and recovery from PD catheter-related adverse events and mortality in individuals who had surgical catheter insertion with those who had medical catheter insertion, and evaluate health economics...
September 28, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Margarita Kunin, Dganit Dinour, Danny Rosin
BACKGROUND: It is recommended that systemic prophylactic antibiotics be given immediately prior to peritoneal catheter insertion. This administration requires intravenous access and could be inconvenient in dynamic and unpredictable operation room schedule. Intraperitoneal antibiotics could be an alternative simple way for prevention of postoperative peritoneal catheter infections. METHODS: Medical records from 109 patients undergoing permanent PD catheter placement procedures were reviewed retrospectively...
September 14, 2017: Clinical and Experimental Nephrology
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