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Peritoneal cycler

Daniela Ponce, Cassiana Góes, Mariele Oliveira, Andre Balbi
This study aimed to explore the role of high-volume peritoneal dialysis (HVPD) in cardiorenal syndrome (CRS) type 1 patients in relation to metabolic and fluid control and outcome. Sixty-four patients were treated by HVPD (prescribed Kt/V = 0.50/session), flexible catheter and cycler. Mean age was 68.8 ± 15.4 years, 54.7% needed intravenous inotropic agents and/or intravenous vasodilators, 31.2% were on mechanical ventilation, acute coronary syndrome (ACS) was the main cause of acute disease heart failure (ADHF) 48...
September 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
C Kennedy, S A Ryan, T Kane, R W Costello, P J Conlon
BACKGROUND: Sleep disorders are common and multi-factorial in patients with advanced chronic kidney disease and end-stage renal disease (ESRD). Sleep disorders and disturbance have a negative impact on wellbeing and quality of life. OBJECTIVE: To assess the impact of a change in renal replacement therapy (RRT) modality on sleep quality and sleep disturbance in patients with ESRD. DATA SOURCES: Multiple electronic databases were searched without publication type/period restrictions...
February 2018: Journal of Nephrology
Cláudia Gomes, Lia Oliveira, Rosário Ferreira, Carla Simão
OBJECTIVE: There are few reports describing sleep disturbance (SD) in children on automated peritoneal dialysis (APD), and they are mostly based on the application of questionnaires. As far as we know, only two studies used polysomnography (PSG), the gold standard for the diagnosis of SD. This is the first study assessing SD in children with chronic kidney disease (CKD) on APD in our country. METHODS: This was an observational and descriptive study. Children up to 18 years of age who had undergone APD for a minimum of three months were considered eligible...
April 2017: Sleep Medicine
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
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
March 2017: Seminars in Dialysis
Daniela Ponce, Mariele Gobo-Oliveira, Andre Luís Balbi
BACKGROUND: Peritoneal dialysis (PD) may be a feasible and safe alternative to haemodialysis not only in the chronic but also in the acute setting. It was previously widely accepted as a modality for acute kidney injury (AKI) treatment, but its practice declined in favor of other types of extracorporeal therapies. SUMMARY: The interest in PD to manage AKI patients has been increased and PD is now frequently used in developing countries because of its lower cost and minimal infrastructural requirements...
2017: Blood Purification
Beth Piraino
Early innovations in the delivery of peritoneal dialysis (PD) markedly improved its acceptability and lowered peritonitis rates. The standard osmotic agent was, and continues to be dextrose, an agent that is not ideal as it is readily absorbed. The development of icodextrin-containing dialysis fluid has allowed a long dwell time to provide more effective ultrafiltration. The development of a smaller, more easily used automated cycler, led to an increase in the proportion of patients on the cycler as opposed to CAPD...
March 2017: Seminars in Dialysis
Micheli U Bevilacqua, Linda Turnbull, Sushila Saunders, Lee Er, Helen Chiu, Penny Hill, Rajinder S Singh, Adeera Levin, Michael A Copland, Abeed Jamal, Catherine Brumby, Orla Dunne, Paul A Taylor
♦ BACKGROUND: Peritoneal dialysis (PD) is challenging for patients with functional limitations, and assisted PD can support these patients, but previous reports of assisted PD have not examined the role of temporary assisted PD and had difficulty identifying adequate comparator cohorts. ♦ METHODS: Peritoneal Dialysis Assist (PDA), a 12-month pilot of long-term and temporary assisted PD was completed in multiple PD centers in British Columbia, Canada. Continuous cycler PD (CCPD) patients were identified for PDA by standardized criteria, and service could be long-term or temporary/respite...
May 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Rahul Chanchlani, Susan Ackerman, Elizabeth Piva, Elizabeth Harvey
Active Vitamin D sterols such as calcitriol and alfacalcidol are quite effective in the treatment of mineral bone disease secondary to chronic kidney disease. However, some children on peritoneal dialysis (PD) are resistant to oral formulations of active Vitamin D, and use of an intravenous formulation in such patients is inconvenient. In these children, intraperitoneal (IP) calcitriol has been shown to be effective in the treatment of secondary hyperparathyroidism. However, its use has declined. We report 2 children, aged 1 and 9...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Tabo Sikaneta, George Wu, Mohamed Abdolell, Anita Ng, Sara Mahdavi, Anton Svendrovski, Tony Tu, Trish Mercer, Matthew Tong, Dimitrios Oreopoulos, Paul Tam
UNLABELLED:BACKGROUND AND OBJECTIVE: Residual renal function (RRF) correlates with mortality and morbidity rates in patients receiving peritoneal dialysis (PD). We examined the effect of a biocompatible PD solution (Gambrosol Trio; Gambro Lundia AB, Lund, Sweden) with lower concentrations of glucose degradation products on rates of decline in RRF. ♦ DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Incident patients at 2 centers in Canada and 1 in Hong Kong were randomized (by minimization) in an open-label parallel group trial to receive Gambrosol Trio or standard PD solution (Dianeal; Baxter Healthcare, Mississauga, Canada) for 2 years...
September 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Lynn Redahan, Andrew Davenport
INTRODUCTION: CA125 in peritoneal dialysis (PD) effluent dialysate has been used as a surrogate biomarker for the health of the peritoneum in PD patients. However CA125 is synthesised by epithelial cells and as such is not specific for the peritoneum, and most studies have only measured peritoneal CA125, without serum CA125 values. As such we wished to determine the factors which influenced PD effluent CA125 in a large contemporaneous cohort. METHODS: We measured dialysate effluent CA125 in PD patients attending for routine assessment of peritoneal membrane function with a peritoneal equilibration test (PET), with corresponding serum CA125...
June 2016: Journal of Nephrology
Nicanor Vega-Diaz, Fayna Gonzalez-Cabrera, Silvia Marrero-Robayna, Raquel Santana-Estupiñan, Roberto Gallego-Samper, Fernando Henriquez-Palop, Patricia Perez-Borges, José Carlos Rodriguez-Perez
BACKGROUND: In order to reduce the cardiovascular risk, morbidity and mortality of peritoneal dialysis (PD), a minimal level of small-solute clearances as well as a sodium and water balance are needed. The peritoneal dialysis solutions used in combination have reduced the complications and allow for a long-time function of the peritoneal membrane, and the preservation of residual renal function (RRF) in patients on peritoneal dialysis (PD) is crucial for the maintenance of life quality and long-term survival...
July 22, 2015: Journal of Clinical Medicine
Cecile Courivaud, Andrew Davenport
UNLABELLED:BACKGROUND: Interventional trials failed to demonstrate that increasing urea clearance improved peritoneal dialysis (PD) patient survival. Hyperphosphatemia is a well-recognized predictor of cardiovascular and all-cause mortality in PD patients. Simplification of PD small solute clearance targets focuses away from larger solutes, including phosphate. In the US and UK, increasing use of automated peritoneal dialysis (APD) cyclers with shorter dwell times could also potentially reduce peritoneal phosphate removal compared to continuous ambulatory peritoneal dialysis (CAPD)...
January 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Thyago Proença de Moraes, Maria Cláudia Cruz Andreoli, Maria Eugênia Canziani, Dirceu Reis da Silva, Jacqueline Costa Teixeira Caramori, Daniela Ponce, Hélio Vida Cassi, Kleyton de Andrade Bastos, Danyelle Romana Alves Rio, Sergio Wyton Pinto, Sebastião Rodrigues Ferreira Filho, Ludimila Guedim de Campos, Marcia Olandoski, José Carolino Divino-Filho, Roberto Pecoits-Filho
BACKGROUND: Insulin resistance is a common risk factor in chronic kidney disease patients contributing to the high cardiovascular burden, even in the absence of diabetes. Glucose-based peritoneal dialysis (PD) solutions are thought to intensify insulin resistance due to the continuous glucose absorption from the peritoneal cavity. The aim of our study was to analyse the effect of the substitution of glucose for icodextrin on insulin resistance in non-diabetic PD patients in a multicentric randomized clinical trial...
November 2015: Nephrology, Dialysis, Transplantation
Rafia I Chaudhry, Thomas A Golper
Peritoneal dialysis (PD) is a widely accepted and increasingly popular form of dialysis. The invention and technological advancement of the PD cycler further makes PD a convenient option. Prescription-specific parameters are entered into the cycler, which then automatically carries out the steps involved in continuous cycling PD. We review the basics, technical aspects, challenges, and advancements of the cycler.
2015: Medical Devices: Evidence and Research
Michel Fischbach, Ariane Zaloszyc, Betti Schaefer, Claus Schmitt
Conventional automated peritoneal dialysis (APD) is prescribed as a repetition of the same dwell time and the same fill volume delivered by the cycler during the dialysis session. Nevertheless, it is well recognized that a cycle with a short dwell time and a small fill volume favors ultrafiltration (UF), while a cycle with a long dwell time and a large fill volume favors uremic toxin removal. The use of varied dwell times and dwell volumes, called adapted APD, allows for an optimized peritoneal dialysis prescription with better volume control--that is, both an increased UF volume at a lower metabolic cost [UF per gram of glucose absorbed (mL/g)] and increased dialytic sodium removal resulting in improved removal of uremic toxins (urea, creatinine, phosphate) during dialysis...
2014: Advances in Peritoneal Dialysis
Kashyap Patel, Craig R Rayner, Mylène Giraudon, Mohamed A Kamal, Peter N Morcos, Richard Robson, Carl M Kirkpatrick
AIMS: Patients with end-stage renal disease (ESRD) are at increased risk of developing complications associated with influenza infection. Oseltamivir is indicated for influenza treatment in ESRD patients, but the disposition is poorly understood in this patient population. This study aimed to characterize the pharmacokinetics and tolerability of oseltamivir in automated peritoneal dialysis (APD) and construct a pharmacokinetic model to assist with optimized dosing. METHODS: Ten adults with ESRD were prescribed an aggressive APD regimen consisting of three continuous cycler-assisted peritoneal dialysis (CCPD) sessions during the day and two continuous ambulatory (CAPD) sessions overnight...
April 2015: British Journal of Clinical Pharmacology
Borut Cižman, Steve Lindo, Brian Bilionis, Ira Davis, Aaron Brown, Jennifer Miller, Gerald Phillips, Alex Kriukov, James A Sloand
UNLABELLED: BACKGROUND, OBJECTIVES AND METHODS: Increased intraperitoneal volume (IIPV) can occur during automated peritoneal dialysis (APD). The contribution of factors such as cycler programming and patient/user actions to IIPV has not been previously explored. The relationship between IIPV and cycler programming, patient/user actions, and ultrafiltration over a two-year period was investigated using US data from Baxter cyclers. Drain/fill volume ratios of > 1.6 to ≤ 2.0 and > 2...
June 2014: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Katie E Cardone, Wen Zhen Chen, Darren W Grabe, Amber Batzold, Harold J Manley, Thomas P Lodise
OBJECTIVES: The intent of this study was to evaluate the appropriateness of commonly used intravenous (iv) vancomycin dosing schemes in patients on automated peritoneal dialysis (APD) using population pharmacokinetic (PK) modelling and Monte Carlo simulation. METHODS: Data from a single-dose PK study of 10 non-infected APD patients ≥18 years old were analysed. Patients received iv vancomycin (15 mg/kg) followed by three cycler-assisted APD dwells over 8 h, followed by two 8 h dwells...
July 2014: Journal of Antimicrobial Chemotherapy
Poyyapakkam Srivaths, Rajesh Krishnamurthy, Lori Brunner, Barbara Logan, Michael Bennett, Qing Ma, Rene VanDeVoorde, Stuart L Goldstein
BACKGROUND: Children receiving maintenance dialysis exhibit high cardiovascular (CV) associated mortality. We and others have shown high prevalence of cardiac calcifications (CC) in children with endstage renal disease (ESRD). However, no pediatric study has examined modality difference in CC prevalence. The current study was conducted to assess for a difference in CC prevalence between hemodialysis (HD) and peritoneal dialysis (PD) in children with ESRD. METHODS: 38 patients (19 female, 19 male; mean age 15...
April 2014: Clinical Nephrology
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