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Emergency peritoneal dialysis

Manreet Padwal, Peter J Margetts
Peritoneal fibrosis is one of the major complications occurring in long-term peritoneal dialysis patients as a result of injury. Peritoneal fibrosis is characterized by submesothelial thickening and fibrosis which is associated with a decline in peritoneal membrane function. The myofibroblast has been identified as the key player involved in the development and progression of peritoneal fibrosis. Activation of the myofibroblast is correlated with expansion of the extracellular matrix and changes in peritoneal membrane integrity...
September 2016: Kidney Research and Clinical Practice
Francesco Esposito, Marco Di Serafino, Concetta Ambrosio, Maria Rita Panico, Francesca Malacario, Carmela Mercogliano, Carmine Pecoraro, Patrizia Oresta
PURPOSE: Over the past two decades, continuous ambulatory peritoneal dialysis has emerged as the first-choice dialysis modality in children awaiting for transplantation. Despite the improvements observed in catheter survival over the past several years, the obstruction is one of the reasons for immediate catheter non-function. This study assessed usefulness of ultrasound (US) in visualizing the obstruction of chronic peritoneal dialysis (CPD) catheter and identifying the etiology. MATERIALS AND METHODS: Between January 2000 and November 2012, 38 patients (20 M, 18 F) were treated with CPD and examined with US...
September 2016: Journal of Ultrasound
Wen Tang, Xiu-Hong Hu, Lei Zhu, Zhe-Li Niu, Chu-Yan Su, Qing-Feng Han, Tao Wang
PURPOSE: To investigate the effect of pre-dialysis renal care on peritoneal dialysis (PD) patients' outcomes in China. METHODS: In this retrospective cohort study, patients who started PD during January 1, 2006, to December 31, 2014, were included. Patients' medical charts were reviewed to extract the information. To explore the effect of pre-dialysis renal care on patients' outcomes, patient were divided into two groups according to whether or not they had frequent renal clinic visits: Group A (with frequent visits) and Group B (without frequent visits)...
November 2016: International Urology and Nephrology
Keren Ladin, Naomi Lin, Emily Hahn, Gregory Zhang, Susan Koch-Weser, Daniel E Weiner
BACKGROUND: Although shared decision-making (SDM) can better align patient preferences with treatment, barriers remain incompletely understood and the impact on patient satisfaction is unknown. METHODS: This is a qualitative study with semistructured interviews. A purposive sample of prevalent dialysis patients ≥65 years of age at two facilities in Greater Boston were selected for diversity in time from initiation, race, modality and vintage. A codebook was developed and interrater reliability was 89%...
August 30, 2016: Nephrology, Dialysis, Transplantation
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
Vickie Wai-Ki Kwong, Philip Kam-Tao Li
BACKGROUND: There is a growing demand of dialysis in Asia for end-stage renal failure patients. Diabetes mellitus is the leading cause of end-stage renal failure in many countries in Asia. SUMMARY: The growth of peritoneal dialysis (PD) in Asia is significant and seeing a good trend. With the enhanced practices of PD, the quality of care in PD in Asia is also improved. Overall, PD and hemodialysis (HD) are comparable in clinical outcome. There is a global trend in the reduction of peritonitis rates and Asian countries also witness such improvement...
December 2015: Kidney Diseases
Belkacem Issad, Guy Rostoker, Corinne Bagnis, Gilbert Deray
Acute renal failure (ARF) in adults in the intensive care unit (ICU) often evolves in a context of multiple organ failure, which explains the high mortality rate and increase treatment needs. Among, two modalities of renal replacement therapy, peritoneal dialysis (PD) was the first modality used for the treatment of ARF in the 1950s. Today, while PD is generalized for chronic renal failure treatment, its use in the ICU is limited, particularly, due to the advent of new hemodialysis techniques and the development of continuous replacement therapy...
July 2016: Néphrologie & Thérapeutique
Anne-Marie E Sirany, Christopher J Chow, Hiroko Kunitake, Robert D Madoff, David A Rothenberger, Mary R Kwaan
BACKGROUND: More than 450,000 US patients with end-stage renal disease currently dialyze. The risk of morbidity and mortality for these patients after colorectal surgery has been incompletely described. OBJECTIVE: We analyzed the 30-day morbidity and mortality rates of chronic dialysis patients who underwent colorectal surgery. DESIGN: This was a retrospective analysis. SETTINGS: Hospitals that participate in the American College of Surgeons National Surgical Quality Improvement Program were included...
July 2016: Diseases of the Colon and Rectum
Anna T Mathew, Steven Fishbane, Yoshitsugu Obi, Kamyar Kalantar-Zadeh
Residual kidney function (RKF) may confer a variety of benefits to patients on maintenance dialysis. RKF provides continuous clearance of middle molecules and protein-bound solutes. Whereas the definition of RKF varies across studies, interdialytic urine volume may emerge as a pragmatic alternative to more cumbersome calculations. RKF preservation is associated with better patient outcomes including survival and quality of life and is a clinical parameter and research focus in peritoneal dialysis. We propose the following practical considerations to preserve RKF, especially in newly transitioned (incident) hemodialysis patients: (1) periodic monitoring of RKF in hemodialysis patients through urine volume and including residual urea clearance with dialysis adequacy and outcome markers such as anemia, fluid gains, minerals and electrolytes, nutritional, status and quality of life; (2) avoidance of nephrotoxic agents such as radiocontrast dye, nonsteroidal anti-inflammatory drugs, and aminoglycosides; (3) more rigorous hypertension control and minimizing intradialytic hypotensive episodes; (4) individualizing the initial dialysis prescription with consideration of an incremental/infrequent approach to hemodialysis initiation (e...
August 2016: Kidney International
Ninoo George, Suceena Alexander, Vinoi G David, Gopal Basu, Anjali Mohapatra, Anna T Valson, Shibu Jacob, Harish K Pathak, Antony Devasia, Veerasamy Tamilarasi, Santosh Varughese
♦ Background: There are no large studies that have examined ultra-short break-in period with a blind, bedside, midline approach to Tenckhoff catheter insertion.♦ Methods: Observational cohort study of 245 consecutive adult patients who underwent percutaneous catheter insertion for chronic peritoneal dialysis (PD) at our center from January 2009 to December 2013. There were 132 (53.9%) diabetics and 113 (46.1%) non-diabetics in the cohort.♦ Results: The mean break-in period for the percutaneous group was 2...
April 4, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Ping-Nam Wong, Gensy M W Tong, Yuk-Yi Wong, Kin-Yee Lo, Shuk-Fan Chan, Man-Wai Lo, Kwok-Chi Lo, Lo-Yi Ho, Cindy W S Tse, Siu-Ka Mak, Andrew K M Wong
UNLABELLED:BACKGROUND AND OBJECTIVES: Catheter-related infection, namely exit-site infection (ESI) and peritonitis, is a major infectious complication and remains a main cause of technique failure for patients receiving peritoneal dialysis (PD). Topical application of antibiotic cream might reduce catheter-related infection but emergence of resistant or opportunistic organisms could be a concern. Optimal topical agents and regimens remain to be determined. We did a study to examine the effect of an alternating topical antibiotic regimen in preventing catheter-related infection...
May 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
P S Atwal, C Macmurdo, P C Grimm
Acute metabolic decompensation in maple syrup urine disease can occur during intercurrent illness and is a medical emergency. A handful of reports in the medical literature describe the use of peritoneal dialysis and haemodialysis as therapeutic inventions. We report the only patient from our centre to have haemodialysis performed in this setting. Combined with dietary BCAA restriction and calorific support, haemodialysis allows rapid reduction in plasma leucine concentrations considerably faster than conservative methods...
September 2015: Molecular Genetics and Metabolism Reports
Chen-Yi Liao, Chi-Chang Tsai, Wu-Hsien Kuo, Ren-Jy Ben, Ho-Cheng Lin, Ching-Chang Lee, Kuan-Jen Su, Han-En Wang, Chih-Chiang Wang, I-Hung Chen, Shang-Tao Chien, Ming-Kai Tsai
BACKGROUND: Emphysematous cholecystitis is a rare variant of acute cholecystitis with a high mortality rate. The combination of emphysematous cholecystitis, liver abscess and pneumoperitoneum are even rarer. Herein we present a case of emphysematous cholecystitis in a senile diabetic lady who had worsening hemodynamics while undergoing hemodialysis. CASE PRESENTATION: A 64-year-old woman with history of type 2 diabetes mellitus and end stage renal disease with regular hemodialysis presented to the emergency department with a 1-day history of sudden onset of lassitude and hypotension during hemodialysis...
2016: BMC Nephrology
David W Mudge, Neil Boudville, Fiona Brown, Philip Clayton, Michelle Duddington, Stephen Holt, David W Johnson, Matthew Jose, Walaa Saweirs, Kamal Sud, David Voss, Rowan Walker
This paper updates a previous 'Call to Action' paper (Nephrology 2011; 16: 19-29) that reviewed key outcome data for Australian and New Zealand peritoneal dialysis patients and made recommendations to improve care. Since its publication, peritonitis rates have improved significantly, although they have plateaued more recently. Peritoneal dialysis patient and technique survival in Australian and New Zealand have also improved, with a reduction in the proportion of technique failures attributed to 'social reasons'...
July 2016: Nephrology
Gui-Na Wei, Jian-Hua Mao
We herein describe a case of tension hydrothorax that occurred on continuous ambulatory peritoneal dialysis (CAPD), highlighting the problems of diagnosis and a novel management. A 38-year-old male with end-stage renal disease (ESRD) due to diabetes mellitus developed dyspnea and poor drainage after 13 months of CAPD. Chest X-ray revealed massive right-sided hydrothorax and mediastinal shift. He underwent emergency thoracentesis and pleural fluid showed a high level of glucose. Pleuroperitoneal communication was strongly suspected, although the methylene blue test was negative...
May 2016: Clinical Nephrology
Christophe Vinsonneau, Emma Allain-Launay, Clarisse Blayau, Michael Darmon, Damien Ducheyron, Theophile Gaillot, Patrick M Honore, Etienne Javouhey, Thierry Krummel, Annie Lahoche, Serge Letacon, Matthieu Legrand, Mehran Monchi, Christophe Ridel, René Robert, Frederique Schortgen, Bertrand Souweine, Patrick Vaillant, Lionel Velly, David Osman, Ly Van Vong
Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD)...
December 2015: Annals of Intensive Care
Sarbjit Vanita Jassal
Individuals aged over 70 years at the time of starting dialysis have a varied and often challenging existence on dialysis. Canadian data suggest those starting dialysis between the ages of 75 and 79 years will have an average life expectancy of 3.2 years, while based on US data, patients can expect an average life expectancy of 25 months. A substantial proportion of these patients will, however, experience transient or permanent loss of personal independence within the first few months to years on dialysis...
November 2015: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Mark R Marshall, Kevan R Polkinghorne, Peter G Kerr, Carmel M Hawley, John W M Agar, Stephen P McDonald
BACKGROUND: Intensive hemodialysis (HD) is characterized by increased frequency and/or session length compared to conventional HD. Previous analyses from Australia and New Zealand did not suggest benefit with intensive HD, although recent research suggests that relationships have changed. We present updated analyses. STUDY DESIGN: Observational cohort study using marginal structural modeling to adjust for changes in renal replacement modality and time-varying medical comorbid conditions...
April 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
BACKGROUND: Chronic kidney disease, including end-stage renal disease, has been identified as a possible risk factor for primary septicemia and wound infection by Vibrio vulnificus. However, cases of severe septicemia, necrotizing fasciitis, and peritonitis caused by V. vulnificus in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) have not been described. We report a case of severe septicemia, necrotizing fasciitis, and peritonitis due to V. vulnificus in a patient undergoing CAPD after ingesting raw seafood...
2015: BMC Infectious Diseases
Monika Tooulou, Pieter Demetter, Anwar Hamade, Caroline Keyzer, Joëlle L Nortier, Agnieszka A Pozdzik
Background. Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of peritoneal dialysis (PD). Besides the endothelial-to-mesenchymal transition (EMT), recently peritoneal adipocytes emerged as a potential source of fibrosis. We performed immunohistochemistry to approach EMT and to localize peritoneal adipocytes in peritoneal biopsies from PD-related EPS patients. Material and Methods. We investigated tissue expression of podoplanin, cytokeratin AE1/AE3 (mesothelium), calretinin (adipocytes), alpha-smooth muscle actin [α-SMA] (mesenchymal cells), interstitial mononuclear cell inflammation, and neoangiogenesis (CD3, CD4, CD8, CD20, CD68, and CD31 immunostainings, resp...
2015: International Journal of Nephrology
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