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https://www.readbyqxmd.com/read/28096442/kinetic-modeling-of-incremental-ambulatory-peritoneal-dialysis-exchanges
#1
Steven Guest, John K Leypoldt, Michelle E Cassin, Martin J Schreiber
♦ Background: Incremental peritoneal dialysis (PD), the gradual introduction of dialysate exchanges at less than full-dose therapy, has been infrequently described in clinical reports. One concern with less than full-dose dialysis is whether urea clearance targets are achievable with an incremental regimen. In this report, we used a large database of PD patients, across all membrane transport types, and performed urea kinetic modeling determinations of possible incremental regimens for an individual membrane type...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28096440/tnf-signaling-in-peritoneal-mesothelial-cells-pivotal-role-of-cflipl
#2
Willie M Lüdemann, Danijela Heide, Lars Kihm, Martin Zeier, Peter Scheurich, Vedat Schwenger, Julia Ranzinger
♦ Background: Peritoneal dialysis (PD) coincides with high concentrations of proinflammatory cytokines, such as tumor necrosis factor (TNF), in the peritoneal cavity. During treatment, chronic inflammatory processes lead to damage of the peritoneal membrane and a subsequent ultrafiltration failure. Human peritoneal mesothelial cells (HPMCs) play a central role as mediators and targets of PD-related inflammatory changes. Although TNF Receptor 1 (TNFR1) is expressed in high numbers on the cells, TNF-induced apoptosis is inhibited...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28012100/the-peritoneal-sieving-of-sodium-a-simple-and-powerful-test-to-rule-out-the-onset-of-encapsulating-peritoneal-sclerosis-in-patients-undergoing-peritoneal-dialysis
#3
Vincenzo La Milia, Selena Longhi, Elisabetta Sironi, Giuseppe Pontoriero
BACKGROUND AND AIMS: Encapsulating peritoneal sclerosis (EPS) is an uncommon but severe complication of peritoneal dialysis (PD). A reliable screening tool to identify patients at risk of developing or not EPS is currently not available. We aimed to evaluate whether the reduction in dialysate sodium concentration (sodium sieving) at 60 min (ΔDNa60), during a peritoneal equilibration test with 3.86% glucose concentration (3.86%-PET) was able to early rule out patients who will not develop EPS...
December 24, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/28004069/-emodin-ameliorates-the-peritoneal-dialysis-related-peritoneal-fibrosis-via-inhibiting-the-activation-of-notch-pathway
#4
Hui-Chao Wang, Xu-Hong Lin, Xiao-Peng Fang, Xiao-Yun Mu, Tie-Jun Li, Jian-Lin Liu
Long term peritoneal dialysis (PD) is often associated with peritoneal fibrosis. The aim of this study was to explore the effect of emodin on PD-related peritoneal fibrosis and its related cellular and molecular mechanism. PD-related peritoneal fibrosis rats and cultured rat peritoneal mesothelial cells were recruited in the experiment. PD-related peritoneal fibrosis was induced by intraperitoneal injection of lactate-buffered solution containing 4.25% glucose. The peritoneal equilibrium test (PET) was performed at the end of 2 weeks, 4 weeks, and 6 weeks, respectively...
December 25, 2016: Sheng Li Xue Bao: [Acta Physiologica Sinica]
https://www.readbyqxmd.com/read/27964722/hyperbranched-polyglycerol-is-superior-to-glucose-for-long-term-preservation-of-peritoneal-membrane-in-a-rat-model-of-chronic-peritoneal-dialysis
#5
Caigan Du, Asher A Mendelson, Qiunong Guan, Ghida Dairi, Irina Chafeeva, Gerald da Roza, Jayachandran N Kizhakkedathu
BACKGROUND: Replacing glucose with a better biocompatible osmotic agent in peritoneal dialysis (PD) solutions is needed in PD clinic. We previously demonstrated the potential of hyperbranched polyglycerol (HPG) as a replacement for glucose. This study further investigated the long-term effects of chronic exposure to HPG as compared to a glucose-based conventional PD solution on peritoneal membrane (PM) structure and function in rats. METHODS: Adult male Wistar rats received once-daily intraperitoneal injection of 10 mL of HPG solution (1 kDa, HPG 6%) compared to Physioneal™ 40 (PYS, glucose 2...
December 13, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27951568/the-clear-space-index
#6
Akihiro C Yamashita
BACKGROUND: Kt/V for urea (Kt/V) is a dimensionless clinical index of dialysis dose; however, it does not directly reflect the removal capacity of the solute. Since the total amount of solute removal, M, is directly proportional to the initial solute concentration CB(0), it is reasonable to introduce an index by dividing M by CB(0). This index was termed 'clear space' (CS) because it was later found that it reflects the body fluid volume, the concentration of which becomes zero by the treatment...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951558/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvements
#7
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951555/evidence-for-biocompatible-peritoneal-dialysis-solutions
#8
Melissa Nataatmadja, Yeoungjee Cho, David W Johnson
Glucose-based peritoneal dialysis (PD) solutions are the mainstay of therapy for PD patients, yet are accompanied by a number of adverse effects and potential complications. The high glucose content can cause both systemic effects, such as hyperglycaemia, as well as local effects on the peritoneal membrane, which can interfere with its function. In addition, glucose degradation products (GDPs) generated during heat sterilization of the solutions and the acidic pH at which these solutions are kept have been shown to cause peritoneal membrane injury and precipitate inflow pain, respectively...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27936520/factors-effective-on-peritoneal-phosphorus-transport-and-clearance-in-peritoneal-dialysis-patients%C3%A2
#9
Egemen Cebeci, Meltem Gursu, Sami Uzun, Serhat Karadag, Rumeyza Kazancioglu, Savas Ozturk
AIMS: Transport characteristics of phosphorus are different from other small solutes that are evaluated in routine peritoneal equilibration test (PET) in peritoneal dialysis (PD) patients. We aimed to evaluate peritoneal phosphorus clearance and permeability, and their relationship with peritoneal membrane transport type and creatinine clearance as well as factors affecting peritoneal phosphorus clearance. METHODS: 70 adult patients on a PD program were included in our study...
February 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/27935537/predictors-of-residual-renal-function-decline-in-peritoneal-dialysis-patients-the-balanz-trial
#10
Htay Htay, Yeoungjee Cho, Elaine M Pascoe, Darsy Darssan, Carmel M Hawley, David W Johnson
♦ Objective: Preservation of residual renal function (RRF) is associated with improved survival. The aim of the present study was to identify independent predictors of RRF and urine volume (UV) in incident peritoneal dialysis (PD) patients. ♦ Methods: The study included incident PD patients who were balANZ trial participants. The primary and secondary outcomes were RRF and UV, respectively. Both outcomes were analyzed using mixed effects linear regression with demographic data in the first model and PD-related parameters included in a second model...
December 1, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27932866/effect-of-peritoneal-dialysis-fluid-containing-osmo-metabolic-agents-on-human-endothelial-cells
#11
Mario Bonomini, Sara Di Silvestre, Pamela Di Tomo, Natalia Di Pietro, Domitilla Mandatori, Lorenzo Di Liberato, Vittorio Sirolli, Francesco Chiarelli, Cesare Indiveri, Assunta Pandolfi, Arduino Arduini
BACKGROUND: The use of glucose as the only osmotic agent in peritoneal dialysis (PD) solutions (PDSs) is believed to exert local (peritoneal) and systemic detrimental actions, particularly in diabetic PD patients. To improve peritoneal biocompatibility, we have developed more biocompatible PDSs containing xylitol and carnitine along with significantly less amounts of glucose and have tested them in cultured Human Vein Endothelial Cells (HUVECs) obtained from the umbilical cords of healthy (C) and gestational diabetic (GD) mothers...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27860413/development-of-a-wearable-bioartificial-kidney-using-the-bioartificial-renal-epithelial-cell-system-brecs
#12
Kimberly A Johnston, Angela J Westover, Alvaro Rojas-Pena, Deborah A Buffington, Christopher J Pino, Peter L Smith, H David Humes
Cell therapy for the treatment of renal failure in the acute setting has proved successful, with therapeutic impact, yet development of a sustainable, portable bioartificial kidney for treatment of chronic renal failure has yet to be realized. Challenges in maintaining an anticoagulated blood circuit, the typical platform for solute clearance and support of the biological components, have posed a major hurdle in advancement of this technology. This group has developed a Bioartificial Renal Epithelial Cell System (BRECS) capable of differentiated renal cell function while sustained by body fluids other than blood...
November 18, 2016: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/27810276/-peritoneal-equilibration-test-conventional-versus-adapted-preliminary-study
#13
Ariane Zaloszyc, Claus Peter Schmitt, Betti Schaefer, Armelle Doutey, Joëlle Terzic, Soraya Menouer, Laetitia Higel, Michel Fischbach
Conventional automated peritoneal dialysis (APD) is prescribed as a repetition of cycles with the same dwell time and the same fill volume. Water and sodium balance remains a common problem among patients on peritoneal dialysis. More recently, adapted automated peritoneal dialysis was described, as a combination of short dwells with a low volume, in order to enhance ultrafiltration, followed by long dwells with a large fill volume to favor solute removal. We performed a preliminary crossover study on 4 patients...
October 31, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27795628/swan-neck-versus-straight-peritoneal-dialysis-catheter-long-term-effect-on-patient-and-method-survival
#14
V Filiopoulos, D Biblaki, L Takouli, A Dounavis, D Hadjiyannakos, D Vlassopoulos
Peritoneal dialysis (PD) is limited mainly by a higher technique failure rate as compared to hemodialysis (HD), catheter malfunction being an important reason. Intra- and extra-peritoneal catheter configuration may be associated with mechanical and infectious complications affecting method survival. We report our experience with two extra-peritoneal catheter configurations: the straight and the swan-neck (SN) catheters. A total of 85 consecutive patients, 58 males and 27 females were included in the study. Among them, 26 were diabetics; 52 were treated with automated PD (APD) and 33 with continuous ambulatory PD (CAPD)...
September 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27782116/screening-for-muscle-loss-in-patients-established-on-peritoneal-dialysis-using-bioimpedance
#15
G H B Greenhall, A Davenport
: Background/objectivesKidney dialysis patients with sarcopenia have increased mortality. Screening for low muscle mass may allow interventions at an earlier stage to help improve outcomes. We wished to determine the prevalence of low muscle mass in a cohort of peritoneal dialysis (PD) patients.Subjects/methodsWe measured lean body mass index (LBMI) in 490 PD patients by bioimpedance, grading patients using two different classifications of sarcopenia. RESULTS: LBMI was 9...
January 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/27772644/intensive-hemodialysis-and-potential-risks-with-increasing%C3%A2-treatment
#16
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
https://www.readbyqxmd.com/read/27768727/addition-of-alanyl-glutamine-to-dialysis-fluid-restores-peritoneal-cellular-stress-responses-a-first-in-man-trial
#17
Klaus Kratochwill, Michael Boehm, Rebecca Herzog, Katharina Gruber, Anton Michael Lichtenauer, Lilian Kuster, Dagmar Csaicsich, Andreas Gleiss, Seth L Alper, Christoph Aufricht, Andreas Vychytil
BACKGROUND: Peritonitis and ultrafiltration failure remain serious complications of chronic peritoneal dialysis (PD). Dysfunctional cellular stress responses aggravate peritoneal injury associated with PD fluid exposure, potentially due to peritoneal glutamine depletion. In this randomized cross-over phase I/II trial we investigated cytoprotective effects of alanyl-glutamine (AlaGln) addition to glucose-based PDF. METHODS: In a prospective randomized cross-over design, 20 stable PD outpatients underwent paired peritoneal equilibration tests 4 weeks apart, using conventional acidic, single chamber 3...
2016: PloS One
https://www.readbyqxmd.com/read/27759470/the-influence-of-low-calcium-dialysate-on-left-ventricular-diastolic-function-in-peritoneal-dialysis-patients
#18
Zebin Wang, Yueqiang Wen, Jianbo Liang, Xinling Liang, Wei Shi
Left ventricular (LV) diastolic function was found to be a significant predictor of cardiovascular events and general mortality in dialysis. Studies have indicated that dialysate calcium concentrations were significantly associated with cardiac function. However, the relationship between low calcium dialysate and LV diastolic function has not been clear. The aim of this study was to investigate the influence of low calcium dialysate on cardiac function in peritoneal dialysis (PD) patients. A total of 60 PD patients were enrolled in this study, with a calcium content of the PD solution of 1...
November 2016: Renal Failure
https://www.readbyqxmd.com/read/27738089/short-dwell-cycling-intraperitoneal-cefazolin-plus-ceftazidime-in-peritoneal-dialysis-patients
#19
Sadudee Peerapornratana, Pajaree Chariyavilaskul, Talerngsak Kanjanabuch, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Pisut Katavetin
♦ Background: Current guidelines suggest that intraperitoneal (IP) antibiotics should be administered only in a long peritoneal dialysis (PD) dwell (≥ 6 hours). The long dwell might result in low ultrafiltration and volume overload. We aim to examine plasma and dialysate concentration of cefazolin and ceftazidime after IP administration in a short-dwell (≤ 2 hours) automated cyclingexchange. ♦ Methods: Stable PD patients without peritonitis were invited to participate in the present study. Patients underwent 5 2-liter exchanges of PD fluid over 10 hours by the PD cycling machine without last fill or additional dwell...
October 13, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27680756/influence-of-different-peritoneal-dialysis-fluids-on-the-in-vitro-activity-of-cefepime-ciprofloxacin-ertapenem-meropenem-and-tobramycin-against-escherichia-coli
#20
Manuel Kussmann, Linda Schuster, Sarah Wrenger, Petra Pichler, Gottfried Reznicek, Heinz Burgmann, Wolfgang Poeppl, Markus Zeitlinger, Martin Wiesholzer
♦ BACKGROUND: Peritonitis is a major problem among patients on peritoneal dialysis (PD). The influence of diverse PD fluids on the activity of frequently used antibiotics has been insufficiently investigated. Thus, the present study set out to investigate the impact of different PD fluids on the activity of cefepime, ciprofloxacin, ertapenem, meropenem, and tobramycin against Escherichia coli. ♦ METHODS: Time-kill curves in 4 different PD fluids (Dianeal PDG4, Extraneal, Nutrineal PD4 and Physioneal 40, all Baxter Healthcare Corp...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
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