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https://www.readbyqxmd.com/read/28201944/the-association-between-soluble-intercellular-adhesion-molecule-1-levels-in-drained-dialysate-and-peritoneal-injury-in-peritoneal-dialysis
#1
Yusuke Igarashi, Yoshiyuki Morishita, Hiromichi Yoshizawa, Reika Imai, Toshimi Imai, Ichiro Hirahara, Tetsu Akimoto, Susumu Ookawara, Kenichi Ishibashi, Shigeaki Muto, Daisuke Nagata
BACKGROUND: Chronic inflammation of the peritoneum causes peritoneal injury in patients on peritoneal dialysis. Intercellular adhesion molecule-1 and its circulating form, soluble intercellular adhesion molecule-1, play pivotal roles in inflammation. However, their role in peritoneal injury is unclear. METHODS: We measured changes in intercellular adhesion molecule-1 expression in the peritoneum of a peritoneal injury model in rats. The associations between soluble intercellular adhesion molecule-1 levels in drained dialysate and the solute transport rate (D/P-Cr and D/D0-glucose) determined by the peritoneal equilibration test, and matrix metalloproteinase-2 levels in drained dialysate were investigated in 94 peritoneal drained dialysate samples...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28193826/the-nlrp3-inflammasome-has-a-critical-role-in-peritoneal-dialysis-related-peritonitis
#2
Nicolas Hautem, Johann Morelle, Amadou Sow, Cyril Corbet, Olivier Feron, Eric Goffin, François Huaux, Olivier Devuyst
Bacterial peritonitis remains the main cause of technique failure in peritoneal dialysis (PD). During peritonitis, the peritoneal membrane undergoes structural and functional alterations that are mediated by IL-1β The NLRP3 inflammasome is a caspase-1-activating multiprotein complex that links sensing of microbial and stress products to activation of proinflammatory cytokines, including IL-1β The potential roles of the NLRP3 inflammasome and IL-1β in the peritoneal membrane during acute peritonitis have not been investigated...
February 13, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28185405/evaluation-of-long-term-combination-therapy-with-peritoneal-dialysis-and-hemodialysis
#3
Reo Kanda, Hiroaki Io, Junichiro Nakata, Yuko Makita, Yu Sasaki, Mayumi Matsumoto, Keiichi Wakabayashi, Yasuhiko Tomino, Yusuke Suzuki
It is well known that a combination therapy with peritoneal dialysis (PD) and hemodialysis (HD) is feasible and may improve clinical status in patients for whom adequate solute and fluid removal is difficult to achieve with PD alone. The objective of the present study was to evaluate whether the therapy is useful in the likelihood of long-term peritoneal membrane and cardiac function. The therapy was 6 days of PD and one session of HD per week. Physical, biochemical, dialysate-to-plasma ratio of creatinine (D/P Cr), arteriovenous fistula (AVF) blood flow, and left ventricular mass index (LVMI) data were prospectively analyzed in 30 patients with measurements performed at 0 and 6 months, and for 21 patients, 12 or 18 months after initiation of the therapy...
February 10, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28153966/effect-of-uv-light-on-disinfection-of-peritoneal-dialysis-catheter-connections
#4
John Ashley, Julia A Rasooly, Ian Tran, Lawrence E Yost, Glenn M Chertow
We evaluated the microbiological performance of an ultraviolet (UV) light-based peritoneal dialysis catheter connection system. The system includes a UV light-generating device combined with a UV transmissive window incorporated into the transfer set. Each UV transparent transfer set was inoculated with 10 μL of cultured inoculum consisting of either S. aureus, E. coli, or C. albicans After being inoculated, we attached a solution set connector to the transfer catheter, and exposed that connection to a UV light dose of approximately 340 mJoules/cm(2) After exposure to UV light, we broke the seal of the solution set and opened the plunger valve on the UV transmissive transfer catheter...
January 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28153198/encapsulating-peritoneal-sclerosis
#5
REVIEW
Helen Alston, Stanley Fan, Masaaki Nakayama
Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of peritoneal dialysis. In this review, we describe the clinical picture and histologic changes to the peritoneal membrane that are associated with EPS and provide an update on current diagnosis and management. We also discuss the recent studies that have suggested that the use of more biocompatible solutions containing lower concentrations of glucose degradation product that often are pH neutral in combination with a change in clinical practice (reducing glucose exposure and monitoring peritoneal membrane function) might ameliorate peritoneal degeneration, reduce the incidence of EPS, and minimize the severity of the disease...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153197/peritoneal-membrane-preservation
#6
REVIEW
M Auxiliadora Bajo, Gloria Del Peso, Isaac Teitelbaum
Peritoneal dialysis (PD) is a successfully used method for renal replacement therapy. However, long-term PD may be associated with peritoneal fibrosis and ultrafiltration failure. The key factors linked to their appearance are repeated episodes of inflammation associated with peritonitis and long-term exposure to bioincompatible PD fluids. Different strategies have been proposed to preserve the peritoneal membrane. This article reviews the functional and structural alterations related to PD and strategies whereby we may prevent them to preserve the peritoneal membrane...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153194/fluid-overload-in-peritoneal-dialysis-patients
#7
REVIEW
Yong-Lim Kim, Wim Van Biesen
Volume management in peritoneal dialysis patients is of importance, as both volume overload and dehydration are associated with worse outcomes. When assessing volume status, it is important to understand that different techniques measure different fluid compartments (intracellular vs extracellular vs circulating volume) and the impact of cardiac function. Attention to salt restriction and diuretics can help to maintain euvolemia without need for hypertonic bags. Glycaemia should be monitored to avoid thirst...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153193/low-gdp-solution-and-glucose-sparing-strategies-for-peritoneal-dialysis
#8
REVIEW
Cheuk Chun Szeto, David W Johnson
Long-term exposure to a high glucose concentration in conventional peritoneal dialysis (PD) solution has a number of direct and indirect (via glucose degradation products [GDP]) detrimental effects on the peritoneal membrane, as well as systemic metabolism. Glucose- or GDP-sparing strategies often are hypothesized to confer clinical benefits to PD patients. Icodextrin (glucose polymer) solution improves peritoneal ultrafiltration and reduces the risk of fluid overload, but these beneficial effects are probably the result of better fluid removal rather than being glucose sparing...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153192/current-challenges-and-opportunities-in-pd
#9
REVIEW
Philip Kam-Tao Li, Vickie Wai-Ki Kwong
Despite the gradual increased use of peritoneal dialysis (PD) globally around the world, it is recognized that a number of areas in PD as a renal-replacement therapy require attention and improvements. The current challenges in PD include how to tackle technique failure and sustain long-term PD, manage and prevent peritoneal infections, malnutrition and inflammation, cardiovascular mortality, volume overload, glucose exposure, adequacy of solute removal, peritoneal access, peritoneal physiology and changes with long-term PD, patient fatigue, psychosocial issues, and care of elderly patients on PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28113962/a-handheld-and-textile-enabled-bioimpedance-system-for-ubiquitous-body-composition-analysis-an-initial-functional-validation
#10
Javier Ferreira Gonzalez, Ivan Pau de la Cruz, Kaj Lindecrantz, Fernando Seoane
In recent years, many efforts have been made to promote a healthcare paradigm shift from the traditional reactive hospital-centered healthcare approach towards a proactive, patient-oriented and self-managed approach that could improve service quality and help reduce costs while contributing to sustainability. Managing and caring for patients with chronic diseases accounts over 75% of healthcare costs in developed countries. One of the most resource demanding diseases is chronic kidney disease (CKD), which often leads to a gradual and irreparable loss of renal function, with up to 12% of the population showing signs of different stages of this disease...
November 15, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28111028/solute-and-water-transport-in-peritoneal-dialysis-a-case-based-primer
#11
Ramesh Khanna
Peritoneal dialysis (PD) is an effective therapy for patients with end-stage kidney disease. Dialysis solutions containing physiologic concentrations of electrolytes and base, as well as glucose often at supraphysiologic concentrations, are infused into the peritoneal cavity for solute and water exchange, and the patient's own peritoneal membrane is used for dialysis. The peritoneal membrane is dominated by small pores, which allow transport of water and small-molecular-size solutes, including electrolytes, by way of both diffusion and convection...
January 19, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28096442/kinetic-modeling-of-incremental-ambulatory-peritoneal-dialysis-exchanges
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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