Specimen collection in peritoneal dialysis

A prospective study was done to determine whether zinc (Zn) and selenium (Se) loss occurs in patients on continuous ambulatory peritoneal dialysis through their dialysate effluent. Fifty pairs of aliquots of dialysis fluid were collected from 29 patients. Each paired set of specimens consisted of the dialysate fluid before instillation into the peritoneal cavity and a specimen of the spent effluent after dialysis for comparison. Zn and Se concentrations were measured using inductively coupled plasma atomic emission spectrophotometry...

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Critical parameters which influence the direct determination of trace elements in spent continuous ambulatory peritoneal dialysis (CAPD) fluids by electrothermal atomic absorption spectrometry (ETAAS) were investigated. Samples were collected after CAPD fluid exchange in 5.0 ml polyethylene cups and stored at -20 degrees C. Daily spent CAPD fluids were frozen immediately, while nightly spent CAPD fluids were frozen 2-3 h after the morning exchange. Before analysis samples were equilibrated to room temperature and analysed within 8 h...

BACKGROUND: Peritonitis is a common complication in patients with end-stage renal disease treated by continuous ambulatory peritoneal dialysis (CAPD). Empirical treatment is based on the organisms that are most frequently isolated and their susceptibilities. OBJECTIVE: To analyze and then compare peritoneal fluid culture results from adult and pediatric patients on CAPD, with respect to micro-organisms and antimicrobial susceptibilities. DESIGN: Three-year retrospective review of peritoneal fluid cultures from adults and children on CAPD...

AIM: To evaluate the effect of PD Plus on weekly Kt/Vurea and creatinine clearance (Kcr) among patients undergoing CAPD/CCPD (continuous ambulatory peritoneal dialysis/continuous cyclic peritoneal dialysis). METHODS: The kinetic studies of 92 CAPD and 18 CCPD patients who transferred to PD Plus were analyzed. All patients underwent CAPD/CCPD and PD Plus for a minimum of 3 months. Standard collection methods were used and kinetic indices calculated with the Pack PD Kinetic Modeling program...

We report a fatal case a fungal peritonitis caused by the yeast-like dematiaceous mould Hormonema dematioides in a 45-year-old woman. The woman had a 13-year history of insulin-dependent diabetes mellitus and had been on continuous ambulatory peritoneal dialysis for chronic renal failure. H. dematioides was repeatedly isolated from the dialysate culture specimens collected on days 3, 9, 16, and 20 of her hospital stay. Preliminary culture reports on day 7 of the growth of a yeast-like fungus, a probable Candida species, prompted the administration of fluconazole (FLU)...

We wished to investigate lactic dehydrogenase (LDH) and its isoenzymes in the dialysate of peritoneal dialysis (PD) patients under noninfected conditions. Twenty-seven continuous ambulatory peritoneal dialysis (CAPD) patients (20 males, 7 females; mean age 53 years; average duration of CAPD 29 months) were studied. Overnight dialysate and blood samples were collected. LDH activities, isoenzymes, glucose, creatinine of both specimens, and cancer antigen 125 (CA125) of the dialysate were determined. Serum and dialysate LDH was 470 +/- 163 and 10 +/- 4 U/L, respectively...

Varying components of the syndrome of human immunodeficiency virus nephropathy (HIVN) have been described, the most pertinent including proteinuria/nephrotic syndrome, progressive azotemia, normal blood pressure, enlarged and hyperechoic kidneys, rapid progression to end-stage renal disease (ESRD), and no response to treatment regimens. The diagnosis of HIVN requires identification of excessive proteinuria or albuminuria, determined by a total protein excretion on a timed urine collection or a high protein/creatinine ratio in a random specimen...

Hemoccult test was performed on stool specimens of 249 patients; 64 with advanced renal failure prior to dialysis (CRF), 144 on maintenance hemodialysis (HD), and 41 receiving chronic ambulatory peritoneal dialysis CAPD. Each patient collected spontaneously evacuated stool specimens on three different days. None of the patients had overt gastrointestinal bleeding prior to participation in the study. The patients were not taking aspirin, or any other ulcerogenic medication, nor receiving iron supplements at the time of study...

Total leukocyte count, microscopy, and conventional bacteriologic culture (10-ml sediment) of dialysis effluent were assessed for their ability to detect peritonitis in patients on peritoneal dialysis. A total of 73 patients were surveyed over a 17-month period. Laboratory findings included an examination of 1,774 dialysate samples and culture results from blood, wounds, indwelling catheters, and other specimens. Of 90 peritonitis events, 72 were culture positive. Gram-stained films were positive in no more than 14% of the dialysates collected during periods of clinical peritonitis...

This paper presents an interim report on the findings of the International Peritoneal Biopsy Registry (IPBR). The registry was set up for the collection and morphological examination of specimens of peritoneal tissue obtained at surgical implantation or removal of the catheter before, during or after treatment with continuous ambulatory peritoneal dialysis (CAPD). The key objective of the Registry is the accumulation of information on the effect of peritoneal dialysis, peritonitis and any other complication of the therapy, on the structural integrity of peritoneal mesothelium, stroma and blood vessels...

We describe a case of fatal overdosage with primidone and methsuximide. During the early phase of the patient's hospital course we found concentrations of methsuximide, N-desmethylmethsuximide, and primidone in serum that far exceeded the usual therapeutic concentrations, as determined by gas-liquid chromatography. Determination of N-desmethylmethsuximide in peritoneal fluid demonstrated concentrations comparable to those in serum. This led to the therapeutic decision to manage the patient by dialysis. Subsequently, serum samples collected during the course of hospitalization were analyzed quantitatively by gas-liquid chromatography for methsuximide, N-desmethylmethsuximide, primidone, phenobarbital, and diphenylhydantoin...

Acetohexamide hypoglycemia in a patient with renal failure has been successfully treated by peritoneal dialysis. Peritoneal dialysis was done in such a patient, and specimens of serum were collected to measure levels of acetohexamide and its main active metabolite, hydroxyhexamide. During dialysis, hypoglycemia was corrected. After 17 1/2 hours of dialysis, serum acetohexamide level was essentially unchanged. Serum hydroxyhexamide level had decreased at a slower rate than the rate of decrease previously measured in a uremic patient not on dialysis...

Severe hypoglycemia in a 67-year-old black male as a result of the ingestion of acetohexamide is described. Because of both his renal status as well as the severity of the hypoglycemia, the patient received peritoneal dialysis. Sequential specimens of serum, urine and dialysate were collected to measure the levels of acetohexamide and its main active metabolite, hydroxyhexamide. The data indicate that these compounds are not dialyzable. In patients with reduced renal function, peritoneal dialysis may be one way to administer large amounts of glucose with very little administration of fluid in the treatment of acetohexamide-induced hypoglycemia...

Twelve chronic peritoneal dialysis patients were studied on 20 occasions to measure peritoneal clearances of creatinine, urea, uric acid, and potassium. Two clearance techniques were employed, the classical type using timed collections and a midpoint blood specimen and an experimental type using calculated dialysate flow and predialysis peritoneal fluid solute concentrations. Comparison of the two techniques demonstrated a close correlation between simultaneously measured clearances and also for repeat measurements in the same patient...