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hypotension peritoneal dialysis

Yanchen Zhang, Kristin M Corapi, Maria Luongo, Ravi Thadhani, Sagar U Nigwekar
BACKGROUND: Calciphylaxis is a rare but devastating condition in end-stage renal disease (ESRD) patients. Most research in the field of calciphylaxis is focused on hemodialysis (HD) patients; however, data on calciphylaxis incidence, risk factors, and mortality in peritoneal dialysis (PD) patients are limited. METHODS: In this cohort study, we examined data from adult patients who initiated PD for ESRD management at our institute's PD unit from January 2001 to December 2015...
2016: International Journal of Nephrology and Renovascular Disease
Malcolm G Coulthard
Most babies with chronic renal failure are identified antenatally, and over half that are treated with peritoneal dialysis receive kidney transplants before school age. Most infants that develop acute renal failure have hypotension following cardiac surgery, or multiple organ failure. Sometimes the falls in glomerular filtration and urine output are physiological and reversible, and sometimes due to kidney injury, but (illogically) it is now common to define them all as having 'acute kidney injury'. Contrary to widespread opinion, careful interpretation of the plasma creatinine concentrations can provide sensitive evidence of early acute renal failure...
September 25, 2016: Early Human Development
D Y Mah, H J Yia, W S Cheong
Dialysis disequilibrium syndrome (DDS) is a neurological disorder with varying severity that is postulated to be associated with cerebral oedema. We described a case of DDS resulting in irreversible brain injury and death following acute haemodialysis. A 13-year-old male with no past medical history and weighing 30kg, presented to hospital with severe urosepsis complicated by acute kidney injury (Creatinine 1422mmol/L; Urea 74.2mmol/L, Potassium 6.3mmol/L, Sodium 137mmol/L) and severe metabolic acidosis (pH 6...
April 2016: Medical Journal of Malaysia
Kevin Quach, Lyubov Lvtvyn, Colin Baigent, Joe Bueti, Amit X Garg, Carmel Hawley, Richard Haynes, Braden Manns, Vlado Perkovic, Christian G Rabbat, Ron Wald, Michael Walsh
BACKGROUND: Patients who require dialysis are at high risk for cardiovascular mortality, which may be improved by mineralocorticoid receptor antagonists (MRAs). STUDY DESIGN: Systematic review and meta-analysis of randomized controlled trials. SETTING & POPULATION: Adults undergoing long-term hemodialysis or peritoneal dialysis with or without heart failure. SELECTION CRITERIA FOR STUDIES: Randomized controlled trials evaluating an MRA in dialysis and reported at least one outcome of interest...
October 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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
Ryan Deweese, Jennifer Slavens, Antara Barua, James Sutton
PURPOSE: A case of eosinophilic peritonitis (EP) with severe cardiovascular compromise in a patient receiving intraperitoneal vancomycin therapy is described. SUMMARY: A woman with a medical history including hypertension, end-stage renal disease, and anemia of chronic disease was hospitalized for complaints of severe abdominal pain and loss of appetite over the preceding four days; she had been undergoing peritoneal dialysis for about one year. Bacterial infection was diagnosed on the basis of peripheral blood and peritoneal fluid analyses showing highly elevated neutrophil and total nucleated cell (TNC) counts...
May 1, 2016: American Journal of Health-system Pharmacy: AJHP
Emilie Trinh, Joanne M Bargman
While oral diuretics are commonly used in patients with chronic kidney disease for the management of volume and blood pressure, they are often discontinued upon initiation of dialysis. We suggest that diuretics are considerably underutilized in peritoneal dialysis and haemodialysis patients despite numerous potential benefits and few side effects. Moreover, when diuretics are used, optimal doses are not always prescribed. In peritoneal dialysis, the use of diuretics can improve volume status and minimize the need for higher glucose-containing solutions...
September 2016: Seminars in Dialysis
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
Kenneth Abreo, Adrian Sequeira
Interventional nephrologists and radiologists place peritoneal dialysis catheters using the percutaneous fluoroscopic technique in both the inpatient and outpatient setting. Nephrologists caring for such patients may have to diagnose and manage the complications resulting from these procedures. Abdominal pain can occur following peritoneal dialysis catheter placement when the local and systemic analgesia wears off. However, abdominal pain with hypotension is suggestive of a serious complication. Bleeding into the abdomen and perforation of the colon or bladder should be considered in the differential diagnosis...
August 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Janine Farragher, Tasleem Rajan, Ernest Chiu, Ozkan Ulutas, George Tomlinson, Wendy L Cook, Sarbjit V Jassal
UNLABELLED:BACKGROUND: Accidental falls are common in the hemodialysis (HD) population. The high fall rate has been attributed to a combination of aging, kidney disease-related morbidity, and HD treatment-related hazards. We hypothesized that patients maintained on peritoneal dialysis (PD) would have fewer falls than those on chronic HD. The objective of this study was to compare the falls risk between cohorts of elderly patients maintained on HD and PD, using prospective data from a large academic dialysis facility...
January 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Felipe Cavagnaro Santa María, Jorge Roque Espinosa, Pamela Guerra Hernández, Marta Smith Torres, Isabel González Largo, Ricardo Ronco Macchiavello
: The indications of continuous renal replacement therapy (CRRT) in children have widened in recent years. The implications of these therapies in the newborn (NB) is complicated and uncommon, and its use has not been described in our country. OBJECTIVE: To report on a series of NB treated with CRRT in the context of septic shock, and to discuss the types of renal replacement techniques used, the indications, vascular access, and the complications of the procedure...
October 9, 2015: Revista Chilena de Pediatría
Elizabeth Wright, Michel Fischbach, Ariane Zaloszyc, Fabio Paglialonga, Christoph Aufricht, Stephanie Dufek, Sevcan Bakkaloğlu, Günter Klaus, Aleksandra Zurowska, Mesiha Ekim, Gema Ariceta, Tuula Holtta, Augustina Jankauskiene, Claus Peter Schmitt, Constantinos J Stefanidis, Johan Vande Walle, Karel Vondrak, Alberto Edefonti, Rukshana Shroff
BACKGROUND: Hemodialysis (HD) in children with a concomitant ventriculoperitoneal shunt (VPS) is rare. Registry data suggest that peritoneal dialysis with a VPS is safe, but little is known about HD in the presence of a VPS. METHODS: We performed a 10-year survey to determine the prevalence of a VPS, complications and outcome in children with a VPS on HD in 15 dialysis units from the 13 countries participating in the European Pediatric Dialysis Working Group. RESULTS: Eleven cases of HD with a VPS were reported (prevalence 1...
January 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
E Çankaya, Y Bilen, M Keles, A Uyanik, N Bilen, B Aydınlı
AIM: Cardiovascular diseases and infections are the leading two causes of morbidity and mortality in end-stage renal disease (ESRD) patients. Kidney transplantation is the preferred method for renal replacement owing to better survival. There are reports of irreversibly damaged immune system in dialysis patients, which did not return to normal even after kidney transplantation. The neutrophil-lymphocyte ratio (NLR) is an easily applicable method for evaluation of inflammation. We hypothesized that preemptive kidney transplantation can improve inflammatory state compared with nonpreemptive recipients...
June 2015: Transplantation Proceedings
Jonathan Wong, Enric Vilar, Andrew Davenport, Ken Farrington
Thrice-weekly haemodialysis schedules have become the standard default haemodialysis prescription worldwide. Whereas the measurement of residual renal function is accepted practice for peritoneal dialysis patients and the importance of residual renal function in determining technique success is well established, few centres routinely assess residual renal function in haemodialysis patients. Although intradialytic hypotension and episodes of acute kidney injury may predispose to an earlier loss of residual renal function, a significant proportion of haemodialysis patients maintain some residual function long after dialysis initiation...
October 2015: Nephrology, Dialysis, Transplantation
Daniela Falconi, Fabio Tattoli, Carlo Brunetti, Ornella De Prisco, Maurizio Gherzi, Federico Marazzi, Marita Marengo, Ilaria Serra, Michela Tamagnone, Marco Formica
Gabapentin (GBP) is a drug with different indications.Is not metabolized and is excreted by the kidney. The common side effects are: arthralgia, myalgia, fatigue, dizziness and ataxia. Rhabdomyolysis is an extremely rare side effect. This latter, that can be caused by trauma, strenuous exercise, infections, drugs and toxins, is a syndrome characterized by loss of skeletal muscle resulting in the release of myocyte components in the circulation. Following a case of rhabdomyolysis caused by GBP in patient with chronic renal failure (CRF)...
March 2015: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Giacomo Di Zazzo, Isabella Guzzo, Lara De Galasso, Michele Fortunato, Giovanna Leozappa, Licia Peruzzi, Enrico Vidal, Ciro Corrado, Enrico Verrina, Stefano Picca, Francesco Emma
BACKGROUND: Anterior ischemic optic neuropathy (AION) is characterized by infarction of the optic nerve head due to hypoperfusion of the posterior ciliary arteries and causes sudden blindness in adults on chronic dialysis, but has rarely been described in children. Unlike adults, children do not have comorbidities related to aging. METHODS: We retrospectively analyzed data of 7 children on nocturnal continuous cycling peritoneal dialysis (CCPD) who developed AION identified within the Italian Registry of Pediatric Chronic Dialysis...
March 2015: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Macaulay A C Onuigbo
In recent years, icodextrin 7.5% has been used in PD as an alternative to glucose to achieve sustained reliable ultrafiltration (UF) and clearance without adversely increasing glucose absorption. Icodextrin is generally well tolerated. The most commonly reported adverse events are cutaneous reactions. We report a rare form of hypersensitivity to icodextrin 7.5% that was accompanied by dyspnea and symptomatic hypotension, without increased UF to account for the observed hypotension. Icodextrin produces symptomatic hypotension in up to 40% of patients by a known mechanism of increased UF and corresponding weight loss...
2014: Advances in Peritoneal Dialysis
Vincent Forster, Rea Deborah Signorell, Maurizio Roveri, Jean-Christophe Leroux
Peritoneal dialysis confers therapeutic advantages in patients with renal insufficiency and has proven beneficial in other indications, such as removal of excess metabolites or overdosed drugs. However, it is used in only about 10% of the dialyzed population worldwide, partly owing to the lower clearance rate compared with hemodialysis. We have developed a dialysis medium based on liposomes with a transmembrane pH gradient (basic or acidic aqueous core) that could improve the efficacy of peritoneal dialysis, specifically for the removal of excess metabolites or overdosed drugs...
October 15, 2014: Science Translational Medicine
Samuel A Silver, Ziv Harel, Jeffrey Perl
BACKGROUND: Icodextrin is a peritoneal dialysis solution that is commonly used to increase ultrafiltration during the long dwell. The other major clinical benefit of icodextrin is that it is glucose-sparing, which may help preserve peritoneal membrane function. Since it has a different chemical composition than dextrose, and with its increasing use, there are several clinical considerations healthcare providers must familiarize themselves with prior to prescribing icodextrin. SUMMARY: Failure to recognize these special properties of icodextrin can lead to adverse events reaching patients...
2014: American Journal of Nephrology
Rebekah Beyers, Michael Baldwin, Sevilay Dalabih, Abdallah Dalabih
Clostridium sordellii is a toxin producing ubiquitous gram-positive anaerobe, mainly associated with trauma, soft tissue skin infections, and gynecologic infection. We report a unique case of a new strain of Clostridium sordellii (not present in the Center for Disease Control (CDC) database) infection induced toxic shock syndrome in a previously healthy two-year-old male with colitis-related hemolytic uremic syndrome (HUS). The patient presented with dehydration, vomiting, and bloody diarrhea. He was transferred to the pediatric critical care unit (PICU) for initiation of peritoneal dialysis (PD)...
2014: Case Reports in Pediatrics
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