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PD DIALYSIS

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https://www.readbyqxmd.com/read/28102814/successful-induction-of-peritoneal-dialysis-in%C3%A2-a%C3%A2-patient-with-massive-hydrothorax-due-to%C3%A2-pleuroperitoneal-communication%C3%A2
#1
Takahiro Uchida, Yuji Yamada, Toshihiko Imakiire, Naoki Oshima, Hiroo Kumagai
A 74-year-old woman with liver cirrhosis and chronic kidney disease (CKD) who had complained of chronic abdominal distension due to prominent ascites presented with sudden dyspnea. Chest radiography showed massive right pleural effusion that shifted the mediastinum. Peritoneal scintigraphy using 99mTc-macroaggregated albumin revealed pleuroperitoneal communication (PPC). As her hydrothorax was refractory and frequent thoracentesis did not improve her respiratory distress, thoracoscopic surgery was performed for repair of the diaphragm defect...
January 19, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28100993/cdc-group-eo-4-and-candida-tropicalis-peritonitis-in-a-patient-on-peritoneal-dialysis-after-upper-endoscopy-colonoscopy-and-coil-embolization-of-the-gastroduodenal-artery
#2
Shameek Gayen, Yonah Ziemba, Shikha Jaiswal, Adam Frank, Yasmin Brahmbhatt
Peritoneal dialysis (PD) is an excellent form of renal replacement therapy for many patients with end-stage renal disease (ESRD). Over 10,000 patients receive PD in the United States [United States Renal Data System: 2015 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, 2015]. PD has superior outcomes compared to hemodialysis in the first 2 years of ESRD [Sinnakirouchenan and Holley: Adv Chronic Kidney Dis 2011;18: 428-432]. However, peritonitis is a known complication and may result in significant morbidity and necessitate transition to hemodialysis, which increases medical costs [Holley and Piraino: Semin Dial 1990;3: 245-248]...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28098100/impact-of-residual-renal-function-on-clinical-outcome-and-quality-of-life-in-patients-on-peritoneal-dialysis
#3
Manns Manohar John, Amit Gupta, Raj K Sharma, Anupama Kaul
We studied the impact of residual renal function (RRF) on clinical outcome and quality of life in 61 patients on peritoneal dialysis (PD). They were assigned to two groups, at the time of initiation of PD, based on their estimated glomerular filtration rate (eGFR). The high RRF group had eGFR ≥5 mL/min/1.73 m[2] and the low RRF group hade GFR <5 mL/min/1.73 m[2]. All patients were followed up at regular intervals for clinical and biochemical variables. Baselines characteristics including age, sex, body mass index and cause of the kidney disease were similar in both groups...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28096442/kinetic-modeling-of-incremental-ambulatory-peritoneal-dialysis-exchanges
#4
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/28096441/improved-outcome-of-enteric-peritonitis-in-peritoneal-dialysis-patients-aged-50-years-and-older-with-temporary-discontinuation-of-peritoneal-dialysis-and-intravenous-meropenem
#5
Alferso C Abrahams, Wim Rüger, Pieter M Ter Wee, Frans J van Ittersum, Walther H Boer
♦ Background: Peritonitis is a major cause of morbidity, mortality, and technique failure in peritoneal dialysis (PD) patients, especially when caused by enteric microorganisms (EM). We have implemented a treatment protocol specifically aimed at improving the outcome in EM peritonitis. The adapted protocol was applied in all PD patients 50 years and older presenting with peritonitis who were considered to be at risk of EM peritonitis and involves 3 interventions: 1) temporary discontinuation of PD without removing the catheter (peritoneal rest), 2) intravenous meropenem, and 3) meropenem intracatheter as lock (Mero-PerRest protocol)...
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
#6
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/28096439/the-24-month-changes-in-body-fat-mass-and-adipokines-in-patients-starting-peritoneal-dialysis
#7
Soo Jeong Choi, Moo Yong Park, Jin Kuk Kim, Seung Duk Hwang
♦ Background: Peritoneal dialysis (PD) is characterized by a gain in fat mass. The fat tissue is a complex endocrine organ that releases various adipokines. In this study, we prospectively examined serial changes of fat composition and adipokines in patients undergoing PD. ♦ Methods: Body composition was assessed by computed tomography (CT). Nutrition status and adipokines (leptin, adiponectin, interleukin [IL]-6, and tumor necrosis factor [TNF]-α) were assessed on the 7th day and 6 months, 12 months, and 24 months after the start of PD...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28096438/infection-prophylaxis-in-peritoneal-dialysis-patients-results-from-an-australia-new-zealand-survey
#8
Denise J Campbell, David W Mudge, Martin P Gallagher, Wai H Lim, Ranganathan Dwarakanathan, Walaa Saweirs, Jonathan C Craig
♦ Background: Clinical practice guidelines aim to reduce the rates of peritoneal dialysis (PD)-related infections, a common complication of PD in end-stage kidney disease patients. We describe the clinical practices used by Australian and New Zealand nephrologists to prevent PD-related infections in PD patients. ♦ Methods: A survey of PD practices in relation to the use of antibiotic and antifungal prophylaxis in PD patients was conducted of practicing nephrologists identified via the Australia and New Zealand Society of Nephrology (ANZSN) membership in 2013...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28096437/phase-angle-predicts-arterial-stiffness-and-vascular-calcification-in-peritoneal-dialysis-patients
#9
Margarida Sarmento-Dias, Carla Santos-Araújo, Rui Poínhos, Bruno Oliveira, Maria Sousa, Liliana S Silva, Isabel S Silva, Flora Correia, Manuel Pestana
♦ Objectives: Fluid overload (FO) is frequently present in peritoneal dialysis (PD) patients and is associated with markers of malnutrition, inflammation, and atherosclerosis/calcification (MIAC) syndrome. We examined the relationships in stable PD patients between phase angle (PhA) and the spectrum of uremic vasculopathy including vascular calcification and arterial stiffness and between PhA and changes in serum fetuin-A levels. ♦ Methods: Sixty-one stable adult PD patients were evaluated in a cross-sectional study (ST1)...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28090226/more-use-of-peritoneal-dialysis-gives-significant-savings-a-systematic-review-and-health-economic-decision-model
#10
Eva Pike, Vida Hamidi, Tove Ringerike, Torbjorn Wisloff, Marianne Klemp
BACKGROUND: Patients with end-stage renal disease (ESRD) are in need of renal replacement therapy as dialysis and/or transplantation. The prevalence of ESRD and, thus, the need for dialysis are constantly growing. The dialysis modalities are either peritoneal performed at home or hemodialysis (HD) performed in-center (hospital or satellite) or home. We examined effectiveness and cost-effectiveness of HD performed at different locations (hospital, satellite, and home) and peritoneal dialysis (PD) at home in the Norwegian setting...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28088773/epidemiology-and-outcome-of-acute-pancreatitis-in-end-stage-renal-disease-dialysis-patients-a-10-year-national-cohort-study
#11
Hung-Jui Chen, Jhi-Joung Wang, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Chih-Chiang Chien
BACKGROUND: The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. METHODS: We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28086826/offering-patients-therapy-options-in-unplanned-start-options-implementation-of-an-educational-program-is-feasible-and-effective
#12
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul Rashid Qureshi, Bengt Lindholm, Peter Rutherford
BACKGROUND: Patients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. METHODS: This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28078749/total-phosphate-elimination-is-negatively-associated-with-increased-serum-fibroblast-growth-factor-23-levels-in-patients-who-undergo-peritoneal-dialysis
#13
Shunsuke Yamada, Kazuhiko Tsuruya, Masanori Tokumoto, Hisako Yoshida, Narihito Tatsumoto, Hiroaki Ooboshi, Takanari Kitazono
As fibroblast growth factor 23 (FGF23) has been shown to induce cardiovascular disease directly in patients with chronic kidney disease, identification of factors and treatments that can modulate serum FGF23 (sFGF23) level is clinically important. This retrospective longitudinal study investigated factors that modulate sFGF23 in 49 patients who underwent peritoneal dialysis (PD). sFGF23 ratio (sFGF23 at 18 months/baseline sFGF23) was used as an indicator of changes in sFGF23 level. Total phosphate elimination was the sum of both renal phosphate excretion and dialysate phosphate elimination...
January 12, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28077410/health-policies-on-dialysis-modality-selection-a-nationwide-population-cohort-study
#14
Yi-Chun Lin, Yen-Chung Lin, Chih-Chin Kao, Hsi-Hsien Chen, Chih-Cheng Hsu, Mai-Szu Wu
OBJECTIVES: In Taiwan, peritoneal dialysis (PD) and haemodialysis are fully accessible to patients with end-stage renal disease. However, the usage of PD is considered low in Taiwan. Since 2005, 4 major policies have been implemented by Taiwan's Ministry of Health and Welfare, namely a multidisciplinary predialysis care programme and usage increasing the PD incidence as a key performance indicator (KPI) for hospital accreditation, both of which were implemented in 2006; reimbursement of the glucose-free dialysate, icodextrin that was implemented in 2007; and insurance reimbursement for renting automated PD machines that was implemented in 2008...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28069285/dialysis-modality-and-readmission-following-hospital-discharge-a-population-based-cohort-study
#15
Jeffrey Perl, Eric McArthur, Chaim Bell, Amit X Garg, Joanne M Bargman, Christopher T Chan, Shai Harel, Lihua Li, Arsh K Jain, Danielle M Nash, Ziv Harel
BACKGROUND: Readmissions following hospital discharge among maintenance dialysis patients are common, potentially modifiable, and costly. Compared with patients receiving in-center hemodialysis (HD), patients receiving peritoneal dialysis (PD) have fewer routine dialysis clinic encounters and as a result may be more susceptible to a hospital readmission following discharge. STUDY DESIGN: Population-based retrospective-cohort observational study. SETTINGS & PARTICIPANTS: Patients treated with maintenance dialysis who were discharged following an acute-care hospitalization during January 1, 2003, to December 31, 2013, across 164 acute-care hospitals in Ontario, Canada...
January 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28066919/innovations-in-treatment-delivery-risk-of-peritonitis-and-patient-retention-on-peritoneal-dialysis
#16
Beth Piraino
Early innovations in the delivery of peritoneal dialysis (PD) markedly improved its acceptability and lowered peritonitis rates. The standard osmotic agent was, and continues to be dextrose, an agent that is not ideal as it is readily absorbed. The development of icodextrin-containing dialysis fluid has allowed a long dwell time to provide more effective ultrafiltration. The development of a smaller, more easily used automated cycler, led to an increase in the proportion of patients on the cycler as opposed to CAPD...
January 8, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28064452/in-vitro-data-support-the-investigation-of-vinegar-as-an-antimicrobial-agent-for-pd-associated-pseudomonas-exit-site-infections
#17
Christine F Carson, Oliver Ash, Aron Chakera
Peritoneal dialysis exit site infections caused by Pseudomonas spp. are difficult to treat and can lead to peritonitis and/or modality failure. Effective alternative or adjunct non-antibiotic antimicrobial agents could improve treatment as well as reduce the use of antibiotics and contribute to a reduction in antibiotic selection pressure and the further development of antibiotic resistance. Vinegar is popularly promoted as a topical antimicrobial agent and has been recommended as an adjunct treatment for Pseudomonas exit site infections in PD patients...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28064160/specific-heparanase-inhibition-reverses-glucose-induced-mesothelial-to-mesenchymal-transition
#18
Valentina Masola, Simona Granata, Gloria Bellin, Giovanni Gambaro, Maurizio Onisto, Carlo Rugiu, Antonio Lupo, Gianluigi Zaza
BACKGROUND: Epithelial-to-mesenchymal transition (EMT) of peritoneal mesothelial cells induced by high glucose (HG) levels is a major biological mechanism leading to myofibroblast accumulation in the omentum of patients on peritoneal dialysis (PD). Heparanase (HPSE), an endoglycosidase that cleaves heparan sulfate chains, is involved in the EMT of several cell lines, and may have a major role in this pro-fibrotic process potentially responsible for the failure of dialysis. Its specific inhibition may therefore plausibly minimize this pathological condition...
January 7, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28062748/risk-of-empyema-in-patients-with-end-stage-renal-disease-a-nationwide-propensity-matched-cohort-study
#19
REVIEW
Te-Chun Shen, Chia-Hung Chen, I-Kuan Wang, Cheng-Li Lin, Chih-Yen Tu, Te-Chun Hsia, Chuen-Ming Shih, Wu-Huei Hsu, Fung-Chang Sung, Chih-Yen Tu, Fung-Chang Sung Contributed Equally
BACKGROUND: Empyema is a rare but important complication among patients with end-stage renal disease (ESRD). However, a nationwide, propensity-matched cohort study has never been performed. METHODS: We conducted a retrospective cohort study using data from the National Health Insurance Research Database of Taiwan. The ESRD group consisted of 82,765 patients diagnosed between 2000 and 2008. The comparison group consisted of individuals without kidney disease selected at a 1:1 ratio matched by propensity score estimated with age, gender, year of diagnosis, and comorbidities...
January 5, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28058668/impact-of-gender-and-dialysis-adequacy-on-anaemia-in-peritoneal-dialysis
#20
Alicja Ryta, Michal Chmielewski, Alicja Debska-Slizien, Piotr Jagodzinski, Malgorzata Sikorska-Wisniewska, Monika Lichodziejewska-Niemierko
PURPOSE: In the general population, haemoglobin (Hb) concentration is higher in men than in women. However, target Hb levels in dialysis patients are set constant regardless of the patient's sex. The aim of this study was to evaluate Hb concentration and the use of erythropoiesis-stimulating agents (ESA) in peritoneal dialysis (PD) patients taking gender and dialysis adequacy into account. METHODS: The study comprised two parts. The first was a cross-sectional analysis of Hb and ESA in 2180 prevalent PD patients...
January 5, 2017: International Urology and Nephrology
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