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Tuo Pan, Dan Li, Shoujun Li, Jun Yan, Xu Wang
OBJECTIVES: Postoperative fluid overload is common in children after cardiac surgery, especially for those with right ventricular outflow tract obstruction, which is associated with poor outcomes. This study was conducted to investigate whether early peritoneal dialysis (PD) was associated with improved outcomes in these children at high risk of fluid overload. METHODS: Between January 2010 and January 2015, a total of 2555 consecutive patients with right ventricular outflow tract obstruction underwent anatomical repair...
March 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Ying Ma, Ying Wang, Hai-Yun Wang, Yang Li, Zi-Juan Zhou, Bing-Yan Liu, Xue-Mei Li, Li-Meng Chen
Objective To investigate the risk factors predicting the short-term outcomes of patients with peritoneal dialysis(PD)-associated peritonitis (PDAP). Methods In this retrospective cohort study,the clinical data at baseline and 0-3 months before peritonitis onset (peritonitis-free period) were collected from end-stage renal disease patients who started PD and suffered from PDAP between January 1,2004 and March 31,2017 in Peking Union Medical College Hospital. After 4 weeks of follow-up,these patients were divided into two groups according to the clinical outcomes,namely poor outcome group and good outcome group...
February 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
John J Sim, Hui Zhou, Jiaxiao Shi, Sally F Shaw, Shayna L Henry, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Steven J Jacobsen
PURPOSE: The early period after chronic kidney disease (CKD) patients transition to end-stage renal disease (ESRD) represents the highest mortality risk but is variable among different patient populations and clinical circumstances. We compared early mortality outcomes among a diverse CKD population that transitioned to ESRD. METHODS: A retrospective cohort study (1/1/2002 through 12/31/2013) of CKD patients (age ≥ 18 years) who transitioned to peritoneal dialysis (PD), hemodialysis (HD) with arteriovenous fistula/grafts, and HD with catheters was performed...
March 12, 2018: International Urology and Nephrology
R Jhorawat, N Bansal, P Beniwal, D Agarwal, V Malhotra
The aim of this study was to measure insulin resistance (IR) in dialysis patients and its relation to Vitamin D status and nutritional parameters. We included patients on maintenance dialysis, both hemodialysis and peritoneal dialysis (HD and PD). IR was measured by homeostatic model assessment (HOMA)-IR index defined as fasting serum insulin (μU/L) × fasting blood sugar (mmol/L)/22.5. Baseline Vitamin D levels were measured by chemiluminescence immunoassay (CLIA) method. HOMA-IR index correlated with nutritional parameters such as 7-point subjective global assessment (SGA) and anthropometric measures, for example, body fat percentage, lean body weight (LBW), mid-arm circumference (MAC), and mid-arm muscle circumference (MAMC)...
January 2018: Indian Journal of Nephrology
Kamyar Kalantar-Zadeh, Vidhya Parameswaran, Linda H Ficociello, Ludmila Anderson, Norma J Ofsthun, Christopher Kwoh, Claudy Mullon, Robert J Kossmann, Daniel W Coyne
BACKGROUND: A database analysis was conducted to assess the effectiveness of sucroferric oxyhydroxide (SO) on lowering serum phosphorus and phosphate binder (PB) pill burden among adult peritoneal dialysis (PD) patients prescribed SO as part of routine care. METHODS: Adult PD patients (n = 258) prescribed SO through a renal pharmacy service were analyzed. Baseline was 3 months before SO prescription. SO-treated follow-up was for 6 months or until either a new PB was prescribed, SO was not refilled, PD modality changed, or patient was discharged...
March 7, 2018: American Journal of Nephrology
Jiefei Yao, Luke Witherspoon, Brendan B McCormick, Eric Belanger, Jeffrey E Warren
Delayed visceral organ perforations after PD catheter insertions are extremely rare. We report two patients who presented with asymptomatic visceral perforation from their buried PD catheters. Five months after a laparoscopic buried PD catheter insertion in a 92-year-old man PD was initiated; bile and bowel contents were noted in the PD effluent. He subsequently expired (from pneumonia) to autopsy revealed the PD catheter within the small bowel. Despite this perforation, there was no evidence of peritonitis, inflammation, nor any bowel content within the peritoneal cavity...
March 7, 2018: Seminars in Dialysis
Bülent Erdoğan, Barış Eser, Özlem Yayar, Mehmet Deniz Aylı
OBJECTIVE: Recently, the role of hepcidin as a cardiovascular marker in the chronic kidney disease (CKD) population has gained interest. The aim of this study was to investigate the relationship between serum hepcidin-25, inflammation, iron parameters, and carotid intima-media thickness (CIMT) in peritoneal dialysis (PD) patients. METHODS: A total of 58 patients (30 male, 51.3%; mean age: 46.8±13.6 years; mean dialysis duration: 69.2±39.1 months) were included in this cross-sectional study...
March 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Yen-Chung Lin, Yi-Chun Lin, Chiung-Chi Peng, Kuan-Chou Chen, Hsi-Hsien Chen, Te-Chao Fang, Shian-Ying Sung, Mai-Szu Wu
The effect of dyslipidemia on peritoneal dialysis (PD) patients based on the presence of residual renal function (RRF; renal creatinine clearance >2 mL/min/1.73 m²) is unknown. Data from the Taiwan Renal Registry Data System between 2005 and 2012 were analyzed to estimate the association between dyslipidemia and mortality in PD patients. Long-term PD patients ( n = 8032) were divided into groups with (RRF; n = 2691, 33.5%) and without RRF (non-RRF; n = 5341, 66.5%). The primary outcome was three-year mortality, and multivariate Cox regression was used for survival analysis...
March 3, 2018: Nutrients
Pan Fang, Jia Lu, Ying-Hong Liu, Hong-Mei Deng, Lei Zhang, Hong-Qing Zhang
BACKGROUND: Peritonitis, which is one of the leading complications of peritoneal dialysis (PD) worldwide, severely affected morbidity and mortality of the PD patients. Although many efforts have been made to prevent PD-related peritonitis, it seems impossible to prevent it completely. Many causes have been reported to lead to peritonitis, and contamination during bag exchange is one of the important risk factors for peritonitis. METHODS: Here, we introduce an operating vehicle, which we invented to provide a sterile and safe space for bag exchange...
March 5, 2018: International Urology and Nephrology
Jenny H C Chen, David W Johnson, Carmel Hawley, Neil Boudville, Wai H Lim
Technique failure is a frequent complication of peritoneal dialysis (PD), but the association between causes of death-censored technique failure and mortality remains unclear. Using Australian and New Zealand Dialysis and Transplant (ANZDATA) registry data, we examined the associations between technique failure causes and mortality in all incident PD patients who experienced technique failure between 1989-2014. Of 4663 patients, 2415 experienced technique failure attributed to infection, 883 to inadequate dialysis, 836 to mechanical failure and 529 to social reasons...
March 5, 2018: Scientific Reports
I-Kuan Wang, Cheng-Li Lin, Tzung-Hai Yen, Shih-Yi Lin, Liu Yao-Lung, Fung-Chang Sung
PURPOSE: Icodextrin can enhance ultrafiltration and consequently improve fluid balance and can control blood pressure and reduce left ventricular mass for peritoneal dialysis (PD) patients. This study investigated whether icodextrin use could reduce the risk of congestive heart failure (CHF) for PD patients. METHODS: From the Taiwan National Health Insurance database, we identified 5462 newly diagnosed end-stage renal disease patients undergoing PD from 2005 to 2010...
February 28, 2018: Pharmacoepidemiology and Drug Safety
Sarah J Swartz, Alicia Neu, Amy Skversky Mason, Troy Richardson, Jonathan Rodean, John Lawlor, Bradley Warady, Michael J G Somers
BACKGROUND: The Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) Collaborative is a quality improvement initiative to reduce dialysis-associated infections. The frequency of peritoneal dialysis (PD) catheter exit site infection (ESI) and variables influencing its development and end result are unclear. We sought to determine ESI rates, to elucidate the epidemiology, risk factors, and outcomes for ESI, and to assess for association between provider compliance with care bundles and ESI risk...
February 26, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Yener Koc, Taner Basturk, Tamer Sakaci, Feyza B Caglayan, Nuri B Hasbal, Elbis Ahbap, Mustafa Sevinc, Ayse Sinangil, Zuhal A Ucan, Perin Nazif, Mahmut Islam, Abdulkadir Unsal
BACKGROUND: Encapsulated peritoneal sclerosis (EPS) is a multifactorial chronic intra- abdominal inflammatory disorder affecting the peritoneum diffusely. The aim of this study was to evaluate the rates of EPS in our peritoneal dialysis (PD) population, to perform a general assessment of the clinical presentation and to determine the outcome of affected patients and risk factors. METHODS: The medical records of consecutive 384 patients who started PD therapy between January 2001 and November 2016 were evaluated...
February 22, 2018: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Joanne M Bargman, Michael Girsberger
BACKGROUND: Peritoneal dialysis (PD) is one of the corner stones of renal replacement therapy and should be strongly considered if preemptive kidney transplantation is not available. SUMMARY: There are several initiatives that may help the growth in the use of PD around the world. First, PD is an underused and valuable option in patients with heart failure and the chronic cardiorenal syndrome, especially in those with frequent hospitalizations despite optimal medical therapy...
January 26, 2018: Blood Purification
Titi Chen, Hicham C Hassan, Pierre Qian, Monica Vu, Angela Makris
BACKGROUND: Dialysis patients have an exceedingly high mortality rate. Biomarkers may be useful tools in risk stratification of this population. We evaluated the prognostic value of high-sensitivity cardiac troponin T (hs-cTnT) and CRP (C-reactive protein) in predicting adverse outcomes in stable hemodialysis and peritoneal dialysis (PD) patients. Variability in hs-cTnT was also examined. METHODS AND RESULTS: A retrospective cohort study included 574 dialysis patients (hemodialysis 347, PD 227)...
February 24, 2018: Journal of the American Heart Association
Masanao Iwamoto, Alice Okazaki, Sayaka Murata, Masaki Hirukawa, Keiichi Miyamoto, Tomohiro Murata, Eiji Ishikawa, Toshimichi Yoshida, Takashi Horiuchi
In vitro biocompatibility assessments that consider physiologically appropriate conditions of cell exposure to peritoneal dialysis fluids (PDFs) are still awaited. In this study, we found that fragmentation of Golgi apparatus occurred in a pH-dependent manner within 30-min exposure to five distinct commercially available PDFs, which showed no marked difference in their effects on cell viability in the conventional MTT assay. Fluorescence microscopy analysis of labeling antibody against cis-Golgi protein GM130 indicated that the stacked cisternal structure was maintained in the perinuclear area of both M199 culture medium and a neutral-pH PDF groups...
February 23, 2018: Artificial Organs
Jwa-Kyung Kim, Young Rim Song, Hyung Seok Lee, Hyung Jik Kim, Sung Gyun Kim
BACKGROUND: Fluid overload is a major risk factor for mortality in patients undergoing peritoneal dialysis (PD). However, few studies have investigated the effect of chronic exposure to sustained fluid overload on long-term outcomes. METHOD: A total of 284 prevalent PD patients were included in this prospective study. Repeated multifrequency body composition analysis was performed 12 months apart, and 1-year cumulative chronic fluid overload were used to predict all-cause mortality and the risk for transfer to hemodialysis (HD) during the ensuing 15...
February 22, 2018: American Journal of Nephrology
J Zuvela, C Trimingham, R Le Leu, R Faull, P Clayton, S Jesudason, A Meade
AIM: To describe the prevalence of all Gastrointestinal (GI) symptoms reported by dialysis patients, as well as the tools being used for diagnosis. BACKGROUND: GI symptoms are commonly reported in patients having haemodialysis (HD) and peritoneal dialysis (PD), but there are multiple definitions and assessment tools reported in the literature. METHODS: A comprehensive systematic review was undertaken using five databases (Embase, Medline, CINAHL, Psycinfo and Web of Science) between 1996 and 2017...
February 22, 2018: Nephrology
Dahai Yu, Yamei Cai, Rui Qin, Xing Tian, Jing Xiao, Zhanzheng Zhao
BACKGROUND/AIMS: During peritoneal equilibrium test (PET), intermediate measures of Dt/P (dialysate/plasma creatinine ratio), D0/P, D2/P and D4/P ratios might provide additional information regarding a patient's cardiovascular mortality. We aimed to characterise heterogeneity of dialysate creatinine response patterns based on three ratios and compare cardiovascular mortality risks by response patterns. METHODS: 3,477 patients initialising peritoneal dialysis (PD) between 2007-2015 were measured D0/P, D2/P and D4/P at baseline and 2-year cardiovascular mortality was defined as the primary outcome...
February 16, 2018: Kidney & Blood Pressure Research
Joseph Meletiadis, Maria Siopi, Athanassios Tsakris, Johan W Mouton, Spyros Pournaras
The lack of a quantifiable marker for echinocandins activity hinders in vitro PK/PD studies for Aspergillus spp. We developed an in vitro PK/PD model simulating anidulafungin pharmacokinetics and assessing its pharmacodynamics against A. fumigatus with a new easily quantifiable, sensitive and reproducible marker. Two clinical A. fumigatus isolates previously used in animals (AZN8196,V52-35) with identical anidulafungin EUCAST (0.03 μg/ml) and CLSI (0.015 μg/ml) MEC and one (AFU79728) with MEC>16 μg/ml were tested in a two-compartment PK/PD dialysis/diffusion closed model containing a dialysis membrane tube (DM) inoculated with 103 cfu/mL...
February 20, 2018: Antimicrobial Agents and Chemotherapy
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