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Changes in Peritoneal Transport and Peritoneal Damage in Japanese Patients Undergoing Peritoneal Dialysis Using Neutral-pH Dialysate: A Retrospective Cohort Study at Two Centers.
Authors: Oishi D, Sakurada T, Koitabashi K, Kojima S, Kaneshiro N, Shibagaki Y Abstract The effects of medium- or long-term use of neutral-pH dialysate on peritoneal transport and peritoneal damage have not been sufficiently researched.We retrospectively evaluated time-dependent changes in the dialysate-to-plasma ratio of creatinine (D/P Cr) and biomarkers of peritoneal damage in the effluent of 65 patients who underwent peritoneal dialysis (PD) with neutral-pH dialysate, including 48 who underwent medium-term PD (≥3 years) and 17 who underwent long-term PD (≥5 years).Patients who underwent medium-term...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Maintaining Peritoneal Dialysis Adequacy: The Process of Incremental Prescription.
Authors: Lew SQ Abstract Urea kinetics (weekly Kt/V) greater than 1.7 generally define adequate peritoneal dialysis (PD). Adequacy of PD depends on residual renal function and PD clearance. Preserving residual renal function and peritoneal membrane characteristics helps to maintain PD adequacy.The dose of PD can be augmented by increasing the total dialysate volume. Greater volume can be achieved by increasing either the fill volume per exchange or the number of exchanges. Increased time on dialysis can be achieved by keeping PD fluid in the peritoneal cavity at all times. Increasing the convective force e...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Comparison of Various Scaling Parameters and Energy Expenditure in Peritoneal Dialysis Patients.
Authors: Davenport A Abstract Peritoneal dialysis (PD) dosing is determined by urea clearance scaled to total body water (TBW). However, studies delivering greater peritoneal Kt/V urea have failed to demonstrate improved survival. Body surface area (BSA) has been suggested as an alternative scaling factor. Cellular metabolism generates toxins, and thus total energy expenditure (TEE) might be a preferable scaling factor. Because TEE is cumbersome to determine, we set out to determine the association of anthropomorphic scaling factors with TEE.The TEE was determined using the Recent Physical Activity Questio...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Prevention of Peritoneal Dialysis Drop-Out.
Authors: Ambruso SL, Teitelbaum I Abstract Compared with hemodialysis (HD), peritoneal dialysis (PD) is associated with reduced cost and improved quality of life. But despite those benefits, PD represents a small percentage of the renal replacement therapy performed. Although a number of factors contribute to that situation, peritoneal drop-out is a complex issue that leads to as much as a 35% annual transition from PD to in-center HD. The reasons for drop-out are multifaceted and include contributions from the patient or caregiver, health care regulatory systems, and factors intrinsic to the PD modality. ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Accuracy of a Newly-Introduced Oscillometric Device for the Estimation of Arterial Stiffness Indices in Patients on Peritoneal Dialysis: A Preliminary Validation Study.
Authors: Vaios V, Georgianos PI, Pikilidou MI, Eleftheriadis T, Zarogiannis S, Papagianni A, Zebekakis PE, Liakopoulos V Abstract The aim of the present study was to compare the aortic systolic blood pressure (aSBP), heart-rate-adjusted augmentation index (AIx75), and pulse wave velocity (PWV) obtained using the Mobil-O-Graph (IEM, Stolberg, Germany) and SphygmoCor (AtCor, Sydney, Australia) devices in patients receiving peritoneal dialysis (PD).After a 10-minute rest in the supine position, the Mobil-O-Graph and SphygmoCor devices were applied in randomized order in 27 consecutive PD patients. The agreeme...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Telehealth in Peritoneal Dialysis: Review of Patient Management.
Authors: Lew SQ Abstract Telehealth encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services. Telemedicine is the use of electronic communications for the exchange of medical information from one site to another to improve a patient's clinical health status.Several studies show that, by providing better patient oversight and communication, telehealth in PD enhances patient care, outcomes, quality of care, and satisfaction. Associated benefits include increased patient retention to home dialysis, reduced use of hospital services, and reduced costs of...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Experience Managing Adult Patients on Continuous Ambulatory Peritoneal Dialysis in Bangladesh.
Authors: Iqbal S, Iqbal MM, Chowdhury TA, Rahim MA, Bhuiyan ASMMM, Ananna MA, Chowdhury MAA, Hossain RM, Islam N, Islam MN Abstract Continuous ambulatory peritoneal dialysis (CAPD) is becoming increasingly known to the patients of Bangladesh, and patient numbers are increasing. Here, we report our experience and clinical outcomes in this field.Our analysis included all CAPD patients managed in a tertiary care hospital in Bangladesh between 2003 and 2015. All patients received a Tenckhoff double-cuff catheter by mini-laparotomy, and twin bags were used in most patients. In acute cases, regular exchanges wer...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

A Case in Which Renal Function and Peritoneal Function Were Maintained for Ten Years by Proactive Combination Therapy with Peritoneal Dialysis and Hemodialysis.
Authors: Ueda A, Nagai K, Saito C, Yamagata K Abstract To avoid loss of residual renal function (RRF) and to enhance solute clearance, we sometimes, from the initiation of peritoneal dialysis (PD) therapy, combine PD with hemodialysis (HD) that removes little or no fluid. In one typical valuable case, a 51-year-old woman with diabetic nephropathy who selected combined PD and HD therapy as her first dialysis method has continued on that therapy for 10 years. Her dialysis schedule consists of 5 PD days and 1 HD day without fluid removal weekly. Because this combination therapy was proactively started at dial...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Neisseria mucosa Peritonitis in the Setting of a Migrated Intrauterine Device.
We present an uncommon case of N. mucosa peritonitis in a 30-year-old African American female patient treated with nocturnal intermittent PD. The infection occurred in the setting of a translocated intrauterine contraceptive device (IUCD) in the infrahepatic region because of transmural migration. Our patient underwent laparoscopic removal of the IUCD and received empiric intraperitoneal (IP) vancomycin and intravenous ceftriaxone. After the isolate was identified as N. mucosa, her regimen was changed to IP ceftriaxone for a total of 21 days. Cell count after completion of antibiotics showed resolution of the peritonitis. ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

When Love Hurts, It Leaves No Options! An Unusual Case of Pasteurella Peritoneal Dialysis Peritonitis Causing Severe Intra-abdominal Adhesions Preventing a Future Peritoneal Dialysis Option.
Authors: Dumor K, Malhotra K Abstract A 67-year-old white man with a history of end-stage renal disease receiving peritoneal dialysis (PD) presented with acute onset of vomiting, chills, and abdominal pain. He was diagnosed with PD-associated peritonitis secondary to Pasteurella. After failure of 3 weeks of antibiotic treatment, catheter loss occurred. On follow-up, the patient was found to have extensive intra-abdominal adhesions precluding placement of a new PD catheter. PMID: 30480538 [PubMed - in process] (Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis)
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Better Healing of the Exit Site with Negative-Pressure Wound Therapy.
Authors: Mori T, Sato S, Oba-Yabana I, Hirose T, Kinugasa S, Muroya Y, Ota K, Nakayama S, Nakamura H, Tani J, Takahashi C, Ito S Abstract Exit-site infection poses a risk for peritonitis and can shorten peritoneal dialysis (PD) vintage. A loose fit of the skin around the catheter at the exit site can push bacteria surrounding the catheter into the subcutaneous tunnel. Negative-pressure wound therapy (NPWT) has been used to hasten healing of the wound after an operation or to treat pressure ulcers. We hypothesized that NPWT could speed the healing of the exit site and tighten the fit of the skin around the ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Is It Safe to Initiate Peritoneal Dialysis Treatment Immediately After Percutaneous Catheter Placement?
Authors: Gülcan E Abstract In this retrospective study, the safety of initiating peritoneal dialysis (PD) immediately after percutaneous PD catheter insertion was evaluated. Patients who underwent peritoneal catheter insertion and then immediately began dialysis treatment were included in the study. Patient age, sex, treatment modalities, and method of catheter insertion were recorded.Acute PD was performed in 33 patients (age: 57.7 ± 16.7 years; 21 men, 12 women). Catheters were inserted percutaneously in 28 patients and surgically in 5 patients. The PD modalities used were continuous ambulatory PD in 1...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

A Rare Complication During Percutaneous Peritoneal Dialysis Catheter Insertion: Intravesical Placement.
Authors: Gülcan E, Sahin SY, Korkmaz M, Kabak O Abstract Peritoneal dialysis (PD) is one of the treatment options for patients with end-stage renal failure. To start PD treatment, a catheter must be placed for access to the abdominal cavity, and it can be placed using surgical, laparoscopic, or percutaneous methods. However, complications can develop during catheter placement.In the present case report, we describe a patient in whom treatment was pursued after an unusual complication rarely mentioned in the literature: a dialysis catheter accidentally inserted percutaneously into the bladder. Under ultras...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Treatment of a Dialysate Leak by Simultaneous Catheter Removal and Replacement in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis.
Authors: Gülcan E, Kalay ME, Kabak Ö, Özbay S Abstract Continuous ambulatory peritoneal dialysis (PD) is one of the treatment methods used for end-stage renal failure. When mechanical complications occur with this treatment method, methods such as tomographic peritoneography, abdominal scintigraphy, and magnetic resonance peritoneography are used to uncover the problem. Here, we report the detection by tomographic peritoneography of a subcutaneous dialysate leak in a patient undergoing PD. The PD catheter was subsequently removed, and a new catheter was inserted. The patient then restarted continuous am...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 29, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Incisional Hernia After Peritoneal Dialysis Catheter Placement in a Patient on Sirolimus.
We report a rare occurrence of incisional hernia attributable to internal wound dehiscence after PD catheter placement in a patient on sirolimus.A 34-year-old Latino American man was started on PD training 4 weeks after placement of a PD catheter. Soon after completing training, he developed a large soft bulge close to the PD catheter, with expansile cough impulse suggestive of an incisional hernia filled with peritoneal dialysate. The size of the bulge would decrease after the dialysate was drained. No external leak of dialysate was evident along the exit site.Because of the size of the hernia and the history of it fillin...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research