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 PD ini...
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 enhances s...
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 Questionnaire co...
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. In this r...
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 agreement betwee...
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 care.The...
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 were started...
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 dialysis init...
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 catheter....
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 ...
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 ultrasonogr...
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...
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

Peritoneal Phosphate Clearance: The Effect of Peritoneal Dialysis Modality and Peritoneal Transport Status.
Authors: Davenport A Abstract Hyper- and hypophosphatemia are recognized risk factors for all-cause mortality in peritoneal dialysis (PD) patients. Recent changes have now focused PD solute clearance targets on urea clearance, rather than on larger solutes, including phosphate. We therefore studied peritoneal phosphate clearance in a cohort of PD patients to determine which factors were clinically relevant.We reviewed results from 451 adult PD patients who were attending for their first assessment of peritoneal membrane function [31.2% treated by continuous ambulatory PD (CAPD); 24.2.%, by automated PD (APD); and 4...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

No Relation Between Peritoneal Fibrosis and Free Water Transport in a Rat Model.
Authors: Krediet RT, Vlahu CA, Barreto DL, Struijk DG Abstract Free water transport (FWT) during peritoneal dialysis (PD) can easily be measured by Na+ kinetics. In long-term PD, FWT might reflect peritoneal fibrosis, but morphologic or functional relationships have not been investigated. Nonconventional dialysis solutions might be associated with better preservation of peritoneal tissues and function. We developed a long-term peritoneal exposure model in rats with impaired kidney function and investigated peritoneal morphology and function in that model after exposure to conventional and nonconventional solutions....
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Peritoneal Dialysis Preserves Residual Renal Function and Reduces Oxidative Stress During the Initial Period of Dialysis Therapy.
Authors: Ueda A, Nagai K, Hirayama A, Saito C, Yamagata K Abstract Patients with end-stage renal failure are believed to have an increase of oxidative stress. However, any variation in oxidative stress between patients receiving hemodialysis (HD) and those receiving peritoneal dialysis (PD) are still unclear. In the present study, we investigated variation in oxidative stress in 54 HD and 23 PD patients during their initial dialysis period.We measured serum pentosidine and indoxylsulfuric acid as markers of oxidative stress every 6 months from the start of the dialysis therapy to 30 months of treatment. Serum pento...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Successful Peritoneal Dialysis Catheter Placement in a New End-Stage Renal Disease Patient with Combined Antiphospholipid Syndrome and Factor XI Deficiency.
We present the case of a 68-year-old woman with combined antiphospholipid syndrome and factor XI deficiency, with chronic prolongation of activated partial thromboplastin time that was not correctable with fresh-frozen plasma (FFP).The patient had a history of stroke, but was not on antiplatelet therapy because of mucocutaneous bleeding events. She had progressive renal failure attributed to her autoimmune disease, and a decision was made to pursue peritoneal dialysis (PD) when she reached end-stage kidney disease. She was admitted to the hospital the day before her planned PD catheter placement and was transfused with FFP...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Early Postoperative Complications of Peritoneal Dialysis Catheter Surgery Conducted by Nephrologists: A Single-Center Experience Over an Eight-Year Period.
Authors: Osako K, Sakurada T, Koitabashi K, Sueki S, Shibagaki Y Abstract The results of several recent studies indicate that the practice of peritoneal dialysis catheter (PDC) insertion by nephrologists is safe. However, few studies have addressed the important issue of safety in surgeries related to PD, including PDC removal and other types of surgery. In the present study, we aimed to verify whether the incidence of early postoperative complications for surgical procedures related to PD and performed by nephrologists meets the audit standards of clinical practice guidelines for peritoneal access.Between April 20...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Long-Term Prognosis of Peritoneal Dialysis Patients with a Re-embedded Catheter.
Authors: Sakurada T, Kaneshiro N, Taki Y, Kojima S, Koitabashi K, Sueki S, Shibagaki Y Abstract Upon peritoneal dialysis (PD) discontinuation in frail patients, we have re-embedded the catheter and left it subcutaneously buried. However, we have not evaluated the long-term prognosis of those patients after the procedure or the complications associated with buried catheters. We therefore aimed to clarify the long-term prognosis of patients with a re-embedded catheter and to identify any associated complications.The outcomes of 10 patients having a catheter that was re-embedded between February 2010 and May 2016 were...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 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

Peritoneal Dialysis in Patients with Abdominal Surgeries and Abdominal Complications.
Authors: Aziz F, Chaudhary K Abstract Peritoneal dialysis (PD) is an excellent treatment option for the patients with end-stage renal disease, having been shown to yield improved patient satisfaction and economic benefit. Many surgeons and physicians believe that patients with prior abdominal surgeries or other abdominal complications are not viable candidates for PD and that prevalent PD patients needing abdominal surgery should be switched to hemodialysis. The purpose of the present review is to address those misconceptions.Our review of literature shows that, when appropriately planned, PD can still be an accept...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Diagnostic Dilemma: A Case of Endogenous Peritonitis.
Authors: Edo-Ohonba O, Khanna R, Misra M Abstract Endogenous peritonitis resulting from inflammation or perforation of an abdominal viscus-a result, for example, of diverticulitis, cholecystitis, or acute appendicitis-can be a complication in patients undergoing peritoneal dialysis (PD), with significant morbidity and a high incidence of catheter loss.Here, we describe an end-stage renal disease patient on PD who presented with acute abdominal pain and who was diagnosed with uncomplicated PD peritonitis. His clinical course was complicated by development of eosinophilic peritonitis because of an allergy to vancomyc...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Bleeding Peritoneum During Peritoneal Dialysis: A Case of Early Encapsulating Peritoneal Sclerosis?
Authors: Banoth P, Khanna R Abstract Complications of peritoneal dialysis (PD) create a significant burden for patients and providers. Some complications, such as infections and leaks, are preventable or easily treatable; however, potential fatal complications, such as encapsulating peritoneal sclerosis (EPS), cost patients their lives. Here, we present the case of a PD patient who might have had early, subtle, but ominous symptoms and signs of EPS, diagnosed in its early stages and promptly managed.A 57-year-old man who had been receiving PD for 6 years began having recurrent episodes of abdominal pain, blood-ting...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Antibiotic Prophylaxis in Peritoneal Dialysis Patients.
Authors: Dhruve MJ, Bargman JM Abstract Peritonitis is an important cause of morbidity, mortality, and technique failure in patients on peritoneal dialysis (PD). The most effective approach to peritonitis is prevention, which includes careful patient training and follow-up. Although peritonitis as a result of contiguous spread of bacteria or fungi during invasive procedures, or as a result of seeding of the peritoneum during bacteremia, is uncommon, the likelihood of such spread is often predictable, and the risk can be mitigated with antibiotic prophylaxis. Here, we describe the rationale for, and approach to, ant...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis: What, Who, Why, and How? Review and Case Study.
This article uses a practical case study to highlight the intricacies of the calculations behind PD prescription to achieve clearance goals. The objective is to demonstrate that all modalities of PD should be considered in the spectrum of clinical tools for achieving adequate dialysis. PMID: 29668434 [PubMed - in process] (Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis)
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Pilot Study: Improving Patient Outcomes with Healing Touch.
Authors: Hendricks K, Wallace KF Abstract Healing Touch therapies use a practitioner's intentional placement of hands to influence the patient's energy fields to promote self-healing. In the changing climate of health care, in which the patient experience increasingly drives reimbursements, it is vital to find unique and meaningful ways beyond traditional medical therapies to ensure positive patient experiences. To that end, our peritoneal dialysis clinic staff adopted Jean Watson's theoretical framework, by which patients are treated as whole unique individuals with a "multidimensional system of energy, with ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Predictive Factors for Withdrawal from Peritoneal Dialysis: A Retrospective Cohort Study at Two Centers in Japan.
Authors: Taki Y, Sakurada T, Koitabashi K, Imai N, Shibagaki Y Abstract Peritoneal dialysis (PD) is recognized as an excellent method of dialysis because the therapy is gentle, continuous, and cost-effective. However, a large number of patients must unfortunately transfer from PD to hemodialysis because of peritonitis or fluid overload in the early phase after PD initiation. In the present study, we reviewed clinical indicators before PD initiation to try to identify predictive factors for early withdrawal from PD.For this retrospective cohort study at two hospitals between March 2003 and October 2016, we defined w...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Combination Therapy with Peritoneal Dialysis and Hemodialysis from the Initiation of Renal Replacement Therapy Preserves Residual Renal Function and Serum Albumin.
Authors: Ueda A, Nagai K, Hirayama A, Saito C, Yamagata K Abstract Peritoneal dialysis (PD) and hemodialysis (HD) combination therapy is considered for the improvement of ultrafiltration failure and uremic symptoms in PD patients with loss of residual renal function (RRF). However, a rapid decline in RRF is one of the critical drawbacks to such therapy. In contrast, we started patients on combination therapy as a proactive option at the initiation of dialysis.In patients on HD (n = 52), PD (n = 21), and combination dialysis (n = 13), we studied changes in RRF, blood parameters, and peritoneal permeability for 30 mo...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Renastart Use in an Infant on Peritoneal Dialysis.
The objective of the present case study was to examine whether Renastart, a pediatric renal formula (Nestlé Health Science, Florham Park, NJ, U.S.A.), could be used alongside expressed breast milk (EBM) to meet the nutritional needs of an infant with renal disease, while maintaining normal serum electrolytes.A 9-month-old infant received EBM with Similac PM 60/40 treated with Kayexalate (Concordia Pharmaceuticals, Bridgetown, Barbados) because of hyperkalemia. That formulation was not well tolerated, and the infant's growth trajectory declined. The infant was then switched to EBM with Renastart. During this interven...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Erratum.
Authors: PMID: 29668439 [PubMed - in process] (Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis)
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Rupture of Subcutaneous Peritoneal Dialysis Catheter by Stretching Exercise: A Case Report.
Authors: Kaneshiro N, Sakurada T, Hachisuka R, Hisamichi M, Yazawa M, Shibagaki Y Abstract Rupture of the peritoneal dialysis (PD) catheter is rare complication. Here, we report a case of catheter rupture that occurred because of exercise after partial catheter reimplantation.A 66-year-old man with a history of end-stage kidney disease secondary to diabetic nephropathy experienced refractory exit-site and tunnel infection. After the infected parts of the catheter were excised, a partial catheter reimplantation was performed. At the time of that surgery, a presternal location was selected for the new exit site, and ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Correlation Between Near-Vision Acuity and the Incidence of Peritoneal Dialysis-Related Infections.
Authors: Kojima S, Sakurada T, Koitabashi K, Kojima K, Watanabe S, Uchida D, Kaneshiro N, Konno Y, Shibagaki Y Abstract Peritoneal dialysis (PD)-related infections (PDIs) such as peritonitis, exit-site infection, and tunnel infection are serious complications affecting patients on PD. Because patients with diabetes (DM) and of older age have increased in number in Japan, the number of patients with visual impairment is estimated also to have increased. Near vision is necessary for performing proper PD daily care. However, no studies have reported whether visual impairment is likely to increase the risk of PDIs.Our ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Louisiana State University Nephrology: Initiation of a Multicenter Urgent-Start Peritoneal Dialysis Program.
Authors: Jaikishen A, Lick A, Owen JG, Naljayan MV Abstract Urgent-start peritoneal dialysis (PD) refers to the initiation of PD in new-start end-stage renal disease patients who present either emergently in the hospital or urgently in clinic. These patients are called "late-referred patients." Our academic practice group, like many private practice and academic groups, currently functions within 4 hospitals and 4 clinics. The patient base consists of a large indigent population with limited access to health care and also of insured patients. An urgent-start PD program was initiated to provide all patient...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Erosion of the Silicone Peritoneal Dialysis Catheter with the Use of Gentamicin Cream at the Exit Site.
Authors: Gardezi AI, Schlageter KW, Foster DM, Astor BC, Chan MR, Waheed S Abstract Infection remains the leading complication of peritoneal dialysis (PD). Topical mupirocin and gentamicin are frequently used to prevent infections. Mupirocin ointment has been reported to cause damage to both polyurethane and silicone PD catheters. Gentamicin cream has not been associated with physical damage to catheters.A 64-year-old woman on PD developed relapsing peritonitis with Staphylococcus epidermidis. Because of a drainage problem and white discoloration at the exit site, which is known as " frosting," she underw...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Time Is Not Always the Matter: An Instance of Encapsulating Peritoneal Sclerosis Developing in a Patient on Peritoneal Dialysis for a Short Term.
Authors: De Oleo RR, Villanueva H, Lwin L, Katikaneni M, Yoo J Abstract Encapsulating peritoneal sclerosis (EPS) is an infrequent but serious complication that is observed mostly in patients on long-term peritoneal dialysis (PD). However it can occur after short-term PD, in association with "second hit" risk factors such as peritonitis, acute cessation of PD, or kidney transplantation with the use of calcineurin inhibitors.In our case, a young woman with second-hit risk factors presented with clinical and abdominal computed tomography findings consistent with EPS after short-term PD. She was treated conse...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Comparing Dialysis Modality and Cardiovascular Mortality in Patients on Hemodialysis and Peritoneal Dialysis.
Authors: Refaat H, Sany D, Mohab A, Ezzat H Abstract Patients undergoing dialysis are at high risk for cardiovascular disease (CVD). Mortality differences between peritoneal dialysis (PD) and hemodialysis (HD) are widely debated. The question of whether dialysis modality affects the risk for CVD remains to be addressed.In the present study, we evaluated the influence of hemodialysis (HD) and peritoneal dialysis (PD) on survival and the risk of developing de novo CVD. Our observational prospective study enrolled 157 end-stage renal disease patients on HD or PD for 12 months. Patients with a history of malignancy, ch...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Preoperative Cardiac Evaluation in Kidney Transplant Patients: Is Coronary Angiography Superior? A Focused Review.
Authors: Katta N, Balla S, Velagapudi P, Mittal M, Agrawal H, Kumar A, Aggarwal K Abstract Cardiovascular disease is the major cause of morbidity and mortality in chronic kidney disease patients. Because of a higher occurrence of asymptomatic coronary artery disease and increased perioperative cardiovascular mortality in kidney transplant patients, screening for coronary artery disease before transplant surgery is essential. Various studies have shown that cardiac stress testing is an unreliable screening method in these patients because of significant variability in sensitivity and negative predictive value. We su...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Role of Chronic Use of Tolvaptan in Patients with Heart Failure Undergoing Peritoneal Dialysis.
Authors: Mori T, Kurasawa N, Ohsaki Y, Koizumi K, Sato S, Oba-Yabana I, Shimada S, Sato E, Naganuma E, Tsuchikawa M, Ito S Abstract In the present study, we assessed the effect of chronic tolvaptan treatment and compared it with the effect of conventional treatment without tolvaptan. In addition, changes in cardiac load and body fluid composition were compared.The study enrolled 22 patients undergoing peritoneal dialysis who had been receiving tolvaptan for more than 1 year and 10 patients undergoing peritoneal dialysis who had been treated with conventional diuretics. Left ventricular mass index (LVMI), left ventr...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Efficacy and Biocompatibility of Neutral Icodextrin Peritoneal Dialysis Fluid.
Authors: Shimada S, Mori T, Koizumi K, Sato S, Oba-Yabana I, Ohsaki Y, Sato E, Naganuma E, Kurasawa N, Tsuchikawa M, Ito S Abstract Neutral icodextrin peritoneal dialysis (PD) fluid (n-ICO) has become available for use in Japan. However, removal of water and solutes remains to be elucidated in detail. The present study was designed to determine removal of water, electrolytes, and small, middle, and large molecules in a period of 16 hours. In addition, biocompatibility with respect to peritoneal mesothelial cells was determined.Three stable patients undergoing PD at Tohoku University Hospital were administered n-ICO...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Treatment of Calciphylaxis: A Case for Oral Sodium Thiosulfate.
Authors: Shetty A, Klein J Abstract Calciphylaxis is a major cause of morbidity and mortality in end-stage renal disease (ESRD). Intravenous sodium thiosulfate (STS) is the mainstay of therapy for calciphylaxis. In peritoneal dialysis (PD) patients with calciphylaxis, intravenous STS poses logistic and financial challenges. Even though pharmacokinetic studies show poor bioavailability of oral STS, we report successful use of oral STS in 2 PD patients with calciphylaxis.A 55-year-old Latina American woman with diabetes was initiated on PD after access failure and chronic hypotension. She developed painful ischemic l...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Bullous Skin Lesions in a Patient with End-Stage Renal Disease and Hepatitis C.
We present a female patient with end-stage renal disease, bullous skin lesions affecting mainly sun-exposed areas, and high ferritin levels. She also had hepatitis C. Her serum porphyrin panel was suggestive of porphyria cutanea tarda. Skin biopsy excluded inflammatory pathologies. Phlebotomy during each hemodialysis, continuation of darbepoetin, and avoidance of any further doses of intravenous iron, with close monitoring of hemoglobin, resulted in a gradual drop in ferritin level and improvement of the skin lesions. PMID: 28988591 [PubMed] (Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis)
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Successful Peritoneal Dialysis in Large-Weight Subjects: Clinical Features and Comparisons with Normal-Weight Subjects.
Authors: Salim SA, Akula Y, Kandhuri S, Afshan S, Zsom L, Dixit MP, Fülöp T Abstract Peritoneal dialysis (PD) obviates the need for temporary vascular access in end-stage renal disease; however, extremely heavy weight has been viewed as a relative contraindication to PD.We performed a cross-sectional review of multiple clinical and laboratory variables for 75 current or past PD patients (vintage> 6 months), comparing dialysis adequacy parameters for those with a large body weight (>100 kg, LWS group) and with a normal body weight (
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - October 13, 2017 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Can Plasma Hyaluronan and Hyaluronidase Be Used As Markers of the Endothelial Glycocalyx State in Patients with Kidney Disease?
Authors: Vlahu CA, Krediet RT Abstract Hyaluronan (HA) is widely spread in the body and is an important component of the extracellular matrix, including the endothelial glycocalyx (EG). Essential for its vasculoprotective function, HA is involved in vascular permeability and many other processes. In patients with kidney disease, plasma HA is higher than expected, but the extent to which plasma HA and its degrading enzyme hyaluronidase can be used as markers for the state of the EG has not yet been determined. In the first part of this review, we describe HA synthesis and degradation; we then focus on the involvemen...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - January 16, 2016 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Relationship Between Peritoneal Transport Characteristics and Natriuretic Peptides in Peritoneal Dialysis Patients.
Authors: Kojima S, Sakurada T, Uehara M, Okamoto T, Kaneshiro N, Konno Y, Shibagaki Y Abstract Few studies have attempted to evaluate the relationship between peritoneal permeability and fluid status in peritoneal dialysis (PD). The aim of the present study was to clarify the relationship between change in the dialysate-to-plasma ratio of creatinine (D/P Cr) and change in fluid status as evaluated by natriuretic peptides. We studied 49 PD patients (29 men, 62 ± 11 years, 36.7% with diabetes) who underwent a peritoneal equilibration test at least twice after PD initiation. We evaluated correlations between th...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - January 16, 2016 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Glucose and Insulin Response to Peritoneal Dialysis Fluid in Diabetic and Nondiabetic Peritoneal Dialysis Patients.
Authors: Oba I, Mori T, Chida M, Kurasawa N, Naganuma E, Sato E, Koizumi K, Sato S, Tsuchikawa M, Ito S Abstract A postprandial increase in blood glucose in peritoneal dialysis (PD) patients with diabetes was observed in our previous study using continuous blood glucose monitoring. The response was observed in diabetic but not in nondiabetic PD patients. In addition, the response was reduced when patients used icodextrin; glucose absorbed from the peritoneum was responsible for the postprandial increase in blood glucose. Because our PD patients often change their PD fluid before meals, the present study aimed to de...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - January 16, 2016 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Using a Peritoneal Dialysis Access Simulator in Surgical Training for Nephrologists.
Authors: Sakurada T, Taki Y, Kojima S, Oishi D, Koitabashi K, Sueki S, Kaneshiro N, Shibagaki Y Abstract In Japan, peritoneal dialysis (PD) catheter insertion has been performed by both nephrologists and surgeons. However, nephrologists have fewer opportunities to train in the insertion procedure. We therefore used a PD access simulator to provide training in this operative technique for nephrologists. A PD access simulator developed by Terumo Medical Corporation was used for the training. The simulator uses a mannequin made of acrylic resin. The abdominal wall of a pig is attached to the abdominal area, and a plas...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - January 16, 2016 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Lymphangiogenesis and Lymphatic Absorption Are Related and Increased in Chronic Kidney Failure, Independent of Exposure to Dialysis Solutions.
Authors: Vlahu CA, de Graaff M, Aten J, Struijk DG, Krediet RT Abstract Increased lymphatic absorption might contribute to ultrafiltration failure in peritoneal dialysis (PD). Lymphangiogenesis develops during PD, but little is known about the relationship between its morphologic and functional parameters. The relationships between lymph vessel density, the effective lymphatic absorption rate (ELAR), and fibrosis were investigated in a rat model of chronic kidney failure (CKD) with exposure to dialysis solutions. Wistar rats (n = 44) were allocated to these groups: NKF (normal kidney function), CKD (70% nephrectomy...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - January 16, 2016 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

European Training and Research in Peritoneal Dialysis--A Network to Deliver Scientific Peritoneal Dialysis Training to a New Generation of Researchers.
Authors: Machowska A, van Wier T, Aufricht C, Beelen R, Rutherford P Abstract Peritoneal dialysis (PD) utilization varies across countries, and of the factors that explain the variation, the scientific and clinical knowledge of health care professionals is potentially important. In this paper, we describe a European collaboration--between 8 academic PD research programs, a small-to-medium-sized enterprise, and a large PD product manufacturer--that received significant research funding from the EU commission to establish a training network. European Training and Research in Peritoneal Dialysis (EuTRiPD) is providing...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - January 16, 2016 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research