Peritoneal Dialysis International最新文献

{"title":"Improving self-dependency in Pakistan: Correspondence.","authors":"Hineptch Daungsupawong, Viroj Wiwanitkit","doi":"10.1177/08968608241285989","DOIUrl":"https://doi.org/10.1177/08968608241285989","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of frailty on mortality and transfer to hemodialysis after peritoneal dialysis initiation.","authors":"Sophie Gaube, David Clark, Dylan Cooper, Annie-Claire Nadeau-Fredette, Amanda Vinson, Karthik Tennankore","doi":"10.1177/08968608241274095","DOIUrl":"https://doi.org/10.1177/08968608241274095","url":null,"abstract":"<p><strong>Background: </strong>Frailty is associated with poor outcomes for patients on dialysis; however, dedicated studies among incident peritoneal dialysis (PD) patients are lacking. This study aims to determine the association between frailty and mortality/transfer to hemodialysis (HD) among incident PD patients and identify whether dialysis modality (PD vs. HD) modifies the association of frailty and mortality following dialysis initiation.</p><p><strong>Methods: </strong>A single center retrospective cohort of incident PD and HD patients was analyzed from 2009 to 2020 (last follow-up December 2021). The first version of the clinical frailty scale (CFS) ranging from 1, very fit, to 7, severely frail, was used to characterize patient frailty at dialysis initiation. Time to death/transfer to HD was analyzed using multivariable Cox Survival analyses. Patients were censored at transplant/last follow-up. Dialysis modality was evaluated as a potential effect modifier on the impact of frailty on mortality.</p><p><strong>Results: </strong>Of 253 patients who initiated PD, 182 had completed CFS scores. Mean age at dialysis initiation was 63 ± 13 years and mean CFS score was 3 ± 1. There were 42 deaths and 69 instances of transfer to HD over 379 patient-years at risk. Vulnerable/frail patients (CFS ≥ 4) had a two-fold increase in the adjusted relative hazard for death/transfer to HD (HR 2.04, 95% CI [1.10-3.77]). Incident dialysis modality did not modify the association between frailty and mortality.</p><p><strong>Conclusions: </strong>A higher severity of frailty at PD initiation is associated with both mortality/transfer to HD and mortality alone, and the association between frailty and mortality is not modified by dialysis modality.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous endoscopic gastrostomy in children receiving peritoneal dialysis: A tertiary centre long-term experience and literature review.","authors":"Federica Fati, Rebecca Pulvirenti, Germana Longo, Luca Maria Antoniello, Elisa Zambaiti, Piergiorgio Gamba","doi":"10.1177/08968608231223812","DOIUrl":"10.1177/08968608231223812","url":null,"abstract":"<p><strong>Background: </strong>Children with severe chronic kidney disease receiving maintenance peritoneal dialysis (PD) are often malnourished and may require nutritional supplementation. Recent PD guidelines address laparoscopic and open surgical gastrostomy as safe approaches in children established on PD, while existing evidence on percutaneous endoscopic gastrostomy (PEG) is still lacking; as well as the role of perioperative antibiotic and antifungal prophylaxis. Hence, this study aimed to report our experience with PEG placement in patients on PD and compare it with the available literature.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records from patients on PD, who underwent PEG placement at a tertiary referral centre between 2000 and 2020. Data on perioperative management, complications and outcomes were retrieved. An extensive literature search was performed; studies describing PEG placement and perioperative prophylaxis in patients on PD were used as a comparison. Descriptive statistical analysis was conducted.</p><p><strong>Results: </strong>Seven patients (five males) were included. Perioperative antibiotic and antifungal prophylaxis were standard practice. At a median follow-up of 27 months (10-75), the peritonitis rate was 0.2 patient/years. No statistical significance was found between the peritonitis rate before and after PEG placement (<i>p</i> = 0.2). Patients' demographics and postoperative complications were comparable to the reported studies.</p><p><strong>Conclusions: </strong>Based on our experience, our technique of PEG insertion with antimicrobial prophylaxis is feasible and associated with an acceptable complication risk in patients on PD. Further multicentric studies about surgical technique in patients on PD will be necessary to verify the feasibility of PEG and standardise the perioperative protocol.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discontinuation of maintenance peritoneal dialysis in children-A 10-year review from a single center in a low resource setting.","authors":"Judith Caroline Aujo, Ashton Coetzee, Adelaide Masu, Anthony Enimil, Valerie A Luyckx, Peter J Nourse, Mignon I McCulloch","doi":"10.1177/08968608241259608","DOIUrl":"10.1177/08968608241259608","url":null,"abstract":"<p><strong>Introduction: </strong>In South Africa, only children considered eligible for transplantation are offered dialysis as bridge to kidney transplantation. Maintenance peritoneal dialysis (PD) is preferred and has several advantages over hemodialysis (HD). While awaiting transplantation, PD may be discontinued due to permanent transfer to HD or death while on PD, of which the occurrence and burden is not known in our setting. We investigated the rate of discontinuation of maintenance PD, and associated factors among children awaiting a kidney transplant under challenging socio-economic circumstances in a low resource setting.</p><p><strong>Methods: </strong>Single center retrospective analysis of children receiving maintenance PD. Outcomes included the proportion of children who discontinued PD before transplantation, associated factors and timing of discontinuation, and the proportion transplanted. Time to discontinuation or transplantation was displayed using a Kaplan-Meier curve.</p><p><strong>Results: </strong>Sixty-seven children who received maintenance automated PD as initial dialysis modality were identified from the kidney transplant waiting list between January 2009 and December 2018. Complete data was available for 52 of the 67 children. Four children had prior failed kidney transplants. The median age was 11 years (interquartile range 6.0, 13.1). Overall, 17/52 (32.7%) children discontinued PD, with 13 (25%) transfers to HD and 4 deaths (7.7%), whereas 29/52 (55.8%) received a kidney transplant. Three of the deaths were PD related. Six children remained on maintenance PD at the end of the study period. Over a half of our patients discontinued PD by 12 months, and 80% by 30 months. Most PD discontinuations were associated with peritonitis.</p><p><strong>Conclusions: </strong>The proportion discontinuing PD was high, highlighting the need to optimize measures to improve retention rates, especially through prevention of peritonitis.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'A constant threat': Parent and child perspectives on infection in paediatric peritoneal dialysis.","authors":"Amanda Dominello, Madeleine Reicher","doi":"10.1177/08968608241274465","DOIUrl":"10.1177/08968608241274465","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interobserver agreement of peritoneal dialysis exit site scoring: Results from the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative.","authors":"Mahima Keswani, Kathleen Mallet, Troy Richardson, Sarah J Swartz, Alicia Neu, Bradley A Warady","doi":"10.1177/08968608241254278","DOIUrl":"10.1177/08968608241254278","url":null,"abstract":"<p><strong>Background: </strong>Exit site infections are a risk factor for the development of peritonitis in patients on long-term peritoneal dialysis. Visual assessments of an exit site utilising currently available tools (Twardowski and Mid-European Pediatric Peritoneal Dialysis Study Group (MEPPS)) are necessary to objectively characterise the appearance of an exit site. The aim of this study was to assess the interobserver agreement of exit site evaluations utilising both exit site scoring tools.</p><p><strong>Methods: </strong>Exit site evaluations were independently performed by two evaluators during outpatient visits at 13 sites within the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease collaborative. The frequency and percentage of evaluations where both reviewers agreed were calculated. A sub-analysis was performed looking at evaluations where disagreement occurred.</p><p><strong>Results: </strong>A total of 371 paired exit site evaluations were collected over 6 months. For the majority of evaluations (range: 78%-97% Twardowski, 78%-97% MEPPS), both reviewers agreed that no abnormality was present across all domains. When the analysis was restricted to evaluations where at least one reviewer noted an abnormality, interobserver agreement fell across all domains (range: 31%-61% Twardowski, 56%-66% MEPPS). Disagreements more commonly occurred regarding the presence versus absence of an abnormality, rather than a difference in the severity of an abnormality.</p><p><strong>Conclusions: </strong>Whereas interobserver agreement is high when the appearance of a peritoneal dialysis catheter exit site is characterised as 'normal', interobserver disagreement is common when the appearance of the exit site is 'abnormal'. Further work is warranted to improve interobserver agreement of exit site assessments and to identify domains conferring an increased risk of infection.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention and management of peritoneal dialysis associated infections in children: Continuing to grow and reaching new milestones.","authors":"Rupesh Raina, Sanat Subhash, Claus Peter Schmitt, Rukshana Shroff","doi":"10.1177/08968608241279094","DOIUrl":"10.1177/08968608241279094","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Green Nails, Red Alert: An Unusual Exit site infection Presentation.","authors":"Takuto Nakamura, Marino Yamauchi, Shinichiro Sonoda, Daigo Aharen, Masaki Ikemura, Kentaro Kohagura, Kenya Kusunose","doi":"10.1177/08968608241234529","DOIUrl":"10.1177/08968608241234529","url":null,"abstract":"<p><p>Green nail syndrome is an infectious nail disorder caused most commonly by <i>Pseudomonas aeruginosa</i>. We report a rare case of peritoneal dialysis (PD) exit site infection (ESI) accompanied by <i>P. aeruginosa</i>-associated green nail syndrome. The patient was treated with oral and topical antibiotics without the need for PD catheter removal. We aim to emphasise the importance of nail assessment for ESI in patients undergoing PD.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guideline for the prevention and management of peritoneal dialysis associated infections in children: 2024 update.","authors":"Bradley A Warady, Rebecca Same, Dagmara Borzych-Duzalka, Alicia M Neu, Ibrahim El Mikati, Reem A Mustafa, Brandy Begin, Peter Nourse, Sevcan A Bakkaloglu, Vimal Chadha, Francisco Cano, Hui Kim Yap, Qian Shen, Jason Newland, Enrico Verrina, Ann L Wirtz, Valerie Smith, Franz Schaefer","doi":"10.1177/08968608241274096","DOIUrl":"10.1177/08968608241274096","url":null,"abstract":"<p><p>Infection-related complications remain the most significant cause for morbidity and technique failure in infants, children and adolescents who receive maintenance peritoneal dialysis (PD). The 2024 update of the Clinical Practice Guideline for the Prevention and Management of Peritoneal Dialysis Associated Infection in Children builds upon previous such guidelines published in 2000 and 2012 and provides comprehensive treatment guidance as recommended by an international group of pediatric PD experts based upon a review of published literature and pediatric PD registry data. The workgroup prioritized updating key clinical issues contained in the 2012 guidelines, in addition to addressing additional questions developed using the PICO format. A variety of new guideline statements, highlighted by those pertaining to antibiotic therapy of peritonitis as a result of the evolution of antibiotic susceptibilities, antibiotic stewardship and clinical registry data, as well as new clinical benchmarks, are included. Recommendations for future research designed to fill important knowledge gaps are also provided.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal dialysis in children, what's different: Your questions answered.","authors":"Heather L Wasik, Elizabeth Harvey, Alicia Neu","doi":"10.1177/08968608241273633","DOIUrl":"10.1177/08968608241273633","url":null,"abstract":"<p><p>Maintenance peritoneal dialysis (PD) is the most used kidney replacement therapy for children with kidney failure throughout the world. Underlying causes of kidney failure, indications for dialysis, body size, and nutritional requirements differ between children and adults on PD. These differences, along with the ongoing growth and development that occurs throughout childhood, impact PD access, prescription, and monitoring in children. This review highlights the unique challenges and management approaches to optimize the care of children on maintenance PD.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}