Peritoneal Dialysis International最新文献

{"title":"Impact of sampling side of peritoneal biopsies on peritoneal thickness and histopathological diagnosis-A quantitative histological study in body donors.","authors":"Gabriele Eden, Frederick Pfister, Vedat Schwenger, Shogoofa Barakzai, Gernot Beutel, Jan T Kielstein, Kerstin Amann, Heike Kielstein","doi":"10.1177/08968608261429723","DOIUrl":"https://doi.org/10.1177/08968608261429723","url":null,"abstract":"<p><p>BackgroundCurrently several registries investigate the structure of the peritoneum in response to uremia and peritoneal dialysis. Those registries using a single peritoneal sample obtained during surgical procedures involving the abdomen. There are no data to support the assumption that a single random sample from the peritoneum is representative of other regions of the peritoneum. The aim of our study was to investigate the potential effect of the sampling site of the parietal peritoneum on peritoneal thickness.MethodsFor the study 19 body donors (8 F /11 M), medium [IQR] age 82 [77-88] years were investigated. Peritoneal samples were obtained from five different, predefined sites of the peritoneal cavity involving visceral and parietal peritoneum. Routine histology was performed at the Department of Nephropathology Erlangen.ResultsA total number 95 samples from 19 body donors were analyzed. There was a wide intraindividual variation of the peritoneal thickness. In the entire cohort, median [IQR] maximum thickness of the peritoneum did not significantly differ between the four samples of the parietal peritoneum 130 [60-170] µm | 130 [70-200] µm | | 140 [110-240] µm | 140 [110-150] µm. Median [IQR] maximum thickness of the visceral peritoneum was however thinner 90 [60-130] µm than all parietal peritoneal samples (<i>p</i> = .01). Based on the intraindividual variation in our cohort we calculated a cohort of 24.7 patients needed to detect longitudinal changes of peritoneal thickness at medium effect size with a power of 0.8 at <i>p</i> < .05.ConclusionsThe visceral peritoneum differs in thickness form the parietal peritoneum. The sample site of the parietal peritoneum has no effect on the peritoneal thickness. The large intraindividual variation in the peritoneal thickness require large cohorts to detect longitudinal change of the peritoneum. Despite the limitation that it remains uncertain if these results from body donors can be assumed to be true in ex-vivo biopsies, it seems prudent to state that interpreting sequential peritoneal biopsies in single patients or small case series should be interpreted with caution.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261429723"},"PeriodicalIF":3.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675955","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":"Automated measurement of intraperitoneal pressure versus patient fill-volume.","authors":"Peter Rutherford, Brad Keller, Alyssa Wilmington, Jaime Uribarri, Shuchita Sharma, Marzuq Billah, Michael Mao, Nabeel Aslam","doi":"10.1177/08968608261435113","DOIUrl":"https://doi.org/10.1177/08968608261435113","url":null,"abstract":"<p><p>Measuring intraperitoneal pressure (IPP) has been proposed as a means to help maintain optimal ultrafiltration and prevent complications such as hernias, peritoneal leaks, and gastroesophageal reflux, which are linked with high IPP levels. The Durand method is a commonly accepted method for measuring IPP; however, it is cumbersome and not routinely used in clinics due to its complexity. Here we report the outcome of a pilot study that evaluated the agreement between IPP measured using an in-line pressure transducer and IPP measured using the Durand method during in-clinic automated peritoneal dialysis (APD) therapy. This was an exploratory, descriptive, early feasibility study conducted among patients with a diagnosis of kidney failure who were on APD therapy. IPP was continuously measured using an investigational device (x-MIP transducer) and at fixed timepoints using the Durand method. The study included 10 patients with a median age of 47.0 years and a median body mass index of 28.1 kg/m². The study population was predominantly female, comprising 70% of the participants. The transducer IPP showed a moderate agreement with manual IPP, as most differences in measurements were within ±3 cmH₂O. Overall, IPP did not correlate with fill-volume. However, when examined on a per-patient level, six patients showed stronger correlations (<i>ρ</i> > 0.7) between IPP and fill-volume, while the remaining four patients had weaker correlations (<i>ρ</i> < 0.5). No safety concerns were identified in the study. In summary, this study indicates that a transducer-based IPP measurement device could serve as an alternative to the Durand method.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261435113"},"PeriodicalIF":3.7,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628488","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":"Paraneoplastic leukocytosis in peritoneal dialysis.","authors":"Hei Yan Chan, Wah Cheuk, Chi Yuen Cheung","doi":"10.1177/08968608261434274","DOIUrl":"https://doi.org/10.1177/08968608261434274","url":null,"abstract":"<p><p>Liposarcoma (LPS) typically occurs in the extremities and retroperitoneum, but rarely occurs in visceral organs such as pancreas. Only few cases of primary pancreatic LPS have been reported in literature. Here we describe the first case of primary pancreatic LPS in a patient receiving continuous ambulatory peritoneal dialysis (CAPD). This patient was a 60-year-old female who had been on CAPD for 3 years due to kidney failure from type 2 diabetes mellitus. She presented with a 2-week history of intermittent fever measuring up to 38 degrees Celsius. The septic workup including peripheral blood, peritoneal dialysis (PD) fluid, urine, and sputum cultures were all negative. Intravenous piperacillin/tazobactam was empirically started but there was persistent fever with increasing blood leukocytosis (blood white cell count up to 37.5×10⁹/L). In addition, she developed cloudy peritoneal dialysate, suggestive of PD peritonitis, 2 weeks into the hospitalization. Piperacillin/tazobactam was then switched to intravenous meropenem and intraperitoneal vancomycin. Computerized tomography scan of the abdomen showed a large heterogeneous enhancing mass with central hypoattenuating area arising from the pancreatic tail. There were also local invasion and multiple metastatic lesions. Ultrasound-guided fine-needle biopsy of the abdominal mass confirmed the diagnosis of primary dedifferentiated LPS of the pancreas. In view of the advanced nature of the disease, she was treated with palliative chemotherapy. Her clinical condition deteriorated progressively and she passed away from pneumonia 10 months after the diagnosis of LPS. Our case shows that patients on CAPD with pancreatic LPS can develop symptoms mimicking infectious peritonitis and also highlights the importance of considering malignancies in the differential diagnosis of fever and unexplained leukocytosis after ruling out infective causes.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261434274"},"PeriodicalIF":3.7,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623554","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":"Urgent-start peritoneal dialysis in a large pediatric STEC-HUS outbreak: Clinical and operational rationale.","authors":"Naji Al Dhawi, Julian P Midgley, Lorraine A Hamiwka, Andrew W Wade, Anke M Banks, Susan M Samuel, Alyssa J Archibald, Silviu Grisaru","doi":"10.1177/08968608261434803","DOIUrl":"https://doi.org/10.1177/08968608261434803","url":null,"abstract":"<p><p>In September 2023, Calgary, Canada experienced a large point-source outbreak of Shiga toxin-producing Escherichia coli (STEC) infection linked to a centralized kitchen serving daycare centers. More than 200 children presented with bloody diarrhea, and 21 developed hemolytic uremic syndrome (HUS). Nine children required acute kidney replacement therapy (KRT). All were managed with urgent-start peritoneal dialysis (PD) initiated on general pediatric wards. Tenckhoff catheters were inserted by pediatric urologists and PD was initiated approximately 12 h after placement using low initial fill volumes that were escalated as tolerated. Mean PD duration was 10 days (range 4-16). No patients required conversion to extracorporeal KRT, and all patients recovered kidney function with normal estimated glomerular filtration rates by 3 months post-discharge. PD effectively managed solute clearance and acid-base balance while minimizing ultrafiltration, supporting maintenance of intravascular volume, a strategy that was linked to better neurological and kidney outcomes in STEC-HUS. One patient developed culture-negative peritonitis treated with intraperitoneal antibiotics, and the same patient subsequently experienced delayed bowel perforation requiring surgical intervention after PD discontinuation and catheter removal. Neurologic outcomes in two children showed substantial recovery at 3 months evaluation. Our findings demonstrate that urgent-start PD can be implemented in general ward settings rather than in pediatric ICUs, conserving critical care resources during periods of high demand. These results underscore the importance of maintaining PD as a viable KRT modality for children with AKI and ensuring ongoing institutional training, readiness, and infrastructure to support effective deployment during surges or outbreaks.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261434803"},"PeriodicalIF":3.7,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623545","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 complicated by fecalith-induced intestinal perforation.","authors":"Qingqing You, Yan Cai, Ling Jiang, Shujian Zhang","doi":"10.1177/08968608261435114","DOIUrl":"https://doi.org/10.1177/08968608261435114","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261435114"},"PeriodicalIF":3.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581912","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":"The gain in Spain of home dialysis is mainly on the plain.","authors":"J Emilio Sánchez-Alvarez, María Jesús Puchades Montesa, María Fernanda Slon-Roblero","doi":"10.1177/08968608261434264","DOIUrl":"https://doi.org/10.1177/08968608261434264","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261434264"},"PeriodicalIF":3.7,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514023","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":"The greenest exchange: Environmental stewardship in peritoneal dialysis.","authors":"Meera Shah, Jeffrey Perl","doi":"10.1177/08968608261435115","DOIUrl":"https://doi.org/10.1177/08968608261435115","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261435115"},"PeriodicalIF":3.7,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513986","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":"Family caregiver-assisted peritoneal dialysis in Argentina: A multicenter descriptive study.","authors":"Guillermo Fragale, Romina Fabro, Daniela Rodriguez, Sergio Dessole","doi":"10.1177/08968608261435118","DOIUrl":"https://doi.org/10.1177/08968608261435118","url":null,"abstract":"<p><p>Assisted peritoneal dialysis (PD) enables home-based kidney replacement therapy for patients with physical, cognitive, or social limitations. Although structured-assisted PD programs exist internationally, little is known about their implementation in Argentina. We conducted a multicenter, cross-sectional study including adult patients (≥18 years) on assisted PD from 29 centers across the country between 28 July and 18 August 2025. Among 874 active PD patients, 184 (21%) were receiving assisted PD. Median age was 64 years (IQR: 45.5-75), and 75% initiated PD directly under assisted conditions. Most assistance was provided by family caregivers (90.8%), while professional support was uncommon (4.9% nurses; 3.3% paid caregivers). Motor impairment (45.1%), learning difficulties (38.6%), visual limitations (35.9%), and cognitive disorders (22.8%) were the most frequent indications for assistance. Patients reporting ≥3 contributing factors were significantly more likely to require complete assistance (p = 0.001). Older age was associated with complete assistance (p < 0.001), lower transplant listing rates (p < 0.001), and history of peritonitis (p = 0.033). Assistance type was not associated with peritonitis occurrence or dialysis adequacy (Kt/V ≥ 1.7). These findings show that assisted PD in Argentina relies predominantly on informal, family-based support rather than structured or funded professional programs. The model reflects unmet needs in training, caregiver support, and resource allocation. Strengthening formal-assisted PD programs may improve equity, ensure sustainable access to home dialysis and better support functionally dependent patients.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261435118"},"PeriodicalIF":3.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499638","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":"The sex factor in peritoneal dialysis: Advantage or inequity?","authors":"Ahmad Makeen, Wendy Wq Ye","doi":"10.1177/08968608261432161","DOIUrl":"https://doi.org/10.1177/08968608261432161","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261432161"},"PeriodicalIF":3.7,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475055","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":"The associations between quality of life and a five-day per week peritoneal dialysis prescription: A pilot randomized controlled study.","authors":"Louis L Huang, Matthew Rp Davies, Catherine A Brumby, Fiona G Brown, Peter G Kerr, Matthew A Roberts, Peter F Mount, Lawrence P McMahon","doi":"10.1177/08968608261432149","DOIUrl":"https://doi.org/10.1177/08968608261432149","url":null,"abstract":"<p><p>BackgroundIncremental peritoneal dialysis (PD) has been recommended as a patient-focused prescription; however, its safety and potential clinical benefits are based on retrospective studies.MethodsWe conducted a pilot, randomized controlled study comparing 5-day versus 7-day/week PD in incident patients with preserved residual kidney function in three centers in Australia. Modality of PD accorded to patient and clinician preferences for both groups. Participants on 5-day PD were transitioned to daily PD if symptoms of uremia did not respond to an increase in dialysate volume, or if residual renal creatinine clearance fell to <50 L/week/1.73m². Duration of the 5-day regimen, quality of life, and clinical outcomes were compared to standard treatment over 12 months.ResultsTwenty-four participants were randomized to 7-day (<i>n</i> = 13) or 5-day (<i>n</i> = 11) PD. At baseline, age, gender, diabetes prevalence, and estimated glomerular filtration rate were similar. The mean and median durations of the 5-day prescription were 8.4 ± 4.7 and 12 (IQR 5-12) months, respectively. On average, participants in the 5-day Group had 73 dialysis-free days/person and utilized less PD fluid (957 ± 218 vs. 1558 ± 436 L/person, <i>P</i> < 0.0001). No differences were observed in peritonitis (0.12 vs. 0.26 episodes/patient-year) or hospitalization (0.12 vs. 0.09 episodes/patient-year) rates between 5- and 7-day groups, respectively. Although physical, mental, and kidney-disease composite scores were comparable between groups, sleep quality and patient satisfaction were higher in the 5-day Group.ConclusionIncremental PD was feasible in patients with preserved residual kidney function in the first year of dialysis and was not associated with more complications compared with daily PD. Differences observed in sleep quality of treatment satisfaction are hypothesis-generating and warrant further evaluation.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261432149"},"PeriodicalIF":3.7,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463593","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}