Peritoneal Dialysis International最新文献

{"title":"Successful treatment with clofazimine for macrolide-resistant <i>Mycobacterium abscessus</i> infection in a peritoneal dialysis patient: A case report and literature review.","authors":"Mizuki Kimura, Kanako Watanabe-Kusunoki, Mina Eguchi, Fumihiko Hattanda, Daigo Nakazawa, Saori Nishio, Takayuki Hirose, Keisuke Kamada, Tatsuya Atsumi","doi":"10.1177/08968608261432158","DOIUrl":"https://doi.org/10.1177/08968608261432158","url":null,"abstract":"<p><p>Nontuberculous mycobacteria are rare but serious pathogens in peritoneal dialysis (PD)-associated infections. <i>Mycobacterium abscessus (M. abscessus</i>) is usually resistant to standard anti-tuberculosis drugs. Macrolide antibiotics are key drugs for treating <i>M. abscessus</i>, but macrolide-resistant strains pose particular challenges, and an optimal antimicrobial treatment strategy or duration has not been established for <i>M. abscessus</i> PD-associated infections. We report a case of a 63-year-old man on PD who developed persistent purulent discharge from his PD catheter exit site. Skin swab culture identified macrolide-resistant <i>M. abscessus,</i> with imaging confirming inflammation along the catheter tunnel. These findings led to the diagnosis of <i>M. abscessus</i> PD catheter tunnel infection, with peritonitis excluded. Initial management included early catheter removal, extensive surgical debridement, and 6 weeks of combination antibiotic therapy, including imipenem-cilastatin, amikacin, and clarithromycin, achieving clinical cure. However, the infection recurred after 5 months, necessitating retreatment with debridement and an antibiotic regimen including imipenem-cilastatin, amikacin, azithromycin, and clofazimine for 4 weeks, followed by a continuation regimen with amikacin, clofazimine, and sitafloxacin for 4 months. This approach achieved sustained clinical cure without recurrence at 14 months of follow-up. Based on a literature review of 67 cases of <i>M. abscessus</i> PD-associated infections, all six cases treated with clofazimine achieved clinical cure, but there were no reports on cases of macrolide-resistant <i>M. abscessus</i> treated with clofazimine. Our case represents the first successful clofazimine treatment of macrolide-resistant <i>M. abscessus</i> PD-associated infection, demonstrating clofazimine as a potentially effective oral antibiotic option in combination therapy, particularly in macrolide-resistant cases with limited therapeutic options.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261432158"},"PeriodicalIF":3.7,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463556","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":"Reading beyond the abstract and conclusion: Embracing diagnostic technology-continuous glucose monitoring and positron emission tomography-while safeguarding individuals receiving peritoneal dialysis.","authors":"James A Sloand","doi":"10.1177/08968608261429726","DOIUrl":"https://doi.org/10.1177/08968608261429726","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261429726"},"PeriodicalIF":3.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434581","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 patients exhibit cognitive deficits but not ischemic brain injury: A magnetic resonance spectroscopy & diffusion tensor imaging study.","authors":"Jessica A Vanderlinden, Dickson Wong, Michael Chiu, Christopher McIntyre, Arsh K Jain","doi":"10.1177/08968608261421102","DOIUrl":"https://doi.org/10.1177/08968608261421102","url":null,"abstract":"<p><p>BackgroundMaintaining neurocognitive function is essential in the care of patients requiring dialysis. Currently, it is known that intradialytic systemic injury occurs during hemodialysis (HD) leading to ischemic injury and subcortical abnormalities that correspond to neurocognitive impairments. However, the pathophysiology of the intradialytic effects of peritoneal dialysis (PD) on the brain and neurocognitive function is unknown.MethodsPatients completed a neurocognitive battery (The Montreal Cognitive Assessment [MoCA], Trails Making Test [TMT], and Cambridge Brain Science [CBS]), a diffusion tensor imaging scan, and proton magnetic resonance spectroscopy (¹H-MRS). Imaging and neurocognitive assessments were performed before PD exchange, with repeat imaging after 90 min of dwell time.ResultsTwelve patients receiving PD were studied. Patient demographics included (mean ± SD): 67 ± 8 years, 75% male, 75% diabetic, with a dialysis vintage of 18 ± 9 months. Intradialytic ¹H-MRS detected a 21% increase in glucose after 90 min (<i>p</i> = 0.006); however, no acute white matter effects were evident. The neurocognitive battery indicated that most impairment was seen on the TMT A/B (92%/50% impaired), indicating impairments in attention and executive function. Four CBS tasks showed impairment representing verbal, short-term memory, and reasoning impairments. Finally, 17% of the cohort was impaired on the MoCA.ConclusionsThis study demonstrated that PD is not associated with the same acute intradialytic ischemic injury routinely experienced by patients receiving HD, which may indicate that PD has a neuro-hemodynamic protective effect. However, those receiving PD did experience metabolic stress in the form of significant cerebral hyperglycemia, which may precipitate neurocognitive impairments indicating further investigation is warranted.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261421102"},"PeriodicalIF":3.7,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377834","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":"Prescript peritoneal dialysis: Patterns of iron prescribing in peritoneal dialysis.","authors":"Sebastian Spencer, Samantha Hunter, Sunil Bhandari","doi":"10.1177/08968608251335554","DOIUrl":"10.1177/08968608251335554","url":null,"abstract":"<p><p>BackgroundIron deficiency and anaemia are prevalent in people undergoing peritoneal dialysis (PD), necessitating effective iron supplementation. While oral iron is often preferred for its accessibility and cost, it may be insufficient or poorly tolerated. Intravenous (IV) iron is generally well tolerated and associated with improved haemoglobin response and reduced erythropoiesis-stimulating agent requirements, yet optimal dosing, administration intervals, and haematological targets remain under-researched, particularly in PD populations. Current prescribing practices vary significantly, reflecting gaps in evidence and consensus. This study aimed to evaluate UK clinical practices for iron therapy in PD and estimate patient eligibility for a future randomised controlled trial (RCT).MethodsA cross-sectional survey was conducted among UK-based kidney clinicians using a structured 9-item questionnaire distributed electronically via the UK Kidney Association. The survey explored iron repletion strategies, diagnostic thresholds, and circumstances for withholding therapy. Responses were analysed using descriptive statistics for quantitative data and thematic analysis for free-text responses.ResultsA total of 41 clinicians from 23 dialysis units participated, including consultants (73.2%), registrars (17.1%), and specialist nurses (9.7%). High-dose IV iron (≥500 mg per visit) was the preferred strategy for 65.9% of respondents, while none used oral iron alone. Most clinicians initiated iron therapy when serum ferritin was <200 µg/L (53.7%) or transferrin saturation (TSAT) was <20% (78.1%). Diagnostic measures beyond serum ferritin and TSAT, such as reticulocyte haemoglobin content, were rarely used (14.6%). The majority avoided iron therapy in the presence of active infection (90.2%) or IV iron allergy (92.7%). Estimates of trial eligibility indicated that 6-10% of people receiving PD might not meet inclusion criteria, largely due to elevated C-reactive protein, ferritin, or TSAT levels.ConclusionsThis survey highlights significant variability in iron therapy practices for people receiving PD in the UK. Most clinicians favour high-dose IV iron, reflecting its practical advantages in outpatient settings. However, diagnostic and safety concerns remain, with limited use of advanced biomarkers and inconsistent thresholds for therapy initiation. These findings underscore the need for a robust RCT to address gaps in evidence, establish optimal iron repletion strategies, and ensure safe and effective anaemia management in PD populations.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"154-162"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030932","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":"Vegetable crudités and peritoneal dialysis-associated peritonitis: An unusual case of foreign body PD peritonitis.","authors":"Michael Che, Tushar Malavade","doi":"10.1177/08968608251400520","DOIUrl":"10.1177/08968608251400520","url":null,"abstract":"<p><p>Peritoneal dialysis-associated peritonitis (peritoneal dialysis (PD) peritonitis) is a common complication of peritoneal dialysis associated with adverse events and mortality. Outcomes are poorer when two or more organisms are isolated in the dialysis effluent culture, known as polymicrobial PD peritonitis, which can be caused by an underlying secondary process, such as gastrointestinal tract pathology and, rarely, a foreign body. Here, we report a case of polymicrobial PD peritonitis due to a vegetable matter foreign body perforating the colon. The patient was conservatively managed with antibiotic treatment and subsequent colonoscopic removal of the foreign body without the need for peritoneal dialysis catheter removal. She continues to remain on peritoneal dialysis 18 months after the PD peritonitis episode.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"190-193"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637705","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":"Successful localization and repair of pleuroperitoneal communication using indocyanine green fluorescence in peritoneal dialysis: A case series.","authors":"Hyeran Park, Kwan Yong Hyun, Hanbi Lee, Cheol Whee Park, Yaeni Kim","doi":"10.1177/08968608251351132","DOIUrl":"10.1177/08968608251351132","url":null,"abstract":"<p><p>Pleuroperitoneal communication affects 1.6%-10% of continuous ambulatory peritoneal dialysis (PD) patients and often leads to discontinuation of peritoneal dialysis. In pleuroperitoneal communication, an important aspect is not only the diagnosis but also the detection of the diaphragmatic defect. Traditional methods have often failed to detect small defects, which contributes to the recurrence of pleuroperitoneal communication. We present three cases of intractable diaphragmatic defects in pleuroperitoneal communication, successfully localized and treated using indocyanine green (ICG) fluorescence staining of peritoneal dialysate, visualized with an infrared camera. After detecting the defect, surgical repair involved defect plication and the application of talc for pleural adhesion. This approach enabled immediate and successful on-site repair, allowing all patients to resume peritoneal dialysis post-surgery. Even the smallest diaphragmatic defects were accurately identified using ICG fluorescence dye dissolved in peritoneal dialysate. This case series demonstrates that ICG fluorescence staining enhances the diagnosis and treatment of pleuroperitoneal communication by improving defect localization. Our protocol shows promise in increasing diagnostic accuracy, reducing recurrence rates, and helping patients maintain their preferred dialysis modality.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"178-182"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326543","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":"Single-port video-assisted thoracoscopic surgery for peritoneal dialysis-related pleuroperitoneal communication using near-infrared fluorescence with indocyanine green.","authors":"Yue Qian, Haiping Lin, Qing Ye, Zanzhe Yu, Lijun Qian, Zhaohui Ni, Leyi Gu, Wei Fang, Hao Yan","doi":"10.1177/08968608251335831","DOIUrl":"10.1177/08968608251335831","url":null,"abstract":"<p><p>BackgroundPeritoneal dialysis (PD)-related pleuroperitoneal communication is strongly associated with PD discontinuation. Video-assisted thoracoscopic surgery (VATS) has emerged as a promising therapeutic approach. However, there are still challenges in detecting diaphragmatic defects under conventional thoracoscopy, and the repair methods vary significantly.MethodsWe have developed an intervention protocol for pleuroperitoneal communication that includes single-port VATS utilizing near-infrared fluorescence with indocyanine green, as well as the management of perioperative kidney care and PD reinitiation. Patients who underwent VATS for pleuroperitoneal communication repair from September 2022 to March 2024 were identified at a single center. The procedures and outcomes were evaluated, and the success rate of PD resumption was compared with that of a historical cohort treated with non-surgical therapies.ResultsA total of 6 patients underwent VATS. The age was 48.7 ± 11.8 years, 2 were female, and the PD vintage was 8.7 (2.0-28.4) months. Non-dialysis therapy (<i>n</i> = 4) or temporary hemodialysis (<i>n</i> = 2) was prescribed during PD suspension. Fluorescence thoracoscopy identified diaphragmatic defects in all patients, including lesions that were unrecognizable under white light. Mechanical pleurodesis by direct suture of the defects with local mechanical reinforcement was performed. All patients reinitiated PD 15-30 days postoperatively, with no recurrence during a follow-up of 17.0 ± 6.4 months. The success rate significantly exceeded that in the patients who underwent PD suspension or chemical pleurodesis (100% vs. 29%, <i>p</i> = 0.005).ConclusionsThe minimally invasive VATS integrating fluorescence with indocyanine green and pleurodesis with multiple mechanical reinforcements, along with appropriate perioperative care and an incremental approach to resume PD, was a reliable treatment for PD-related pleuroperitoneal communication.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"146-153"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037361","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":"Transitions to and from peritoneal dialysis: Your questions answered.","authors":"Louis-Charles Desbiens, Annie-Claire Nadeau-Fredette","doi":"10.1177/08968608251343768","DOIUrl":"10.1177/08968608251343768","url":null,"abstract":"<p><p>Modality transitions are very common in patients undergoing peritoneal dialysis (PD); they can either occur before the initiation of PD, following its termination, or as a temporary interruption during PD treatment. Transfers to and from facility hemodialysis represent the majority of these transitions. In addition to their impact on the quality of life of patients and their caregivers, modality transitions are often linked with hospitalizations, mortality, and increased health expenditures. Yet, some of these transfers are unavoidable and should be considered as part of the \"dialysis life plan\" for patients receiving PD. In this review, we will present the epidemiology, risk factors, and clinical impacts of the most frequent transitions that PD patients experience. We will also discuss strategies to optimize the outcomes of patients undergoing modality transfers. Finally, we will review the evidence underlying the integrated home dialysis paradigm, in which patients transition from PD to home hemodialysis.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"85-94"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199855","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":"Predictive models on patients' eligibility for peritoneal dialysis.","authors":"Yang Yang, Helen H Chen, Robert R Quinn, Joel A Dubin, Matthew J Oliver","doi":"10.1177/08968608251317463","DOIUrl":"10.1177/08968608251317463","url":null,"abstract":"<p><p>BackgroundPeritoneal dialysis (PD) is being promoted because it is cost-effective and has equivalent outcomes to facility-based hemodialysis (HD). Determining PD eligibility is critical but subjective, with high variability among renal programs. This study aimed to establish a predictive model for PD eligibility among individuals who started treatment with HD. A secondary objective was to identify predictors of PD eligibility and determine if eligible patients went on to receive PD.MethodsThis retrospective cohort study included individuals starting HD at multiple hospitals in Alberta, Canada, as part of the START program between 1 October 2016 and 31 March 2018. Twenty-seven predictors, including patient characteristics, laboratory values, and comorbidities, were considered in logistic regression modeling. The outcome variable was PD eligibility, as determined by a standardized interdisciplinary assessment. The model selection was based on the Akaike information criterion. The confusion matrix was used for each model to compare the predicted versus observed eligibility. The final model was calibrated and presented.ResultsAmong the 598 participants, 391 (65.4%) were considered eligible for PD. The logistic regression model achieved a modest performance in discriminating patients who were eligible for PD, with a high sensitivity of 91.3%, an accuracy of 0.68 (95% CI, 0.65-0.72), and an area under the receiver operating characteristic curve ranging from 0.69 to 0.71. Age (OR = 0.98; 95% CI, 0.97-0.99), body mass index (OR = 0.95; 95% CI, 0.93-0.97), starting dialysis in intensive care unit (OR = 0.53; 95% CI, 0.31-0.92), and polycystic kidney disease (OR = 0.37; 95% CI, 0.13-0.99) were statistically significant factors associated with a lower likelihood of being considered eligible for PD. Out of the 391 eligible PD patients, 87 (22.3%) received PD treatment within 6 months of starting HD.ConclusionsThe majority of patients starting HD were considered eligible for PD. Our model exhibits a high level of sensitivity and could serve as a valuable tool for screening potential candidates following the commencement of HD.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"115-123"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516285","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 catheter type for acute kidney injury and clinical outcomes: How rigid should we be?","authors":"Mignon McCulloch, Danielle E Soranno, Arpana Iyengar","doi":"10.1177/08968608251362116","DOIUrl":"https://doi.org/10.1177/08968608251362116","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":"46 2","pages":"79-82"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434566","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}