Peritoneal Dialysis International最新文献

{"title":"Outcomes of acute peritoneal dialysis using rigid catheters in the critically ill pediatric population.","authors":"Raajashri Rajasegar, Madhileti Sravani, Bobbity Deepthi, Narayanan Parameswaran, Sudarsan Krishnasamy, Sivamurukan Palanisamy, Sriram Krishnamurthy","doi":"10.1177/08968608251344078","DOIUrl":"10.1177/08968608251344078","url":null,"abstract":"<p><p>BackgroundPeritoneal dialysis (PD) offers comparable survival for acute kidney injury (AKI) as other kidney replacement therapies, but concerns about rigid catheter complications like peritonitis persist. This study evaluated outcomes of acute PD using rigid catheters in critically ill children, including peritonitis rates and mechanical complications.MethodsThis retrospective study analyzed data from consecutive pediatric patients (aged <18 years) admitted to our tertiary-level pediatric intensive care unit, who underwent acute PD using either rigid or improvised catheters, with each PD session limited to 72 h followed by re-insertion after 24 h if indicated. Data on primary diagnosis, PD indication, and laboratory parameters were collected from patient records and dialysis registers. Outcome measures, such as peritonitis rates and mechanical complications, were assessed.ResultsOver a 10-year span (January 2014-September 2023), 202 children, 57% males, with a median age of 11 (3.6, 30) months, underwent PD. PD was initiated for fluid overload in 65 (32%), persistent anuria in 51 (25.2%), and refractory hyperkalemia in 47 (23.3%). In 13 (6.4%) patients, PD was initiated for metabolic crisis in the absence of AKI. The median estimated glomerular filtration rate at PD initiation was 21.4 (13.2, 46.5) mL/1.73m²/min. A total of 250 PD sessions/catheter insertions were performed on 202 children, for a median duration of 72 (24, 72) hours. Fourteen (6.9%) children developed peritonitis. Among children who received PD for ≤ 72 h (<i>n</i> = 164), peritonitis frequency was 3%, while it was 15.7% in those with one catheter re-insertion (<i>n</i> = 19) and 31.5% in >1 catheter reinsertion (<i>n</i> = 19). The peritonitis rate-per-catheter was 3% in children with single catheter insertion (<i>n</i> = 164), and 10.4% in children with ≥ 1 catheter re-insertions (<i>n</i> = 38). Among six children, who had extended PD sessions (single PD session duration, irrespective of it being the first or subsequent catheter) of 84 [84,100] (median [IQR]) hours, 3 (50%) developed peritonitis. Mechanical complications included peritubal-leak 28 (13.8%), hemorrhagic effluent in 8 (3%), catheter dislodgement in 3 (1.5%), and PD catheter block in 13 (6.4%). One child (0.49%) developed intestinal perforation.ConclusionsAcute PD with a rigid catheter limited to 72 h appears safe and feasible in resource-constrained settings where soft Tenckhoff PD catheters are not easily available, though peritonitis rates increase with increasing cumulative duration on PD.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"95-104"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142969","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":"Gallbladder perforation: A rare cause of non-infectious peritonitis with yellow effluent.","authors":"Zeynep Ural, Galip Güz, Ülver Derici","doi":"10.1177/08968608251321918","DOIUrl":"10.1177/08968608251321918","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"186-187"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701041","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":"Thoracic spinal anesthesia for laparoscopic peritoneal dialysis catheter placement in older high-risk end-stage kidney disease patients.","authors":"Maddalena Ricci, Anna Rita Bonfigli, Olga Protic, Fabiola Olivieri, Roberto Starnari, Salvatore Iuorio, Federica Lenci","doi":"10.1177/08968608251336674","DOIUrl":"10.1177/08968608251336674","url":null,"abstract":"<p><p>Peritoneal dialysis (PD) catheter placement is considered a controversial procedure in patients with a history of abdominal surgeries or peritonitis. In these subjects, video laparoscopic (VLS)-assisted placement under general anesthesia (GA) is the gold standard procedure. However, older multimorbid patients are at high risk for complications in GA. In our opinion, thoracic spinal anesthesia (TSA) instead of GA could also be used in older multimorbid patients undergoing PD. Here, we report five cases of older multimorbid end-stage kidney disease (ESKD) patients aged 79.6 ± 3.5 years with a history of abdominal surgery or peritonitis needing renal replacement therapy. Overall comorbidity was high (Cumulative Illness Rating Scale (CIRS) comorbidity index 4.0 ± 1.2 and CIRS severity index 2.1 ± 0.5). We placed the PD catheter in these patients using the VLS-assisted placement under TSA. All subjects underwent TSA performed at the T9-T10 thoracic level, obtaining optimal pain control and no periprocedural side effects. This is the first attempt to utilize the TSA in PD catheter VLS placement in very old multimorbid patients. Further studies could be useful to confirm whether TSA can be successfully used in VLS-assisted PD catheter placement, especially in subjects ineligible for GA such as older frailty patients.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"174-177"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018991","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":"External validation of a prognostic model in routine practice for short- and long-term survival in peritoneal dialysis.","authors":"Sara N Davison, Sarah Rathwell","doi":"10.1177/08968608251364097","DOIUrl":"10.1177/08968608251364097","url":null,"abstract":"<p><p>BackgroundThere are several indices to predict survival at dialysis start but tools to predict mortality for prevalent patients are lacking. This study provides evidence for external validity of the Cohen model to assess 6-, 12-, and 18-months survival of prevalent peritoneal dialysis (PD) patients.MethodsProspective cohort study of 464 PD patients in a university-based program between 2015 and 2019. Survival probabilities were compared to observed survival. Discrimination and calibration were assessed through predicted risk-stratified observed survival, cumulative area under the curve, Somer's Dxy, and a calibration slope estimate.ResultsDiscrimination performance was moderate with c-statistic of 0.73 to 0.74 for all 3 time points. The model over predicted mortality risk with the best predictive accuracy for 6-month survival. The difference between observed and mean predicted survival at 6, 12, and 18 months was 3.1%, 5.5%, and 11.0%. Kaplan-Meier curves showed good discrimination between low- and high-risk patients with hazard ratios [95% confidence interval (CI)]: C4 vs C1 32.0 [4.3-236.5]. Miscalibration of the model was the greatest for the highest risk patient group in whom 12 and 18 months predicted survival was 15% and 28% lower than observed survival.ConclusionsThe Cohen prognostic model can identify PD patients at high risk for death over 6, 12, and 18 months. Given it overestimates mortality risk for the highest risk patients, care must be taken to not use predictions to withhold treatment but rather to risk stratify and identify those who may benefit from enhanced kidney supportive care. This miscalibration provides an imperative to refine the tool for PD patients.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"105-114"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13044472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcellular transport of ¹⁸F-deoxyglucose via facilitative glucose channels in experimental peritoneal dialysis.","authors":"Giedre Martus, Premkumar Siddhuraj, Jonas S Erjefält, András Kádár, Martin Lindström, Karin Bergling, Carl M Öberg","doi":"10.1177/08968608241299928","DOIUrl":"10.1177/08968608241299928","url":null,"abstract":"<p><p>BackgroundLocal and systemic side effects of glucose remain major limitations of peritoneal dialysis (PD). Glucose transport during PD is thought to occur via inter-endothelial pathways, but recent results show that phloretin, a general blocker of facilitative glucose channels (glucose transporters [GLUTs]), markedly reduced glucose diffusion capacity indicating that some glucose may be transferred via facilitative glucose channels (GLUTs). Whether such transport mainly occurs into (absorption), or across (trans-cellular) peritoneal cells is as yet unresolved.MethodsHere we sought to elucidate whether diffusion of radiolabeled ¹⁸F-deoxyglucose ([¹⁸F]-DG) in the opposite direction (plasma → dialysate) is also affected by GLUT inhibition. During GLUT inhibition, such transport may either be increased or unaltered (favors absorption hypothesis) or decreased (favors transcellular hypothesis). Effects on the transport of solutes other than [¹⁸F]-DG (or glucose) during GLUT inhibition indicate effects on paracellular transport (between cells) rather than via GLUTs.ResultsGLUT inhibition using phloretin markedly reduced [¹⁸F]-DG diffusion capacity, improved ultrafiltration (UF) rates and enhanced the sodium dip. No other solutes were significantly affected with the exception of urea and bicarbonate.ConclusionThe present results indicate that part of glucose is transported via the transcellular route across cells in the peritoneal membrane. Regardless of the channel(s) involved, inhibitors of facilitative GLUTs may be promising agents to improve UF efficacy in patients treated with PD.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"138-145"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786434","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":"Comparing residual kidney function equations based on β2-microglobulin in Chinese patients undergoing continuous ambulatory peritoneal dialysis.","authors":"Chunxiang Huang, Dan Liu, Ning Weng, Fenxia Luo","doi":"10.1177/08968608241312748","DOIUrl":"10.1177/08968608241312748","url":null,"abstract":"<p><p>BackgroundFew studies have evaluated the predictive capability of equations for residual kidney function (RKF) in patients undergoing peritoneal dialysis (PD). Moreover, the applicability of each equation remains unclear. Therefore, we aimed to evaluate the performances of the estimated RKF (eRKF) equations of Shafi, Steubl, and Jaques in Chinese patients undergoing continuous ambulatory peritoneal dialysis (CAPD).MethodsThis was a retrospective study. We enrolled patients who underwent CAPD and RKF measurements (via 24-h urine collection) in our hospital between November 2021 and May 2022. Using the measured RKF (mRKF) as the reference, we derived the bias, precision and accuracy of each equation.ResultsWe enrolled 174 participants. The mean β2-microglobulin and median mRKF were 29.00 ± 8.69 mg/L and 2.94 (1.26, 4.65) mL/min/1.73 m², respectively. The Steubl equation had the least bias (MD [95% confidence interval, CI]: -0.52 [-0.77 to -0.38]), higher precision (interquartile range: 1.43 [1.16, 1.76]), and highest accuracy (83%). It also had a high diagnostic accuracy for identifying patients with an mRKF of > 2.5 mL/min/1.73 m², area under the curve of 0.936 95% CI [0.903-0.970], <i>p</i> < 0.001), cut-off value of 1.80 mL/min/1.73 m², specificity of 0.895, and sensitivity of 0.847.ConclusionAlthough no equation was fully accurate, the Steubl equation identified patients suitable for an incremental PD prescription more accurately than the Shafi and Jaques versions. It may be useful for monitoring the RKF of Chinese patients undergoing CAPD who are unable to reliably collect urine.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"130-137"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009574","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":"PD-associated peritonitis: Something's fishy.","authors":"Shiyu Lu, Ron Merko, David Gomez, Felipe Castillo, Jeffrey Perl","doi":"10.1177/08968608241312751","DOIUrl":"10.1177/08968608241312751","url":null,"abstract":"<p><p>Peritoneal dialysis (PD)-associated peritonitis commonly arises from touch contamination events, however, it is important to be mindful of alternative etiologies and to take a detailed history and perform a root cause analysis for each episode. In fact, the PD effluent can be a window into intra-abdominal pathologies which may require surgical management. We present an unusual case of secondary enteric peritonitis due to foreign body bowel perforation from ingestion of a fish bone.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"188-189"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458928","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":"Retrospective review of assisted peritoneal dialysis: The Alberta, Canada experience.","authors":"Veronica Hammer, Danielle Fox, Warda Munawar, Chel Hee Lee, Robert R Quinn, Jennifer M MacRae","doi":"10.1177/08968608251313680","DOIUrl":"10.1177/08968608251313680","url":null,"abstract":"<p><p>BackgroundAssisted peritoneal dialysis (PD), where trained health care providers assist individuals with PD in their home, allows individuals, who would otherwise be ineligible, to pursue home dialysis. Alberta Kidney Care South started an assisted PD program in 2011 using licensed practical nurses (LPNs) and switched to health care aids (HCA) July 2018.MethodsA retrospective chart review to describe characteristics of assisted PD patients and their outcomes for each of the models of health care. The primary outcome was the duration of assisted PD from initiation to exit. Secondary outcomes included reasons for exit and the proportion of patients who performed independent PD.ResultsA total of 135 patients received assisted PD, mean age 70.7 ± 11.2 years and 44.4% (60/135) women. The average time to exit from assisted PD was 366.2 ± 378.1 days. There was no difference between time in PD between LPN (1.89 [1.02, 3.85] years) and HCA (2.09 [0.89, 3.26] years), <i>p</i> = 0.98. Main reasons for exit from assisted PD included death 30.4% (41/135) and switching to hemodialysis 26.7% (36/135). Total of 29 patients (21.5%) continued PD independently for an additional 495 ± 399 days. There was no difference in reasons for exit, <i>p</i> = 0.90 or peritonitis rates between the two care models, <i>p</i> = 0.60.ConclusionAssisted PD allows patients to maintain independence in the community and facilitates the uptake of independent PD in a significant proportion. Utilizing an HCA model offers a cost-effective alternative while still providing high-quality care.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"124-129"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256013","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":"Crystal balls for PD care: How predictive models can help us see ahead.","authors":"Keith McCullough, Lisa Henn, Dean Tsai","doi":"10.1177/08968608251413925","DOIUrl":"10.1177/08968608251413925","url":null,"abstract":"<p><p>Care teams and patients want to know what happens next, and researchers have put together a lot of tools, such as predictive models, to help them predict the future. While these researchers are well-intentioned, the tools they develop are not always helpful. Most researchers know enough to perform various tests of their predictive models, such as statistical tests that answer the question: \"Are the predictions based on this model better than a coin flip?\" We urge researchers to add another test to their existing lists: \"Does this model tell care teams anything they don't already know?\"</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"83-84"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019267","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":"Incremental start and clinical outcomes in peritoneal dialysis: International results from PDOPPS.","authors":"Ashik Hayat, Melissa S Cheetham, Yeoungjee Cho, Junhui Zhao, Keith McCullough, Douglas S Fuller, Rathika Krishnasamy, Neil Boudville, Ana E Figueiredo, Yasuhiko Ito, Talerngsak Kanjanabuch, Jeffrey Perl, Beth M Piraino, Ronald L Pisoni, Cheuk C Szeto, Isaac Teitelbaum, Graham Woodrow, Ken Tsuchiya, David W Johnson, Louis L Huang","doi":"10.1177/08968608251385614","DOIUrl":"10.1177/08968608251385614","url":null,"abstract":"<p><p>BackgroundThe impact of incremental peritoneal dialysis (PD) on outcomes is poorly understood, and there is a paucity of evidence informing best practices regarding the dialysis dose at the commencement of PD. This international prospective cohort study aimed to compare PD prescription practices at dialysis commencement and their subsequent association with clinical outcomes.MethodsAdult patients who started PD for less than three months at the time of enrolment in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) between 1 January 2014 and 31 December 2017 were included. Patients were defined as initiating incremental PD if prescribed a total of <4 exchanges/day for continuous ambulatory peritoneal dialysis (CAPD) or, with dry days or having PD less than seven days per week for automated peritoneal dialysis (APD). All other prescriptions were considered standard PD. The primary outcome was the transfer to haemodialysis (HD). Secondary outcomes included peritonitis rate, time to first peritonitis and mortality. Logistic regression analysed PD uptake and the Cox proportional hazards regression model analysed HD transfer, peritonitis and patient survival.ResultsOverall, 1365 PD patients from 128 facilities across seven countries were included. Fewer individuals started on incremental PD than standard PD (37% vs 63%, <i>p</i> < 0.001). Higher incremental PD uptake was associated with receiving treatment in Japan (odds ratio [OR] 2.35, 95% CI 1.05-5.26, <i>p</i> = 0.04; ref: Canada), age >75 years (OR 1.51, 95% CI 1.02-2.24, <i>p</i> = 0.04), icodextrin use (OR 8.54, 95% CI 6.26-11.64, <i>p</i> < 0.001), lower serum creatinine concentration at PD start (OR 1.01, 95% CI 1.01-1.01, <i>p</i> = 0.007) and higher number of PD patients at a facility (OR 1.01, 95% CI 1.00-1.01, <i>p</i> = 0.02). Crude HD transfer rates for the incremental and standard PD groups were 0.14 (95% CI, 0.12-0.16) and 0.15 (95% CI, 0.13-0.17) per patient-year of follow-up, respectively (incidence rate ratio [IRR], 0.93; 95% CI, 0.75-1.15; <i>p</i> = 0.49). There was no significant difference in the hazard of HD transfer between the incremental and standard PD groups (hazard ratio [HR] 0.87, 95% CI 0.68-1.12, <i>p</i> = 0.29). There were also no differences between the two groups concerning peritonitis and mortality.ConclusionsIncremental PD start was prescribed in approximately one-third of patients and, in low certainty evidence, was associated with comparable risks of HD transfer, peritonitis and death.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"163-173"},"PeriodicalIF":3.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378200","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}