Peritoneal Dialysis International最新文献

{"title":"Body roundness Index on the clinical outcome of peritoneal dialysis patients: Analysis of two cohorts.","authors":"Lixing Xu, Jack Kit-Chung Ng, Gordon Chun-Kau Chan, Winston Wing-Shing Fung, Kai-Ming Chow, Cheuk-Chun Szeto","doi":"10.1177/08968608261446827","DOIUrl":"10.1177/08968608261446827","url":null,"abstract":"<p><p>BackgroundCentral obesity is common among patients undergoing peritoneal dialysis (PD) and may have important metabolic consequences. The body roundness index (BRI) is a convenient anthropometric measurement that represents central adiposity and visceral fat. However, its prognostic value in PD patients has not yet been explored.MethodWe conducted a retrospective study involving two cohorts of PD patients: an exploratory cohort of 249 prevalent PD patients and a validation cohort of 162 incident ones. In addition to BRI, we performed bioimpedance spectroscopy and other routine clinical and biochemical tests. Outcome measures included patient survival, rate of alive and remained on PD, peritonitis-free survival, and hospitalization rates.ResultsIn the exploratory cohort, the baseline BRI was an independent risk factor for all-cause mortality, with an adjusted hazard ratio of 1.346 (95% CI: 1.094 to 1.655, p = 0.005), and for rate of alive and remained on PD, with an adjusted hazard ratio of 1.279 (95% CI: 1.079 to 1.517, p = 0.004). A high BRI was also associated with a higher frequency of hospitalizations (p = 0.001) and longer hospital stays (p = 0.002). In the validation cohort, baseline BRI was also associated with patient survival by univariable Cox regression analysis, but the result became insignificant after adjusting for confounding clinical factors by multi-variable Cox regression.ConclusionA high BRI is associated with increased rates of all-cause mortality and hospitalization. However, the results from the exploratory and validation cohorts were somewhat inconsistent, indicating the necessity for further research to validate our findings.<b>Index Words:</b> kidney failure; obesity; cardiovascular disease.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"569-577"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778347","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":"How we can bulk up randomized control trials in peritoneal dialysis.","authors":"Shreeyukta Bhattarai, Ankur D Shah","doi":"10.1177/08968608261469979","DOIUrl":"10.1177/08968608261469979","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"422-423"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430875","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 peritoneal dialysis fluid composition and infusion timing on 18F-fluoro-2-deoxy-2-d-glucose positron emission tomography-computed tomography interpretability in peritoneal dialysis patients.","authors":"Guillaume Fernandes, Michael Moryoussef, Inès Dufour, Renaud Lhommel, Eric Goffin","doi":"10.1177/08968608251412166","DOIUrl":"10.1177/08968608251412166","url":null,"abstract":"<p><p>BackgroundGlucose and insulin blood levels are well known altering factors for 18F-fluoro-2-deoxy-2-d-glucose positron emission tomography-computed tomography ([18F]-FDG PET-CT) interpretability in peritoneal dialysis (PD) patients. A potential influence of glucose-based solutions and Icodextrin in PD patients has not been studied. The aim of this study was to assess PET-CT interpretability in PD patients according to the osmotic agent used in the dialysis fluid (Icodextrin vs. glucose) and the timing of dialysate infusion before imaging.MethodsWe searched for all PET-CT performed on individuals receiving PD between January 2020 and March 2024 at Cliniques universitaires Saint-Luc, Brussels, Belgium. Peritoneal membrane characteristics, data regarding dialysis solutions, PET-CT parameters and results were collected. We analyzed available data regarding insulinemia and glycemia during a PD exchange.ResultsFourteen PET-CTs were available for study of which four were performed on PD patients with a glucose-based solution dwell at imaging, six with Icodextrin, and three with an empty abdomen. Data regarding the presence or absence of PD fluid was missing for one patient. The only uninterpretable exam was performed on a patient injected with [18F]-FDG 86 min after an exchange with a glucose-based solution. All other exams in the glucose-based group were interpretable with a mean PD fluid infusion to [18F]-FDG injection time of 186 min. All PET-CTs in patients with an Icodextrin dwell were interpretable.ConclusionIn this small PD cohort, PET-CT interpretability appears preserved with Icodextrin dwells and may be adequate with glucose-based solutions if sufficient time elapses, requiring confirmation in larger studies.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"544-550"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003849","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 flushing in children: A national survey of practice patterns.","authors":"Eva M Glenn Lecea, Alexandra C Bicki, Meghan Finn, Audrey Anaya, Donna Claes, Bradley A Warady, Marsha M Lee","doi":"10.1177/08968608261480219","DOIUrl":"10.1177/08968608261480219","url":null,"abstract":"<p><p>BackgroundPeritoneal dialysis (PD) is widely used for the management of pediatric kidney failure due to quality-of-life advantages. However, practices for PD catheter flushing between placement and dialysis initiation are not well standardized and rely largely on expert opinion. This study aimed to characterize variation in flushing practices across U.S. pediatric centers.MethodsWe conducted a cross-sectional survey of Standardizing Care to Improve Outcomes in Pediatric End-Stage Kidney Disease (SCOPE)-affiliated pediatric PD programs. A 17-item questionnaire assessing institutional protocols and flushing practices was distributed in person to representatives from the centers attending the 2025 SCOPE Fall Meeting, with follow-up emails and the accompanying survey sent to nonattending and nonresponding centers. Responses were analyzed descriptively at the center level.ResultsForty-three of the 60 SCOPE-affiliated centers (72%) responded; 83% reported having a flushing protocol. Routine flushing was nearly universal (98%) across all pediatric age groups and was primarily performed by PD nurses. Initial flushing occurred either within postoperative days 0-1 or around 1 week after placement. Weekly flushing was most common, though frequency varied. Dianeal 1.5% (49%) and normal saline (39%) were the most common solutions, with a typical volume of 10 mL/kg. Heparin use varied: 34% used it routinely, 27% selectively, and 39% not at all, most often at 0.5 U/mL. Management of bloody effluent also differed across centers.ConclusionDespite near-universal PD catheter flushing in pediatric centers, practices vary considerably. These findings highlight the need for multicenter studies to inform evidence-based guidelines and standardize care.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261480219"},"PeriodicalIF":1.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841081","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":"An impressive start, but there is more to be done.","authors":"Peter G Blake, Matthew J Oliver","doi":"10.1177/08968608261479008","DOIUrl":"https://doi.org/10.1177/08968608261479008","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261479008"},"PeriodicalIF":1.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813739","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 pre-implantation hernia screening by ultrasound on hernia surgery during peritoneal dialysis.","authors":"Katrin König, Roswitha Köberle, Ineke Grendelmeier, Felix Burkhalter","doi":"10.1177/08968608261469981","DOIUrl":"https://doi.org/10.1177/08968608261469981","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261469981"},"PeriodicalIF":1.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796618","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":"Incidence of peritoneal dialysis transfer to hemodialysis after the free-choice dialysis policy in Thailand; A tertiary center experience.","authors":"Patipan Sorajj, Washirawarach Teeraseehatri, Wasinee Saelim, Kanyaporn Ngiwsa, Watanyu Parapiboon","doi":"10.1177/08968608261479080","DOIUrl":"https://doi.org/10.1177/08968608261479080","url":null,"abstract":"<p><p>Thailand has changed its kidney replacement therapy policy in the universal coverage scheme from peritoneal dialysis (PD)-first to free-choice dialysis in February 2022. We aim to compare the incidence rate (IR) of permanent PD transfer to hemodialysis (HD) before and after the national policy change. The records of PD persons in a tertiary hospital in Thailand from February 2020 to January 2023 were reviewed. The time on therapy (TOT) per person-year, the number of PD transfer to HD during the study period were investigated. The incidence of permanent PD transfer to HD was calculated as IR per 100-person-years and the incidence rate ratio (IRR) with a 95% confidence interval (CI) before and after the policy change was analyzed. The IR of PD transfer to HD was 4.31 (95% CI 3.32 to 5.51) per 100 person-years in the PD-first era (TOT of 1483 person-years) and increased to 10.89 (95%CI 8.5-13.74) per 100-person-years (TOT of 652 person-years) after the change to the free-choice dialysis era. The IRR of PD transfer to HD after the change to the free-choice dialysis era significantly increased to 2.52 (95%CI 1.77-3.59, p < 0.001) compared with the PD-first era. The most common reason for PD transfer to HD in the free-choice dialysis era was peritonitis. The cause of transfer to HD by patient preference was only 12.6%. After the change to the free-choice dialysis policy, the IRR of PD transfer to HD significantly increased immediately. The most common cause of PD transfer to HD was peritonitis, not patient preference.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261479080"},"PeriodicalIF":1.8,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760501","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 effluent-derived mononuclear phagocyte immune profiles may relate to cardiac function in peritoneal dialysis.","authors":"Micky Karsten, Nico Hahn, Puck Vree, Luke C Davies, Marc G Vervloet, Jan Van Den Bossche, Lily Jakulj","doi":"10.1177/08968608261476527","DOIUrl":"https://doi.org/10.1177/08968608261476527","url":null,"abstract":"<p><p>IntroductionCardiovascular-kidney-metabolic (CKM) syndrome is characterized by chronic inflammation that may drive heart failure. Peritoneal dialysis (PD), while lifesaving, may induce local and systemic inflammation through bioincompatible intraperitoneal solutions, potentially amplifying CKM syndrome. We investigated peritoneal mononuclear phagocyte phenotypes, key-drivers of inflammation, and whether these correlate with systemic inflammation and cardiac function in PD-treated patients.MethodsWe collected patient-matched peripheral blood-derived and PD-effluent (PDE)-derived cells from 13 adult PD-treated patients and characterized peritoneal immune populations by unbiased clustering using a mononuclear phagocyte-selective flow cytometry panel. In a subsequent cohort of 21 PD-treated patients, we correlated cardiac function [left ventricular global longitudinal strain (LV-GLS)] with peritoneal immune profiles and serum inflammatory markers.ResultsMononuclear phagocytes predominated in PDE and exhibited a more differentiated phenotype than blood-derived mononuclear phagocytes. Unbiased clustering revealed substantial overlap between blood- and PDE-derived classical monocytes. A higher PDE-derived differentiated monocyte-to-dendritic cell ratio was related to more impaired LV-GLS. Peritoneal monocytes showed reduced antigen-presenting capacity in patients with impaired cardiac function, potentially influenced by diabetes mellitus. Systemic inflammatory markers were largely undetectable in this stable PD-cohort.ConclusionOur findings suggest a link between peritoneal immune characteristics and cardiac dysfunction, characterized by a shift towards a higher monocyte-to-dendritic cell ratio in PD-treated patients with more pronounced cardiac dysfunction. The directionality and mechanisms underlying this association remain to be established and given the limited patient number and cross-sectional design, these findings should be considered as hypothesis-generating. The applied flow cytometry and unsupervised clustering approach offers a promising and scalable tool for future in-depth investigation of the peritoneal immune microenvironment and its relation to PD-related clinical outcomes, including CKM sequelae.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261476527"},"PeriodicalIF":1.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762615","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":"Human factors testing in a novel automated peritoneal dialysis system.","authors":"Nupur Gupta, Vikram Aggarwal, James A Sloand, Rick Pendergraft, Steve J Lindo, Brent Miller","doi":"10.1177/08968608261476545","DOIUrl":"https://doi.org/10.1177/08968608261476545","url":null,"abstract":"<p><p>BackgroundBecause automated peritoneal dialysis (APD) systems are used in the home and operated by patients or their care partners, the human-device interface must be thoughtfully designed to facilitate intuitive operation to reduce the risk of errors that could occur during their use. User-friendly design should also help reduce anxiety to peritoneal dialysis (PD) adoption by patients incident to end-stage kidney disease (ESKD). Usability issues remain a significant barrier to PD adoption and are an important contributor to premature death, serious injuries, and PD technique failure.MethodsA summative human factors usability study was conducted on a novel, gravity-based APD device (<i>Archimedes</i>™) with 15 current or former PD patients and 15 dialysis nurses. Participants were trained for 2 h, followed by a training decay period, then evaluated with critical Use Scenario tasks consisting of Simulated Use tasks and Knowledge tasks reflecting tasks that could result in patient harm if performed incorrectly.ResultsOf the Simulated Use tasks evaluated, 97.3% were deemed successful across all users. This high success rate demonstrates the effectiveness of the <i>Archimedes</i> APD device in facilitating the tasks required for PD. For patients, success outcomes were achieved in 96.8% of Simulated Use tasks. Nurses achieved a success rate of 97.8% for Simulated Use tasks evaluated. For Knowledge tasks, success outcomes were achieved in 99.3% and 98.6% of tasks for patients and nurses.ConclusionIn this summative human factors usability study, the <i>Archimedes</i> APD system usability was found to be safe, accessible and easy for its intended users and use environments after the relatively short training period compared to the status quo.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261476545"},"PeriodicalIF":1.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761415","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":"Emerald effluent in severe pancreatitis: Acute PD as dual-action support?","authors":"Kamol Khositrangsikun, Chalermpon Na Petvicharn, Wongsakorn Boonkarn, Wipapat Chujorn, Talerngsak Kanjanabuch","doi":"10.1177/08968608261476540","DOIUrl":"https://doi.org/10.1177/08968608261476540","url":null,"abstract":"<p><p>A 50-year-old man with severe presumed gallstone pancreatitis, multiorgan failure, and oliguric stage 3 acute kidney injury underwent bedside acute peritoneal dialysis (PD) for haemodynamically tolerated kidney support and intra peritoneal lavage. Catheter insertion drained a large volume of ascites that rapidly became vivid emerald green. Cultures remained sterile, whereas effluent amylase (11,041 U/L) and lipase (50,750 U/L) were markedly elevated, favouring inflammatory pancreatic leakage over infectious peritonitis or biliary perforation. During PD, effluent enzyme concentrations and cell counts declined, acidosis resolved, and kidney function improved. The patient subsequently died of septic shock. Emerald-green peritoneal effluent is rare and warrants urgent evaluation for serious intra-abdominal pathology.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261476540"},"PeriodicalIF":1.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766575","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}