Peritoneal Dialysis International最新文献

{"title":"The greenest exchange: Environmental stewardship in peritoneal dialysis.","authors":"Meera Shah, Jeffrey Perl","doi":"10.1177/08968608261435115","DOIUrl":"10.1177/08968608261435115","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"301-302"},"PeriodicalIF":3.7,"publicationDate":"2026-07-01","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":"Quercetin attenuates peritoneal fibrosis by upregulating ferroptosis-related glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11) in MeT-5A and rat models: Supported by clinical mRNA expression data.","authors":"Shaxi Ouyang, Yu Chen, Siyuan Yan, Xiangyi Li, Yunling Liu, Yuling Xiao, Guoli Li, Zangyue Sun, Xiaofang Hu","doi":"10.1177/08968608261463605","DOIUrl":"https://doi.org/10.1177/08968608261463605","url":null,"abstract":"<p><p>BackgroundPeritoneal fibrosis (PF) limits the long-term use of peritoneal dialysis (PD), with effective therapies lacking. Ferroptosis, an iron-dependent cell death process, has been implicated in organ fibrosis, but its role in PD-related PF remains unexplored. Quercetin, a natural flavonoid, possesses potential anti-fibrotic and anti-ferroptotic properties.MethodsPD effluent cells from patients with different dialysis durations were analyzed for the expression of fibrosis markers (α-smooth muscle actin and collagen I) and ferroptosis-related markers (glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11)). In vitro, human peritoneal mesothelial cells (MeT-5A) exposed to high glucose were treated with quercetin to examine its effects on mitochondrial ultrastructure and marker expression. A rat model of PF was established through daily intraperitoneal injection of high-glucose dialysate, with or without quercetin administration, to evaluate histological and molecular changes in the parietal peritoneum.ResultsProlonged dialysis duration was associated with upregulated fibrotic markers and downregulated ferroptosis-related genes in patient samples. In vitro, high glucose induced mitochondrial damage and a profibrotic phenotype in MeT-5A cells, which were significantly attenuated by quercetin. Quercetin restored the expression of GPX4 and SLC7A11, comparable to the effects of the ferroptosis inhibitor ferrostatin-1. In vivo, quercetin treatment markedly alleviated high-glucose-induced peritoneal thickening and fibrosis while enhancing the expression of ferroptosis suppressors.ConclusionOur findings demonstrate that ferroptosis contributes to the pathogenesis of PD-associated PF. Quercetin mitigates fibrotic progression by modulating ferroptosis, highlighting its promise as a novel therapeutic agent for preventing or treating this complication.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261463605"},"PeriodicalIF":1.8,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346066","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":"What is the effect of the assistance on the risk of transfer to HD after an unplanned peritoneal dialysis initiation? A cohort study with data from the RDPLF.","authors":"Ivan Fred Djomkam, Clémence Béchade, Antoine Lanot, Maxence Ficheux, Thierry Lobbedez, Annabel Boyer","doi":"10.1177/08968608261460228","DOIUrl":"https://doi.org/10.1177/08968608261460228","url":null,"abstract":"<p><p>BackgroundsUnplanned initiation of peritoneal dialysis (PD) is linked to higher risks of complications and transfer to hemodialysis (HD). This study evaluates whether assisted PD was associated with the risk of transitioning to hemodialysis, for the individuals experiencing unplanned PD initiation.MethodsThis retrospective study analyzed data from the French Language Peritoneal Dialysis Registry (RDPLF), including 1009 patients with unplanned PD initiation, defined as a period of <30 days on HD before PD initiation, between January 1, 2002, and December 31, 2018. We compared assisted PD (nurse/family-assisted) versus self-care PD using cause-specific analyses. Time-dependent coefficient Cox regression addressed non-proportional hazards. Mediation analysis was conducted to explore the direct and indirect effects of assisted PD on the risk of transfer to HD, considering early peritonitis as a mediator.ResultsIn unplanned starters, Assisted PD was associated with an increased early risk of transfer to HD within the first six months (cs-HR 2.00, 95% CI 1.30-3.30), but a reduced risk thereafter (cs-HR 0.70, 95% CI 0.50-0.90). Patients on assisted PD had a higher risk of death (cs-HR 2.39, 95% CI 1.77-3.24) and a lower likelihood of transplantation (cs-HR 0.23, 95% CI 0.12-0.42). Mediation analysis revealed no significant indirect effect of assisted PD on the risk of transfer to HD via early peritonitis.ConclusionUnplanned PD initiation presents significant early risks, with assisted PD showing delayed protective effects after six months. Targeted early support (psychological and social) and further research are crucial to optimize outcomes for this patient group.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261460228"},"PeriodicalIF":1.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302567","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":"An in vitro comparison of bacterial touch contamination prevention between a novel APD cycler connector and existing APD connectors.","authors":"James A Sloand, Jeremy P Burton, Chris I Munday, Arsh K Jain, Osama El Shamy, Rick Pendergraft, Steve J Lindo","doi":"10.1177/08968608261461078","DOIUrl":"https://doi.org/10.1177/08968608261461078","url":null,"abstract":"<p><p>BackgroundPeritoneal dialysis (PD)-associated peritonitis remains a leading cause of hospitalization, technique failure, and transfer to in-center hemodialysis, with touch contamination during connections accounting for many episodes. Although shrouded connectors and \"flush before fill\" mechanisms reduce contamination risk, most automated peritoneal dialysis (APD) systems incorporate recessed fluid paths on only one side of the tubing-bag interface, potentially allowing bacterial transfer. We evaluated whether bilateral shrouded connectors with recessed fluid paths reduce bacterial contamination during simulated APD therapy.MethodsIn vitro microbiological testing was performed using three APD systems: Vantive/Baxter Claria™ (System A), Fresenius Liberty™ (System C), and Simergent Archimedes™ (System B). Connectors were deliberately contaminated with <i>Staphylococcus aureus</i> to simulate touch contamination, followed by a simulated APD treatment. Bacterial growth was quantified from pre-therapy flush fluid and the first patient fill (\"mock peritoneum\"). Agar imprinting was used to assess bacterial distribution relative to connector geometry.ResultsBacterial growth adjacent to the fluid path was observed with contaminated System A connectors but not with System B or System C, where growth was confined to the shroud. Quantitative cultures demonstrated markedly higher bacterial transfer with System A compared with System B and System C across both flush and mock peritoneal samples. Systems B and C employing bilateral shrouded, recessed connectors showed bacterial counts several orders of magnitude lower. All aseptic controls were sterile.ConclusionBilateral shrouded connectors with recessed fluid paths substantially reduce transfer of touch contaminants during simulated APD therapy. This design may mitigate a major mechanism of PD-related peritonitis, warranting clinical evaluation.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261461078"},"PeriodicalIF":1.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302262","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":"2026 ISPD Position Statement on tracking and reporting loss from PD therapy.","authors":"Rob R Quinn, David W Johnson, Rajnish Mehrotra, Simon J Davies, Angela Yee-Moon Wang, Annie-Claire Nadeau-Fredette, Jeffrey Perl, Ali K Abu-Alfa, Olof Heimbürger, Annabel Boyer, Arpana Iyengar, Danielle Eleri Fox, Thyago Proença de Moraes, Mignon McCulloch, Patricia Gooden, Nancy Verdin, Mark Lambie","doi":"10.1177/08968608261461639","DOIUrl":"10.1177/08968608261461639","url":null,"abstract":"<p><p>Peritoneal dialysis (PD) is being promoted worldwide, but nearly half of all patients who start PD will no longer be on therapy at two years, representing an important barrier to maximizing the safe and effective use of the therapy. Loss most commonly occurs due to HD transfer, death, or the receipt of a kidney transplant, but can also occur because patients recover kidney function, transfer to another dialysis program, or are lost to follow-up. Historically, the term \"technique failure\" has been used to describe loss from PD, but there has been no consistent definition, and as a consequence, it has been unclear whether the observed variability in the reported risk is related to differences in patient characteristics, practice patterns, or simply differences in the way it was defined, measured, analyzed, or reported. The International Society for Peritoneal Dialysis (ISPD) convened a working group to provide recommendations around key issues related to measuring time on PD therapy. These included standardizing definitions for causes of loss, as well as their measurement, analysis, and reporting. Key performance indicators were proposed for the purpose of benchmarking and to facilitate quality improvement and research. The target audience of this document includes physicians and other healthcare providers, dialysis programs, researchers, and national registries.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261461639"},"PeriodicalIF":1.8,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265639","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":"Important factors in the choice of dialysis modality among Japanese patients initiating peritoneal dialysis.","authors":"Yudo Tanno, Yukio Maruyama, Nanae Matsuo, Masato Ikeda, Takashi Yokoo","doi":"10.1177/08968608261460222","DOIUrl":"https://doi.org/10.1177/08968608261460222","url":null,"abstract":"<p><p>BackgroundThe Standardized Outcomes in Nephrology-Peritoneal Dialysis (SONG-PD) initiative identified core outcomes for patients receiving peritoneal dialysis (PD). However, this study included very few Japanese participants, raising concerns whether their findings applied to Japanese patients. This study aimed to identify important factors in the choice of dialysis modality from the SONG-PD list.MethodsParticipants comprised 199 patients receiving dialysis (mean age, 61 ± 12 years; male, 71.9%) who initiated PD between January 1, 2018, and September 30, 2024. Important factors in the choice of dialysis modality were investigated using a questionnaire and clinical data were obtained from medical records.ResultsImportant factors with high voting percentages included \"Flexibility with time (ability to schedule dialysis according to one's day)\" \"Life participation (ability to work, study, do home duties),\" \"Mobility/fitness (ability to move without assistance, and to train to achieve physical goals)\" and \"Ability to travel.\" These findings, except for \"Life participation,\" differed from the core outcomes identified in the SONG-PD study. Subgroup analysis showed that \"Death\" had a higher voting percentage in patients with diabetic nephropathy. Additionally, important factors varied partly depending on age and employment status.ConclusionImportant factors in the choice of dialysis modality among Japanese patients initiating PD, particularly regarding flexibility, daily activities, mobility, and travel, highlight specific needs that may not be fully captured by the internationally derived SONG-PD core outcomes, except for life participation itself. Important factors identified in this study may be included in clinical trials involving Japanese patients to support shared decision making.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261460222"},"PeriodicalIF":1.8,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265626","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":"Severe hyponatremia associated with unintended infusion of an unmixed neutral-pH peritoneal dialysis solution in an elderly patient with cognitive impairment.","authors":"Minoru Ito, Ikuto Masakane, Kiyotaka Yabuki","doi":"10.1177/08968608261458138","DOIUrl":"https://doi.org/10.1177/08968608261458138","url":null,"abstract":"<p><p>Neutral-pH, low-glucose degradation product peritoneal dialysis (PD) solutions are widely used because of their favorable biocompatibility. These solutions are typically packaged in dual-chamber bags and must be mixed immediately before use. Although the mixing procedure is simple, improper preparation may occur, particularly in patients with cognitive impairment, potentially resulting in unintended electrolyte exposure. We report a case of severe hyponatremia with altered mental status associated with inadvertent infusion of an unmixed neutral-pH PD solution in an elderly patient undergoing automated peritoneal dialysis (APD). A man in his eighth decade with diabetic nephropathy and progressive cognitive decline presented with somnolence and severe hyponatremia after a dual-chamber PD bag with an unopened septum was connected. Based on the clinical course and the finding that a PD solution bag with an unopened inter-chamber septum had been connected, hyponatremia due to exposure to an unmixed dialysate compartment was diagnosed. Management consisted of immediate discontinuation of the improperly prepared dialysate and correction using appropriately mixed PD solutions, without administration of hypertonic saline. Serum sodium levels improved gradually without neurological complications, accompanied by recovery of mental status. This case highlights a rare but serious complication related to improper preparation of dual-chamber PD solutions. Increased awareness of this risk and careful monitoring of vulnerable patients, particularly those with cognitive impairment, are essential to ensure safe home PD therapy.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261458138"},"PeriodicalIF":3.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199745","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":"Unexpected drainage failure in a patient receiving long-term peritoneal dialysis.","authors":"Akira Hirano, Hiroyuki Kadoya, Hajime Nagasu, Tamaki Sasaki, Naoki Kashihara","doi":"10.1177/08968608261457795","DOIUrl":"https://doi.org/10.1177/08968608261457795","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261457795"},"PeriodicalIF":3.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199704","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":"Residual confounding in the prognostic interpretation of iron deficiency in incident peritoneal dialysis.","authors":"Dongjie Yan, Hongyu Chen","doi":"10.1177/08968608261458082","DOIUrl":"https://doi.org/10.1177/08968608261458082","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261458082"},"PeriodicalIF":3.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199750","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":"Current status of assisted peritoneal dialysis in Japan: A nationwide questionnaire survey.","authors":"Tsutomu Sakurada, Harumi Kitamura, Kohkichi Morimoto, Kyoko Kataoka, Hiroka Owaki, Chiharu Kinoshita, Saya Imai, Hiroki Ohashi, Takuo Kusumoto, Masanobu Miyazaki, Masaaki Nakayama, Hideki Kawanishi, Jun Minakuchi, Tadashi Tomo","doi":"10.1177/08968608261457525","DOIUrl":"https://doi.org/10.1177/08968608261457525","url":null,"abstract":"<p><p>BackgroundThe aim of this study was to clarify the current status of assisted peritoneal dialysis (PD) implementation in Japan.MethodsA nationwide, cross-sectional, questionnaire survey was conducted by the Working Group of the Academic Committee of the Japanese Society for Peritoneal Dialysis. A paper-based questionnaire of 22 items was developed based on a literature review and clinical experience. The questionnaires were sent to all 310 facilities that were members of the Japanese Society for Peritoneal Dialysis (JSPD).ResultsResponses were received from 209 facilities (response rate 67.4%). It was found that assisted PD is already being implemented in approximately two-thirds of PD facilities, accounting for 15.9% of all PD patients. Cognitive decline and muscle weakness were the leading reasons for starting assisted PD. Family members, particularly spouses and adult children, were the main caregivers in this cohort, either alone or in collaboration with visiting nurses; cooperation with general practitioners was relatively limited. Facilities with a large number of PD patients made use of collaboration with visiting nurses and respite care facilities, remote monitoring, and medical care-specific social networking sites.ConclusionThis nationwide survey demonstrates that assisted PD is widely practiced in Japan and plays a critical role in sustaining PD therapy for elderly and functionally impaired patients. However, substantial heterogeneity in implementation and insufficient integration with broader medical and social care systems remain major challenges. Addressing these issues through standardization, multidisciplinary collaboration, and policy reform will be essential to meet the needs of Japan's rapidly aging dialysis population.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261457525"},"PeriodicalIF":3.7,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176628","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}