Peritoneal Dialysis International最新文献

{"title":"Discontinuation of maintenance peritoneal dialysis in children-A 10-year review from a single center in a low resource setting.","authors":"Judith Caroline Aujo, Ashton Coetzee, Adelaide Masu, Anthony Enimil, Valerie A Luyckx, Peter J Nourse, Mignon I McCulloch","doi":"10.1177/08968608241259608","DOIUrl":"10.1177/08968608241259608","url":null,"abstract":"<p><strong>Introduction: </strong>In South Africa, only children considered eligible for transplantation are offered dialysis as bridge to kidney transplantation. Maintenance peritoneal dialysis (PD) is preferred and has several advantages over hemodialysis (HD). While awaiting transplantation, PD may be discontinued due to permanent transfer to HD or death while on PD, of which the occurrence and burden is not known in our setting. We investigated the rate of discontinuation of maintenance PD, and associated factors among children awaiting a kidney transplant under challenging socio-economic circumstances in a low resource setting.</p><p><strong>Methods: </strong>Single center retrospective analysis of children receiving maintenance PD. Outcomes included the proportion of children who discontinued PD before transplantation, associated factors and timing of discontinuation, and the proportion transplanted. Time to discontinuation or transplantation was displayed using a Kaplan-Meier curve.</p><p><strong>Results: </strong>Sixty-seven children who received maintenance automated PD as initial dialysis modality were identified from the kidney transplant waiting list between January 2009 and December 2018. Complete data was available for 52 of the 67 children. Four children had prior failed kidney transplants. The median age was 11 years (interquartile range 6.0, 13.1). Overall, 17/52 (32.7%) children discontinued PD, with 13 (25%) transfers to HD and 4 deaths (7.7%), whereas 29/52 (55.8%) received a kidney transplant. Three of the deaths were PD related. Six children remained on maintenance PD at the end of the study period. Over a half of our patients discontinued PD by 12 months, and 80% by 30 months. Most PD discontinuations were associated with peritonitis.</p><p><strong>Conclusions: </strong>The proportion discontinuing PD was high, highlighting the need to optimize measures to improve retention rates, especially through prevention of peritonitis.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"380-389"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306469","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":"'A constant threat': Parent and child perspectives on infection in paediatric peritoneal dialysis.","authors":"Amanda Dominello, Madeleine Reicher","doi":"10.1177/08968608241274465","DOIUrl":"10.1177/08968608241274465","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":"44 5","pages":"297-298"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308271","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":"Interobserver agreement of peritoneal dialysis exit site scoring: Results from the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative.","authors":"Mahima Keswani, Kathleen Mallet, Troy Richardson, Sarah J Swartz, Alicia Neu, Bradley A Warady","doi":"10.1177/08968608241254278","DOIUrl":"10.1177/08968608241254278","url":null,"abstract":"<p><strong>Background: </strong>Exit site infections are a risk factor for the development of peritonitis in patients on long-term peritoneal dialysis. Visual assessments of an exit site utilising currently available tools (Twardowski and Mid-European Pediatric Peritoneal Dialysis Study Group (MEPPS)) are necessary to objectively characterise the appearance of an exit site. The aim of this study was to assess the interobserver agreement of exit site evaluations utilising both exit site scoring tools.</p><p><strong>Methods: </strong>Exit site evaluations were independently performed by two evaluators during outpatient visits at 13 sites within the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease collaborative. The frequency and percentage of evaluations where both reviewers agreed were calculated. A sub-analysis was performed looking at evaluations where disagreement occurred.</p><p><strong>Results: </strong>A total of 371 paired exit site evaluations were collected over 6 months. For the majority of evaluations (range: 78%-97% Twardowski, 78%-97% MEPPS), both reviewers agreed that no abnormality was present across all domains. When the analysis was restricted to evaluations where at least one reviewer noted an abnormality, interobserver agreement fell across all domains (range: 31%-61% Twardowski, 56%-66% MEPPS). Disagreements more commonly occurred regarding the presence versus absence of an abnormality, rather than a difference in the severity of an abnormality.</p><p><strong>Conclusions: </strong>Whereas interobserver agreement is high when the appearance of a peritoneal dialysis catheter exit site is characterised as 'normal', interobserver disagreement is common when the appearance of the exit site is 'abnormal'. Further work is warranted to improve interobserver agreement of exit site assessments and to identify domains conferring an increased risk of infection.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"390-396"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198918","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":"Prevention and management of peritoneal dialysis associated infections in children: Continuing to grow and reaching new milestones.","authors":"Rupesh Raina, Sanat Subhash, Claus Peter Schmitt, Rukshana Shroff","doi":"10.1177/08968608241279094","DOIUrl":"10.1177/08968608241279094","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"299-302"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126382","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":"Green Nails, Red Alert: An Unusual Exit site infection Presentation.","authors":"Takuto Nakamura, Marino Yamauchi, Shinichiro Sonoda, Daigo Aharen, Masaki Ikemura, Kentaro Kohagura, Kenya Kusunose","doi":"10.1177/08968608241234529","DOIUrl":"10.1177/08968608241234529","url":null,"abstract":"<p><p>Green nail syndrome is an infectious nail disorder caused most commonly by <i>Pseudomonas aeruginosa</i>. We report a rare case of peritoneal dialysis (PD) exit site infection (ESI) accompanied by <i>P. aeruginosa</i>-associated green nail syndrome. The patient was treated with oral and topical antibiotics without the need for PD catheter removal. We aim to emphasise the importance of nail assessment for ESI in patients undergoing PD.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"397-398"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040029","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 in children, what's different: Your questions answered.","authors":"Heather L Wasik, Elizabeth Harvey, Alicia Neu","doi":"10.1177/08968608241273633","DOIUrl":"10.1177/08968608241273633","url":null,"abstract":"<p><p>Maintenance peritoneal dialysis (PD) is the most used kidney replacement therapy for children with kidney failure throughout the world. Underlying causes of kidney failure, indications for dialysis, body size, and nutritional requirements differ between children and adults on PD. These differences, along with the ongoing growth and development that occurs throughout childhood, impact PD access, prescription, and monitoring in children. This review highlights the unique challenges and management approaches to optimize the care of children on maintenance PD.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":"44 5","pages":"365-373"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308273","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":"Clinical practice guideline for the prevention and management of peritoneal dialysis associated infections in children: 2024 update.","authors":"Bradley A Warady, Rebecca Same, Dagmara Borzych-Duzalka, Alicia M Neu, Ibrahim El Mikati, Reem A Mustafa, Brandy Begin, Peter Nourse, Sevcan A Bakkaloglu, Vimal Chadha, Francisco Cano, Hui Kim Yap, Qian Shen, Jason Newland, Enrico Verrina, Ann L Wirtz, Valerie Smith, Franz Schaefer","doi":"10.1177/08968608241274096","DOIUrl":"10.1177/08968608241274096","url":null,"abstract":"<p><p>Infection-related complications remain the most significant cause for morbidity and technique failure in infants, children and adolescents who receive maintenance peritoneal dialysis (PD). The 2024 update of the Clinical Practice Guideline for the Prevention and Management of Peritoneal Dialysis Associated Infection in Children builds upon previous such guidelines published in 2000 and 2012 and provides comprehensive treatment guidance as recommended by an international group of pediatric PD experts based upon a review of published literature and pediatric PD registry data. The workgroup prioritized updating key clinical issues contained in the 2012 guidelines, in addition to addressing additional questions developed using the PICO format. A variety of new guideline statements, highlighted by those pertaining to antibiotic therapy of peritonitis as a result of the evolution of antibiotic susceptibilities, antibiotic stewardship and clinical registry data, as well as new clinical benchmarks, are included. Recommendations for future research designed to fill important knowledge gaps are also provided.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":"44 5","pages":"303-364"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308272","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":"Susceptibility of hepato-splanchnic perfusion to intra-abdominal pressure in peritoneal dialysis patients.","authors":"Werner Ribitsch, Thomas A Lehner, Notburga Sauseng, Alexander R Rosenkranz, Daniel Schneditz","doi":"10.1177/08968608241275922","DOIUrl":"https://doi.org/10.1177/08968608241275922","url":null,"abstract":"<p><strong>Background: </strong>The impact of peritoneal filling on hepato-splanchnic perfusion during peritoneal dialysis has not been fully elucidated yet.</p><p><strong>Methods: </strong>Measurements were done in 20 prevalent peritoneal dialysis patients during a peritoneal equilibration test (PET) with 2L of standard dialysate. Data were obtained in the drained state at baseline (<i>T</i>₀), after instillation (<i>T</i>₁), and after 2 h of dwell time (<i>T</i>₂). Intra-abdominal pressure (IAP) was measured by Durand's approach. The hepatic clearance index (KI) of indocyanine-green (ICG) was determined as an indirect measure of hepato-splanchnic blood flow. Cardiac index (CI), heart rate (HR), and total peripheral resistance index (TPRI) were derived from continuous arterial pulse analysis. Fluid volume overload (VO) was evaluated by multifrequency bioimpedance analysis. Ejection fraction (EF) was obtained from echocardiographic examination.</p><p><strong>Results: </strong>IAP was 5.8 ± 3.5 mmHg at baseline (<i>T</i>₀), rose to 9.4 ± 2.8 mmHg after instillation of dialysate (<i>T</i>₁), and further to 9.7 ± 2.8 mmHg after 2 h of dwell time (<i>p </i>< 0.001). KI slightly declined from 0.60 ± 0.22 L/min/m² at <i>T</i>₀ to 0.53 ± 0.15 L/min/m² at <i>T</i>₁ (<i>p </i>= 0.075), and returned to 0.59 ± 0.22 L/min/m² at <i>T</i>₂ (<i>p </i>= 0.052). CI, HR, and TPRI did not change significantly. In five patients with an EF < 40% KI was significantly lower at <i>T</i>₁ (0.42 ± 0.12 L/min/m²; <i>p </i>= 0.039), and further decreased at <i>T</i>₂ (0.40 ± 0.04 L/min/m²; <i>p </i>= 0.016) compared to patients with normal EF (<i>T</i>₁: 0.58 ± 0.15 L/min/m² and <i>T</i>₂: 0.67 ± 0.22 L/min/m²).</p><p><strong>Conclusions: </strong>Overall, hepatic clearance of ICG as a marker of hepato-splanchnic blood flow is not affected by the filling of the peritoneal cavity.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608241275922"},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081192","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":"Open suture repair versus Permacol^TM mesh repair of small ventral hernias in patients with end-stage kidney disease.","authors":"Yan Luk, Jia-Ning Lee, Tsz Ting Law, Jason Yu Yin Li, Lily Ng, Kin Yuen Wong","doi":"10.1177/08968608241274100","DOIUrl":"https://doi.org/10.1177/08968608241274100","url":null,"abstract":"<p><strong>Background: </strong>Ventral hernia is a common surgical problem among patients with end-stage kidney disease (ESKD), while the optimal repair technique for small ventral hernias is controversial. This study aimed to compare the outcomes of open suture repair versus biological mesh repair of small ventral hernias with defect size ≤2 cm in ESKD patients.</p><p><strong>Method: </strong>Data from consecutive ESKD patients who underwent elective ventral hernia repair with defect size ≤2 cm at a single institution from January 2012 to January 2022 were retrospectively reviewed. Outcomes of open suture repair were compared to Permacol^TM mesh repair. The primary outcome was recurrence rate. Secondary outcomes included post-operative complications, peri-operative and post-operative dialysis regimen.</p><p><strong>Results: </strong>Forty-seven ventral hernia repairs were included, with 20 being suture repairs and 27 being Permacol^TM mesh repairs. Median age at hernia repair was 60 (range 32-81) years old. Pre-operatively, 42 patients (89.4%) were on peritoneal dialysis (PD). Paraumbilical hernia (59.6%) was most common. Median hernia defect size was 15 mm (range 2-20 mm). Upon median follow-up of 56 (range 9-119) months, more patients in the suture repair group developed recurrence (30% vs. 0%, <i>p</i> = 0.004). Median time to recurrence was 10 (range 5-16) months. There was no wound or mesh infection. The majority of patients underwent intermittent PD peri-operatively and were able to resume on PD in the long run.</p><p><strong>Conclusion: </strong>Ventral hernia repair is indicated in ESKD patients even for small defects; repair with Permacol^TM mesh was associated with a lower recurrence rate when compared to suture repair and post-operative morbidity was low.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608241274100"},"PeriodicalIF":2.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004930","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":"Scrotal edema due to bilateral metachronous tears in the spigelian fascia in a peritoneal dialysis patient: A case report.","authors":"Kentaro Watanabe, Kosuke Fukuoka, Mana Nishikawa, Motoko Kanzaki, Noriaki Shimada, Kenichiro Asano","doi":"10.1177/08968608241274094","DOIUrl":"https://doi.org/10.1177/08968608241274094","url":null,"abstract":"<p><p>Scrotal and penile edema is a noninfectious complication of peritoneal dialysis (PD). A tear in the Spigelian fascia is occasionally recognized as a Spigelian hernia. However, there is no documented evidence that this is a contributing factor for scrotal edema in individuals undergoing PD. We encountered a case of scrotal edema in a patient undergoing PD due to bilateral metachronous tears in the Spigelian fascia, which was successfully treated through surgical repair. A 20-year-old man with end-stage kidney disease due to Alport syndrome underwent PD. Eight months after induction of PD, he heard a rupture sound in the left inguinal region after coughing and developed genital edema. A computed tomography scan showed a tear in the left Spigelian fascia. Surgical repair was successful and there was no recurrence after PD was resumed. Seven months after surgery, he heard a rupture sound in the right inguinal region after coughing and developed genital edema. A computed tomography scan showed a tear in the right Spigelian fascia. Surgical repair was successful and there has been no recurrence since. It is important to recognize that the development of scrotal edema in a patient undergoing PD may be indicative of a tear in the Spigelian fascia.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608241274094"},"PeriodicalIF":2.7,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988531","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}