Peritoneal Dialysis International最新文献

{"title":"A wolf in sheep's clothing: An unusual zoonotic pathogen in peritoneal dialysis effluent and an important diagnostic strategy.","authors":"Chen Wang, Pan Dou, Yanyan Wang, Xiang Li, Yiming Zhang, Xiaofen Ma","doi":"10.1177/08968608261448060","DOIUrl":"https://doi.org/10.1177/08968608261448060","url":null,"abstract":"<p><p>Brucellosis is an infectious disease characterized by a natural foci, caused by <i>Brucella</i>, a genus of Gram-negative bacilli known for its obligate aerobic growth and capability for intracellular parasitism. This pathogen can be transmitted zoonotically between animals and humans. Due to its mechanism of intracellular survival, monotherapy with a single antibiotic often proves ineffective in eradicating <i>Brucella</i>. Therefore, clinical management necessitates the implementation of multidrug combination therapy alongside extended therapeutic regimens to achieve optimal bacteriological clearance. Conventional diagnostic methods, such as bacterial culture and serological testing, are frequently hindered by the fastidious growth requirements of the pathogen and the risk of false-positive serological cross-reactivity. These limitations may result in delayed diagnosis or unnecessary interventions. Recent advancements in molecular biology-particularly genomic analysis technologies-have revolutionized pathogen detection by facilitating rapid and precise identification of elusive pathogens. This study reports the first documented case of refractory peritoneal dialysis-associated peritonitis caused by <i>Brucella</i> diagnosed via metagenomic next-generation sequencing (mNGS). By employing mNGS to identify the pathogen, we summarize the clinical characteristics of this case and highlight the diagnostic advantages of this technology. Our findings aim to guide clinicians in selecting appropriate diagnostic approaches for similar cases, avoiding unnecessary delays and optimizing resource utilization in clinical practice.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261448060"},"PeriodicalIF":3.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841448","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":"Procedure-related PD-peritonitis following gastroscopy and colonoscopy: A 15-year binational data-linkage study from Australia and New Zealand.","authors":"Shaun Chandler, Dharmenaan Palamuthusingam, Carmel M Hawley, Elaine M Pascoe, David Wayne Johnson, Magid Fahim","doi":"10.1177/08968608261444886","DOIUrl":"https://doi.org/10.1177/08968608261444886","url":null,"abstract":"<p><p>AimTo describe the risk of post-procedural peritoneal dialysis (PD) peritonitis episodes following gastroscopy and colonoscopy over a 15-year period in Australia and New Zealand.BackgroundThe risk of post-procedural PD peritonitis is well recognised following colonoscopy and current ISPD guidelines recommend prophylactic antibiotics. Current guidelines do not recommend this prior to gastroscopy alone due to low level evidence.MethodsData linkage between hospital admission datasets and ANZDATA was performed in all jurisdictions in Australia and New Zealand, to identify all incident and prevalent patients on PD who underwent either gastroscopy or colonoscopy. ANZDATA reporting of peritonitis was interrogated to describe the risk of peritonitis occurring within seven days of either type of endoscopic procedure. The risk of permanent dialysis modality change at 30 days was estimated using competing risk analysis, as well as a description of the microbiology of these episodes.ResultsIn total, 4433 admissions for gastroscopy (2447) colonoscopy (1191) or both (795) were identified amongst 3674 unique patients. In total there were 106 episodes of peritonitis, 51 of which occurred after gastroscopy alone. The event rate of post-procedure peritonitis was similar following gastroscopy (2.1%) and colonoscopy (2.4%) alone. Risk of peritonitis was similar when considering gastroscopy with and without intervention: 1.7% (95% CI 1.1-2.3) and 2.2% (95% CI 1.3-3.1), respectively. A similar trend was also present for colonoscopy with and without intervention: 2.8% (95%CI 1.0-4.7) and 2.7% (95%CI 1.5-4.0), respectively. The most important predictor of dialysis modality change after either procedure was having a polymicrobial infection (sHR 78.98, 95%CI 35.3-176.7). Regardless of procedure type, organisms of enteric origin along with coagulase negative staphylococcus were the most commonly identified.ConclusionsThere was a similar risk of peritonitis following either gastroscopy or colonoscopy over the time period. Further studies evaluating the effect and role of prophylactic antibiotics prior to gastroscopy alone are required.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608261444886"},"PeriodicalIF":3.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819490","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":"Sex disparities in in-hospital treatments, outcomes, and resource utilization among peritoneal dialysis patients: A nationwide inpatient sample analysis.","authors":"Charat Thongprayoon, Wisit Kaewput, Wannasit Wathanavasin, Supawadee Suppadungsuk, Paul W Davis, Supawit Tangpanithandee, Wisit Cheungpasitporn","doi":"10.1177/08968608251362904","DOIUrl":"10.1177/08968608251362904","url":null,"abstract":"<p><p>BackgroundSex-based differences may influence the clinical management, complication risks, and healthcare resource utilization of hospitalized end-stage kidney disease (ESKD) patients undergoing peritoneal dialysis (PD). Understanding these disparities is essential for optimizing patient care and informing healthcare policy.MethodsThis study was conducted using the National Inpatient Sample to identify hospitalized adult ESKD patients receiving PD from the year 2003 to 2018. The outcomes included 1) PD-related outcomes, defined as a composite of peritonitis, mechanical complications, catheter removal or revision, and adequacy issues, 2) non-PD-related outcomes, defined as a composite of sepsis, cardiac arrest, and need for mechanical ventilation 3) transfer to hemodialysis, and 4) in-hospital mortality. The associations between sex and in-hospital outcomes were analyzed using multivariable logistic regression and were adjusted for demographic factors, comorbidities, primary diagnoses, admission types, and hospital characteristics. Discharge weights were applied to generate nationally representative estimates.ResultsOf 97,036 hospitalized ESKD patients receiving PD analyzed, 48,906 (50.4%) were females. In adjusted analyses, there were no overall sex differences in PD-related outcomes, non-PD-related outcomes, or in-hospital mortality. However, age- and comorbidity-based variations were observed in PD-related outcomes. Female sex was associated with lower odds of transfer to hemodialysis, particularly among younger patients and those without heart failure or peripheral vascular disease. Notably, sex differences in in-hospital mortality were observed only among patients with elective admissions.ConclusionThere were sex-based disparities in the outcomes and healthcare utilization of hospitalized ESKD patients receiving PD. These findings underscore the need for sex-specific, individualized strategies to improve PD care and inform clinical and policy decisions.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"213-222"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144744130","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":"Pregnancy in women on home dialysis: Your questions answered.","authors":"Divya Bajpai, Shreepriya Mangalgi, Prasoon Verma, Silvi Shah","doi":"10.1177/08968608251389274","DOIUrl":"10.1177/08968608251389274","url":null,"abstract":"<p><p>Women with kidney failure have impaired fertility challenges due to disruption of the hypothalamic gonadal axis and hormonal dysregulation, with pregnancy rates on home dialysis being much lower than those with normal kidney function. Pregnant women on dialysis are at high risk of hypertensive disorders, preterm birth, and fetal growth restriction, but intensified dialysis can mitigate these risks. Home dialysis offers advantages like flexibility, better hemodynamic stability, and improved fetal outcomes, but logistical and training challenges remain. Hybrid approaches combining hemodialysis and peritoneal dialysis may benefit select women during pregnancy. Effective management of pregnancy on dialysis requires treatment of anemia, optimized nutrition, close obstetric monitoring, and multi-disciplinary care. Postpartum care should focus on breastfeeding support, home dialysis prescription adjustment, and contraception counseling. Systematic capacity-building in home dialysis can lead to better pregnancy outcomes while alleviating in-center dialysis burdens.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"202-212"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378239","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":"Discolored peritoneal dialysis (PD) fluid after colonoscopy: Not so black and white.","authors":"Beatriz Hernandez Sevillano, Nerea Begona Boldova, José Ramón Rodriguez-Palomares, Katia Matilde Perez Del Valle, Alba Benito Salmeron, Yohana Gil Giraldo, Gabriel de Arriba de la Fuente","doi":"10.1177/08968608251332715","DOIUrl":"10.1177/08968608251332715","url":null,"abstract":"<p><p>In peritoneal dialysis, the appearance of effluent with an abnormal appearance or color is usually a sign of a serious complication such as peritonitis. In other cases, it may be a specific event that lacks clinical importance. Even in these mild cases, the alarm and concern of patients and professionals can be high.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"282-284"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020875","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":"Bacterial biofilm on peritoneal dialysis catheters: A retrospective observational study.","authors":"Aichun Liu, Huiping Zhao, Bei Wu, Shuying Zheng, Lixia Lu, Jie Qiao, Xinxin Chu, Chuncui Men, Yuting He, Li Zuo, Mei Wang","doi":"10.1177/08968608251331894","DOIUrl":"10.1177/08968608251331894","url":null,"abstract":"<p><p><b>Objective:</b> Biofilm formation significantly impacts infection risks in peritoneal dialysis (PD) patients. However, few studies focused on biofilms on PD catheters. This study aims to explore the formation and characteristics of bacterial biofilm on PD catheters. <b>Methods:</b> A retrospective study was conducted on maintenance PD patients from January 2007 to January 2024. We summarized the general characteristics of the patients, the reasons for catheter removal, scanning electron microscopy (SEM) results of the PD catheter, and bacterial culture results from the PD effluent. The selected patients were divided into two groups: catheter removal due to peritonitis group (20 cases) and catheter removal due to non-peritonitis group (8 cases). <b>Results:</b> (1) The average dialysis duration in catheter removal due to peritonitis group was 84.2 ± 46.6 months, significantly longer than that in catheter removal due to non-peritonitis group (21.8 ± 18.7 months). Thirteen patients (65.5%) in catheter removal due to peritonitis group had a history of peritonitis before the current episode, whereas none in catheter removal due to non-peritonitis group had experienced it previously (<i>p</i> = 0.002). (2) Bacterial biofilm was detected in 20 (71.4%) out of 28 patients. Of these, bacterial biofilm was found in 18 patients (90.0%) in catheter removal due to peritonitis group, compared to only 2 patients (25.0%) in catheter removal due to non-peritonitis group (<i>p</i> = 0.002). SEM revealed that the bacterial biofilm forms present on the PD catheters were exclusively cocci biofilms. The bacterial culture results from the PD fluid of patients in catheter removal due to peritonitis group indicated that the three most prevalent pathogens were Escherichia coli (7/20), methicillin-sensitive Staphylococcus aureus (3/20), and Staphylococcus epidermidis (3/20). <b>Conclusion:</b> Bacterial biofilm formation on PD catheters is common among long-term PD patients. It is important to note that not all PD catheters removed due to peritonitis exhibit bacterial biofilms, and such biofilms may also be present in patients without peritonitis.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"252-260"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120516","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":"Preserved fertility of a young woman with bilateral peritoneal dialysis catheter fimbrial adhesions, a priority to consider.","authors":"Nehal Elshabrwy, Mohamed Saad Rakab, Mohamed Shetiwy, Ahmed Elghrieb","doi":"10.1177/08968608241287325","DOIUrl":"10.1177/08968608241287325","url":null,"abstract":"<p><p>Peritoneal dialysis (PD) has become an established treatment modality for end-stage kidney disease (ESKD) in recent years, though catheter dysfunction remains a common issue, often due to adhesions or migration. Laparoscopic surgery is an effective method for addressing these problems with precision and minimal trauma. A rare cause of catheter dysfunction is fimbriae adhesions, where the fimbriae of the fallopian tubes obstruct the catheter. We present a case of a 23-year-old woman with ESKD who transitioned to PD, complicated by catheter blockage within days. Radiographs suggested adhesions and diagnostic laparoscopy revealed fimbriae entangling the catheter. Laparoscopic adhesiolysis and catheter replacement were performed, with the fallopian tubes secured to the ipsilateral ovary to prevent recurrence. Post-surgery, catheter function was restored, and an 18-month follow-up showed no complications. This case highlights the importance of considering fertility preservation in cases of fimbrial adhesions and underscores the value of laparoscopic intervention.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"270-272"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351819","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":"Determinants of thirst in peritoneal dialysis patients.","authors":"Vítor Fernandes, Andrew Davenport","doi":"10.1177/08968608251343766","DOIUrl":"10.1177/08968608251343766","url":null,"abstract":"<p><p>BackgroundFluid overload adversely impacts on peritoneal dialysis (PD) patients, and fluid restriction is often advised. Thirst is a prevalent and distressing symptom in patients with end-stage kidney disease. Thirst determinants in PD patients are poorly understood, so we wished to evaluate thirst and its determinants in this population.MethodsWe report a cross-sectional study of 387 adult PD patients attending a dialysis centre in London from January 2020 to December 2023. Patients completed a visual analogue scale for thirst, and clinical, biochemical and multifrequency bioelectrical bioimpedance data were reviewed. Based on thirst intensity scores, patients were categorized into three groups: 121 patients (0-3; low thirst), 136 (5-6; moderate thirst) and 130 (6-10; high thirst).ResultsHigher thirst scores were associated with female gender (<i>p</i> = 0.03); lower median of total weekly urea clearance (1.92 vs 1.97 and 2.09, lower and moderate thirst groups respectively; <i>p</i> = 0.04); and higher daily net sodium removal (136 vs 123 and 115 mmoL, lower and moderate thirst groups respectively; <i>p</i> = 0.009). On bivariate analysis, body mass index (BMI) showed a weak inverse correlation with thirst score (<i>p</i> = 0.046). However, there was no association with measured serum osmolality.ConclusionWhile there were weak to moderate associations between thirst and female gender, BMI, higher daily net sodium removal and lower weekly total Kt/V, there was a lack of a robust association with any routinely collected clinical measure. This study highlights the complex mechanism and determinants of thirst in PD patients warranting further study.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"233-239"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111662","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":"Catalyzing peritoneal dialysis growth in Brunei: The crucial role of governmental support.","authors":"Chiao Yuen Lim, Yee Yin Lim, Jackson Tan, Swee Hui Ang","doi":"10.1177/08968608251331878","DOIUrl":"10.1177/08968608251331878","url":null,"abstract":"<p><p>Brunei Darussalam, a small Southeast Asian nation, faces a unique healthcare challenge with one of the world's highest incidence and prevalence of kidney replacement therapy. This report highlights the remarkable success of Brunei in increasing the utilization of peritoneal dialysis (PD) to address this challenge. As of August 2023, Brunei's PD penetrance rate stands at 16%, a significant leap from 9.7% just three years ago. This is comparable to many other high-income countries. The key to this success lies in a series of governmental support strategies that fostered rapid PD growth. These strategies include the establishment of a dedicated task force, securing dedicated operating theater slots, collaboration with surgery and anesthesia departments, nephrologist training, a dedicated surgeon for complex cases, outsourcing to private hospitals, prioritizing nursing staff, structured patient training programs, patient advocacy and established clinical protocols. These collaborative efforts, along with a patient-centric approach, have not only reduced PD catheter insertion waiting times but also empowered patients to voice their preferences in shared decisions. Brunei's journey serves as an inspiring example for other nations seeking to proliferate their PD services.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"277-281"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028168","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":"\"I Feel My Catheter Moving Around\": A clue for the diagnosis of late pregnancy while on peritoneal dialysis.","authors":"Amanda Kalishman, Khadeeja Ashai, Marie D Philipneri, Kana N Miyata","doi":"10.1177/08968608241297860","DOIUrl":"10.1177/08968608241297860","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"296-297"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591125","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}