Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis最新文献

{"title":"Outcomes following peritoneal dialysis for COVID-19-induced AKI: A literature review.","authors":"Mahendra Kumar Atlani,&nbsp;Rakesh Kumar Pilania,&nbsp;Girish Chandra Bhatt","doi":"10.1177/08968608221115000","DOIUrl":"https://doi.org/10.1177/08968608221115000","url":null,"abstract":"<p><p>Acute kidney injury (AKI) has been shown to be associated with significant morbidity and mortality in patients with severe COVID-19 disease. Due to increasing number of cases in pandemic, there is a significant shortage of medical facilities and equipment in relation to patient load. In low resource settings where access to intermittent haemodialysis (HD) or continuous kidney replacement therapy (CKRT) is limited, peritoneal dialysis (PD) may play a vital role in the management of COVID-19-induced AKI. A literature search using Medline/PubMed, Embase, Google Scholar and Cochrane register was performed using following search strategy: (((COVID 19) OR (SARS-CoV-2)) AND (((acute kidney injury) OR (acute renal failure)) OR (acute renal dysfunction))) AND (peritoneal dialysis). Search strategy yielded total 79 articles. After going through titles and abstracts, full text of 15 articles was obtained. Finally, six studies were included in the review after exclusion of 10 studies. Five studies were single centre and one study was multicentric; four studies were conducted in the United States and one in the United Kingdom; PD catheter placement was done by surgeons in three studies and by nephrologist in one study. The mortality reported in the studies varied from 43% to as high as 63%.</p>","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"554-561"},"PeriodicalIF":2.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40701937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life participation: When there is more to life than dialysis.","authors":"Dawn Edwards,&nbsp;Karine Manera","doi":"10.1177/08968608221134680","DOIUrl":"https://doi.org/10.1177/08968608221134680","url":null,"abstract":"","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"552-553"},"PeriodicalIF":2.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40471970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ISPD 2022 recommendations for identification of causative organisms in peritonitis.","authors":"Gautam Bhave,&nbsp;Thomas A Golper","doi":"10.1177/08968608221126835","DOIUrl":"https://doi.org/10.1177/08968608221126835","url":null,"abstract":"We read the newest 2022 ISPD recommendations on the evaluation and management of peritonitis with interest. We greatly appreciate the committee’s critical work to summarise the literature and distill it into a cogent review and set of useful clinical practice recommendations. However, we wanted to raise attention to what we felt was a potentially confusing discussion in the Identification of Causative Organisms section (page 121). The recommended method of choice is to directly inoculate automated blood culture bottles (BACTEC) with peritoneal effluent. We strongly agree with this recommendation. Alternative techniques which may improve yield are discussed as follows:","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"652-653"},"PeriodicalIF":2.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33491385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are salvage techniques safe and effective in the treatment of peritoneal dialysis catheter-related exit-site and tunnel infections? A systematic review and description of the authors' preferred technique.","authors":"Joel Jia Yi Soon,&nbsp;Nick Zhi Peng Ng,&nbsp;Shaun Qing-Wei Lee,&nbsp;Seck Guan Tan","doi":"10.1177/08968608221116689","DOIUrl":"https://doi.org/10.1177/08968608221116689","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis catheter (PDC)-related infections account for significant morbidity, PD disruptions and costs. Patients with refractory exit-site or tunnel track infections without peritonitis may need catheter removal and reinsertion which can be complicated by bleeding, organ injury, catheter failure or malposition. Some patients may need to switch to haemodialysis in such a setting. An alternative is a salvage procedure. The purpose of this systematic review is to evaluate the safety and efficacy of salvage techniques.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Medline and Scopus databases was performed from inception to December 2021 in accordance with PRISMA guidelines. After a broad search, articles were stratified into two main categories for assessment: (1) cuff-shaving (CS) techniques and its variations of en-bloc resection (BR) and/or catheter diversion (CD) and (2) partial reimplantation with CD.</p><p><strong>Results: </strong>A total of 409 patients (445 salvage procedures) from 20 studies were included in analysis. Of 409 patients, 234 patients (57.2%) underwent 251 (56.4%) CS procedures and its variations, 163 patients (39.9%) underwent 182 (40.9%) partial PDC reimplantations with CD and 12 patients (2.7%) underwent local curettage. Overall PDC salvage rate after intervention was 73.2%. Overall PDC removal rate attributable to infection was 26.8%. Overall complication rate attributable to the procedures was 2.7%, with the most common complication being dialysate leakage (<i>n</i> = 10) followed by PDC laceration (<i>n</i> = 1) and subcutaneous haematoma (<i>n</i> = 1). We also included a description of our technique of BR of infected tissue, CS and CD. In a series of six patients, the PDC salvage rate was 83.3% and median PDC survival after intervention was 10 months.</p><p><strong>Conclusion: </strong>PDC salvage techniques are relatively safe and provide reasonable catheter salvage rates in selected patients. Results of this review should lend weight to consideration of a salvage-first approach as an option in selected patients.</p>","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"591-601"},"PeriodicalIF":2.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40598105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cloudy fluid, cloudy diagnosis.","authors":"Jimena Del Risco-Zevallos,&nbsp;Juan Piñeyroa,&nbsp;Diana Rodríguez-Espinosa,&nbsp;Marta Garrote,&nbsp;Anna Gaya,&nbsp;José Jesús Broseta,&nbsp;Luis F Quintana,&nbsp;Miquel Blasco,&nbsp;Manel Vera Rivera","doi":"10.1177/08968608211072345","DOIUrl":"https://doi.org/10.1177/08968608211072345","url":null,"abstract":"<p><p>Here, we report a case of a patient with cloudy effluent that was initially diagnosed as bacterial peritonitis. The persistence of a cloudy effluent despite antibiotic therapy led to an extensive peritoneal dialysis (PD) effluent analysis, with the final diagnosis being high-grade B-cell lymphoma. This case will increase the awareness of this rare presentation of a lymphoproliferative disorder reminding clinicians to consider this diagnosis as a part of the differential diagnosis PD effluent.</p>","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"643-646"},"PeriodicalIF":2.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39956477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trimethylamine-N-oxide (TMAO) and clinical outcomes in patients with end-stage kidney disease receiving peritoneal dialysis.","authors":"Dongyuan Chang,&nbsp;Xiao Xu,&nbsp;Zhikai Yang,&nbsp;Tiantian Ma,&nbsp;Jing Nie,&nbsp;Jie Dong","doi":"10.1177/08968608211051809","DOIUrl":"https://doi.org/10.1177/08968608211051809","url":null,"abstract":"<p><strong>Background: </strong>Trimethylamine-N-oxide (TMAO) is a gut bacteria-derived metabolite of l-carnitine and choline. A high concentration of TMAO has been proven to relate to cardiovascular disease (CVD), all-cause mortality and chronic kidney disease progression. We aimed to investigate the relation between the value of serum TMAO and outcomes for peritoneal dialysis (PD) patients.</p><p><strong>Methods: </strong>This is a prospective cohort study with data retrospectively analysed. All incident PD patients were enrolled and followed up. Log-rank test, competing risk survival analysis and COX regression were performed to test the effect of serum TMAO on developing first-episode peritonitis, all-cause and CVD mortality.</p><p><strong>Results: </strong>A wide distribution of serum TMAO concentration was observed in 513 PD patients, with a median level of 72.3 (43.7, 124.7) µmol/L. Patients with lower TMAO concentration were more likely to be without diabetes and hypertension. Patients with lower TMAO concentration showed better residual kidney function and solute clearance at baseline. Participants in the higher three TMAO quartiles showed an increased risk for first-episode peritonitis (<i>p</i> = 0.039). By competing risk survival analysis, after adjusting for age, sex, diabetes mellitus, CVD, body mass index, albumin, high-sensitive C-reactive protein, potassium, phosphorus, residual kidney function, normalised protein equivalent of total nitrogen appearance and calendar year of catheter implantation, patients in the higher three TMAO quartiles had a statistically or marginally higher risk for first-episode peritonitis compared with patients in the lowest quartile, with hazard ratio (HR) 1.65 (1.05, 2.58), 1.46 (0.92, 2.31) and 1.66 (1.05, 2.61), respectively. In the COX model, patients in the third quartile TMAO group had significantly higher CVD mortality risk compared with the lowest quartile group, as HR 2.27 (1.02, 5.05) after adjusting for various factors. As for all-cause mortality, TMAO did not show any associated effects.</p><p><strong>Conclusions: </strong>Serum TMAO concentration is associated with the risk of first-episode peritonitis and CVD mortality in PD patients. No obvious association between serum TMAO and all-cause mortality was observed.</p>","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"622-630"},"PeriodicalIF":2.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39581908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living life on PD to its fullest: Towards a PD-focused life participation measure.","authors":"Matthew B Rivara,&nbsp;Amol Patel","doi":"10.1177/08968608221133722","DOIUrl":"https://doi.org/10.1177/08968608221133722","url":null,"abstract":"Achieving true person-centred care, defined as personalised care that is respectful of and responsive to an individual’s preferences, needs and values, has rightly become a high-priority focus for the nephrology community. Recently published clinical practice guidelines for the care of patients treated with dialysis have increasingly emphasised person-centred goals such as maintaining quality of life, ameliorating symptoms and minimising treatment burden rather than focusing narrowly on specific targets for small solute clearance or markers of mineral metabolism. For example, in the recently published International Society for Peritoneal Dialysis practice recommendations on prescribing high-quality goal-directed peritoneal dialysis (PD), the first key recommendation states that PD should be prescribed using shared decision-making with an aim to (1) ‘maintain quality of life for the person doing PD . . . by enabling them to meet their life goals’ and (2) to minimise symptoms and treatment burden. In 2021, World Kidney Day, a joint initiative of the International Society of Nephrology and the International Federation of Kidney Foundations, selected ‘Living Well with Kidney Disease’ as its central theme, with the concept of life participation at the centre of its conceptual framework. Life participation was defined by the World Kidney Day steering committee as the ability to do meaningful activities of life including, but not limited to, work, study, family responsibilities, travel, social and recreational activities. Life participation has been identified as a high-priority core outcome for inclusion as a clinical trial outcome by members of the Standardized Outcomes in Nephrology (SONG) initiative, including specifically for studies of patients treated with PD. The SONG initiative is an international collaboration that has worked for over a decade to establish a set of core outcomes and outcome measures across the spectrum of kidney disease based on robust multi-stakeholder methodology to identify shared priorities among patients, caregivers, clinicians and other relevant stakeholders. Separate core outcome sets have been identified for patients treated with haemodialysis, transplantation and PD. Despite the great importance placed on life participation by participants in the SONG-PD initiative, there currently exists no content valid, robustly developed and widely used measure for assessment of life participation among patients treated with PD. To this end, in this issue of Peritoneal Dialysis International, Cheetham et al. report the results of a SONG workshop focused on establishing the essential characteristics of a life participation patientreported outcome measure (PROM) to be used as a clinical trial outcome for patients receiving PD. The workshop included 56 participants from 15 countries, although the majority were from Australia and the United Kingdom. Importantly, 17 participants were patients or care partners; the inclusion of patients","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"549-551"},"PeriodicalIF":2.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40471971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: ISPD 2022 recommendations for identification of causative organisms in peritonitis.","authors":"Naomi Runnegar,&nbsp;Kai Ming Chow,&nbsp;David Johnson,&nbsp;Philip Kam-Tao Li","doi":"10.1177/08968608221126834","DOIUrl":"https://doi.org/10.1177/08968608221126834","url":null,"abstract":"We thank Drs Bhave and Golper for their comments regarding the 2022 ISPD peritonitis guideline recommendations. As stated, for the diagnosis of peritoneal dialysis-associated peritonitis, the preferred culture method is direct inoculation of 5–10 mL of effluent into aerobic and anaerobic blood culture bottles at the bedside. This method generally has a high yield of culture-positive results as described in Table 1 of Dr Bhave and Golper’s letter. Both the BACTEC (Becton, Dickinson) and the BacT/Alert (bioMerieux) automated blood culture systems were used in the described studies. There are no data to suggest that any particular automated system is superior to others. Regarding alternative techniques to increase culture yield, we agree that the optimal method is centrifugation of 50 mL PD effluent at 3000 g for 15 min, followed by resuspension of the sediment in 3–5 mL supernatant and inoculation into blood culture bottles used in automated systems, as demonstrated in both the BACTEC (Becton, Dickinson) system and BacT/Alert (bioMerieux) system. We agree that culturing re-suspended sediment on solid media or liquid media that is not a component of an automated system is inferior and not a recommended method and hope the wording of our statement hasn’t caused confusion for other readers. This is a legacy of prior versions of the guideline in 2005, 2010 and 2016 and will be amended in future. Declaration of conflicting interests","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"654-655"},"PeriodicalIF":2.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33490583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimised versus standard automated peritoneal dialysis regimens pilot study (OptiStAR): A randomised controlled crossover trial.","authors":"Karin Bergling,&nbsp;Javier de Arteaga,&nbsp;Fabián Ledesma,&nbsp;Carl M Öberg","doi":"10.1177/08968608211069232","DOIUrl":"https://doi.org/10.1177/08968608211069232","url":null,"abstract":"<p><strong>Background: </strong>The continuous global rise of end-stage kidney disease creates a growing demand of economically beneficial home-based kidney replacement therapies such as peritoneal dialysis (PD). However, undesirable absorption and exposure of peritoneal tissues to glucose remain major limitations of PD.</p><p><strong>Methods: </strong>We compared a reference (standard) automated PD regimen 6 × 2 L 1.36% glucose (76 mmol/L) over 9 h with a novel, theoretically glucose sparing (optimised) prescription consisting of 'ultrafiltration cycles' with high glucose strength (126 mmol/L) and 'clearance cycles' with ultra-low, physiological glucose (5 mmol/L) for approximately 40% of the treatment time. Twenty-one prevalent PD patients underwent the optimised regimen (7 × 2 L 2.27% glucose + 5 × 2 L 0.1% glucose over 8 h) and the standard regimen in a crossover fashion. Six patients were excluded from data analysis.</p><p><strong>Results: </strong>Median glucose absorption was 43 g (IQR 41-54) and 44 g (40-55) for the standard and optimised intervention, respectively (<i>p</i> = 1). Ultrafiltration volume, weekly Kt/V creatinine and urea were significantly improved during optimised interventions, while no difference in sodium removal was detected. Post hoc analysis showed significantly improved ultrafiltration efficiency (ml ultrafiltration per gram absorbed glucose) during optimised regimens. No adverse events were observed except one incidence of drain pain.</p><p><strong>Conclusion: </strong>Optimised treatments were feasible and well tolerated in this small pilot study. Despite no difference in absorbed glucose, results indicate possible improvements of ultrafiltration efficiency and small solute clearances by optimised regimens. Use of optimised prescriptions as glucose sparing strategy should be evaluated in larger study populations.</p>","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"615-621"},"PeriodicalIF":2.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39825971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice variations in antibiotic administration for the management of peritonitis in patients on automated peritoneal dialysis in Australia and New Zealand.","authors":"Chau Wei Ling,&nbsp;Kamal Sud,&nbsp;Connie Van,&nbsp;Gregory M Peterson,&nbsp;Rahul P Patel,&nbsp;Syed Tabish Razi Zaidi,&nbsp;Ronald L Castelino","doi":"10.1177/08968608211069231","DOIUrl":"https://doi.org/10.1177/08968608211069231","url":null,"abstract":"<p><p>In the absence of guidelines on the management of peritoneal dialysis (PD)-associated peritonitis in patients on automated peritoneal dialysis (APD), variations in clinical practice potentially exist between PD units that could affect clinical outcomes. This study aimed to document the current practices of treating PD-associated peritonitis in patients on APD across Australia and New Zealand and the reasons for practice variations using a cross-sectional online survey. Of the 62 PD units, 34 medical leads (55%) responded to the survey. When treating APD-associated peritonitis, 21 units (62%) continued patients on APD and administered intraperitoneal (IP) antibiotics in manual daytime exchanges; of these, 17 (81%) considered allowing at least 6 h dwell time for adequate absorption of the IP antibiotics as an important reason for adding manual daytime exchange. Nine units (26%) temporarily switched patients from APD to continuous ambulatory peritoneal dialysis (CAPD); of these, five (55%) reported a lack of pharmacokinetic (PK) data for IP antibiotics in APD, four (44%) reported a shortage of APD-trained nursing staff to perform APD exchanges during hospitalisation and three (33%) reported inadequate time for absorption of IP antibiotics on APD as important reasons for their practice. Four units (12%) continued patients on APD and administered IP antibiotics during APD exchanges; of these, three (75%) believed that PK data available in CAPD could be extrapolated to APD. This study demonstrates wide variations in the management of APD-associated peritonitis in Australia and New Zealand; it points towards the lack of PK on antibiotics used to treat peritonitis as an important reason underpinning practice variations.</p>","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"647-651"},"PeriodicalIF":2.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39900582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}