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

{"title":"An unexpected cause of residual renal function loss.","authors":"Elsa Soares,&nbsp;Patricia Valério,&nbsp;Catarina Abrantes,&nbsp;Teresa Furtado,&nbsp;José Assunção,&nbsp;Alvaro G Vaz","doi":"10.1177/0896860820904550","DOIUrl":"https://doi.org/10.1177/0896860820904550","url":null,"abstract":"<p><p>The residual renal function (RRF) in a peritoneal dialysis (PD) patient is clinically important because it contributes to dialytic adequacy, quality of life and mortality. We present the case of a patient in PD with a marked decrease in RRF. Even after the increase of dialysis, the patient maintained asthenia and anorexia, was prostrate and showed no improvement analytically. The study revealed hypothyroidism, iatrogenic due to the use of amiodarone. After suspension of the drug and replacement with levothyroxine, there was a normalization of thyroid function and recovery of RRF to baseline values. A thyroid dysfunction is associated with several changes in renal function, in most cases reversible after obtaining euthyroid state. The association between thyroid dysfunction and loss of RRF continues to be under-recognized. We should consider monitoring thyroid function annually as routine in this group of patients.</p>","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"422-424"},"PeriodicalIF":2.8,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0896860820904550","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37626668","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":"Risk factors for loss of residual renal function in children with end-stage renal disease undergoing automatic peritoneal dialysis.","authors":"Qian Shen,&nbsp;XiaoYan Fang,&nbsp;YiHui Zhai,&nbsp;Jia Rao,&nbsp;Jing Chen,&nbsp;QianFan Miao,&nbsp;YiNv Gong,&nbsp;MingHui Yu,&nbsp;Qing Zhou,&nbsp;Hong Xu","doi":"10.1177/0896860819893818","DOIUrl":"https://doi.org/10.1177/0896860819893818","url":null,"abstract":"<p><strong>Background: </strong>This study analysed children with end-stage renal disease treated with automated peritoneal dialysis (APD) in our centre to explore the risk factors associated with residual renal function (RRF) loss.</p><p><strong>Methods: </strong>Children treated with APD as the initial renal replacement therapy regimen from January 2008 to December 2016 were included. All the children had a daily urine volume of ≥100 ml/m² when APD was initiated and a dialysis follow-up time of ≥12 months. A daily urine volume of <100 ml/m² after 12 months of APD treatment was defined as loss of RRF. Possible risk factors that may be associated with RRF loss were analysed.</p><p><strong>Results: </strong>A total of 66 children were included in the study. After 12 months of APD treatment, the daily urine volume decreased by 377.45 ± 348.80 ml/m², the residual glomerular filtration rate decreased by 6.39 ± 3.69 ml/min/1.73 m² and 29 of the patients (43.9%) developed RRF loss. The higher risk of RRF loss after 1 year of APD treatment was most pronounced in patients with daily urine volume of ≤400 ml/m² before treatment, higher glucose exposure and higher ultrafiltration volume, while the lower risk of RRF loss was in patients with administration of diuretics. Each increase of 1 g/m²/day glucose exposure was associated with a 5% increase in RRF loss (odds ratio (OR) 1.05, <i>p</i> = 0.023) and each increase of 1 ml/m²/day ultrafiltration volume was associated with a 1% increase in RRF loss (OR 1.01, <i>p</i> = 0.013).</p><p><strong>Conclusion: </strong>In children undergoing APD, the risk for loss of RRF is associated with low urine volume at the start of APD, high glucose loading and high peritoneal ultrafiltration volume, while preservation of RRF is associated with the usage of diuretics.</p>","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"368-376"},"PeriodicalIF":2.8,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0896860819893818","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37648208","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":"Remote patient management of peritoneal dialysis during COVID-19 pandemic.","authors":"Claudio Ronco,&nbsp;Sabrina Milan Manani,&nbsp;Anna Giuliani,&nbsp;Ilaria Tantillo,&nbsp;Thiago Reis,&nbsp;Edwina A Brown","doi":"10.1177/0896860820927697","DOIUrl":"https://doi.org/10.1177/0896860820927697","url":null,"abstract":"On 11 March 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) outbreak a pandemic. In areas where a large number of individuals become infected, the local resources might become insufficient and a specific plan should be made for the most severe cases and hospital admission. Based on this observation, new unprecedented measures have been taken in the north of Italy. Social distancing and cities lock down was to limit interaction among individuals and virus diffusion. For the general population, but in particular for dialysis patients, a special set of recommendations are made not to access directly hospital facilities in case of symptoms but rather follow specific triage pathways. Dialysis centers in large hospitals should offer specific plans for patients. While hemodialysis (HD) patients need to be triaged at every access for their dialysis session, peritoneal dialysis (PD) patients should be subject to specific recommendations and guidelines. We schematically report our policy to prevent virus dissemination among PD patients as far as regular treatment and complications management.","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"363-367"},"PeriodicalIF":2.8,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0896860820927697","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38095126","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":"Peritoneal Dialysis in the time of COVID-19.","authors":"Martin Wilkie,&nbsp;Simon Davies","doi":"10.1177/0896860820921657","DOIUrl":"https://doi.org/10.1177/0896860820921657","url":null,"abstract":"","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"357-358"},"PeriodicalIF":2.8,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0896860820921657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37852226","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":"The benefit of early survival on PD versus HD-Why this is (still) very important.","authors":"Mark R Marshall","doi":"10.1177/0896860819895177","DOIUrl":"https://doi.org/10.1177/0896860819895177","url":null,"abstract":"<p><p>There are a number of misconceptions around the identified early survival benefit of peritoneal dialysis (PD) relative to hemodialysis (HD), including that such benefits \"even out in the end\" since the relative risk of death over time eventually encompasses 1.0 (or even an estimate that is unfavorable to PD); that the early benefit is, in fact, most likely due to unmeasured confounding; and such benefits are only due to the influence of central venous catheters and \"crash starters\" in the HD group. In fact, the early survival benefit results in a substantial gain of patient life years in PD cohorts relative to HD ones, even if it the benefit appears to \"even out in the end,\" is relatively insensitive to unmeasured confounding, and persists even when the effects of central venous catheters are accounted for. In this review, the calculations and arguments are made to support these tenets. Survival on dialysis is still one of the most important considerations for all stakeholders in the end-stage kidney disease community, including patients who rank it among their top priorities. Shared decision-making is a fundamental patient right and requires both balanced information and an iterative mechanism for a consensual decision based on shared understanding and purpose. A cornerstone of this process should be an explicit discussion of the early survival benefit of PD relative to HD.</p>","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"405-418"},"PeriodicalIF":2.8,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0896860819895177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37652093","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 letter from A Karkar.","authors":"Edwina A Brown,&nbsp;Neil Boudville,&nbsp;Fredric Finkelstein,&nbsp;David Johnson,&nbsp;Adrian Liew,&nbsp;Thyago Moraes,&nbsp;Isaac Teitelbaum,&nbsp;Bradley Warady","doi":"10.1177/0896860820920144","DOIUrl":"https://doi.org/10.1177/0896860820920144","url":null,"abstract":"","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"427-428"},"PeriodicalIF":2.8,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0896860820920144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37862161","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":"Evaluating a remote patient monitoring program for automated peritoneal dialysis.","authors":"Juan G Ariza,&nbsp;Surrey M Walton,&nbsp;Mauricio Sanabria,&nbsp;Alfonso Bunch,&nbsp;Jasmin Vesga,&nbsp;Angela Rivera","doi":"10.1177/0896860819896880","DOIUrl":"https://doi.org/10.1177/0896860819896880","url":null,"abstract":"<p><strong>Background: </strong>The benefits of automated peritoneal dialysis (APD) have been established, but patient adherence to treatment remains a concern. Remote patient monitoring (RPM) programs are a potential solution; however, the cost implications are not well established. This study modeled, from the payer perspective, expected net costs and clinical consequences of a novel RPM program in Colombia.</p><p><strong>Methods: </strong>Amarkov model was used to project costs and clinical outcomes for APD patients with and without RPM. Clinical inputs were directly estimated from Renal Care Services data or taken from the literature. Dialysis costs were estimated from national fees. Inpatient costs were obtained from a recent Colombian study. The model projected overall direct costs and several clinical outcomes. Deterministic and probabilistic sensitivity analyses (DSA and PSA) were also conducted to characterize uncertainty in the results.</p><p><strong>Results: </strong>The model projected that the implementation of an RPM program costing US$35 per month in a cohort of 100 APD patients over 1 year would save US$121,233. The model also projected 31 additional months free of complications, 27 fewer hospitalizations, 518 fewer hospitalization days, and 6 fewer peritonitis episodes. In the DSA, results were most sensitive to hospitalization rates and days of hospitalization, but cost savings were robust. The PSA found there was a 91% chance for the RPM program to be cost saving.</p><p><strong>Conclusion: </strong>The results of the model suggest that RPM is cost-effective in APD patients which should be verified by a rigorous prospective cost analysis.</p>","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"377-383"},"PeriodicalIF":2.8,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0896860819896880","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37648395","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":"\"Pseudo-empty pelvis\" in a pre-dialysis patient.","authors":"Ayumi Matsumoto,&nbsp;Isao Matsui,&nbsp;Yusuke Sakaguchi,&nbsp;Harumi Kitamura,&nbsp;Maki Shinzawa,&nbsp;Chikako Monden,&nbsp;Atsushi Takahashi,&nbsp;Yoshitsugu Takabatake,&nbsp;Yoshitaka Isaka","doi":"10.1177/0896860819899579","DOIUrl":"https://doi.org/10.1177/0896860819899579","url":null,"abstract":"While peritoneal integrity is crucially important for peritoneal dialysis (PD) patients, there are various pathological conditions which induce peritoneal dysfunction. Here we present a case of a non-dialysis chronic kidney disease patient with asymptomatic peritoneal sclerosis which was diagnosed during laparoscopic screening at the placement of a PD catheter. A 57-year-old woman with end-stage kidney disease was admitted for the placement of a PD catheter. Fifteen years prior to admission, she was diagnosed with acute lymphocytic leukemia (ALL) for which she had been treated with chemotherapy and an unrelated bone marrow transplant. Although ALL had been in remission, she developed enterocolitis with slight ascites as a consequence of chronic graft-versus-host disease (GVHD); subsequently, her renal function gradually deteriorated. Three years after the transplantation, she experienced acute appendicitis with a local abscess, which was treated nonsurgically by antibiotics. She had no history of diabetes mellitus, autoimmune diseases, intraperitoneal malignancies, abdominal surgery, or tuberculosis. She had been prescribed carvedilol for heart failure for the previous 10 years. At admission, she was afebrile and had no complaints of nausea, hypophagia, or abdominal pain. Her physical examination was unremarkable. Her serum C-reactive protein level was within the normal range. Ultrasonography and computed tomography (CT) scans showed no evidence of ascites, peritoneal calcification, air-fluid levels, or intestinal wall thickening (Figure 1(a)). However, intraoperative laparoscopy revealed collagenous connective tissues bridged between the liver and the parietal peritoneum (Figure 1(b)). Furthermore, a diffuse cocoon-like thickening of the peritoneum completely covered up the small bowel loops, ovary, uterus, and rectum. As a consequence, the pelvic cavity appeared to be empty (“pseudo-empty pelvis”) (Figure 1(c)). We diagnosed this patient with simple peritoneal sclerosis, but not encapsulating peritoneal sclerosis (EPS), given that the diagnosis of EPS requires a constellation of clinical symptoms with some evidence of inflammation. Based on the laparoscopic Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan Department of Inter-Organ Communication Research in Kidney Disease, Osaka University Graduate School of Medicine, Suita, Osaka, Japan Department of Internal Medicine, Kisei Hospital, Osaka, Japan","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"431-432"},"PeriodicalIF":2.8,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0896860819899579","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37648749","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":"Acute peritoneal dialysis in COVID-19.","authors":"Watanyu Parapiboon,&nbsp;Daniela Ponce,&nbsp;Brett Cullis","doi":"10.1177/0896860820931235","DOIUrl":"https://doi.org/10.1177/0896860820931235","url":null,"abstract":"In December 2019, the world faced the new challenge of a novel pandemic virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 (COVID-19)). Acute kidney injury (AKI) has been increasingly recognized in those patients with severe disease resulting in a significant strain on dialysis resources and staff even in high resource countries. Health-care systems have been severely impacted due to a rapidly increasing number of patients globally, resulting in significant shortages of medical supplies, especially respirators and personal protective equipment (PPE). A large number of health-care workers have been infected with the virus, resulting in reduced workforce and significant mental stress among staff who are faced with the risks of exposure to COVID-19 patients. Several subspecialties of medicine have put forward their strategies regarding how to respond to COVID-19 pandemic. European Dialysis Working Group, American Society of Nephrology, and International Society for Peritoneal Dialysis have recently announced their recommendation regarding the management of chronic kidney disease patients in hemodialysis and peritoneal dialysis (PD) units during COVID-19. However, dialysis management of AKI from COVID-19 has not gained much attention. The more severe the shortage of resources, the more important exploring the various modalities of dialysis for AKI have become. The massive influx of intensive care unit (ICU) patients has resulted in many units not having sufficient facilities and resources to offer acute hemodialysis (AHD) or continuous extracorporeal renal replacement therapies (CRRTs). Along with this has been the observation that many of the COVID-19 patients have abnormalities of coagulation and repeated clotting of extracorporeal circuits along with running out of dialysate has presented additional problems. PD offers a number of potential advantages in this scenario as it is highly costeffective, requires minimal training of staff, is not affected by hypercoagulability, and, despite its reduced popularity among intensivists, has been shown in randomized trials to have equivalent survival in critically ill patients. This article addresses the key question of whether acute PD has a role to play in COVID-19-induced AKI. COVID-19 predominantly involves the respiratory system. Around 5% of the cases are critically ill patients who develop a pneumonitis which eventually leads to acute respiratory distress syndrome (ARDS). The kidney is not the main target of SARS-CoV-2, but AKI can occur up to 4% to 23%. Direct infection of tubular cells and peritubular capillary thrombosis has been demonstrated, and this along with acute tubular injury associated with multiorgan failure has resulted in approximately 25% of critically ill patients requiring acute dialysis. Extracorporeal therapies have been the mainstay of treatment of AKI in COVID-19, although apart from dialytic management of the AKI, some units have tried hemoperfusion/hemadsorption","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"359-362"},"PeriodicalIF":2.8,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0896860820931235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38056725","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":"Fluid Assessment in Peritoneal Dialysis-There Is Still a Place for Clinical Acumen.","authors":"Martin Wilkie,&nbsp;Simon Davies","doi":"10.3747/pdi.2017.00248","DOIUrl":"https://doi.org/10.3747/pdi.2017.00248","url":null,"abstract":"","PeriodicalId":519220,"journal":{"name":"Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis","volume":" ","pages":"81-82"},"PeriodicalIF":2.8,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3747/pdi.2017.00248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35934819","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}