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Advances in peritoneal dialysis. Conference on Peritoneal Dialysis最新文献

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Excellent ultrafiltration and clearance after more than 12 years of peritoneal dialysis: two case reports. 12年以上腹膜透析后的超滤和清除率:2例报告。
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis Pub Date : 2013-01-01
Barbara G Delano, Marcia Joseph, Adina Luboa, Nadage Richard, Anthony J Joseph
{"title":"Excellent ultrafiltration and clearance after more than 12 years of peritoneal dialysis: two case reports.","authors":"Barbara G Delano,&nbsp;Marcia Joseph,&nbsp;Adina Luboa,&nbsp;Nadage Richard,&nbsp;Anthony J Joseph","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Because of a higher (but improving) incidence of technique failure, peritoneal dialysis (PD) is not thought to equal hemodialysis (HD) for long-term use. Other than death and transplantation, the reasons that patients leave PD include peritonitis, catheter problems, patient burnout, and (in long-duration patients) the development of encapsulating peritoneal sclerosis or ultrafiltration failure. Here, we report 2 patients who have been on continuous ambulatory PD continuously for more than 12 years, maintaining good ultrafiltration and clearances. In the case reports, we suggest potential reasons for the long duration of therapy in these women. We conclude that, in some patients on continuous ambulatory PD who sparingly use very hyperosmolar dextrose solutions and who are able to avoid frequent episodes of peritonitis, long-term PD is possible and may not require transition to HD.</p>","PeriodicalId":7361,"journal":{"name":"Advances in peritoneal dialysis. Conference on Peritoneal Dialysis","volume":"29 ","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31959465","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}
引用次数: 0
Nondialytic therapy for end-stage renal disease is an underutilized care paradigm in the United States: time for a more robust reappraisal of this treatment option. 在美国，终末期肾病的非透析治疗是一种未充分利用的护理模式:是时候对这种治疗方案进行更有力的重新评估了。
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis Pub Date : 2013-01-01
Macaulay A C Onuigbo
{"title":"Nondialytic therapy for end-stage renal disease is an underutilized care paradigm in the United States: time for a more robust reappraisal of this treatment option.","authors":"Macaulay A C Onuigbo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nondialytic therapy (NDT)--also calledconservative kidney management--is a growing modality of treatment for select chronic kidney disease and end-stage renal disease (ESRD) patients globally. Nevertheless, NDT is rarely practiced in the United States. We set out to investigate NDT activity before initiation of renal replacement therapy in a Northwestern Wisconsin Mayo Clinic ESRD population. Records of all prevalent ESRD patients on chronic hemodialysis in our practice were retrospectively reviewed in May 2012. Dialysis nurses and social workers were informally interviewed to augment the review process. Of the 166 ESRD patients reviewed, 82 (49%) were 70 years of age or older, 46 (28%) were 70-79 years, and 36 (22%) were 80-89 years. Most of these older patients had multiple significant comorbidities (\"multimorbidity\"). Evidence for NDT activity before initiation of renal replacement therapy was virtually nonexistent. The older ESRD patients with multimorbidity experienced frequent hospitalizations. Our preliminary review suggests that their quality of life may have been better with NDT. Almost one half of our ESRD population was made up of people more than 70 years of age, most with multimorbidity. In our practice, NDT is a neglected paradigm, as it is in most U.S. nephrology practices. The place of NDT, actively provided by a specialized multidisciplinary team, for U.S. ESRD patients demands urgent attention and robust reappraisal by U.S. nephrologists.</p>","PeriodicalId":7361,"journal":{"name":"Advances in peritoneal dialysis. Conference on Peritoneal Dialysis","volume":"29 ","pages":"73-6"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31960475","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}
引用次数: 0
The experience of dialysis therapy among younger adults. 年轻人透析治疗的经验。
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis Pub Date : 2013-01-01
Hima Bindu Yalamanchili, Peter Murray, Kwabena T Awuah, Paul Harden, Susan H Finkelstein, Fredric O Finkelstein
{"title":"The experience of dialysis therapy among younger adults.","authors":"Hima Bindu Yalamanchili,&nbsp;Peter Murray,&nbsp;Kwabena T Awuah,&nbsp;Paul Harden,&nbsp;Susan H Finkelstein,&nbsp;Fredric O Finkelstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The present study was undertaken to examine the experience of younger dialysis patients with end-stage renal disease (ESRD) care. Structured tape-recorded interviews focusing on perceptions of ESRD care and how that care could be improved were initially conducted with 25 dialysis patients [16 on conventional hemodialysis (HD), 6 on nocturnal in-center HD, 2 on home peritoneal dialysis (PD), and 1 on home HD]. The mean age of the patients was 43.8 +/- 12.2 years, and their mean dialysis duration was 4.6 +/- 3. Oyears. Five important domains were identified from the interviews. Based on those findings, a questionnaire was developed and distributed to 62 ESRD patients (49 on HD, 13 on PD). Several domains were identified that provide insight into how the patients thought their care could be improved. Our results suggest that certain changes in ESRD care might improve the experience of younger dialysis patients.</p>","PeriodicalId":7361,"journal":{"name":"Advances in peritoneal dialysis. Conference on Peritoneal Dialysis","volume":"29 ","pages":"46-9"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31961590","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}
引用次数: 0
Icodextrin-based continuous ambulatory peritoneal dialysis therapy effectively reduces left ventricular mass index and protects cardiac function in patients with end-stage renal disease. 基于icodextrin的连续动态腹膜透析治疗可有效降低终末期肾病患者左心室质量指数并保护心功能。
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis Pub Date : 2013-01-01
Ikuko Oba, Michiya Shinozaki, Kenji Harada, Takefumi Mori, Hidetoshi Kanai
{"title":"Icodextrin-based continuous ambulatory peritoneal dialysis therapy effectively reduces left ventricular mass index and protects cardiac function in patients with end-stage renal disease.","authors":"Ikuko Oba,&nbsp;Michiya Shinozaki,&nbsp;Kenji Harada,&nbsp;Takefumi Mori,&nbsp;Hidetoshi Kanai","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Increased left ventricular mass index (LVMI) is commonly observed in patients undergoing peritoneal dialysis (PD). The present study aimed to determine the effect of icodextrin (Ico) on LVMI in PD patients with maintained residual renal function (RRF). This retrospective study included 18 patients (12 men, 6 women; average age: 62 +/- 10 years) diagnosed with indications for PD therapy and divided into two groups: those treated with Ico (Ico group) and without Ico (non-Ico group). Echocardiography was performed at the beginning of continuous ambulatory PD and after 6 and 12 months. A significant reduction in LVMI (p < 0.01) and an increase in ultrafiltration (p < 0.01) were observed after 6 months of lco treatment and were maintained for 12 months. Ejection fraction was significantly lower in the non-Ico group after 12 months (p < 0.01), but was not altered in the Ico group. Blood pressure, cardiothoracic ratio, urine volume, and N-terminal prohormone of brain natriuretic peptide were unaffected by PD treatment up to 12 months. The year-averaged ultrafiltration and the reduction in LVMI were significantly correlated (p < 0.05). Ico effectively improved LVMI and maintained ejection fraction in end-stage renal disease patients within 1 year from PD initiation. Notably, treatment with Ico resulted in a reduction of LVMI (associated with increased ultrafiltration), with no significant reduction in RRF.</p>","PeriodicalId":7361,"journal":{"name":"Advances in peritoneal dialysis. Conference on Peritoneal Dialysis","volume":"29 ","pages":"14-8"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31959461","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}
引用次数: 0
Does bioimpedance analysis or measurement of natriuretic peptides aid volume assessment in peritoneal dialysis patients? 生物阻抗分析或利钠肽测量是否有助于腹膜透析患者的容量评估?
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis Pub Date : 2013-01-01
Andrew Davenport
{"title":"Does bioimpedance analysis or measurement of natriuretic peptides aid volume assessment in peritoneal dialysis patients?","authors":"Andrew Davenport","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiovascular mortality remains the commonest cause of death for peritoneal dialysis patients. As such, preventing persistent hypervolemia is important. On the other hand, hypovolemia may potentially risk episodes of acute kidney injury and loss of residual renal function, a major determinant of peritoneal dialysis technique survival. Bioimpedance has developed from a single-frequency research tool to a multi-frequency bioelectrical impedance analysis readily available in the clinic and capable of measuring extracellular, intracellular, and total body water. Similarly, natriuretic peptides released from the heart because of myocardial stretch and increased intracardiac volume have also been variously reported to be helpful in assessing volume status in peritoneal dialysis patients. The question then arises whether these newer technologies and biomarkers have supplanted the time-honored clinical assessment of hydration status or whether they are merely adjuncts that aid the experienced clinician.</p>","PeriodicalId":7361,"journal":{"name":"Advances in peritoneal dialysis. Conference on Peritoneal Dialysis","volume":"29 ","pages":"64-8"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31961594","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}
引用次数: 0
When should icodextrin be started to improve atherosclerosis in peritoneal dialysis patients? 什么时候开始使用醋酸糊精来改善腹膜透析患者的动脉粥样硬化?
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis Pub Date : 2013-01-01
Takeyuki Hiramatsu, Takahiro Hayasaki, Akinori Hobo, Shinji Furuta, Koki Kabu, Yukio Tonozuka, Yoshiyasu Iida
{"title":"When should icodextrin be started to improve atherosclerosis in peritoneal dialysis patients?","authors":"Takeyuki Hiramatsu,&nbsp;Takahiro Hayasaki,&nbsp;Akinori Hobo,&nbsp;Shinji Furuta,&nbsp;Koki Kabu,&nbsp;Yukio Tonozuka,&nbsp;Yoshiyasu Iida","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Icodextrin-based peritoneal dialysis (PD) has many advantages over glucose-based PD. The present study aimed to investigate when icodextrin should be started for better management of cardiovascular status (as defined by echocardiography findings) and residual renal function (RRF). We retrospectively analyzed 40 patients treated with continuous ambulatory PD or automated PD. The patients were divided into these groups: Group A: started icodextrin within 2 weeks after PD onset. Group B: started icodextrin 1 year after PD onset. Group C: started icodextrin 2 years after PD onset. Group D: never used icodextrin during the study period. At the start of PD, we observed no significant difference in left ventricular mass index (LVMI) or urine volume (UV) between the groups. At 4 years, LVMI and UV were both significantly improved in group A compared with group D. The amelioration in LVMI was negatively associated with phosphate elimination. Our study showed that icodextrin preserved RRF and ameliorated left ventricular hypertrophy. Moreover, the timing of icodextrin introduction in PD patients influenced the clinical effects, including progression of cardiac hypertrophy and RRF.</p>","PeriodicalId":7361,"journal":{"name":"Advances in peritoneal dialysis. Conference on Peritoneal Dialysis","volume":"29 ","pages":"4-8"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31959458","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}
引用次数: 0
Changing the paradigm from contraction of peritoneal dialysis programs to increasing prevalent peritoneal dialysis numbers. 改变范例，从腹膜透析计划的收缩到腹膜透析数量的增加。
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis Pub Date : 2013-01-01
Jennifer Cross, Andrew Davenport
{"title":"Changing the paradigm from contraction of peritoneal dialysis programs to increasing prevalent peritoneal dialysis numbers.","authors":"Jennifer Cross,&nbsp;Andrew Davenport","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Compared with other European and North American countries, the United Kingdom traditionally had proportionally more dialysis patients treated by peritoneal dialysis. However as in many economically developed countries, peritoneal dialysis numbers have fallen in the United Kingdom, particularly since the early 2000s. In an effort to increase home-based dialysis therapies, the U.K. Department of Health introduced a new system of reimbursement tariffs favoring peritoneal dialysis and home hemodialysis compared with standard hospital-based hemodialysis. Here, we report how our own center responded to the impending change in reimbursement rates and turned what had been a declining peritoneal dialysis program into one that almost doubled in size within 3 years.</p>","PeriodicalId":7361,"journal":{"name":"Advances in peritoneal dialysis. Conference on Peritoneal Dialysis","volume":"29 ","pages":"50-4"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31961591","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}
引用次数: 0
The importance of residual renal function in peritoneal dialysis patients. 腹膜透析患者残余肾功能的重要性。
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis Pub Date : 2013-01-01
Jose A Diaz-Buxo, Sarah A White, Rainer Himmele
{"title":"The importance of residual renal function in peritoneal dialysis patients.","authors":"Jose A Diaz-Buxo,&nbsp;Sarah A White,&nbsp;Rainer Himmele","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Increased peritoneal clearance can compensate for reductions in renal solute removal in patients receiving peritoneal dialysis (PD); however there is abundant evidence to suggest that renal rather than peritoneal clearance contributes to clinical outcomes. We review the evidence investigating the impact of residual renal function (RRF) and peritoneal solute clearances on survival and quality of life in PD patients. We also provide a comparison of the relative contribution of RRF and peritoneal clearance to patient survival. In addition, mechanisms of survival benefit in patients with preserved renal function, factors contributing to RRF decline, and interventions that may limit the progressive loss of RRF are discussed.</p>","PeriodicalId":7361,"journal":{"name":"Advances in peritoneal dialysis. Conference on Peritoneal Dialysis","volume":"29 ","pages":"19-24"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31959462","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}
引用次数: 0
Hemoperitoneum in a peritoneal dialysis patient from a retroperitoneal source. 腹膜透析患者腹膜后出血。
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis Pub Date : 2013-01-01
Cristina Balsera, Steven Guest
{"title":"Hemoperitoneum in a peritoneal dialysis patient from a retroperitoneal source.","authors":"Cristina Balsera,&nbsp;Steven Guest","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hemoperitoneum in peritoneal dialysis patients is a known but infrequent complication. Hemoperitoneum is more frequent in women because of its association with a variety of gynecologic presentations such as reflux menstruation, ovulation, endometrial tissue implants within the peritoneal cavity (endometriosis), and bleeding follicular cysts. Other intraperitoneal causes of hemoperitoneum include minor catheter or abdominal trauma, vascular anomalies, or hepatic or splenic cysts. Less frequently encountered is a presentation of hemoperitoneum from a retroperitoneal source. These presentations result either from peritoneal inflammation and subsequent peritoneal bleeding or retroperitoneal cavity pathology rupturing into the peritoneal cavity. Here, we present the case of a peritoneal dialysis patient presenting with hemoperitoneum several days after undergoing cardiac catheterization. The catheterization was complicated by a large retroperitoneal hematoma. Details of the case are reported, and other retroperitoneal causes of hemoperitoneum are reviewed.</p>","PeriodicalId":7361,"journal":{"name":"Advances in peritoneal dialysis. Conference on Peritoneal Dialysis","volume":"29 ","pages":"69-72"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31961595","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}
引用次数: 0
Beneficial role of tolvaptan in the control of body fluids without reductions in residual renal function in patients undergoing peritoneal dialysis. 托伐普坦在腹膜透析患者控制体液而不降低残余肾功能中的有益作用。
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis Pub Date : 2013-01-01
Takefumi Mori, Ikuko Oba, Kenji Koizumi, Mayumi Kodama, Miwako Shimanuki, Mizuho Tanno, Makiko Chida, Mai Saito, Hideyasu Kiyomoto, Mariko Miyazaki, Susumu Ogawa, Hiroshi Sato, Sadayoshi Ito
{"title":"Beneficial role of tolvaptan in the control of body fluids without reductions in residual renal function in patients undergoing peritoneal dialysis.","authors":"Takefumi Mori,&nbsp;Ikuko Oba,&nbsp;Kenji Koizumi,&nbsp;Mayumi Kodama,&nbsp;Miwako Shimanuki,&nbsp;Mizuho Tanno,&nbsp;Makiko Chida,&nbsp;Mai Saito,&nbsp;Hideyasu Kiyomoto,&nbsp;Mariko Miyazaki,&nbsp;Susumu Ogawa,&nbsp;Hiroshi Sato,&nbsp;Sadayoshi Ito","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The V2 receptor antagonist tolvaptan has been approved for volume control in heart-failure patients in Japan. Tolvaptan increases renal blood flow, and so the present study was designed to ascertain whether tolvaptan could be a useful diuretic for volume control without reducing residual renal function (RRF) in peritoneal dialysis (PD) patients. Tolvaptan was administered in 15 PD patients (15 mg daily). Urine volume, body weight, and blood pressure were monitored Urinary excretion of urea nitrogen Na+, the osmolality of plasma and urine, and peritoneal and renal Kt/V were analyzed before and after tolvaptan treatment. In 11 of 15 patients, urine volume increased to more than 400 mL daily. A significant increase in diluted urine was observed, as indicated by a reduction in the specific gravity or osmolality of urine (or both). Urinary excretion of urea nitrogen, and Na+ was significantly increased Increases in renal Kt/V were observed, but peritoneal Kt/V was unchanged. Singnificant increase in creatinine clearance was also observed These data suggest that tolvaptan not only stimulates water diuresis, but also natriuresis, without reducing RRF in PD patients. Hence, tolvaptan could be a beneficial tool for the control of body fluid and maintenance of RRF in PD patients.</p>","PeriodicalId":7361,"journal":{"name":"Advances in peritoneal dialysis. Conference on Peritoneal Dialysis","volume":"29 ","pages":"33-7"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31959466","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}
引用次数: 0
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