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    1404 results match your criteria Advances in Peritoneal Dialysis[Journal]

    1 OF 29

    Successful Peritoneal Dialysis in Large-Weight Subjects: Clinical Features and Comparisons with Normal-Weight Subjects.
    Adv Perit Dial 2016 ;32:61-67
    Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi, U.S.A.
    Peritoneal dialysis (PD) obviates the need for temporary vascular access in end-stage renal disease; however, extremely heavy weight has been viewed as a relative contraindication to PD.We performed a cross-sectional review of multiple clinical and laboratory variables for 75 current or past PD patients (vintage > 6 months), comparing dialysis adequacy parameters for those with a large body weight (>100 kg, LWS group) and with a normal body weight (<75 kg, NWS group).In the LWS group (n = 17), mean weight was 117. Read More

    Bullous Skin Lesions in a Patient with End-Stage Renal Disease and Hepatitis C.
    Adv Perit Dial 2016 ;32:56-60
    Methodist Dallas Medical Center, Dallas, Texas, U.S.A.
    Bullous lesions in patients with end-stage renal disease are uncommon and can pose diagnostic and therapeutic challenges. We present a female patient with end-stage renal disease, bullous skin lesions affecting mainly sun-exposed areas, and high ferritin levels. She also had hepatitis C. Read More

    Treatment of Calciphylaxis: A Case for Oral Sodium Thiosulfate.
    Adv Perit Dial 2016 ;32:51-55
    Dallas Nephrology Associates and Methodist Dallas Medical Center, Dallas, Texas, U.S.A.
    Calciphylaxis is a major cause of morbidity and mortality in end-stage renal disease (ESRD). Intravenous sodium thiosulfate (STS) is the mainstay of therapy for calciphylaxis. In peritoneal dialysis (PD) patients with calciphylaxis, intravenous STS poses logistic and financial challenges. Read More

    Efficacy and Biocompatibility of Neutral Icodextrin Peritoneal Dialysis Fluid.
    Adv Perit Dial 2016 ;32:46-50
    Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
    Neutral icodextrin peritoneal dialysis (PD) fluid (n-ICO) has become available for use in Japan. However, removal of water and solutes remains to be elucidated in detail. The present study was designed to determine removal of water, electrolytes, and small, middle, and large molecules in a period of 16 hours. Read More

    Role of Chronic Use of Tolvaptan in Patients with Heart Failure Undergoing Peritoneal Dialysis.
    Adv Perit Dial 2016 ;32:39-45
    Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
    In the present study, we assessed the effect of chronic tolvaptan treatment and compared it with the effect of conventional treatment without tolvaptan. In addition, changes in cardiac load and body fluid composition were compared.The study enrolled 22 patients undergoing peritoneal dialysis who had been receiving tolvaptan for more than 1 year and 10 patients undergoing peritoneal dialysis who had been treated with conventional diuretics. Read More

    Preoperative Cardiac Evaluation in Kidney Transplant Patients: Is Coronary Angiography Superior? A Focused Review.
    Adv Perit Dial 2016 ;32:32-38
    Division of Cardiovascular Medicine, Department of Medicine, University of Missouri School of Medicine, Columbia, Missouri, U.S.A.
    Cardiovascular disease is the major cause of morbidity and mortality in chronic kidney disease patients. Because of a higher occurrence of asymptomatic coronary artery disease and increased perioperative cardiovascular mortality in kidney transplant patients, screening for coronary artery disease before transplant surgery is essential. Various studies have shown that cardiac stress testing is an unreliable screening method in these patients because of significant variability in sensitivity and negative predictive value. Read More

    Comparing Dialysis Modality and Cardiovascular Mortality in Patients on Hemodialysis and Peritoneal Dialysis.
    Adv Perit Dial 2016 ;32:22-31
    Nephrology Department, Ain Shams University, Cairo, Egypt.
    Patients undergoing dialysis are at high risk for cardiovascular disease (CVD). Mortality differences between peritoneal dialysis (PD) and hemodialysis (HD) are widely debated. The question of whether dialysis modality affects the risk for CVD remains to be addressed. Read More

    Time Is Not Always the Matter: An Instance of Encapsulating Peritoneal Sclerosis Developing in a Patient on Peritoneal Dialysis for a Short Term.
    Adv Perit Dial 2016 ;32:19-21
    Montefiore Medical Center, Wakefield Campus, Bronx, New York, U.S.A.
    Encapsulating peritoneal sclerosis (EPS) is an infrequent but serious complication that is observed mostly in patients on long-term peritoneal dialysis (PD). However it can occur after short-term PD, in association with "second hit" risk factors such as peritonitis, acute cessation of PD, or kidney transplantation with the use of calcineurin inhibitors.In our case, a young woman with second-hit risk factors presented with clinical and abdominal computed tomography findings consistent with EPS after short-term PD. Read More

    Erosion of the Silicone Peritoneal Dialysis Catheter with the Use of Gentamicin Cream at the Exit Site.
    Adv Perit Dial 2016 ;32:15-18
    University of Wisconsin, Madison, U.S.A.
    Infection remains the leading complication of peritoneal dialysis (PD). Topical mupirocin and gentamicin are frequently used to prevent infections. Mupirocin ointment has been reported to cause damage to both polyurethane and silicone PD catheters. Read More

    Louisiana State University Nephrology: Initiation of a Multicenter Urgent-Start Peritoneal Dialysis Program.
    Adv Perit Dial 2016 ;32:11-14
    Section of Nephrology and Hypertension, Louisiana State University Health Sciences Center-New Orleans, New Orleans, Louisiana, U.S.A.
    Urgent-start peritoneal dialysis (PD) refers to the initiation of PD in new-start end-stage renal disease patients who present either emergently in the hospital or urgently in clinic. These patients are called "late-referred patients." Our academic practice group, like many private practice and academic groups, currently functions within 4 hospitals and 4 clinics. Read More

    Correlation Between Near-Vision Acuity and the Incidence of Peritoneal Dialysis-Related Infections.
    Adv Perit Dial 2016 ;32:7-10
    Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
    Peritoneal dialysis (PD)-related infections (PDIs) such as peritonitis, exit-site infection, and tunnel infection are serious complications affecting patients on PD. Because patients with diabetes (DM) and of older age have increased in number in Japan, the number of patients with visual impairment is estimated also to have increased. Near vision is necessary for performing proper PD daily care. Read More

    Rupture of Subcutaneous Peritoneal Dialysis Catheter by Stretching Exercise: A Case Report.
    Adv Perit Dial 2016 ;32:3-6
    Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
    Rupture of the peritoneal dialysis (PD) catheter is rare complication. Here, we report a case of catheter rupture that occurred because of exercise after partial catheter reimplantation.A 66-year-old man with a history of end-stage kidney disease secondary to diabetic nephropathy experienced refractory exit-site and tunnel infection. Read More

    Mortality Comparison of Hemodialysis and Peritoneal Dialysis Patients at a Single Japanese Center.
    Adv Perit Dial 2015 ;31:74-7
    To investigate whether peritoneal dialysis (PD) is useful as a first modality in Japan, where hemodialysis (HD) is used in 97% of all patients on maintenance dialysis, we used intention-to-treat (ITT) and as-treated analyses to examine patient survival at our center, where HD and PD are used almost equally. In the ITT analysis, survival was significantly better in the PD group than in the HD group (p = 0.009). Read More

    Offering Patients Therapy Options in Unplanned Start: Development and Implementation of an Education Program for Unplanned-Start Patients.
    Adv Perit Dial 2015 ;31:69-73
    Unplanned start of dialysis is still a common and important problem for dialysis units in Europe and across the world: 30%-50% of patients can commence therapy in that way. Such patients are known to experience increased morbidity and mortality, to make greater demands on health care resources, and to be less likely to receive their dialysis modality choice. We therefore aimed to meet the specific needs of unplanned-start patients by developing and implementing an Unplanned Start Educational Programme in dialysis units. Read More

    Impact of Peritoneal Dialysis Catheter Insertion by a Nephrologist: Results of a Questionnaire Survey of Patients and Nurses.
    Adv Perit Dial 2015 ;31:59-68
    Peritoneal dialysis (PD) is an excellent dialysis mo- dality, but it is underutilized in the United States and Japan. In the present study, we evaluated the impact of interventional nephrology in PD on the impres- sions held by patients and nurses about selection of a renal replacement therapy and the complications associated with PD therapy. Over aperiod of 7 years, PD catheter insertion in 120 patients with end-stage renal disease (age: 63. Read More

    Hypotension in Infants on Chronic Peritoneal Dialysis: Mechanisms, Complications, and Management.
    Adv Perit Dial 2015 ;31:54-8
    Hypotension represents a very serious clinical problem in patients receiving renal replacement therapy, and it is associated with a significant increase in mortality risk. Infants on chronic peritoneal dialysis (CPD) can be particularly prone to chronic hypotension because of the hyponatremic hypovolemia risk related to their primary renal disease, their nutritional needs, and their peritoneal membrane characteristics. In this setting, if an acute clinical event leads to a further decline in systolic blood pressure, the counteract and perfusion pressure autoregulatory mechanisms can both be impaired, leading to severe complications. Read More

    Association Between Residual Kidney Function and Visit-to-Visit Blood Pressure Variability in Peritoneal Dialysis Patients.
    Adv Perit Dial 2015 ;31:49-53
    Visit-to-visit blood pressure (BP) variability has recently been recognized as an important risk factor for decline of residual kidney function (RKF) in patients with chronic kidney disease. However little is known about the impact of visit-to-visit BP variability on RKF in peritoneal dialysis (PD) patients. We retrospectively studied the association between RKF and visit-to-visit BP variability in 42 patients who started on PD between February 2006 and March 2012. Read More

    Relationship of Normalized Protein Catabolic Rate with Nutrition Status and Long-Term Survival in Peritoneal Dialysis Patients.
    Adv Perit Dial 2015 ;31:45-8
    The normalized protein catabolic rate (nPCR) reflects daily dietary protein intake in stable dialysis patients. In peritoneal dialysis (PD) patients, reports about the importance of nPCR as marker of nutrition and outcome have been inconsistent. The objective of the present study was to investigate the relationships of nPCR with body composition parameters, micronutrient electrolytes, and long-term survival in PD patients. Read More

    Association Between Home Blood Pressure and Body Composition by Bioimpedance Monitoring in Patients Undergoing Peritoneal Dialysis.
    Adv Perit Dial 2015 ;31:38-44
    Home blood pressure (HBP) is an independent predictor of cardiovascular and renal function. However, no particular guidelines have been established for optimal HBP in peritoneal dialysis (PD) patients. Bioelectrical impedance analysis (BIA) is a beneficial tool for determining body composition. Read More

    A Comparison Study of Glucose Fluctuation During Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis.
    Adv Perit Dial 2015 ;31:34-7
    In recent years, it has become possible to examine an individual's daily glucose profile with a continuous glucose monitoring system (CGMS). The aim of the present study was to use a CGMS to evaluate the difference in glucose fluctuation between diabetic patients on automated peritoneal dialysis (APD) and those on continuous ambulatory peritoneal dialysis (CAPD). We retrospectively studied 20 diabetic patients on peritoneal dialysis (16 men, 4 women; mean age: 55 ± 10 years) who used a CGMS a total of 23 times (12 times by APD users, 11 times by CAPD users). Read More

    The Vasopressin 2 Receptor Antagonist Tolvaptan Improves Nutrition and Inflammatory States in Peritoneal Dialysis Patients with Diabetes Mellitus.
    Adv Perit Dial 2015 ;31:30-3
    Previously, we reported that, in peritoneal dialysis (PD) patients, tolvaptan preserves residual renal function and ameliorates left ventricular hypertrophy. Here, we evaluated the effect of tolvaptan in terms of nutrition and inflammatory states. Of 24 incident PD patients with diabetes, 12 were assigned to a control group that did not receive tolvaptan, and 12, to a group that, 2 weeks after initiation of PD, received tolvaptan 15 mg daily for 12 months. Read More

    European Training and Research in Peritoneal Dialysis--A Network to Deliver Scientific Peritoneal Dialysis Training to a New Generation of Researchers.
    Adv Perit Dial 2015 ;31:26-9
    Peritoneal dialysis (PD) utilization varies across countries, and of the factors that explain the variation, the scientific and clinical knowledge of health care professionals is potentially important. In this paper, we describe a European collaboration--between 8 academic PD research programs, a small-to-medium-sized enterprise, and a large PD product manufacturer--that received significant research funding from the EU commission to establish a training network. European Training and Research in Peritoneal Dialysis (EuTRiPD) is providing training to 12 PhD students who have moved within the European Union and are completing research training. Read More

    Lymphangiogenesis and Lymphatic Absorption Are Related and Increased in Chronic Kidney Failure, Independent of Exposure to Dialysis Solutions.
    Adv Perit Dial 2015 ;31:21-5
    Increased lymphatic absorption might contribute to ultrafiltration failure in peritoneal dialysis (PD). Lymphangiogenesis develops during PD, but little is known about the relationship between its morphologic and functional parameters. The relationships between lymph vessel density, the effective lymphatic absorption rate (ELAR), and fibrosis were investigated in a rat model of chronic kidney failure (CKD) with exposure to dialysis solutions. Read More

    Using a Peritoneal Dialysis Access Simulator in Surgical Training for Nephrologists.
    Adv Perit Dial 2015 ;31:17-20
    In Japan, peritoneal dialysis (PD) catheter insertion has been performed by both nephrologists and surgeons. However, nephrologists have fewer opportunities to train in the insertion procedure. We therefore used a PD access simulator to provide training in this operative technique for nephrologists. Read More

    Glucose and Insulin Response to Peritoneal Dialysis Fluid in Diabetic and Nondiabetic Peritoneal Dialysis Patients.
    Adv Perit Dial 2015 ;31:11-6
    A postprandial increase in blood glucose in peritoneal dialysis (PD) patients with diabetes was observed in our previous study using continuous blood glucose monitoring. The response was observed in diabetic but not in nondiabetic PD patients. In addition, the response was reduced when patients used icodextrin; glucose absorbed from the peritoneum was responsible for the postprandial increase in blood glucose. Read More

    Relationship Between Peritoneal Transport Characteristics and Natriuretic Peptides in Peritoneal Dialysis Patients.
    Adv Perit Dial 2015 ;31:7-10
    Few studies have attempted to evaluate the relationship between peritoneal permeability and fluid status in peritoneal dialysis (PD). The aim of the present study was to clarify the relationship between change in the dialysate-to-plasma ratio of creatinine (D/P Cr) and change in fluid status as evaluated by natriuretic peptides. We studied 49 PD patients (29 men, 62 ± 11 years, 36. Read More

    Can Plasma Hyaluronan and Hyaluronidase Be Used As Markers of the Endothelial Glycocalyx State in Patients with Kidney Disease?
    Adv Perit Dial 2015 ;31:3-6
    Hyaluronan (HA) is widely spread in the body and is an important component of the extracellular matrix, including the endothelial glycocalyx (EG). Essential for its vasculoprotective function, HA is involved in vascular permeability and many other processes. In patients with kidney disease, plasma HA is higher than expected, but the extent to which plasma HA and its degrading enzyme hyaluronidase can be used as markers for the state of the EG has not yet been determined. Read More

    Telemedicine: the slow revolution.
    Adv Perit Dial 2014 ;30:125-7
    The use of interactive video has been recognized as a means of delivering medical support to isolated areas since the 1950s. The Department of Defense recognized early the capacity of telemedicine to deliver medical care and support to front-line military personnel. In 1989, the Texas Telemedicine Project received grants and support from the then American Telephone and Telegraph Company (now AT&T) and the Meadows Foundation of Dallas, Texas, to establish and evaluate telemedicine delivery in central Texas. Read More

    Favorable outcome of Fournier gangrene in two patients with diabetes mellitus on continuous peritoneal dialysis.
    Adv Perit Dial 2014 ;30:120-4
    Fournier gangrene (FG), a form of necrotizing fasciitis of the perineum and genitals, with high morbidity and mortality in the general population, carries the additional risk of involvement of the peritoneal catheter tunnel and peritoneal cavity in patients on chronic peritoneal dialysis (PD). We describe two men with diabetes who developed FG in the course of PD. Computed tomography showed no extension of FG to the abdominal wall, and spent peritoneal dialysate was clear in both patients. Read More

    A review of diuretic use in dialysis patients.
    Adv Perit Dial 2014 ;30:115-9
    Diuretics are commonly prescribed to manage various conditions in the general population. They can continue to play a role in dialysis patients to manage extracellular fluid volume and hypertension and to reduce the tendency to hyperkalemia. Nevertheless, diuretics are often stopped when patients commence dialysis. Read More

    Impact of hydration and nutrition status on the Watson formula in peritoneal dialysis patients.
    Adv Perit Dial 2014 ;30:110-4
    Urea clearance (Kt/V urea), adjusted for total body water (TBW) using the Watson formula (TBW(Watson)), is widely used to guide peritoneal dialysis (PD) prescription and to ensure dialysis adequacy. The impact of body composition on the determination of TBW(Watson) is well established, but the effect of hydration and nutrition status on TBW(Watson) is not understood. We therefore studied the effects of hydration and nutrition status on TBW(Watson) in PD patients. Read More

    Molecular mechanisms of peritoneal dialysis-induced microvascular vasodilation.
    Adv Perit Dial 2014 ;30:98-109
    Peritoneal dialysis (PD) solutions dilate microvessels by undefined mechanisms. This vasodilation directly affects ultrafiltration and solute exchange during a PD dwell and is thought to account for the variable mass transfer area coefficient for small solutes during a glucose-based hypertonic dwell. We hypothesized that PD-mediated vasodilation occurs by endothelium-dependent mechanisms that involve endothelium energy-dependent K+ channels (K(ATP)), adenosine A1 receptor activation, and NO release. Read More

    Adapted automated peritoneal dialysis.
    Adv Perit Dial 2014 ;30:94-7
    Conventional automated peritoneal dialysis (APD) is prescribed as a repetition of the same dwell time and the same fill volume delivered by the cycler during the dialysis session. Nevertheless, it is well recognized that a cycle with a short dwell time and a small fill volume favors ultrafiltration (UF), while a cycle with a long dwell time and a large fill volume favors uremic toxin removal. The use of varied dwell times and dwell volumes, called adapted APD, allows for an optimized peritoneal dialysis prescription with better volume control--that is, both an increased UF volume at a lower metabolic cost [UF per gram of glucose absorbed (mL/g)] and increased dialytic sodium removal resulting in improved removal of uremic toxins (urea, creatinine, phosphate) during dialysis. Read More

    Serum magnesium concentration is a significant predictor of mortality in peritoneal dialysis patients.
    Adv Perit Dial 2014 ;30:90-3
    We previously reported that lower serum magnesium is associated with poorer nutrition status, impaired cellular health, and increased inflammation in peritoneal dialysis (PD) patients. The present study was designed to investigate the prognostic value of serum magnesium for mortality in PD patients. From November 2000 to July 2008, the study enrolled 62 patients, recording their demographic, clinical, and biochemical data. Read More

    Unexplained hypotension and exertional dyspnea in a night-cycled peritoneal dialysis patient--a rare form of icodextrin hypersensitivity.
    Adv Perit Dial 2014 ;30:87-9
    In recent years, icodextrin 7.5% has been used in PD as an alternative to glucose to achieve sustained reliable ultrafiltration (UF) and clearance without adversely increasing glucose absorption. Icodextrin is generally well tolerated. Read More

    Peritoneal dialysis immediately after kidney transplantation.
    Adv Perit Dial 2014 ;30:83-6
    Approximately 10% - 20% of adult kidney transplant recipients and as many as 40% of pediatric recipients receive peritoneal dialysis (PD) before kidney transplantation. An important aspect of perioperative kidney transplant care is management of the PD catheter. Peritoneal dialysis can be performed immediately after transplantation for delayed graft function (DGF), which can occur with as many as 20% of deceased-donor kidney grafts, especially when expanded criteria or organs from donation after cardiac death are used. Read More

    Blood glucose levels in peritoneal dialysis are better reflected by HbA1c than by glycated albumin.
    Adv Perit Dial 2014 ;30:75-82
    A recent study indicated that, compared with glycated hemoglobin (HbA1c), glycated albumin (GA) provides a more accurate assessment of glycemic control in diabetic patients on hemodialysis. However, the suitability of GA for this purpose in peritoneal dialysis (PD) patients is questionable. We measured blood glucose, GA, HbA1c, serum albumin, protein losses in urine and dialysate, protein catabolic rate, hemoglobin, and dose of erythropoiesis-stimulating agents in 71 PD patients [20 with diabetes (DM), 51 without DM]. Read More

    Hyperosmolality-mediated peritoneal microvascular vasodilation is linked to aquaporin function.
    Adv Perit Dial 2014 ;30:63-74
    Glucose-based peritoneal dialysis (PD) solutions dilate the parietal and visceral peritoneal microvasculature by endothelium-dependent mechanisms that primarily involve hyperosmolality. This PD-mediated dilation occurs by active intracellular glucose uptake and adenosine Al receptor activation, and by hyperosmolality-stimulated glibenclamide-sensitive potassium channels. Both pathways invoke NO as a second messenger for vasodilation. Read More

    Peritoneal dialysis peritonitis: common presentation by an uncommon organism.
    Adv Perit Dial 2014 ;30:60-2
    Peritonitis remains a leading complication of peritoneal dialysis (PD). About 18% of the infection-related mortality in PD patients is a result of peritonitis. We present a case of peritonitis in a patient on automated PD in whom the infection was not related to a break in PD technique, but to an unusual cause: retrograde transmission of a gonococcal organism. Read More

    Diurnal variations of blood glucose by continuous blood glucose monitoring in peritoneal dialysis patients with diabetes.
    Adv Perit Dial 2014 ;30:54-9
    Exaggerated postprandial increase in blood glucose has been postulated to be associated with cardiovascular injury. The concentration of blood glucose is altered by glucose absorption from peritoneal dialysis (PD) fluids. In PD patients, we used continuous blood glucose monitoring (CGM) to analyze diurnal variations in blood glucose. Read More

    Cardiovascular disease in chronic kidney disease: risk factors, pathogenesis, and prevention.
    Adv Perit Dial 2014 ;30:40-53
    Patients with chronic kidney disease (CKD) experience serious adverse cardiovascular (CV) consequences. Cardiovascular disease is the leading cause of morbidity and mortality in patients with CKD, being secondary not only to an increased prevalence of traditional CV risk factors, but also to the presence of a wide array of nontraditional risk factors unique to patients with CKD. Pathogenesis includes both functional and structural alterations in the CV system. Read More

    Early technique success after initiation of treatment with urgent-start peritoneal dialysis.
    Adv Perit Dial 2014 ;30:36-9
    In the United States, interest has recently been renewed in the more urgent initiation of peritoneal dialysis (PD) to avoid temporary vascular access catheters in appropriate patients presenting late in the course of their kidney disease. Urgent-start PD programs have been established across the country, requiring new infrastructure and processes of care. Less is known about early technique success after urgent initiation of PD. Read More

    Long-term survival benefits of combined hemodialysis and peritoneal dialysis.
    Adv Perit Dial 2014 ;30:31-5
    Recently, it was reported that concomitant hemodialysis (HD) in peritoneal dialysis (PD) patients facilitated continuation of PD treatment and mitigated the deterioration of peritoneal function in patients with uremic symptoms and excess body fluid associated with loss of residual renal function. To determine the effect of combined HD and PD on patient and technique survival, we undertook a retrospective cohort study of patients who underwent PD at Saitama Medical University Hospital between 1995 and 2010. We compared patients who started PD during 1995 2002 with those who started during 2003- 2010. Read More

    Evaluation of a single-item screening question to detect limited health literacy in peritoneal dialysis patients.
    Adv Perit Dial 2014 ;30:27-30
    Studies have shown that a single-item question might be useful in identifying patients with limited health literacy. However, the utility of the approach has not been studied in patients receiving maintenance peritoneal dialysis (PD). We assessed health literacy in a cohort of 31 PD patients by administering the Rapid Estimate of Adult Literacy in Medicine (REALM) and a single-item health literacy (SHL) screening question "How confident are you filling out medical forms by yourself?" (Extremely, Quite a bit, Somewhat, A little bit, or Not at all). Read More

    The value of osmotic conductance and free water transport in the prediction of encapsulating peritoneal sclerosis.
    Adv Perit Dial 2014 ;30:21-6
    Qualitative assessments in long-term patients and in those with encapsulating peritoneal sclerosis (EPS) have shown that impaired osmotic conductance is likely a factor contributing to the presence of ultrafiltration failure in those individuals. In the present study, we investigated the value of osmotic conductance, its components LpA and the reflection coefficient sigma, and free water transport (FWT) in 12 patients with EPS, in 21 patients with long-term ultrafiltration failure, and in 26 time-restricted control subjects with normal ultrafiltration. A decrease in all parameters was observed during a period of 4 years in patients with EPS and ultrafiltration failure, with FWT showing the largest difference between all three groups; however, the receiver operating curves showed that only FWT appeared to be a significant predictor of EPS. Read More

    Peritoneal solute transport rate as an independent risk factor for total and cardiovascular mortality in a population of peritoneal dialysis patients.
    Adv Perit Dial 2014 ;30:15-20
    The aim of the present study was to assess the influence of peritoneal permeability expressed as the dialysate-to-plasma ratio of creatinine (D/P Cr) on total and cardiovascular (CV) mortality in a population of peritoneal dialysis (PD) patients during a 6-year observation period. The study recruited 55 patients (mean age: 53 years) treated with PD for a median of 24 months. Hematology parameters and serum albumin were determined using routine methods. Read More

    Subcutaneous pathway diversion for peritoneal dialysis catheter salvage.
    Adv Perit Dial 2014 ;30:11-4
    Peritoneal dialysis (PD) catheter-related infection is still is the most troublesome problem for continuation of PD without the need to switch to hemodialysis. We have been performing subcutaneous pathway diversion (SPD) as a surgical treatment for refractory exit-site and tunnel infection (ESTI). To clarify the efficacy and safety of SPD, we conducted a retrospective study. Read More

    Effects of spironolactone on residual renal function and peritoneal function in peritoneal dialysis patients.
    Adv Perit Dial 2014 ;30:5-10
    There is increasing evidence that long-term peritoneal dialysis (PD) is associated with structural changes in the peritoneal membrane. Inhibition of the renin-angiotensin system has been demonstrated to lessen peritoneal injury and to slow the decline in residual renal function. Whether spironolactone affects residual renal function in addition to the peritoneal membrane is unknown. Read More

    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.
    Adv Perit Dial 2013 ;29:73-6
    College of Medicine, Mayo Clinic, Wisconsin, USA.
    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. Read More

    Hemoperitoneum in a peritoneal dialysis patient from a retroperitoneal source.
    Adv Perit Dial 2013 ;29:69-72
    Baxter Healthcare Corporation, Deerfield, Illinois 60015, USA.
    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. Read More

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