Comparison of clinical outcome and ease of handling in two double-bag systems in continuous ambulatory peritoneal dialysis: A prospective, randomized, controlled, multicenter study

Objective To compare peritonitis occurrence and outcome in a large U.K. study Multicentre Investigation of Icodextrin in Ambulatory Dialysis (MIDAS). Design Prospective, randomized, controlled 6-month comparison of icodextrin with glucose for the long dwell in continuous ambulatory peritoneal dialysis (CAPD) patients. Setting Eleven CAPD units in U.K. teaching hospitals. Patients A total of 209 patients established on CAPD for at least 3 months (103 control, 106 icodextrin). Twentythree control (C) and 22 icodextrin (I) patients experienced peritonitis during the study. Intervention Patients who had peritonitis remained on treatment (unless CAPD was withdrawn, temporarily or permanently). Main Outcome Measures The main outcome measures were the rate of peritonitis and duration of CAPD treatment prestudy; the rate of peritonitis episodes and their outcome during study; the effect of peritonitis on laboratory variables, serum icodextrin metabolites, and ultrafiltration efficacy. Results Prestudy: Nine (39%) of C but 14 (64%) of I patients had suffered previous peritonitis episode(s), with overall rates of 0.58 and 0.78 episodes per patient year, respectively. During study There were 31 C episodes and 35 I episodes, with overall rates of 0.76 and 0.93 per patient year, respectively. The increase in the C and I groups was 31% and 19%, respectively. Serum osmolality and sodium levels were unaffected by peritonitis, and there was no increase in serum icodextrin metabolites during peritonitis. Overnight ultrafiltration volume during peritonitis (mean±SD) declined slightly from 218±354 mL to 185±299 mL (NS) in the control group, but increased in the icodextrin group from 570±146 mL to 723±218 mL (p < 0.01). Conclusions Using icodextrin for the long dwell in CAPD does not increase the rate of peritonitis, nor does it alter the outcome of peritonitis. Peritonitis does not affect uptake of icodextrin from the peritoneum.

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Peritonitis Occurrence in a Multicenter Study of Icodextrin and Glucose in Capd

Peritoneal Dialysis International ◽

10.1177/089686089501506s07 ◽

1995 ◽

Vol 15 (6_suppl) ◽

pp. 226-230 ◽

Cited By ~ 1

Author(s):

◽

Ram Gokal ◽

Chandra D. Mistry ◽

Elizabeth M. Peers ◽

C.B. Brown ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Outcome Measures ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Multicenter Study ◽

Serum Osmolality ◽

Teaching Hospitals ◽

Control Group ◽

Randomized Controlled ◽

Laboratory Variables

Objective To compare peritonitis occurrence and outcome in a large U.K. study Multicentre Investigation of Icodextrin in Ambulatory Dialysis (MIDAS). Design Prospective, randomized, controlled 6-month comparison of icodextrin with glucose for the long dwell in continuous ambulatory peritoneal dialysis (CAPD) patients. Setting Eleven CAPD units in U.K. teaching hospitals. Patients A total of 209 patients established on CAPD for at least 3 months (103 control, 106 icodextrin). Twentythree control (C) and 22 icodextrin (I) patients experienced peritonitis during the study. Intervention Patients who had peritonitis remained on treatment (unless CAPD was withdrawn, temporarily or permanently). Main Outcome Measures The main outcome measures were the rate of peritonitis and duration of CAPD treatment prestudy; the rate of peritonitis episodes and their outcome during study; the effect of peritonitis on laboratory variables, serum icodextrin metabolites, and ultrafiltration efficacy. Results Prestudy: Nine (39%) of C but 14 (64%) of I patients had suffered previous peritonitis episode(s), with overall rates of 0.58 and 0.78 episodes per patientyear, respectively. During study There were 31 C episodes and 35 I episodes, with overall rates of 0.76 and 0.93 per patientyear, respectively. The increase in the C and I groups was 31% and 19%, respectively. Serum osmolality and sodium levels were unaffected by peritonitis, and there was no increase in serum icodextrin metabolites during peritonitis. Overnight ultrafiltration volume during peritonitis (mean±SD) declined slightly from 218±354 mL to 185±299 mL (NS) in the control group, but increased in the icodextrin group from 570±146 mL to 723±218 mL (p < 0.01). Conclusions Using icodextrin for the long dwell in CAPD does not increase the rate of peritonitis, nor does it alter the outcome of peritonitis. Peritonitis does not affect uptake of icodextrin from the peritoneum.

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08 / An open, prospective, non-randomized, controlled, multicenter study to evaluate the clinical outcome of implant treatment in women over 60 years of age with osteoporosis/osteopenia: 5-year results.

10.26226/morressier.5ac383172afeeb00097a3c29 ◽

2018 ◽

Author(s):

Temmerman Andy

Keyword(s):

Clinical Outcome ◽

Multicenter Study ◽

Randomized Controlled ◽

Implant Treatment

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Plasma and Dialysate Immunoglobulin G in Continuous Ambulatory Peritoneal Dialysis Patients: A Multicenter Study

American Journal of Nephrology ◽

10.1159/000168168 ◽

1990 ◽

Vol 10 (6) ◽

pp. 451-456 ◽

Cited By ~ 7

Author(s):

Amedeo F. De Vecchi ◽

Joel D. Kopple ◽

Gerald A. Young ◽

Karl D. Nolph ◽

Edward F. Vonesh ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Multicenter Study ◽

Immunoglobulin G ◽

Dialysis Patients

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Automated vs continuous ambulatory peritoneal dialysis: a systematic review of randomized controlled trials

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfm515 ◽

2007 ◽

Vol 22 (10) ◽

pp. 2991-2998 ◽

Cited By ~ 62

Author(s):

K. S. Rabindranath ◽

J. Adams ◽

T. Z. Ali ◽

C. Daly ◽

L. Vale ◽

...

Keyword(s):

Systematic Review ◽

Peritoneal Dialysis ◽

Randomized Controlled Trials ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Controlled Trials ◽

Randomized Controlled

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Peritonitis in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients: A Randomized Clinical Trial of Cotrimoxazole Prophylaxis

Peritoneal Dialysis International ◽

10.1177/089686088800800203 ◽

1988 ◽

Vol 8 (2) ◽

pp. 125-128 ◽

Cited By ~ 21

Author(s):

D. N. Churchill ◽

D. W. Taylor ◽

S. I. Vas ◽

J. Singer ◽

M. L. Beecroft ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Statistical Power ◽

Controlled Trial ◽

Double Blind ◽

Randomized Controlled ◽

Type 1 Error ◽

Significant Difference ◽

Monthly Changes

A double-blind randomized controlled trial compared the effectiveness of prophylactic oral trimethoprim/sulfamethoxazole (cotrimoxazole) to a placebo in preventing peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients. A daily trimethoprim/sulfamethoxazole dose of 160/800 mg gives a steady state dialysate concentration of 1.07/4.35 mg/L in the final dwell of each dosing interval. Identification of a 40% reduction in peritonitis probability with 80% statistical power and a type 1 error probability of 0.05 required 52 subjects per group. With stratification by previous peritonitis, 56 were allocated to cotrimoxazole and 49 to placebo. For cotrimoxazole there were five deaths and seven catheter losses. For placebo there were three deaths and nine catheter losses. There were 20 withdrawals from cotrimoxazole and 9 from the placebo group. With respect to time to peritonitis, there was no statistically significant difference between cotrimoxazole and placebo groups (p = 0.19). At 6 months, 64.1% of cotrimoxazole and 62.5% of placebo were peritonitis free; at 12 months 41.9% of cotrimoxazole and 35% of placebo were peritonitis free. There was no effect (p > 0.05) of age, sex, catheter care technique, spike or luer, or dialysate additives. Previous peritonitis increased the risk of peritonitis by 2.06 (95% CI, 3.61–1.18) while frequent (six weekly) extension tubing changes increased the risk of by 1.79, (95% CI, 3.04–1.02) when compared to six monthly changes. Cotrimoxazole appears ineffective in prevention of CAPD peritonitis.

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Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: a retrospective multicentre study

BMC Gastroenterology ◽

10.1186/s12876-019-1081-2 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Tae-Geun Gweon ◽

Sung Hoon Jung ◽

Sang Woo Kim ◽

Kang-Moon Lee ◽

Dae Young Cheung ◽

...

Keyword(s):

Risk Factors ◽

Peritoneal Dialysis ◽

Multicentre Study ◽

Endoscopic Mucosal Resection ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Medical Records ◽

Clinical Characteristics ◽

Prophylactic Antibiotics ◽

Randomized Controlled ◽

Mucosal Resection

Abstract Background Colonoscopy is associated with a risk of peritonitis in patients on peritoneal dialysis. However, no study has yet described the risk factors in play. Methods This was a retrospective multicentre study. The medical records of patients on continuous ambulatory peritoneal dialysis (CAPD) who underwent colonoscopy from January 2003 to December 2012 were analysed. We recorded demographic characteristics, colonoscopic factors, use of prophylactic antibiotics, and development of peritonitis. Colonoscopy-related peritonitis was defined as peritonitis developing within 1 week after colonoscopy. Demographic and clinical characteristics were compared between patients who did and those who did not develop peritonitis. Results During the study period, 236 patients on CAPD underwent colonoscopy, of whom 9 (3.8%) developed peritonitis. The rates of polypectomy/endoscopic mucosal resection were significantly higher in the peritonitis group than in the no peritonitis group (66.7 vs. 23.4%, p = 0.009). Prophylactic antibiotics were prescribed before colonoscopy in 65 patients; none developed peritonitis. No patient who developed peritonitis received prophylactic antibiotics (p = 0.067). Conclusions Advanced procedures including polypectomy or endoscopic mucosal resection increase colonoscopy-related peritonitis in patients on CAPD. Randomized controlled trials to investigate whether prophylactic antibiotics are needed to prevent peritonitis in all CAPD patients are warranted.

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