225: Heterogeneity in the Relative Mortality of Incident Hemodialysis and Peritoneal Dialysis Patients, Across Age, Comorbid Disease Burden, and Follow-Up Year

2009 ◽  
Vol 53 (4) ◽  
pp. B79
Keyword(s):  
Peritoneal Dialysis ◽  
Disease Burden ◽  
Comorbid Disease ◽  
Dialysis Patients ◽  
Relative Mortality

The Futility of Pretransplant Coronary Bypass Grafting in Asymptomatic Patients on Peritoneal Dialysis

1998 ◽  
Vol 18 (5) ◽  
pp. 485-488 ◽  
Author(s):  
S. Panduranga Rao ◽  
Susan Lenkei ◽  
Maggie Chu ◽  
Joanne M. Bargman
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Comparison Group ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Study Group ◽  
Bypass Grafting ◽  
Comorbid Disease ◽  
Dialysis Patients ◽  
Asymptomatic Patients

Objective To evaluate the validity of recommending coronary artery bypass grafting (CABG) in preparation for renal transplantation in asymptomatic peritoneal dialysis (PD) patients with evidence of reversible myocardial ischemia. Design Retrospective review in a single PD unit. Participants Ten asymptomatic PD patients who underwent CABG to be placed on the transplant list comprised the study group. Ten age-, sex-, and diseasematched PD patients who did not receive CABG were used as a comparison group. Measurements Clinical outcome from 1990 to the present. Results Only 1 patient in the study group has received a transplant. Seven patients (70%) have died or have been removed from the list because of comorbid illness. Only 2 patients are still on the waiting list. Conclusion As a result of the long waiting time for cadaveric renal transplant and the high risk of interim development of comorbid disease, only a minority of patients come to transplantation. The presence of coronary disease is likely a surrogate for more generalized cardiac and vascular disease in this population. In light of these findings, the policy of prophylactic revascularization in asymptomatic dialysis patients in preparation for renal transplantation needs to be reconsidered.

Longitudinal Trends in Quality of Life and Physical Function in Frail Older Dialysis Patients: A Comparison of Assisted Peritoneal Dialysis and In-Center Hemodialysis

2019 ◽  
Vol 39 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Osasuyi Iyasere ◽  
Edwina Brown ◽  
Fabiana Gordon ◽  
Helen Collinson ◽  
Richard Fielding ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Mixed Model ◽  
Rating Scale ◽  
Depression Scale ◽  
Dialysis Patients ◽  
The Impact ◽  
Assisted Peritoneal Dialysis

Background In-center hemodialysis (HD) has been the standard treatment for older dialysis patients, but reports suggest an associated decline in physical and cognitive function. Cross-sectional data suggest that assisted peritoneal dialysis (aPD), an alternative treatment, is associated with quality of life (QoL) outcomes that are comparable to in-center HD. We compared longitudinal changes in QoL between modalities. Methods We enrolled 106 aPD patients, matched with 100 HD patients from 20 renal centers in England and Northern Ireland. Patients were assessed quarterly for 2 years using the Hospital Anxiety and Depression Scale (HADS), SF-12 physical and mental scores, symptom score, Illness Intrusiveness Rating Scale (IIRS), Barthel's score, and the Renal Treatment Satisfaction Questionnaire (RTSQ). Mixed model analysis was used to assess the impact of dialysis modality on these outcomes during follow-up. P values were adjusted for multiple significance testing. Results Multivariate analysis showed no difference in any of the outcome measures between aPD and HD. Longitudinal trends in outcomes were also not significantly different. Higher age at baseline was associated with lower IIRS and RTSQ scores during follow-up. One-hundred and twenty-five (60.6%) patients dropped out of the study: 59 (28.6%) died, 61 (29.6%) withdrew during follow-up, and 5 (2.5%) were transplanted. Conclusions Quality of life outcomes in frail older aPD patients were equivalent to those receiving in-center HD. Assisted PD is thus a valid alternative to HD for older people with end-stage kidney disease (ESKD) wishing to dialyze at home.

scholarly journals P1547THE EFFECT OF INTERNET-BASED CLOSED-LOOP MANAGEMENT ON QUALITY OF LIFE IN PATIENTS ON PERITONEAL DIALYSIS, A SELF-CONTROL STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Fang Cao
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Management System ◽  
Closed Loop ◽  
Health Management ◽  
Management Model ◽  
Self Management ◽  
Dialysis Patients

Abstract Background and Aims With the continuous advancement of information technology, mobile Internet has entered every family and shown its unique advantages. The development of hospital's information construction on the management of chronic disease, the continuous improvement of hospital APP and Wechat public number functions have provided intelligent services for patients throughout the process. Along with this process, the way of hospital patient follow-up has gradually expanded and improved, and the automation and intellectualization of follow-up work has become a reality. However, The establishment of peritoneal dialysis health management professional team and the implementation of closed-loop health management model, which is based on the Internet closed-loop management model has no clear impact on the self-management ability, quality of life and treatment effect of peritoneal dialysis patients. To explore the effectiveness of Internet based in-hospital and out of hospital closed loop management on the quality of life of patients with peritoneal dialysis, it is necessary to establish a set of closed loop management system for chronic diseases patients with promotion and practical significance. Method From July 2017 to July 2018, 214 patients with continuous peritoneal dialysis were followed up regularly in the Department of Nephrology of our hospital, and voluntarily participated in this study. The mean follow-up time was 12.6 ± 1.5 months. The differences of blood electrolytes, quality control indexes, self-management ability, quality of life of renal disease and hospital satisfaction were observed before and after closed-loop management. Results Ability of self-management behavior (p < 0.001), quality of life (p < 0.001), satisfaction (p < 0.001), the incidence of infection (p < 0.05), serum albumin (p < 0.05), hemoglobin (p < 0.05)were improved after participating in the closed-loop management. Conclusion The closed-loop management system based on Internet closed-loop management model is effective for the quality of life and treatment effect of peritoneal dialysis patients, which integrates the core functions of follow-up records, intelligent early warning, doctor-patient communication and health education. Through this closed-loop management, medical staff can digitally collect, store, transmit and process the information of in-hospital and out-of-hospital conditions through follow-up analysis, health guidance and remote assistance to achieve the purpose of patient health management. This study shows that this closed-loop management system can effectively manage the health of peritoneal dialysis patients, and provides a replicable model for the management of chronic diseases. Therefore, a comprehensive closed-loop management system based on mobile Internet and information technology, with clinical care as the leading factor and peritoneal dialysis patients as the terminal is a feasible and acceptable follow-up management method for peritoneal dialysis patients and hospitals.

Changes in Nutritional Status on Follow-Up of an Incident Cohort of Continuous Ambulatory Peritoneal Dialysis Patients

2008 ◽  
Vol 18 (2) ◽  
pp. 195-201 ◽  
Author(s):  
Narayan Prasad ◽  
Amit Gupta ◽  
Archana Sinha ◽  
Raj Kumar Sharma ◽  
Alok Kumar ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Incident Cohort

scholarly journals Significant Decreasing Incidence of Encapsulating Peritoneal Sclerosis in the Dutch Population of Peritoneal Dialysis Patients

2017 ◽  
Vol 37 (2) ◽  
pp. 230-234 ◽  
Author(s):  
Michiel G.H. Betjes ◽  
Sayed M. Habib ◽  
Els W. Boeschoten ◽  
Aline C. Hemke ◽  
Dick G. Struijk ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
The Netherlands ◽  
Patient Survival ◽  
Average Duration ◽  
Dutch Population ◽  
Dialysis Patients ◽  
Post Transplantation ◽  
Surgical Interventions ◽  
Yearly Incidence

The Dutch Encapsulating Peritoneal Sclerosis (EPS) Registry was started in 2009. Cases were identified by contacting all Dutch nephrologists twice yearly. The predefined criteria for EPS allowed for inclusion of patients with diagnosed and suspected EPS. Cases registered between January 2009 and January 2015 were analyzed with follow-up until September 2015. Fifty-three EPS cases were identified, of which 28.3% were post-transplantation EPS cases. Fourteen patients were initially categorized as suspected EPS, of whom 13 developed EPS. A remarkable 6-fold decrease in the yearly incidence of EPS was observed, from 0.85% in 2009 to 0.14% in 2014. This decrease could not be explained by a decrease in the number of PD patients or average duration of PD treatment in this period. Two-year survival of EPS patients was 52%. The use of tamoxifen and surgical interventions increased significantly over the years. Tamoxifen-treated cases showed a trend to better patient survival and post-transplantation EPS had a significantly favorable outcome. In conclusion, the incidence of EPS has declined significantly in the Netherlands from 2009 to 2014.

scholarly journals Role of macrophages in tuberculous peritonitis: longitudinal follow-up of 16 continuous ambulatory peritoneal dialysis patients

2002 ◽  
Vol 4 (2) ◽  
pp. 90-94 ◽  
Author(s):  
Kai-Ming CHOW ◽  
Wai-Shan WONG ◽  
Viola Chi-Ying CHOW ◽  
Teresa Yuk-Hwa WONG ◽  
Natalie Pui-Ha CHAN ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Tuberculous Peritonitis ◽  
Dialysis Patients

scholarly journals Elevation of whole-blood glutathione in peritoneal dialysis patients by L-2-oxothiazolidine-4-carboxylate, a cysteine prodrug (Procysteine).

1998 ◽  
Vol 9 (6) ◽  
pp. 1093-1099 ◽  
Author(s):  
J B Moberly ◽  
J Logan ◽  
P R Borum ◽  
K O Story ◽  
L E Webb ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Whole Blood ◽  
Oxidant Stress ◽  
Cellular Damage ◽  
Controlled Study ◽  
Dialysis Patients ◽  
Protein Thiols ◽  
Cysteine Prodrug

Glutathione is a major cellular antioxidant that protects protein thiols and inhibits cellular damage due to oxygen free radicals. It has been reported previously that patients undergoing dialysis have low levels of blood glutathione, which may lead to increased susceptibility to oxidant stress. L-2-oxothiazolidine-4-carboxylic acid (OTZ) is a cysteine prodrug that raises cellular glutathione levels by increasing delivery of cysteine, the rate-limiting substrate for glutathione synthesis. This study investigates the effect of OTZ on blood glutathione in a blinded, placebo-controlled study of patients with chronic renal failure treated by peritoneal dialysis. Twenty patients were randomly selected to receive OTZ (0.5 g three times a day orally with meals) or placebo for 14 d. Patients visited the clinic for predose blood collection and safety evaluation at baseline (days 3, 7, and 14 and again at 14 d from the last dose [follow-up]). Glutathione concentrations were determined in whole blood by HPLC. OTZ resulted in a significant rise in whole-blood glutathione at days 7 (594 +/- 129 mumol/L) and 14 (620 +/- 108 mumol/L) compared with baseline (544 +/- 139 mumol/L) (P < 0.01 and P < 0.05, respectively). Glutathione was also significantly increased at days 7 and 14 when normalized by hematocrit (Hct) or hemoglobin to correct for anemic status (e.g., 20.7 +/- 5.7 mumol/L per % Hct [day 7] and 20.9 +/- 4.0 mumol/L per % Hct [day 14] versus 18.0 +/- 4.2 mumol/L per % Hct [baseline]; P < 0.05). Glutathione levels did not change in the placebo group at any patient visit, and levels in the OTZ-treated group returned to baseline at follow-up. There were no serious adverse events attributable to OTZ, and the drug appeared to be well tolerated by patients with renal failure treated by continuous ambulatory peritoneal dialysis. Our results show that OTZ increases blood glutathione levels, which may improve antioxidant status in dialysis patients.

scholarly journals A comparison of mortality between patients treated with hemodialysis and peritoneal dialysis.

1995 ◽  
Vol 6 (2) ◽  
pp. 177-183
Author(s):  
W E Bloembergen ◽  
F K Port ◽  
E A Mauger ◽  
R A Wolfe
Keyword(s):  
Peritoneal Dialysis ◽  
Mortality Rate ◽  
High Mortality ◽  
Epidemiologic Study ◽  
National Sample ◽  
National Study ◽  
Dialysis Patients ◽  
All Cause Mortality ◽  
Males And Females

Patients with ESRD treated with dialysis have a high mortality rate. Controversy exists as to whether this high mortality rate is affected by modality choice. The purpose of this epidemiologic study was to compare mortality in prevalent hemodialysis-treated (HD) and peritoneal dialysis-treated (PD) patients in a large national sample, adjusting for demographic characteristics. Data were obtained from the U.S. Renal Data System for patients prevalent on January 1 of the years 1987, 1988, and 1989, each with 1 yr of follow-up. Patients were censored at transplantation. Death rates per 100 patient years were compared between HD and PD, adjusting for age, race, gender, cause of ESRD (diabetes versus nondiabetes) and < 1 yr or > 1 yr of prior ESRD, by the use of Poisson regression. There were 42,372 deaths occurring over 170,700 patient years at risk. On average, prevalent patients treated with PD had a 19% higher adjusted mortality risk (relative risk (RR) = 1.19; P < 0.001) than did those treated with HD. This risk was found to be insignificant (P > 0.05) and small for ages < 55 and increasingly large and significant for ages > 55 yr. It was accentuated in diabetics (RR = 1.38; P < 0.001) but was also present in nondiabetics (RR = 1.11; P < 0.001). Although present in both males and females, this risk was accentuated in females (RR = 1.30 versus 1.11; both P < 0.001). In this national study of prevalent U.S. dialysis patients, treatment assignment to PD was associated with a 19% higher all-cause mortality rate than HD.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Hyperlipidemia and mortality associated with diabetes mellitus co-existence in Chinese peritoneal dialysis patients

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Xin Wei ◽  
Yueqiang Wen ◽  
Qian Zhou ◽  
Xiaoran Feng ◽  
Fen Fen Peng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Peritoneal Dialysis ◽  
Cox Regression ◽  
Dialysis Patients ◽  
Term Survival ◽  
Risk Of Mortality ◽  
Subgroup Analyses ◽  
All Cause Mortality

Abstract Background To evaluate associations between diabetes mellitus (DM) coexisting with hyperlipidemia and mortality in peritoneal dialysis (PD) patients. Methods This was a retrospective cohort study with 2939 incident PD patients in China from January 2005 to December 2018. Associations between the DM coexisting with hyperlipidemia and mortality were evaluated using the Cox regression. Results Of 2939 patients, with a median age of 50.0 years, 519 (17.7%) died during the median of 35.1 months. DM coexisting with hyperlipidemia, DM, and hyperlipidemia were associated with 1.93 (95% CI 1.45 to 2.56), 1.86 (95% CI 1.49 to 2.32), and 0.90 (95% CI 0.66 to 1.24)-time higher risk of all-cause mortality, compared with without DM and hyperlipidemia, respectively (P for trend < 0.001). Subgroup analyses showed a similar pattern. Among DM patients, hyperlipidemia was as a high risk of mortality as non-hyperlipidemia (hazard ratio 1.02, 95%CI 0.73 to 1.43) during the overall follow-up period, but from 48-month follow-up onwards, hyperlipidemia patients had 3.60 (95%CI 1.62 to 8.01)-fold higher risk of all-cause mortality than those non-hyperlipidemia (P interaction = 1.000). Conclusions PD patients with DM coexisting with hyperlipidemia were at the highest risk of all-cause mortality, followed by DM patients and hyperlipidemia patients, and hyperlipidemia may have an adverse effect on long-term survival in DM patients.

The Self-Locating Catheter: Clinical Experience and Follow-Up

2004 ◽  
Vol 24 (4) ◽  
pp. 359-364 ◽  
Author(s):  
Nicola Di Paolo ◽  
Luigi Capotondo ◽  
Enrico Sansoni ◽  
Valerio Romolini ◽  
Matteo Simola ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Experience ◽  
Large Population ◽  
The Self ◽  
Dialysis Patients ◽  
Tenckhoff Catheter ◽  
Preliminary Results ◽  
Catheter Malfunction ◽  
Control Study

Background The self-locating catheter invented by Nicola Di Paolo has been used increasingly in Italy and elsewhere since 1994, with about a thousand patients currently implanted every year. Twelve grams of tungsten inserted into the tip of the conventional Tenckhoff catheter during extrusion does not significantly change its form, but suffices to keep the tip firmly in the Douglas cavity. Objective The aim of the present study was to confirm our preliminary results in a large population of peritoneal dialysis patients. Setting 16 Italian nephrology departments. Results In addition to confirming the validity of the new catheter, the present results show that patients with the new catheter have fewer episodes of peritonitis, tunnel infection, cuff extrusion, catheter malfunction, obstruction, and leakage. Conclusion The present multicenter control study confirms preliminary results and demonstrates that complications of peritoneal dialysis, such as cuff extrusion, infection, peritonitis, early leakage, and obstruction, are statistically less frequent in patients with self-locating catheters than in patients with classic Tenckhoff catheters.

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