Factors Associated With Transfer to Hemodialysis, Transplantation and Death on Peritoneal Dialysis

2013 ◽  
Vol 61 (4) ◽  
pp. B99
2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 205-209 ◽  
Author(s):  
Elvia García–López ◽  
Juan J. Carrero ◽  
Mohamed E. Suliman ◽  
Bengt Lindholm ◽  
Peter Stenvinkel

Patients on peritoneal dialysis (PD) are at high cardiovascular risk. Although some risk factors are unmodifiable (for example, age, sex, genetics), others are exacerbated in the unfriendly uremic milieu (inflammation, oxidative stress, mineral disturbances) or contribute per se to kidney disease and cardiovascular progression (diabetes mellitus, hypertension). Moreover, several factors associated with PD therapy may both increase (by altered lipid profile, hyperinsulinemia, and formation of advanced glycation end-products) and decrease (by better blood pressure control and anemia management) cardiovascular risk. The present review discusses recent findings and therapy trends in cardiovascular research on the PD population, with emphasis on the roles of inflammation, insulin resistance, homocysteinemia, dyslipidemia, vascular calcification, and genetics/epigenetics.


Nephrology ◽  
2015 ◽  
Vol 20 (9) ◽  
pp. 639-645 ◽  
Author(s):  
Shunsuke Yamada ◽  
Kazuhiko Tsuruya ◽  
Masanori Tokumoto ◽  
Hisako Yoshida ◽  
Hiroaki Ooboshi ◽  
...  

1993 ◽  
Vol 13 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Stephen M. Korbet ◽  
Edward F. Vonesh ◽  
Catherine A. Firanek

Peritonitis is a major reason why patients transfer from peritoneal dialysis (PD) to hemodialysis. We evaluated the peritonitis infection rates In 146 peritoneal dialysis patients who underwent dialysis at our facility between 1 January 1981 and 31 December 1989. Peritonit Is was the primary cause for changing treatment, with 24 (16.4%) of the patients transferring because of this complication. This represented 54.5% of all patients discontinuing CAPD due to method failure. A gamma-Poisson regression analysis was performed in an attempt to Identify potential risk factors associated with an increased Incidence of peritonitis. The results indicated that race, education level, and PD system used were significantly associated with the rate at which peritonitis occurred in our patient population. There was an almost twofold increase in the rate of peritonitis among blacks as compared to whites (2.2 vs 1.2 episodes/patient year). The level of education completed at the start of dialysis had a negative correlation with peritonitis rates. Patients with ≤8, 9–12, and ≥13 years of education had peritonitis rates of 2.4, 1.8, and 1.2 episodes/patient year, respectively. Finally, the system used had a significant effect with our patients on CCPD having lower peritonitis rates as compared to patients on either a connect or disconnect system (0.6 vs 2.5 vs 1.8 episodes/patient year, respectively). Recognizing potential risk factors for peritonitis will help us better understand and address this significant problem in our PD programs. Reducing peritonitis rates should facilitate a decrease in patient transfer due to method failure.


2020 ◽  
Vol 5 (7) ◽  
pp. 1007-1013 ◽  
Author(s):  
Mickael Sigogne ◽  
Lukshe Kanagaratnam ◽  
Caroline Mora ◽  
Malika Pierre ◽  
Andreea Petrache ◽  
...  

2010 ◽  
Vol 30 (6) ◽  
pp. 638-643 ◽  
Author(s):  
Hsiu-Chen Huang ◽  
Jiun-Yi Wang ◽  
Chia-Chu Chang ◽  
Ping-Fang Chiu ◽  
Ming-Che Chiang ◽  
...  

ObjectivesLess than 10% of end-stage renal disease (ESRD) patients in Taiwan receive peritoneal dialysis (PD), which reveals the situation of underutilization of PD. We thus aimed to investigate factors associated with treatment with PD in ESRD patients in Taiwan.PatientsPatients that were 18 years of age or older and had been on dialysis for at least 3 months since 2001 were recruited and interviewed with a structured questionnaire.Results98 hemodialysis (HD) and 102 PD patients were recruited. In univariate analysis, age, sex, level of education, employment status, marital status, traffic time, family support, patient cognition, and receptivity were correlated with treatment with PD. Multivariate analysis showed that patients that were not married ( p = 0.006), that spent more time traveling to the dialysis clinic ( p = 0.006), that were not emergent at the start of dialysis ( p = 0.003), and that had better family support ( p = 0.045), a higher cognition of dialysis ( p = 0.034), and stronger receptivity to dialysis ( p < 0.001) were more likely to receive PD.ConclusionsWe recommend patients follow the standard process to obtain more exhaustive information, consultation, and early referral. In addition, we suggest healthcare providers remind patients to take into account such nonclinical factors as family support and patient receptivity when they choose their dialysis modality.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Malgorzata Debowska ◽  
Rafael Gomez ◽  
Joyce Pinto ◽  
Jacek Waniewski ◽  
Bengt Lindholm

Abstract In renal failure, hyperphosphatemia is common and correlates with increased mortality making phosphate removal a key priority for dialysis therapy. We investigated phosphate clearance, removal and serum level, and factors associated with phosphate control in patients undergoing continuous ambulatory (CAPD), continuous cyclic (CCPD) and automated (APD) peritoneal dialysis (PD). In 154 prevalent PD patients (mean age 53.2 ± 17.6 year, 59% men, 47% anuric), 196 daily collections of urine and 368 collections of dialysate were evaluated in terms of renal, peritoneal and total (renal plus peritoneal) phosphorus removal (g/week), phosphate and creatinine clearances (L/week) and urea KT/V. Dialytic removal of phosphorus was lower in APD (1.34 ± 0.62 g/week) than in CAPD (1.89 ± 0.73 g/week) and CCPD (1.91 ± 0.63 g/week) patients; concomitantly, serum phosphorus was higher in APD than in CAPD (5.55 ± 1.61 vs. 4.84 ± 1.23 mg/dL; p < 0.05). Peritoneal and total phosphate clearances correlated with peritoneal (rho = 0.93) and total (rho = 0.85) creatinine clearances (p < 0.001) but less with peritoneal and total urea KT/V (rho = 0.60 and rho = 0.65, respectively, p < 0.001). Phosphate removal, clearance and serum levels differed between PD modalities. CAPD was associated with higher peritoneal removal and lower serum level of phosphate than APD.


2015 ◽  
Vol 41 (1-3) ◽  
pp. 48-54 ◽  
Author(s):  
Koichi Sasaki ◽  
Hitoshi Mizuno ◽  
Noriyuki Iwamoto ◽  
Masami Imakita ◽  
Keiko Yasuda ◽  
...  

Background: Although laparoscopy may provide more detailed morphological and histological information about peritoneal damage, its significance in patients with long vintage of peritoneal dialysis (PD) is not elucidated. Methods: Findings in 12 patients with PD vintage of 7.3 (5.0-8.4) years who had undergone laparoscopy between 2007 and 2011 were reviewed. Macroscopic (peritoneal change, hypervascular change, adhesion, encapsulation) and histopathological peritoneal findings (interstitial fibrosis, microvascular change, fibrin deposition, inflammatory cell infiltration) were scored and summed as Macro-total score (Macro-TS) and Micro-total score (Micro-TS), respectively. Factors associated with these scores and the relationship between these scores were investigated. Results: Neither Macro-TS nor Micro-TS were related to PD vintage (p = 0.069 and p = 0.769, respectively); moreover, Macro-TS varied from patient to patient regardless of similar PD vintage. However, Macro-TS showed a significant association with duration of acidic dialysate (p = 0.003). Conclusion: Macroscopic and microscopic findings via laparoscopy may help the assessment of peritoneal damage in patients with long PD vintage.


2012 ◽  
Vol 57 (1) ◽  
pp. 84-87 ◽  
Author(s):  
T Hryszko ◽  
E Suchowierska ◽  
A Rydzewska-Rosolowska ◽  
S Brzosko ◽  
M Mysliwiec

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