Tryptophan and its metabolites in patients on continuous ambulatory peritoneal dialysis and following renal transplantation

1984 ◽  
Vol 4 (2) ◽  
pp. 78-81 ◽  
Author(s):  
I. Parsoo ◽  
Y.K. Seedat ◽  
S. Naicker ◽  
J.C. Kallmeyer

This study describes our experience with continuous ambulatory peritoneal dialysis (CAPD) over a four year period, during which 88 patients were offered CAPD. It compares and contrasts the response to CAPD among four racial groups in Natal viz asiatics, blacks, coloureds and whites. Peritonitis -the major complication, occurred with an overall incidence of one episode every 4.41 patient months. CAPD remains a useful alternative therapy in developing countries where a high percentage of patients with chronic renal failure would be denied a chronic renal failure program because of lack of expertise in hemodialysis and/or renal transplantation, or limited financial resources. Continuous ambulatory peritoneal dialysis (CAPD) was first described by Moncrief and Popovich (1) and, since its modification by Oreopoulos and his group (2), this technique has gained world wide usage. South Africa, like many developing countries has a high incidence of end-stage renal disease (ESRD) but because of lack of resources and economical problems, few patients with ESRD can be treated by dialysis or renal transplantation. CAPD affords a relatively simple and inexpensive form of therapy for these patients. At the present time about 200 patients are on CAPD in South Africa. Natal, the smallest of four provinces in South Africa, has a population of about five million, the majority being blacks. The minority groups include whites, asiatics and coloureds. There is only one chronic dialysis centre in Natal; situated in Durban, it serves the entire province including parts of the Transkei. This paper describes a four-year experience with CAPD in this mixed population and discusses problems unique to this situation.


2019 ◽  
Vol 25 ◽  
pp. 100890
Author(s):  
Gede Wirya Kusuma Duarsa ◽  
Anak Agung Gede Oka ◽  
Kadek Budi Santosa ◽  
I. Wayan Yudiana ◽  
Pande Wisnu Tirtayasa ◽  
...  

BMJ ◽  
1985 ◽  
Vol 291 (6501) ◽  
pp. 1004-1007 ◽  
Author(s):  
J B Evangelista ◽  
D Bennett-Jones ◽  
J S Cameron ◽  
C Ogg ◽  
D G Williams ◽  
...  

BMJ ◽  
1985 ◽  
Vol 291 (6501) ◽  
pp. 1001-1004 ◽  
Author(s):  
P K Donnelly ◽  
T W Lennard ◽  
G Proud ◽  
R M Taylor ◽  
R Henderson ◽  
...  

2002 ◽  
Vol 22 (4) ◽  
pp. 488-491 ◽  
Author(s):  
Kai-Chung Tse ◽  
Pok-Siu Yip ◽  
Man-Fei Lam ◽  
Fu-Keung Li ◽  
Bo-Ying Choy ◽  
...  

♦ Objectives To study the clinical features, clinical outcomes, and peritoneal transport characteristics of patients with recurrent hemoperitoneum complicating continuous ambulatory peritoneal dialysis (CAPD). ♦ Design Single-center retrospective case review of patients on CAPD over a 10-year period. ♦ Setting Renal Unit in Queen Mary Hospital, a tertiary-care referral center in Hong Kong. ♦ Patients 549 patients were available for review. 46 patients (8.4%) had at least one episode of hemoperitoneum during their course of CAPD; 25 patients had only one episode of hemoperitoneum and they were excluded. The remaining 21 patients (3.8%) had two or more episodes of hemoperitoneum and they were included for review. ♦ Main Outcome Measures Basic demographic factors and the etiology and episodes of hemoperitoneum were recorded. Clinical outcomes included continuation on peritoneal dialysis, conversion to hemodialysis (HD), renal transplantation, and death. The reason for conversion to HD, the causes of death, and serial peritoneal equilibration tests (PET) using dialysate-to-plasma ratio of creatinine (D/P creat) and ratio of dialysate glucose at hours 4 and zero of the dwell (D4/D0) with standard 2-L 2.5% glucose dialysate were assessed. ♦ Results There were 549 patients with total of 91 episodes of recurrent hemoperitoneum affecting 21 patients (3.8%). Mean age was 50.2 years (range 24 – 76 years) and mean duration of dialysis was 61.6 months (range 2 – 166 months). There were 14 female patients (66.7%) and 7 male patients (33.3%). The average number of hemoperitoneum episodes was 4.3 per patient (range 2 – 12). The mean time interval of the first hemoperitoneum episode from commencement of peritoneal dialysis was 10.5 months (range 1 – 37 months, SD 9.7 months). Most cases were due to retrograde menstruation in females and unknown cause in males. Two patients had intra-abdominal pathology accounting for hemoperitoneum. Thirteen patients (61.9%) continued CAPD, 2 (9.5%) underwent renal transplantation, and 2 (9.5%) were converted to long-term HD. The reason for conversion to HD was related to hemoperitoneum in 1 patient (4.8%) only. Four patients (19.0%) died; the causes of death were unrelated to hemoperitoneum. There was no correlation between recurrent hemoperitoneum and peritonitis episodes ( p = 0.18). There was no significant association between hemoperitoneum episodes and clinical outcomes ( p = 0.91) or survival ( p = 0.52). None of the patients developed ultrafiltration failure on long-term follow-up. ♦ Conclusions Recurrent hemoperitoneum is a benign complication of CAPD, with no significant long-term effects on patient survival, predisposition to peritonitis, or ultrafiltration failure.


1983 ◽  
Vol 3 (1) ◽  
pp. 5-8 ◽  
Author(s):  
Constantinos J. Stefanidis ◽  
J. Williamson Balfe Gerald S ◽  
Arbus Brian E. Hardy Bernard ◽  
M. Churchill ◽  
C. Phillip Rance

Over the last three years 23 children, who were managed by CAPD at the Hospital for Sick Children, Toronto received a renal transplant. Their actuarial graft survival was similar to those of children on hemodialysis and to patients not dialyzed before transplantation. In addition, we analyzed the actuarial graft survival of 130 children treated before transplantation with peritoneal dialysis (IPD and CAPD), hemodialysis or no dialysis to determine the long-term effects of peritoneal dialysis. Again, we found no significant differences among the various groups. Posttransplantation complications in the CAPD patients included fungal peritonitis in one and ascites in seven.


1991 ◽  
Vol 11 (2) ◽  
pp. 166-172 ◽  
Author(s):  
Wai-Kei Lo ◽  
Kwok Tat Chan ◽  
Anthony C.T. Leung ◽  
Siu-Wah Pang ◽  
Chun-Yan Tse

Sclerosing peritonitis (SP) is an uncommon but serious complication of CAPD with various suggested etiologies. We have documented 14 cases of SP in 18 patients who had used chlorhexidine in alcohol (ChA) in the connection procedure for CAPD. Thirteen died. Nine of the 14 patients had been transferred to hemodialysis or renal transplantation, yet all still developed symptoms of SP within a few months after transfer -even the 5 who were originally asymptomatic. The main symptoms of SP were peritoneal ultrafiltration failure, exudative bloody ascites and intestinal obstruction. They presented at around 5 years (30–80 months) after commencement of CAPD. Most deaths were related to intestinal obstruction. Four other patients with a comparable duration of ChA exposure were continued on CAPD with the Travenol Spike System (TSS), without further exposure to ChA. They were all asymptomatic of SP after 9–12 months. Comparing the 2 groups of asymptomatic patients, those transferred to TSS had a much better outcome after 9 months than those transferred to HD or renal transplantation (P=0.0476). We suggest that ChA is the main cause of SP in our patients and that continuing CAPD without further exposure to ChA is a better alternative than stopping CAPD to prevent the progression of SP.


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