Peritoneal dialysis in the emergency management of severe neonatal hyperammonemia secondary to citrullinemia type 1

2021 ◽  
Author(s):  
Jose Ramon Fernandez‐Fructuoso ◽  
Juan David Gonzalez‐Rodriguez ◽  
Carmen Fuentes‐Gutierrez
Keyword(s):  
Peritoneal Dialysis ◽  
Emergency Management ◽  
Neonatal Hyperammonemia

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

1988 ◽  
Vol 8 (2) ◽  
pp. 125-128 ◽  
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.

Comorbidity and Mortality in Peritoneal Dialysis: A Comparative Study of Type 1 and 2 Diabetes versus Nondiabetic Patients

Nephron ◽  
2002 ◽  
Vol 90 (3) ◽  
pp. 290-296 ◽  
Author(s):  
Alfonso Miguel ◽  
Rafael García-Ramón ◽  
Javier Pérez-Contreras ◽  
Carmen Gómez-Roldán ◽  
Javier Alvariño ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Comparative Study

scholarly journals Effect of lactate as a peritoneal dialysis fluid buffer on rat peritoneal mesothelial cells

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Chieko Higuchi ◽  
Junko Kuriyama ◽  
Hiroshi Sakura
Keyword(s):  
Peritoneal Dialysis ◽  
Growth Factor ◽  
Mesothelial Cells ◽  
Matrix Metalloproteinase 2 ◽  
Dialysis Fluid ◽  
Mesenchymal Transition ◽  
Peritoneal Mesothelial Cells ◽  
Peritoneal Dialysis Fluid ◽  
E Cadherin

Abstract Background Neutral, low-glucose degradation product (GDP) peritoneal dialysis fluid (PDF) is less damaging to the peritoneum than conventional PDF but is still insufficient for biocompatibility. One remaining issue is the problem of buffering. Methods Using cultured rat peritoneal mesothelial cells (PMCs), the present study examined the difference between the effects of neutral low-GDP lactate PDF and neutral low-GDP bicarbonate/lactate PDF on cells. The effects of lactate stimulation on these cells were also examined. Results Lactate PDF enhanced mRNA expressions of α-smooth muscle actin (αSMA) and type 1 and type 3 collagens and lowered expression of e-cadherin mRNA in PMCs compared to bicarbonate/lactate PDF. Lactate stimulation increased mRNA expressions of αSMA, matrix metalloproteinase 2 (MMP2), and basic fibroblast growth factor (bFGF) and suppressed e-cadherin mRNA expression. Transforming growth factor (TGF)-β1 and TGF-β2 and collagen type 1 and 3 mRNA expressions were also enhanced by lactate stimulation. Conclusions These results suggest that lactate as a PDF buffer may act on PMCs to promote epithelial-mesenchymal transition (EMT) and production of TGF-β, bFGF, and collagen.

scholarly journals Outcomes after Acute Peritoneal Dialysis for Critical Cardiorenal Syndrome Type 1

2021 ◽  
pp. 1-9
Author(s):  
Watanyu Parapiboon ◽  
Tanit Kingjun ◽  
Laddaporn Wongluechai ◽  
Waraporn Leawnoraset
Keyword(s):  
Peritoneal Dialysis ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Fluid Balance ◽  
Multivariable Analysis ◽  
Cardiorenal Syndrome ◽  
Syndrome Type ◽  
Resource Limited ◽  
Limited Setting

<b><i>Introduction:</i></b> The aim of the study was to demonstrate the outcomes of peritoneal dialysis (PD) in critically ill cardiorenal syndrome type 1 (CRS1). <b><i>Methods:</i></b> A cohort of 147 patients with CRS1 who received PD from 2011 to 2019 in a referral hospital in Thailand was analyzed. The primary outcome was 30-day in-hospital mortality. Ultrafiltration and net fluid balance among survivors and nonsurvivors in the first 5 PD sessions were compared. <b><i>Results:</i></b> The 30-day mortality rate was 73.4%. Most patients were critically ill CRS1 (all patients had a respiratory failure of which 68% had cardiogenic shock). Blood urea nitrogen and creatinine at the commencement of PD were 60.1 and 4.05 mg/dL. In multivariable analysis, increasing age, unstable hemodynamics, and positive fluid balance in the first 5 PD sessions were associated with the risk of in-hospital mortality. The change of fluid balance per day during the first 5 dialysis days was significantly different among survivor and nonsurvivor groups (−353 vs. 175 mL per day, <i>p</i> = 0.01). <b><i>Conclusions:</i></b> PD is a viable dialysis option in CRS1, especially in a resource-limited setting. PD can save up to 27% of lives among patients with critically ill CRS1.

Angiotensin Receptor Blocker Telmisartan Improves Insulin Sensitivity in Peritoneal Dialysis Patients

2010 ◽  
Vol 30 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Antonio Cioni ◽  
Caterina Sordini ◽  
Ivo Cavallini ◽  
Roberto Bigazzi ◽  
Vito M. Campese
Keyword(s):  
Peritoneal Dialysis ◽  
Insulin Sensitivity ◽  
Antihypertensive Drugs ◽  
Serum Insulin ◽  
Assessment Method ◽  
Model Assessment ◽  
Angiotensin Receptor ◽  
Improve Insulin Sensitivity ◽  
Insulin Levels

BackgroundInsulin resistance (IR) is common among patients on dialysis and is worse among patients on peritoneal dialysis (PD) than among patients on hemodialysis. In this study we tested the hypothesis that administration of telmisartan, an angiotensin II type 1 receptor antagonist, might improve insulin sensitivity in patients on PD.MethodThis was a crossover study of 30 nondiabetic patients with end-stage renal disease being treated with PD. Group A patients ( n = 15) received telmisartan and other antihypertensive drugs for 4 months, followed by 4 months without telmisartan. Group B patients ( n = 15) received their usual treatment for 4 months, followed by 4 months of treatment with telmisartan. Blood glucose and serum insulin levels were monitored and homeostasis model assessment method for IR (HOMA-IR) was calculated.ResultsTreatment with telmisartan had no significant impact on serum glucose, potassium, and bicarbonate levels. However, telmisartan significantly reduced serum insulin levels and the HOMA index in groups A and B.ConclusionThis study demonstrated that telmisartan, an angiotensin receptor type 1 antagonist, may effectively improve insulin sensitivity as measured by HOMA in patients treated with PD.

Encapsulating Peritoneal Sclerosis in a Patient with Primary Hyperoxaluria Type 1: A Case Report

2010 ◽  
Vol 30 (1) ◽  
pp. 108-111
Author(s):  
Jill Vanmassenhove ◽  
Raymond Vanholder ◽  
Ramses Forsyth ◽  
Annemieke Dhondt
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Calcium Oxalate ◽  
Primary Hyperoxaluria ◽  
Calcium Oxalate Crystals ◽  
Primary Hyperoxaluria Type 1 ◽  
Primary Hyperoxaluria Type ◽  
Oxalate Crystals ◽  
Hyperoxaluria Type

Primary hyperoxaluria type 1 (PH1) is a rare metabolic disorder caused by a defect in glyoxylate metabolism attributable to low or absent activity of the liver-specific peroxisomal enzyme alanine/glyoxylate aminotransferase. This defect leads to enhanced conversion of glyoxylate to poorly soluble oxalate, which is then excreted into the urine. This process may lead to deposition of calcium oxalate crystals in many tissues as well as in the kidneys, resulting in nephrolithiasis, nephrocalcinosis, and/or renal failure.We present a 39-year-old patient with end-stage renal failure due to PH1, who was admitted with symptoms of feeling bloated, vomiting, diarrhea, and abdominal pain related to encapsulating peritoneal sclerosis (EPS). He had been treated with peritoneal dialysis for a total period of 5 years.EPS is a rare condition characterized by fibrosis and adhesions of the peritoneum to loops of the small intestine and has been described secondary to treatment with peritoneal dialysis. It also occurs in a variety of other clinical conditions such as autoimmune diseases and peritoneal and intra-abdominal malignancies.The calcium oxalate crystals found in the peritoneal fascia of this particular patient may suggest a causative relationship between crystal deposits and evolution to fibrosis and sclerosis of the peritoneum. The degree of impact of the peritoneal dialysis treatment itself on the development of EPS, however, is uncertain.

Relation of Intraperitoneal and Intravascular Coagulation and Fibrinolysis Related Antigens in Peritoneal Dialysis

1990 ◽  
Vol 63 (03) ◽  
pp. 356-360 ◽  
Author(s):  
E Gries ◽  
J Kopp ◽  
U Thomae ◽  
H Kuhlmann
Keyword(s):  
Mass Transfer ◽  
Peritoneal Dialysis ◽  
Plasminogen Activator ◽  
Plasminogen Activator Inhibitor ◽  
Fibrinogen Degradation Product ◽  
Intravascular Coagulation ◽  
Continuous Peritoneal Dialysis ◽  
Inhibitor Type ◽  
Activator Inhibitor Type

SummaryPatients received 2,000 ml of dialysate intraperitoneally with five exchanges per day during continuous peritoneal dialysis (CAPD) for the treatment of terminal renal insufficiency. During a dwell time of 4 h the dialysate reached a total protein concentration up to 100 mg/dl by mass transfer of intravascular proteins. The composition is dependent on the molecular weight of the proteins. This results in an intraperitoneal hemostatic system of low concentration and different composition.We found an intraperitoneal fibrinogen cleavage and thrombin- antithrombin Ill-complex formation leading to increased levels of fibrinopeptide A (FPA: 33.3 ± 7.0 ng/ml) and thrombin-antithrombin Ill-complex (TAT: 4.7 ± 0.4 ng/ml) in plasma by mass transfer from dialysate to plasma. t-PA (tissue plasminogen activator) and PAI-1 (plasminogen activator inhibitor type 1) concentrations in plasma were within the normal range. The dialysate concentrations indicated a low local secretion. The fibrinolytic fibrin fragment D-dimer and the fibrinogen degradation product concentrations in plasma were greater than in dialysate. But the relations of the proteins between plasma and dialysate refer to a local intraperitoneal production as well.The results show that intraperitoneal coagulation predominates over fibrinolysis which is accompanied by an intravascular fibrinolysis in patients undergoing CAPD. Neoantigens produced in dialysate and diffused to plasma are comparable to changes seen in disseminated intravascular coagulation.

scholarly journals Effects of Fructo-Oligosaccharide Supplementation on Constipation in Elderly Continuous Ambulatory Peritoneal Dialysis Patients

2016 ◽  
Vol 36 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Kulwara Meksawan ◽  
Chorsakon Chaotrakul ◽  
Napat Leeaphorn ◽  
Suthep Gonlchanvit ◽  
Somchai Eiam-Ong ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Biochemical Parameters ◽  
Bowel Function ◽  
Colonic Transit ◽  
Soluble Fiber ◽  
Double Blind ◽  
Fiber Properties ◽  
Before And After

♦ BackgroundFructo-oligosaccharides (FOS) exhibit soluble-fiber properties that beneficially affect bowel function and relieve constipation. The effects of FOS supplementation on constipation and biochemical parameters were examined in elderly continuous ambulatory peritoneal dialysis (CAPD) patients.♦ MethodsThis randomized, double-blind, placebo-controlled, cross-over study was performed in elderly CAPD patients (5 males and 4 females) with chronic constipation. All subjects were randomly assigned to receive either 20 g FOS or placebo daily for 30 days. After a 14-day washout period, the patients were switched to the other substance for 1 more month. Before and after each treatment period, frequency of defecation, characteristics of feces, and colonic transit were evaluated. Biochemical parameters were also assessed.♦ResultsFructo-oligosaccharides significantly increased the frequency of defecation (10.5 ± 2.0 vs 6.2 ± 1.4 times per week, p < 0.005) and changed the feces’ appearance from type 1 (nut-like) to type 4 (sausage–like). The colonic transit determined by geometric center (GC) was augmented after FOS supplementation (3.9 ± 0.3 vs 3.2 ± 0.4, p < 0.05). Fructo-oligosaccharides had no effects on biochemical parameters. Fructo-oligosaccharides caused mild discomforts which were well tolerated after dose adjustment.♦ ConclusionsFructo-oligosaccharide supplementation is effective, well tolerated, and can be an alternative to other laxatives in CAPD patients with constipation. Further studies are needed to better assess the biochemical effects of FOS in the chronic kidney disease population.

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