Cardiac geometry, function, and remodeling patterns in patients under maintenance hemodialysis and peritoneal dialysis treatment

2021 ◽  
Author(s):  
Maria‐Eleni Alexandrou ◽  
Pantelis Sarafidis ◽  
Μarieta Theodorakopoulou ◽  
Vasileios Sachpekidis ◽  
Christodoulos Papadopoulos ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Maintenance Hemodialysis ◽  
Dialysis Treatment ◽  
Cardiac Geometry ◽  
Geometry Function

The past and the present of peritoneal dialysis treatment

2008 ◽  
Vol 149 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Kálmán Polner
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Treatment ◽  
The Past

A szerző rövid áttekintést ad a peritonealis dialíziskezelés történetéről, kiemelve két magyar nefrológus, Stephen I. Vas és Taraba István munkásságának jelentőségét. A peritonealis dialíziskezelés fejlődése oda vezetett, hogy mára a hemodialízissel egyenrangú vesepótló kezelés lett. A maradék vesefunkció megőrzésével az első két évben a morbiditási, mortalitási mutatók és a betegek életminősége vonatkozásában felül is múlja azt. Gazdasági szempontból egyértelműen előnyösebb a hemodialízisnél, ezért az egyre több veseelégtelen beteg ellátásában várhatóan még nagyobb szerepet fog kapni. Az utóbbi években a technológia fejlődése és az automata peritonealis dialíziskezelések elterjedése is a minőség javítását segíti. A peritonealis dialíziskezelés a beteg önkezelése révén új kapcsolatrendszert alakít ki a betegek és az egészségügyi személyzet között, fokozódik a betegoktatás igénye, javul a betegek önbecsülése, együttműködése, ami összességében jobb rehabilitációs esélyeket és jobb életminőséget eredményez. A hazai peritonealis dialíziskezelés még elmarad az európai átlagtól, de a fejlődés dinamikus, és várhatóan a betegek száma is tovább fog növekedni.

Overview of blood purification in uremia

1980 ◽  
Vol 3 (4) ◽  
pp. 203-208
Author(s):  
B.T. Burton
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Rejection Rate ◽  
Blood Purification ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Transplant Patients ◽  
Maintenance Dialysis ◽  
Transplanted Kidneys

Today, management of irreversible renal failure is based primarily on maintenance hemodialysis and renal transplantation with a growing minority of patients treated by peritoneal dialysis. With regard to renal transplantation — the early promise of renal transplantation in the mid 1960's has given way to the realities of the late 1970's. There have been no major changes in the rejection rate of transplanted kidneys in recent years though today's mortality of transplant patients is considerably reduced over what it used to be. Moreover, universally the lack of availability of a sufficient number of organs for transplantation poses a formidable problem. It is all too apparent that current methods of blood purification in uremia are far from optimal. Even though the mortality in maintenance dialysis is relatively low, hemodialysis is characterized by a variety of complications and most maintenance dialysis patients are not optimally rehabilitated.

Chronic Induction of C-Reactive Protein by Hemodialysis, but Not by Peritoneal Dialysis Therapy

1996 ◽  
Vol 16 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Marion Haubitz ◽  
Reinhard Brunkhorst ◽  
Eike Wrenger ◽  
Peter Froese ◽  
Matthias Schulze ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Insufficiency ◽  
Chronic Renal Insufficiency ◽  
Inflammatory Activity ◽  
C Reactive Protein ◽  
Dialysis Therapy ◽  
Dialysis Treatment ◽  
Reactive Protein ◽  
Before And After ◽  
Patient Groups

Objective Evaluation of the inflammatory activity in patients on chronic peritoneal dialysis (PD) and patients on chronic hemodialysis (HD) in comparison to patients with chronic renal insufficiency without dialysis treatment and healthy volunteers. Design Open, non randomized prospective study. Setting Nephrology Department, including HD and PD therapy in a university hospital. Patients Twenty -four patients on chronic PD, 21 patients on chronic HD therapy using a cuprophan dialyzer, 16 patients with chronic renal insufficiency without dialysis treatment, and 33 healthy volunteers; 8 additional patients before and after initiation of chronic HD therapy. All patients and controls were without infection or immunosuppressive therapy. Main Outcome Measures As a marker of the inflammatory activity in the different patient groups, C-reactive protein (CAP) was measured serially using a sensitive, enzyme-Iinked, immunosorbent assay in order to detect values below the detection limit of standard assays. Results All patient groups had CAP levels higher than the normal controls (p < 0.01). Patients on HD had CAP levels significantly higher than PD patients (p < 0.01) whose levels were comparable to patients without dialysis therapy. Accordingly, longitudinal measurements before and after initiation of chronic HD showed a significant increase in CAP levels after the beginning of HD treatment (p < 0.04). Conclusions The results suggest that induction of the inflammatory activity is lower during PD compared to HD, since stimulation by the dialyzer membrane, dialysate buffer, or bacterial fragments in the dialysate is avoided. This observation might indicate a possible lower risk of long-term complications in patients with PD.

Malnutrition–Inflammation Score is a Useful Tool in Peritoneal Dialysis Patients

2006 ◽  
Vol 26 (6) ◽  
pp. 705-711 ◽  
Author(s):  
Bariş Afşar ◽  
Siren Sezer ◽  
Fatma Nurhan Ozdemir ◽  
Huseyin Celik ◽  
Rengin Elsurer ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Assessment Tool ◽  
Clinical Laboratory ◽  
Correlation Coefficients ◽  
Severe Malnutrition ◽  
Maintenance Hemodialysis ◽  
Anthropometric Parameters ◽  
Mortality And Morbidity ◽  
Moderate Malnutrition ◽  
Inflammation Score

Background Malnutrition–Inflammation Score (MIS) is a quantitative assessment tool based on Subjective Global Assessment (SGA) and predicts mortality and morbidity in maintenance hemodialysis patients. However, there are not enough data about the use of MIS in peritoneal dialysis (PD). In this study, relationships between MIS and prospective hospitalization indices, risk of developing peritonitis, anemia indices, and laboratory and anthropometric parameters were analyzed and compared with SGA in PD. Methods 50 PD patients (M/F 26/24, age 45.2 ± 14.9 years, mean PD duration 30.8 ± 23.1 months) were included. The same physician performed the SGA and MIS evaluations. Clinical, laboratory, and anthropometric parameters were measured. Results 18 patients were classified as SGA-A (without malnutrition), 24 as SGA-B (with moderate malnutrition), and 8 as SGA-C (with severe malnutrition). Increment in MIS was concordant with SGA groups A to C ( p < 0.0001). Peritonitis rate, number of hospitalizations, total number of hospitalization days, erythropoietin requirements, C-reactive protein (CRP), and ferritin levels were positively correlated with MIS ( p < 0.0001). Midarm muscle circumference ( p = 0.04), albumin ( p < 0.0001), prealbumin ( p = 0.001), creatinine ( p = 0.04), hemoglobin ( p = 0.003), transferrin ( p < 0.0001), and cholesterol ( p = 0.009) were negatively correlated with MIS. Correlation coefficients of hospitalization indices, peritonitis rate, anemia indices, erythropoietin requirements, albumin, prealbumin, CRP, and anthropometric parameters were higher with MIS than with SGA. In logistic regression analysis, a higher MIS was independently associated with a higher risk of future hospitalization ( p = 0.029, odds ratio 2.14, confidence interval 1.082 – 4.146). Conclusions This study demonstrated that MIS significantly correlated with clinical, nutritional, inflammatory, and anthropometric parameters and anemia indices in PD patients, and that those correlations were stronger than those with SGA.

Assessment of Liver Ability to Biotransformation of Antipyrine in Uraemic Patients on Regular Peritoneal Dialysis Treatment

1989 ◽  
pp. 413-415
Author(s):  
A. Grzegorzewska ◽  
Z. Łowicki ◽  
E. Chmara ◽  
A. Mrozikiewicz ◽  
K. Bączyk
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Treatment

A Comparison of Bone Scans in Uremic Patients Treated with Intermittent Peritoneal Dialysis Or Hemodialysis

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 312-317
Author(s):  
Hanna Plotast ◽  
Alicja E. Grzegorzewska ◽  
Roman Junik ◽  
Jerzy Sowinski ◽  
Maciej Gernbicki
Keyword(s):  
Peritoneal Dialysis ◽  
Normal Limit ◽  
Cranial Vault ◽  
Entire Group ◽  
Similar Frequency ◽  
Dialysis Treatment ◽  
Younger Age ◽  
Uremic Patients ◽  
Bone Scans ◽  
Sacral Bone

The aim of the study was a comparative analysis of bone scans in uremic patients treated with intermittent peritoneal dialysis (IPD) or hemodialysis (HD). Bone scintigraphy was performed using technetium Tc 99m etidronate (EHDP) in 28 uremics (age 46.0±13.5 years, x±SD) on IPD for 3.1±3.0 months and 28 uremics (age 43.5±11.6 years) on HD for 47.3±33.9 months. Serum c terminal parathormone (cPTH) exceeded 5.3±3.3 and 6.8±3.5 times the upper normal limit of 1.4 ng/mL in IPD and HD patients, respectively. Despite significant differences in dialysis treatment duration in IPD and HD patients, an increased Tc 99m EHDP uptake in bones was shown with similar frequency, when all the groups were compared. However, in the group of patients with serum cPTH exceeding four times the upper normal limit (n = 30) or in the age group less than 45 years old (n = 26), a greater marker uptake was observed in HD patients. Significant differences (p < 0.05) were shown in the cranial vault: 33% of HD patients (n = 18) with higher cPTH and 47% of those less than 45 years old (n = 15) revealed an increased marker uptake, whereas it was not observed in any IPD patient. When scans of HD patients dialyzed less than (n = 11) and more than (n = 17) 30 months were compared, a significantly higher appearance of increased marker uptake was shown in cranial vault (41% vs 0%, p < 0.02) and in sacral bone (82% vs 36%, p < 0.02) in patients with longer dialysis. The latter group of HD patients also showed an increased marker uptake in cranial vault compared to the entire group of PD patients (41% vs 7%, p < 0.01). Our studies suggest that bone scan changes, indicating secondary hyperparathyroidism, progress significantly with prolongation of dialysis treatment, especially in patients with higher cPTH levels of younger age.

scholarly journals Management of peritoneal dialysis under COVID-19: The experience in Sichuan Province People’s Hospital, China

2020 ◽  
pp. 089686082093529 ◽  
Author(s):  
Jin Chen ◽  
Lijuan Yin ◽  
Xiuling Chen ◽  
Hui Gao ◽  
Qin Zhou ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Improve Patient Care ◽  
Patient Survey ◽  
Care Quality ◽  
Medical Support ◽  
Safety Measures ◽  
Dialysis Treatment ◽  
Medical Safety ◽  
Patient Care Quality ◽  
Improve Patient

The outbreak of coronavirus disease 2019 (COVID-19) is becoming a severe challenge to China and the whole world. By now, there is no report about medical support to peritoneal dialysis (PD) patient during COVID-19 pandemic. In this essay, we summed up our safety measures on how to protect PD patients and our staffs, and our experience on how to ensure the dialysis treatment of PD patients during the pandemic period. Using of telehealth has potential to improve patient care quality. As a result, by applying all the actions and efforts above, most of patients got enough medical support. According to the patient survey, 11 patients (3.3% of the total) reduced their treatment of dialysis exchange due to the shortage of PD solution or the affection of the pandemic. None of the PD patient and staff reported COVID-19. We successfully prevented COVID-19 transmission and ensured medical safety in our PD patients during the crisis.

Lipoprotein (a) Levels in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 236-241 ◽  
Author(s):  
Carmen Guindeo ◽  
Nicanor Vega ◽  
Ana M. Fernandez ◽  
Leocadia Palop ◽  
Jose A. Aguilar ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Treatment Group ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
The Other ◽  
Control Group ◽  
Protein Loss ◽  
Significant Relation ◽  
Dialysis Treatment ◽  
Lipoprotein A ◽  
Group I

Most researchers have found increases of lipoprotein (a) [Lp(a)] in uremic patients, as well as in those undergo ng hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD). The mechanisms for this increase remain unclear. We studied 71 patients undergoing CAPD, 48 me n and 23 women. According to the time spent on CAPD, the patients were divided into three groups: group 0: 29 patients at the starting off point of dialysis treatment; group I: 22 patients with an average stay of 15.2 months; group II: 20 patients with an average stay of 69.3 months on CAPD. We have only observed significant increases of Lp(a) levels in those patients initiating the dialysis, but no significant differences are found in the other groups undergoing CAPD for longer periods when compared to the control group. We found no significant relation between Lp(a) levels and peritoneal protein loss, and not with absorption of glucose from the dialysate either. We have found a positive and significant correlation between Lp(a) levels and urinary protein loss (r = 0.41; p < 0.001). It is possible that an element associated with proteinuria might have an effect on the metabolism of Lp(a) in CAPD patients.

scholarly journals P1145ADEQUACY AND SURVIVAL IN PERITONEAL DIALYSIS: TEN YEARS EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Vincenzo Terlizzi ◽  
Elena Pezzini ◽  
Roberta Cortinovis ◽  
Diana Bertoni ◽  
Alessandra Pola ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Peritoneal Dialysis ◽  
Protective Factor ◽  
Residual Renal Function ◽  
Dialysis Modality ◽  
Dialysis Adequacy ◽  
Dialysis Treatment ◽  
Increased Risk ◽  
Uremic Patients

Figure: Background and Aims in Italy only a minority of uremic patients perform peritoneal dialysis (PD). In dialysis centers where PD is practiced and proposed the prevalence is no more than 23%. Proposed advantages of PD over HD are a more preserved Residual renal function (RRF), that has been associated with better survival, and better Quality of life (Qol) due to possible more preservation of previous lifestyle, independence, possibility of traveling, and flexibility. Incremental peritoneal dialysis is a promising way to further improve Qol and to preserve RRF. Lastly, PD is less expensive than HD. Aim of this study has been to retrospectively evaluate our ten-years experience of PD treatment on survival, dialysis adequacy, preservation of RRF and nutrition in uremic patients followed at our Dialysis Center. Method We retrospectively evaluated all the incident patients that started PD treatment due to uremia from 01-01-2008 to 31-12-2018 at the U.O. Nephrology ASST Spedali Civili of Brescia. The exclusion criteria were time of dialysis treatment less than 3 months and absence of previous dialytic treatment or kidney transplantation. For each patient anthropometric, clinical-anamnestic data and comorbidities at dialysis start were recorded. Data on dialysis adequacy, nutrition, RRF and PD dialysis modality performed were also recorded. Results During the observation period 329 patients started PD. 60 were excluded due to follow-up of less than 3 months. Therefore, 269 patients (males 160, 59%) were studied. The average age was 65±16 years, BMI 24±4 kg/m2. Comorbidities were: hypertension (87%), diabetes mellitus (32%), cerebral vascular disease (26%) and ischemic heart disease (25%). The mean duration of dialysis treatment was 2.1±1.5 years. At the end of ten-years follow-up 24% of patients have had a kidney transplant, 18% were on PD treatment, 17% have had a shift towards HD, 39% had died. The main causes of death were: infection (39%) and cardiovascular disease (31%). The most common dialysis modality performed was APD (61%); CAPD was performed in 39% of pts. Dialysis modality (CAPD; APD), nutrition parameters (PNA; BMI), as well as RRF, expressed as an average value during follow-up, are shown in Figure 1. 81 patients (30%) were treated with incremental PD; 85% of them with manual exchanges. The comparison of dialysis parameters between incremental PD and standard PD are shown in Figure 2. Multivariate analysis with survival as dependent variable (Figure 3), showed that age, diabetes mellitus, and low wKt/V were independently associated with an increased risk of mortality. Diuresis volume and male gender were protective factors. No independent influence on mortality of the dialysis treatment modality was found. Conclusion In this ten-years experience of patients undergoing PD at our Center, incremental PD seems to be a protective factor for the maintenance of a preserved diuresis and better dialysis adequacy, and these factors are associated with better survival of the patients.

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