Encapsulating Peritoneal Sclerosis in Long-Termed Peritoneal Dialysis Patients

Background.Encapsulating peritoneal sclerosis (EPS) is a rare but serious clinical complication of long-term peritoneal dialysis (PD) patients with high mortality. The purpose of this study was to assess the clinical characteristics of patients with EPS and to search for possible factors useful for EPS prevention and early diagnosis.Method.This retrospective study was performed in a single dialysis center in Taiwan between August 1990 and April 2014. Overall, a total of 565 patients were included and the medical records of those patients who had developed EPS (EPS group) and those who had not developed EPS (control group) were collected. We compared several factors between these two groups.Result.In the univariate analysis, EPS was significantly associated with a change of transport state (Delta 2) (p= 0.007), duration of PD (p< 0.001), duration of peritonitis treatment (p= 0.001), number of peritonitis episodes (p= 0.002), and fungus related peritonitis (p= 0.031). After multivariate logistic model analysis, we found that only the duration of PD was independently significantly associated with EPS (p= 0.034). In addition, we used the ROC curve and found that a duration of peritoneal dialysis of about 8.4 years is the best cut-off point to predict EPS occurrence.Conclusion.In this study, long-termed PD duration is the only strong independent risk factor for EPS development. Total peritonitis times, total peritonitis treatment duration, and marked increased peritoneal D/Pcrratio were also significantly associated with the duration of PD.

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Clinical characteristics and outcomes of COVID-19 long-term nucleic acid positive patients

Technology and Health Care ◽

10.3233/thc-212921 ◽

2021 ◽

pp. 1-10

Author(s):

Xuan Zhu ◽

Xinxin Zhu ◽

Min Wang ◽

Fang Yang ◽

Zhibing Sun ◽

...

Keyword(s):

Nucleic Acid ◽

Clinical Characteristics ◽

Clinical Symptoms ◽

Control Group ◽

Viral Shedding ◽

Imaging Characteristics ◽

And Gender ◽

Acid Test ◽

Pulmonary Ct

OBJECTIVE: This study aimed to investigate the clinical characteristics and outcomes of coronavirus disease-19 (COVID-19) long-term nucleic acid positive patients (hereinafter referred to as CLTAPs). METHODS: Patients were recruited from the Xiaogan Central Hospital between 16 January 2020 and 28 March 2020. Among the 562 cases of patients with laboratory-identified COVID-19 infection by real-time polymerase chain reaction (qtPCR), 19 cases of COVID-19 patients with more than 41 days from the first to the last time of nucleic acid test were selected as the study group, and 76 cases of age- and gender-matched COVID-19 patients were selected as the control group (hereinafter referred to as C-CLTAPs). Demographic characteristics, clinical symptoms, laboratory examination and computed tomography (CT) imaging characteristics were retrospectively analyzed. RESULTS: On admission, among the 562 cases of patients with COVID-19, there were 398 cases of ordinary COVID-19 patients, 99 cases of severe COVID-19 patients and 99 cases of critical COVID-19 patients. CLTAPs had milder clinical symptoms and longer viral shedding time in comparison to C-CLTAPs. Compared to C-CLTAPs, CLTAPs had a lower infection index at admission. CLTAPs used less oxygen therapy and a higher proportion of hydroxychloroquine treatment in comparison to C-CLTAPs. In comparison to C-CLTAPs, CLTAPs showed slower pulmonary CT progression and faster pulmonary CT absorption. CONCLUSION: In this study, out of the 562 cases, we found 19 CLTAPs. The clinical differences between CLTAPs and C-CLTAPs were compared and analyzed. We hope that these finding can provide a theoretical basis for the treatment of CLTAPs.

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SP507FACTORS AFFECTING LONG TERM TECHNIQUE SURVIVAL OF PERITONEAL DIALYSIS PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfv196.33 ◽

2015 ◽

Vol 30 (suppl_3) ◽

pp. iii546-iii547

Author(s):

Marios Theodoridis ◽

Stylianos Panagoutsos ◽

Eleni Triantafyllidou ◽

Pelagia Kriki ◽

Konstantia Kantartzi ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Dialysis Patients ◽

Technique Survival

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Self-esteem in Recovered Bipolar and Unipolar Out-patients

The British Journal of Psychiatry ◽

10.1192/bjp.163.6.755 ◽

1993 ◽

Vol 163 (6) ◽

pp. 755-762 ◽

Cited By ~ 41

Author(s):

D. Pardoen ◽

F. Bauwens ◽

A. Tracy ◽

F. Martin ◽

J. Mendlewicz

Keyword(s):

Social Adjustment ◽

Clinical Characteristics ◽

Self Esteem ◽

Normal Control Group ◽

Basic Component ◽

Control Group ◽

Bipolar Patients ◽

The Relationship ◽

Depressive Patients

The hypothesis of a low self-esteem in depressive patients was tested using the Rosenberg Self-Esteem Scale in 24 recovered unipolar and 27 recovered bipolar patients, compared with a normal control group of 26 subjects matched for age and sex. The hypothesis was confirmed only for unipolars; bipolar patients presented a self-esteem score not significantly different from normal scores. Self-esteem was not related to clinical characteristics of the affective disorder, suggesting that low self-esteem may be a basic component of a depression-prone personality. The investigation of the relationship between self-esteem and social adjustment confirmed the presence of social conformism in bipolar patients and rigidly set low self-esteem in unipolar patients. These results should stimulate the evaluation of different psychotherapeutic treatments in the long-term psychosocial management of affectively ill patients.

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Can radiological assessment of abdominal computerized scans diagnose encapsulating peritoneal sclerosis in long-term peritoneal dialysis patients?

Nephrology ◽

10.1111/nep.12718 ◽

2016 ◽

Vol 22 (1) ◽

pp. 19-24 ◽

Cited By ~ 2

Author(s):

Sam Stuart ◽

David Stott ◽

Antony Goode ◽

Charlotte J Cash ◽

Andrew Davenport

Keyword(s):

Peritoneal Dialysis ◽

Radiological Assessment ◽

Dialysis Patients

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Rationale and design for Lowering-hyperUricaemia treatment on cardiovascular outcoMes In peritoNeal diAlysis patients: a prospective, multicentre, double-blind, randomised controlled trial (LUMINA)

BMJ Open ◽

10.1136/bmjopen-2020-037842 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037842

Author(s):

Wei Chen ◽

Naya Huang ◽

Haiping Mao ◽

Xiao Yang ◽

Qian Zhou ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Dropout Rate ◽

Cardiovascular Outcomes ◽

Control Group ◽

Type I ◽

Dialysis Patients ◽

Double Blind ◽

Randomised Controlled

IntroductionThe prevalence of hyperuricaemia in peritoneal dialysis patients is quite high. Studies have demonstrated a correlation between hyperuricaemia and cardiovascular disease and treatment of hyperuricaemia reportedly reduces cardiovascular risk in patients with chronic kidney disease. However, whether hyperuricaemia treatment benefits cardiovascular outcomes in continuous ambulatory peritoneal dialysis (CAPD) patients is not yet known.Methods and analysesThis prospective, multicentre, double-blind, randomised controlled trial was designed to evaluate the effects of hyperuricaemia treatment on cardiovascular event risk in CAPD patients. Based on a power of 80%, with type I error α=0.05, two-sided test and 1:1 parallel control study, considering a dropout rate of 20%, a total of 548 eligible patients are expected to be randomly assigned to either the hyperuricaemia treatment group (febuxostat) or control group (placebo).Ethics and disseminationThis study has been approved by the Medical Ethics Committee of the First Affiliated Hospital, Sun Yat-sen University and the ethics committees of other participating institutions. Written informed consent will be obtained from potential trial participants or authorised surrogates.The findings of the study will be disseminated through publications in peer-reviewed journals, and presentations at national and international conferences.Trial registration numberNCT03200210. 25 June 2017. The trial was started on 13 July 2017, and is expected to end by 31 December 2022. Till 20 Jan 2020, a total of 548 patients have been recruited.Protocol versionThe protocol version number and date are YLT-1604-V2.0 and 15 December 2016.

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Waning Humoral Response 3 to 6 Months after Vaccination with the SARS-COV-2 BNT162b2 mRNA Vaccine in Dialysis Patients

Journal of Clinical Medicine ◽

10.3390/jcm11010064 ◽

2021 ◽

Vol 11 (1) ◽

pp. 64

Author(s):

Noa Berar-Yanay ◽

Sarit Freiman ◽

Maʹanit Shapira ◽

Amer Saffoury ◽

Ameer Elemy ◽

...

Keyword(s):

Response Rate ◽

Vaccine Dose ◽

Humoral Response ◽

Albumin Level ◽

High Response Rate ◽

Control Group ◽

Dialysis Patients ◽

Serious Adverse Events ◽

Antibody Levels

Background and objectives: The short-term reported antibody response to SARS-COV-2 vaccination in dialysis patients is high, with a seroconversion response rate up to 97%. Data on the long-term durability of this response are scarce. Our objective was to characterize the long-term anti-spike antibody level in dialysis patients. Design, setting, participants, and measurements: In an observational study, we measured SARS-COV-2 anti-spike antibody levels in dialysis patients who completed 2 doses of the BNT162b2 mRNA SAR S-COV-2 vaccine at 1, 3 and 6 months after the second vaccine dose. We compared the response to dialysis patients who were infected with COVD-19 and to a control group of healthcare-employees. Results: One hundred and forty-two dialysis patients who had been vaccinated (ages 64 ± 11.9 years, 61% male), 33 dialysis patients who had COVID-19 infection (ages 54 ± 14.3 years, 55% male) and 104 individuals in the control group (ages 50 ± 12.2 years, 44% male) were included. The response rate in the vaccinated dialysis patients was 94%, 78% and 73% at 1, 3 and 6 months after the second vaccine dose. In the COVID-19 infected dialysis group and in the control group, the response rate remained at 100% over 6 months. The percentage of change in antibody levels between one and 6 months was −66% in the vaccinated dialysis group, −28% in the control group (p < 0.001) and +48% in dialysis patients who had been infected with COVID-19 (p < 0.001). A non-responder status at 6 months was associated with a lower albumin level. No serious adverse events following vaccination were reported. In conclusion: the initially high response rate to the BNT162b2 vaccine in dialysis patients decreases rapidly. Our results indicate that an early booster (3rd) dose, at three months after the second dose, may be advised for this population to preserve the humoral immunity.

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Catheter Patency and Peritoneal Morphology and Function in a Rat Model of Citrate-Buffered Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.3747/pdi.2009.00132 ◽

2010 ◽

Vol 30 (6) ◽

pp. 602-610 ◽

Cited By ~ 1

Author(s):

Nicola Cavallini ◽

Magnus Braide

Keyword(s):

Peritoneal Dialysis ◽

Rat Model ◽

Fluid Transport ◽

Separate Experiment ◽

Control Group ◽

Vascular Density ◽

Long Term Effects ◽

Catheter Patency ◽

Peritoneal Morphology

BackgroundSingle-dwell studies in rats and humans have shown that supplementing citrate for lactate in peritoneal dialysis (PD) fluids improves ultrafiltration (UF).MethodsThe long-term effects of citrate-substituted PD fluids on PD catheter patency, UF, and peritoneal morphology were evaluated in a rat model over 5 weeks of daily PD fluid exposure. A standard 2.5% glucose 40 mmol/L lactate PD fluid and a corresponding 10/30 mmol/L citrate/lactate PD fluid were compared. In a control group, rats with catheters received no PD fluid.ResultsThe average patency time (% of 36 days) of silicone rubber PD catheters was significantly longer in the citrate PD group (98.8% ± 1.2%) and the control group (100% ± 0%) compared to the lactate PD group (54.7% ± 9.5%). In a separate experiment, heparin-coated polyurethane catheters were used to study peritoneal morphology and fluid transport. The citrate group had a higher net UF than the lactate group at the beginning and at the end of the 5 weeks. During the experiment, both fluid-treated groups suffered from UF loss; the control group showed the highest net UF at the end of the 5 weeks. Peritoneal vascular density and submesothelial thickness, indicators of angiogenesis and fibrosis, were not significantly different among the groups. Fibrosis was significantly negatively correlated to osmotic UF.ConclusionA positive acute effect of citrate on UF was confirmed and conserved over time. Citrate PD strongly improved PD catheter patency time compared with lactate. Both citrate PD and lactate PD induced negative long-term effects on UF compared with control animals.

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