scholarly journals Counteracting the Metabolic Effects of Glucose Load in Peritoneal Dialysis Patients; an Exercise-Based Approach

2019 ◽  
Vol 48 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Sana F. Khan ◽  
Claudio Ronco ◽  
Mitchell H. Rosner
Keyword(s):  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Glucose Absorption ◽  
Metabolic Effects ◽  
Glucose Load ◽  
Dialysis Patients ◽  
Metabolic Complications ◽  
Positive Effects ◽  
Stage Renal Disease ◽  
End Stage

Glucose-based peritoneal dialysis (PD) solutions are the predominantly used dialysate in PD patients. Glucose absorption has been shown to be associated with several unfavorable metabolic complications. Several studies have shown positive effects of exercise in end-stage renal disease patients. This paper provides an overview of glucose-associated metabolic complications, and proposed exercise regimens to counteract the caloric load associated with glucose absorption.

scholarly journals Current Opinion on Usage of L-Carnitine in End-Stage Renal Disease Patients on Peritoneal Dialysis

Molecules ◽  
2019 ◽  
Vol 24 (19) ◽  
pp. 3449 ◽  
Author(s):  
Mario Bonomini ◽  
Lorenzo Di Liberato ◽  
Victor Zammit ◽  
Arduino Arduini
Keyword(s):  
Peritoneal Dialysis ◽  
Insulin Sensitivity ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Metabolic Effects ◽  
Favorable Effect ◽  
Glucose Load ◽  
Positive Effects ◽  
Stage Renal Disease ◽  
End Stage

The advantages of peritoneal dialysis (PD) over hemodialysis (HD) are well-documented. Notwithstanding, only a small proportion of patients with end-stage renal disease (ESRD) are managed with PD. This may be related to the high glucose load that PD solutions in current use have on the patient. The effects of such excess glucose include the relatively early limitation of the ultrafiltration capacity of the peritoneal membrane, and the metabolic effects associated with hyperglycemia, e.g., decreased insulin sensitivity. This article describes the advantages that may be realized by the glucose-sparing effects of substituting part of the glucose load with other osmotically active metabolites, particularly L-carnitine. The latter is anticipated to have metabolic advantages of its own, especially as in PD patients, high plasma concentrations can be achieved in the absence of renal clearance. Besides its better biocompatibility, L-carnitine demonstrates anti-anemia action due to its effects on erythropoiesis, and positive effects on the longevity and deformability of erythrocytes. Observations from our trials on the use of carnitine-enriched PD solutions have demonstrated the effectiveness of L-carnitine as an efficient osmolyte in PD, and its favorable effect on the insulin sensitivity of the patients. The significance of these findings for future developments in the use of PD in the management of patients with ESRD is discussed.

scholarly journals Lipid status association with 25-hydroxy vitamin D: Cross sectional study of end stage renal disease patients

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Neda Milinković ◽  
Marija Sarić ◽  
Snežana Jovičić ◽  
Duško Mirković ◽  
Višnja Ležaić ◽  
...  
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Density Lipoprotein ◽  
Dialysis Patients ◽  
25 Hydroxy Vitamin D ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Lipid Parameters

SummaryBackgroundSome observational studies indicate an association of 25-hydroxy vitamin D (25(OH)D) insufficiency and atherogenic cholesterol concentrations. The aim of this study was to investigate relationship between 25(OH)D concentrations and lipid parameters in end stage renal disease (ESRD) patients, separately for predialysis, hemodialysis and peritoneal dialysis patients.MethodsWe have adjusted 25(OH)D concentrations for seasonal variability with cosinor analysis, and performed all further analysis using these corrected 25(OH)D concentrations. Concentrations of 25(OH)D and the lipid parameters were determined in 214 ESRD patients and 50 control group participants. The analysis included the measurement of 25(OH)D by HPLC, apolipoprotein (Apo) AI, ApoB and Lp(a) by nephelometry, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) by spectrophotometry and manually calculated ApoB/ApoAI and LDL-C/HDL-C ratio.ResultsESRD patients with adjusted 25(OH)D concentrations of ≤ 50 nmol/L had significantly higher TC (P = 0.005) and ApoAI (P = 0.049). Significantly higher HDL-C (P = 0.011) and ApoAI (P = 0.020) were found in hemodialysis patients with the 25(OH)D concentrations of ≤ 50 nmol/L. The other analyzed lipid parameters differed significantly between predialysis, hemodialysis and peritoneal dialysis patients with 25(OH)D concentrations of < 50 nmol/L.ConclusionsOur study indicate the significant relationship between 25(OH)D repletion and optimal concentrations of lipid parameters in ESRD patients. Further research is necessary to explain whether joint evaluation of vitamin D status and lipid abnormalities could improve cardiovascular outcome in ESRD patients.

scholarly journals Discover, analysis, and interpretation of problems and comparing satisfaction of hemodialysis and peritoneal dialysis patients: patients' perspective

2020 ◽  
Author(s):  
Ghazanfar Rafiee ◽  
Jamshid Roozbeh
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Dialysis Patients ◽  
Dialysis Treatment ◽  
Patient’S Satisfaction ◽  
Exploratory Approach ◽  
Dialysis Method ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: End-stage renal disease is an irreversible and progressive loss of kidney function and it can be fatal without hemodialysis, peritoneal dialysis or kidney transplantation. Hemodialysis is a type of treatment where the patient is connected to a machine through a catheter via veins for twice or three times a week for approximately four hours. Alternatively, peritoneal dialysis is carried out with a plastic catheter insertion into the abdomen through which dialysis fluid (glucose) enters and is taken out. This study aimed to discover, analyze, interpret and compare end-stage renal disease patient's satisfaction with hemodialysis and peritoneal dialysis with an emphasis on complications and problems that was created during dialysis treatment.Methods: this study a qualitative exploratory approach was used at Shiraz hemodialysis and peritoneal dialysis centers 2017-2018. In these centers there were 345 ESRD patients who were receiving dialysis. A purposeful sample of 35 hemodialysis and 30 peritoneal dialysis patients were interviewed. The data were collected through interview. Each session lasted for 50 minutes. Initially 12 open-ended questions were developed and used to stimulate discussions in sessions. Directed content analysis was used for analyzing the transcribed data. After giving a code to each line or incidence, codes were then compared for similarity and differences, merged together, and categorized. Results: Themes of Fatigue experience, Insomnia, Wasting time, Travel and leisure time activities limitations, Hypotension, Dissatisfaction and satisfaction with hemodialysis, Peritoneal catheter problems, peritoneal dialysis difficulties and limitations, satisfaction from peritoneal dialysis emerged. Each dialysis method has its own problems. Some problems and limitations were more emphasized on by patients. Conclusion: Each dialysis method has its own problems. Some problems and limitations were more emphasized on by patients.

Erythropoietin and iron use in peritoneal dialysis patients: Report from the 1997 HCFA end-stage renal disease core indicators project

1999 ◽  
Vol 33 (6) ◽  
pp. 1187-1189 ◽  
Author(s):  
George R. Bailie ◽  
Diane L. Frankenfield ◽  
Barbara F. Prowant ◽  
William McClellan ◽  
Michael V. Rocco
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Dialysis Patients ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals A metabolomics approach for predicting the response to intravenous iron therapy in peritoneal dialysis patients with anemia

RSC Advances ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. 1915-1922 ◽  
Author(s):  
Qiong Wu ◽  
Xue-li Lai ◽  
Hong-xia Zhao ◽  
Zhen-yu Zhu ◽  
Zhan-ying Hong ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
End Stage Renal Disease ◽  
Intravenous Iron ◽  
Dialysis Patients ◽  
Receive Treatment ◽  
Intravenous Iron Therapy ◽  
Stage Renal Disease ◽  
End Stage

Anemia is an almost universal complication of chronic kidney disease (CKD), and nearly all patients with end-stage renal disease (ESRD) and approximately 70% of those with earlier stages of CKD receive treatment for anemia.

scholarly journals One-Year Mortality Rates in US Children with End-Stage Renal Disease

2015 ◽  
Vol 41 (2) ◽  
pp. 121-128 ◽  
Author(s):  
Blanche M. Chavers ◽  
Julia T. Molony ◽  
Craig A. Solid ◽  
Michelle N. Rheault ◽  
Allan J. Collins
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Mortality Rates ◽  
Transplant Recipients ◽  
Dialysis Patients ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background/Aims: Few published data describe survival rates for pediatric end-stage renal disease (ESRD) patients. We aimed to describe one-year mortality rates for US pediatric ESRD patients over a 15-year period. Methods: In this retrospective cohort study, we used the US Renal Data System database to identify period-prevalent cohorts of patients aged younger than 19 for each year during the period 1995-2010. Yearly cohorts averaged approximately 1,200 maintenance dialysis patients (60% hemodialysis, 40% peritoneal dialysis) and 1,100 transplant recipients. Patients were followed for up to 1 year and censored at change in modality, loss to follow-up, or death. We calculated the unadjusted model-based mortality rates per time at risk, within each cohort year, by treatment modality (hemodialysis, peritoneal dialysis, transplant) and patient characteristics; percentage of deaths by cause; and overall adjusted odds of mortality by characteristics and modality. Results: Approximately 50% of patients were in the age group 15-18, 55% were male, and 45% were female. The most common causes of ESRD were congenital/reflux/obstructive causes (55%) and glomerulonephritis (30%). One-year mortality rates showed evidence of a decrease in the number of peritoneal dialysis patients (6.03 per 100 patient-years, 1995; 2.43, 2010; p = 0.0263). Mortality rates for transplant recipients (average 0.68 per 100 patient-years) were consistently lower than the rates for all dialysis patients (average 4.36 per 100 patient-years). Conclusions: One-year mortality rates differ by treatment modality in pediatric ESRD patients.

Various Obstacles to Peritoneal Dialysis Development in Japan: Too Much Money? Too Much Fear?

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 56-58
Author(s):  
Yoshindo Kawaguchi
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Penetration Rate ◽  
Dialysis Patients ◽  
Number Of Patients ◽  
Stage Renal Disease ◽  
Almost All ◽  
End Stage

At 31 December 2005, the number of patients on maintenance dialysis in Japan was 257,765, with 9599 patients having started dialysis that year. Kidney transplant cases in Japan number about 1000 annually. Thus, almost all end-stage renal disease patients in Japan are likely to live on dialysis for the remainder of their lives. For various reasons, peritoneal dialysis has a lower penetration rate among Japanese dialysis patients, and work to educate patients and nephrologists about PD needs to be done.

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