Long-term Increase in Peritoneal Membrane Transport Rates following Incidental Intraperitoneal Sodium Hypochlorite Infusion

1989 ◽  
Vol 12 (11) ◽  
pp. 711-714 ◽  
Author(s):  
N.M. Dedhia ◽  
L.M. Schmidt ◽  
Z.J. Twardowski ◽  
R. Khanna ◽  
K.D. Nolph
Keyword(s):  
Peritoneal Dialysis ◽  
Membrane Transport ◽  
Sodium Hypochlorite ◽  
Membrane Surface ◽  
Test Results ◽  
Peritoneal Membrane ◽  
Peritoneal Equilibration Test ◽  
Membrane Surface Area ◽  
Connection System

A patient on continuous ambulatory peritoneal dialysis using an “O” set connection system with sodium hypochlorite as a disinfectant incidentally infused the disinfectant intraperitoneally on two occasions. The product of peritoneal membrane permeability and peritoneal membrane surface area increased after both infusions as judged by peritoneal equilibration test results and/or serum chemistries. Elevated peritoneal solute transport rates and reduced ultrafiltration gradually subsided but did not return to preinfusion values. This observation suggests that intraperitoneal sodium hypochlorite infusion may cause significant long-term alteration in peritoneal membrane transport characteristics.

Effect of Dialysis Modality and Membrane Transport Characteristics on Dialysate Protein Losses of Patients on Peritoneal Dialysis

1997 ◽  
Vol 17 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Pranay Kathuria ◽  
Harold L. Moore ◽  
Ramesh Khanna ◽  
Zbylut J. Twardowski ◽  
Sharad Goel ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Membrane Transport ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Cross Sectional Study ◽  
Dialysis Modality ◽  
Test Results ◽  
Sectional Study ◽  
Peritoneal Equilibration Test ◽  
Cross Sectional ◽  
Individual Preferences

Objective To determine if peritoneal dialysis modality has an impact on protein losses in dialysate. Design Retrospective, cross-sectional study. Patients 190 patients who had selected peritoneal dialysis were classified into one of four transport categories (high, high-average, low-average, or low) based on standard peritoneal equilibration test results. Patients were then assigned to continuous ambulatory peritoneal dialysis (CAPD) or nightly intermittent peritoneal dialysis (NIPD) based on membrane transport characteristics and individual preferences. Results Patients with similar membrane transport characteristics had essentially no differences in dialysate protein and albumin losses whether treated with CAPD or NIPD. Conclusions Although high transporters may be better managed with short -dwell therapies such as nocturnal intermittent peritoneal dialysis or daily ambulatory peritoneal dialysis, consistent marked decreases in protein losses cannot be cited as a benefit of NIPD over CAPD.

scholarly journals The Peritoneal Membrane in Peritoneal Dialysis Patients

1999 ◽  
Vol 10 (2) ◽  
pp. 342-346
Author(s):  
AVRY CHAGNAC ◽  
PEARL HERSKOVITZ ◽  
TALIA WEINSTEIN ◽  
SIMCHA ELYASHIV ◽  
JUDITH HIRSH ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Contrast Media ◽  
Surface Area ◽  
Membrane Surface ◽  
Helical Ct ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Membrane Surface Area ◽  
Random Sections ◽  
High Degree

Abstract. The surface area of the peritoneal membrane in contact with dialysate is an important determinant of solute transport across the peritoneum. Yet there is no method for its estimation in peritoneal dialysis patients. In this study, stereologic methods were applied to computerized tomography (CT) imaging of the peritoneal membrane to estimate the peritoneal membrane surface area. The method was first validated by implementing stereologic methods on a phantom of known surface area. The phantom was a distorted bottle filled with contrast media. Series of thin helical CT sections were performed, and random sections were obtained after reconstruction. A transparent counting grid was placed over the random sections. The surface area was estimated using 9, 18, and 36 random sections. To calculate the coefficient of variation (CV) of the method, 20 different combinations of 9, 18, and 36 random sections were used. With 36 random sections, the error in estimation of the bottle's surface area was - 9.4% to + 8.8%. The CV was 5.0%. Decreasing the number of sections used to 18 and 9 yielded a CV of 7.8 and 12.3%, respectively. This method was then applied to the peritoneal membrane, which was visualized by instilling dialysate containing contrast media into the peritoneal cavity of peritoneal dialysis patients. The estimated peritoneal membrane surface area of six patients was 0.55 ± 0.04 m2. This novel method permits the measurement of the peritoneal membrane surface area with a high degree of accuracy.

scholarly journals The Effect of Far-Infrared Therapy on the Peritoneal Membrane Transport Characteristics of Uremic Patients Undergoing Peritoneal Dialysis: An Open-Prospective Proof-of-Concept Study

Membranes ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 669
Author(s):  
Ching-Po Li ◽  
Chyong-Mei Chen ◽  
Chia-Hao Chan ◽  
Szu-Yuan Li ◽  
Ming-Tsun Tsai ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Membrane Transport ◽  
Degradation Products ◽  
Far Infrared ◽  
Proof Of Concept ◽  
Peritoneal Membrane ◽  
Membrane Function ◽  
Glucose Degradation Products ◽  
Average Status

Long-term peritoneal dialysis (PD) can lead to detrimental changes in peritoneal membrane function, which may be related to the accumulation of glucose degradation products. A previous study demonstrated that 6 months of far-infrared (FIR) therapy may decrease glucose degradation products in PD dialysate. Due to limited literature on this matter, this study aims to investigate the effect of FIR therapy on the peritoneal membrane transport characteristics of PD patients. Patients were grouped according to baseline peritoneal transport status: lower transporters (low and low-average) and higher transporters (high-average and high). Both groups underwent 40 min of FIR therapy twice daily for 1 year. In lower transporters, FIR therapy increased weekly dialysate creatinine clearance (6.91 L/wk/1.73 m2; p = 0.04) and D/P creatinine (0.05; p = 0.01). In higher transporters, FIR therapy decreased D/P creatinine (−0.05; p = 0.01) and increased D/D0 glucose (0.05; p = 0.006). Fifty percent of high transporter patients shifted to high-average status after FIR therapy. FIR therapy may decrease D/P creatinine for patients in the higher transporter group and cause high transporters to shift to high-average status, which suggests the potential of FIR therapy in improving peritoneal membrane function in PD patients.

The Short Pet in Pediatrics

2007 ◽  
Vol 27 (4) ◽  
pp. 441-445 ◽  
Author(s):  
Bradley A. Warady ◽  
Janelle Jennings
Keyword(s):  
Peritoneal Dialysis ◽  
Membrane Transport ◽  
Reference Data ◽  
Retrospective Evaluation ◽  
Transport Capacity ◽  
Peritoneal Membrane ◽  
Peritoneal Equilibration Test ◽  
Patient Values ◽  
Similar Experience

Background The peritoneal equilibration test (PET) is a 4-hour procedure that is recommended to be performed in children receiving peritoneal dialysis to assist in prescription management. While a shortened version of the PET has been used in adults and reliably characterizes peritoneal membrane transport capacity, no similar experience with children has been reported. Methods Retrospective evaluation of 2-hour and 4-hour PET data obtained from 20 children receiving chronic peritoneal dialysis in a single center. Characterization of membrane transport capacity was based on evaluation of serum and dialysate samples used to determine the dialysate-to-plasma ratio (D/P) of creatinine and the ratio of dialysate glucose to baseline dialysate glucose (D/D0). Patient values were compared to pediatric reference data. Results In all 20 patients, characterization of peritoneal membrane transport capacity using 2-hour D/P and D/D0 results was identical to that determined using 4-hour data for the same solute. While the creatinine- and glucose-based characterization was discrepant in 14 of 20 patients, in only 1 case was the discrepancy of more than a single transport category. Conclusion These results support the accuracy of a short PET in children, a procedure that should prove beneficial in terms of patient and staff time.

scholarly journals The Fast Peritoneal Equilibration Test First and Second Hour Results

2015 ◽  
Vol 12 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Hakan Akdam ◽  
Alper Alp ◽  
Ozgul Ozbek ◽  
Umut Cakiroglu ◽  
Yavuz Yenicerioglu ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Standard Deviation ◽  
Short Version ◽  
Test Results ◽  
Transport Function ◽  
Peritoneal Membrane ◽  
Peritoneal Equilibration Test ◽  
Creatinine Concentration ◽  
Time Points ◽  
The Mean

Abstract Introduction. The Peritoneal Equilibration Test (PET) is employed to assess peritoneal membrane transport function. The purpose of the test is to determine the optimal peritoneal dialysis regimen. The performance of the test, which is conducted over 4 hours, is time consuming both for the nurses and the patient. There have been studies to validate an approved short version of the original PET protocol, and all have yielded different results. We evaluated the concordance between the 1-hour, 2-hour and 4-hour (classical) test results of the fast PET. Methods. The study included 32 patients (20 males and 12 females). The patients underwent the 4-hour fast PET test, and the dialysate-to-plasma ratio of creatinine concentration (D/Pcrea) was determined. The standard deviation was added to or subtracted from the mean D/Pcrea ratios at hours 1, 2, and 4 to determine transport groups. Results. The mean age of the patients was 51.4±16.7 years. Mean D/Pcrea ratios at hours 1, 2, and 4 were 0.41±0.07, 0.54±0.10, and 0.69+0.12, respectively. There was a strong correlation between the 4-hour D/Pcrea ratio and 1-hour (r=0.756, p<0.001) and 2-hour (r=0.867, p<0.001) D/Pcrea ratios. Seventeen patients (53%) were in the same transport group at hours 1, 2, and 4. Eighteen patients (56%) at 1 hour and 24 patients (75%) at 2 hours fell into the same transport group at 4 hours. The patients that fell into different transport groups at different time points showed a shift to a lower or higher transport group. Conclusions. Two-hour fast PET gives promising results for clinical assessment purposes.

Peritoneal Membrane Transport and Hypoalbuminemia: Cause or Effect?

2000 ◽  
Vol 20 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Peter J. Margetts ◽  
Joseph P. McMullin ◽  
Christian G. Rabbat ◽  
David N. Churchill
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Serum Albumin ◽  
Membrane Transport ◽  
Tertiary Care ◽  
Peritoneal Membrane ◽  
Peritoneal Equilibration Test ◽  
Lower Serum ◽  
Initiation Of Dialysis ◽  
Before And After

Objective Peritoneal membrane transport has been associated with serum albumin and clinical outcome. We examined the relationship between serum albumin and peritoneal membrane transport status before and after the initiation of peritoneal dialysis. Setting Patients were followed at a tertiary-care regional nephrology program at St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada. Methods Incident peritoneal dialysis patients between 1 January 1995 and 31 May 1998 were eligible if there was a peritoneal equilibration test within 180 days of starting dialysis, and a serum albumin value measured within 90 days prior to, and 20 to 70 days after initiating dialysis. Main Outcome Measures Serum albumin, before and after the initiation of dialysis, and the presence of proteinuric renal disease were compared with the peritoneal equilibration test results. Results Among 67 identified patients, there were 7 high, 27 high-average, 26 low-average, and 7 low transporters and the mean serum albumin values before dialysis were 35.1, 37.4, 37.8, and 40.4 g/L, respectively ( p < 0.001). Serum albumin values prior to the initiation of dialysis correlated significantly with the 4-hour D/P creatinine ratio ( r = –0.251, p = 0.040). After initiation of dialysis, the correlation was stronger ( r = –0.447, p < 0.001). Serum albumin prior to initiation of dialysis was lower for those with proteinuric than nonproteinuric renal disease (36.4 g/L vs 38.8 g/L, p = 0.04). The trend to lower serum albumin in high transporters was seen in patients with both proteinuric and nonproteinuric renal disease. Conclusion The association between higher peritoneal membrane transport and lower serum albumin is present before initiation of dialysis in both proteinuric and nonproteinuric renal disease. The poor outcomes associated with low serum albumin and higher peritoneal membrane transport might be explained by other underlying factors. The contribution of inflammation, malnutrition, and fluid overload requires further study.

MO710GALECTIN-3, IS IT A NEW PLAYER IN PERITONEAL INFLAMMATION AMONG PATIENTS UNDERGOING PERITONEAL DIALYSIS?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Yael Einbinder ◽  
Keren Cohen-Hagai ◽  
Sydney Benchetrit ◽  
Tali Zitman-Gal
Keyword(s):  
Cell Culture ◽  
Peritoneal Dialysis ◽  
Endothelial Cell ◽  
Protein Expression ◽  
Inflammatory Process ◽  
Peritoneal Membrane ◽  
Peritoneal Equilibration Test ◽  
Endothelial Cell Culture ◽  
Dialysis Vintage ◽  
Mrna And Protein Expression

Abstract Background and Aims Peritoneal dialysis (PD) is a common used method for renal replacement therapy. Prolonged PD treatment causes structural and functional changes in the peritoneal membrane which are attributed to local inflammatory process in the peritoneal cavity. Galectin-3 (Gal-3) is a galactoside-binding lectin with pro-inflammatory and pro-fibrotic effects. The aim of this study was to assess correlation between Gal-3 serum and dialysate effluent levels with peritoneal membrane transport characteristics. Method Gal-3 levels in serum and dialysate effluent were measured simultaneously in prevalent PD patients in morning visit or during peritoneal equilibration test (PET). Gal-3 levels were correlated with clinical and laboratory parameters. Interlukin (IL) -6 levels were measured in dialysate effluent. Gal-3 mRNA and protein expression were evaluated after exposure of primary endothelial cell culture to several dialysate solutions. Results 37 PD patients were included in the study; mean age was 65.7±13.1 years, mean dialysis vintage was 17.5±13 months. Gal-3 levels in dialysate effluent correlated with peritoneal equilibration test (PET) results (0.663, p=0.005) and effluent IL-6 levels (0.674, p=0.002) but not with serum Gal-3 levels or dialysis vintage. Patients with high PET results had higher effluent Gal-3 levels as compared average low PET results. In multivariate regression analysis effluent IL-6 level was the most dominant predictor of effluent Gal-3 levels. Gal-3 mRNA and protein expression in primary endothelial cell culture were not affected by stimulation with dialysate solutions. Conclusion Our study demonstrated presence of Gal-3 within the dialysate effluent in PD patients. Gal-3 levels correlated with peritoneal membrane transport characteristics and effluent IL-6 levels suggesting a role in the inflammatory process within the peritoneal cavity.

scholarly journals Long-term exposure to new peritoneal dialysis solutions: Effects on the peritoneal membrane

2004 ◽  
Vol 66 (3) ◽  
pp. 1257-1265 ◽  
Author(s):  
Siska Mortier ◽  
Dirk Faict ◽  
Casper G. Schalkwijk ◽  
Norbert H. Lameire ◽  
A.N.S. De Vriese
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Membrane ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions

Pathophysiology of Ultrafiltration in Peritoneal Dialysis

1990 ◽  
Vol 10 (2) ◽  
pp. 119-126 ◽  
Author(s):  
Claudio Ronco ◽  
Mariano Feriani ◽  
Stefano Chiaramonte ◽  
Alessandra Brendolan ◽  
Luisa Bragantini ◽  
...  
Keyword(s):  
Blood Flow ◽  
Peritoneal Dialysis ◽  
Glucose Concentration ◽  
Peritoneal Membrane ◽  
Dialysis Membrane ◽  
Ultrafiltration Rate ◽  
Peritoneal Equilibration Test ◽  
Common Causes ◽  
Catheter Malposition ◽  
Causes Of Failure

Pathophysiology of peritoneal ultrafiltration is analyzed in the present study. Peritoneal equilibration test is the easiest procedure to study in detail the possible causes of failure to control the ultrafiltration rate in patients undergoing peritoneal dialysis. Membrane failure, reduction in peritoneal blood flow, excessive lymphatic reabsorption catheter malposition, and fluid sequestration are the most common causes of ultrafiltration loss. Pharmacologic manipulation of peritoneal membrane, correction of mechanical inconvenients, reduction in peritonitis rate and in the level of immunostimulation of the mesotelial macrophages, together with a careful policy in terms of glucose concentration in the dialysate and dwell times may contribute not only to treat different forms of ultrafiltration loss but also to prevent their incidence.

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