Peritoneal Transport Kinetics of Proteins in Children on Chronic Peritoneal Dialysis

2003 ◽  
Vol 23 (2) ◽  
pp. 162-168 ◽  
Author(s):  
Klaus Arbeiter ◽  
Regina Stemberger ◽  
Laurence Greenbaum ◽  
Thomas Mueller ◽  
Andrea Konstantin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Close Correlation ◽  
Cross Sectional Study ◽  
Transport Kinetics ◽  
Chronic Peritoneal Dialysis ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Pediatric Dialysis ◽  
Molecular Weights ◽  
Peritoneal Transport

Objective This study describes a modified 4-hour peritoneal equilibration test (PET) for analyzing peritoneal transport characteristics of proteins with different molecular weights and predicting daily peritoneal protein losses in children on chronic peritoneal dialysis (PD). Design Cross-sectional study. Setting A single regional pediatric dialysis unit in a teaching hospital. Patients 9 stable pediatric dialysis patients; 4 were on continuous ambulatory PD, 5 were on continuous cycling PD. Main Outcome Measures Serum and dialysate concentrations of IgG, albumin, β2-microglobulin, and transferrin were determined during a PET. Changes in dialysate-to-plasma (D/P) ratios were determined hourly. Agreement between PET-derived and measured daily peritoneal protein losses was examined. Results The D/P ratio decreased with increased molecular radius ( p < 0.0001). Many children had low plasma levels of IgG, albumin, and transferrin, but elevated levels of β2-microglobulin. The D/P ratio increased linearly during the PET for all measured proteins, regardless of molecular weight. There was close correlation between 4-hour PET protein losses and 24-hour losses during routine PD. Conclusions Proteins are lost through the peritoneum according to their size, demonstrating linear transport kinetics during a 4-hour PET. The PET-derived data predicted daily protein losses in children on chronic PD. This approach might help to eliminate inaccuracies due to incomplete dialysate collection.

Thyroid Dysfunction and Nodular Goiter in Hemodialysis and Peritoneal Dialysis Patients

1998 ◽  
Vol 18 (5) ◽  
pp. 516-521 ◽  
Author(s):  
Chih Ching Lin ◽  
Tzen Wen Chen ◽  
Yee Yung Ng ◽  
Yi Hong Chou ◽  
Wu Chang Yang
Keyword(s):  
Peritoneal Dialysis ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Nodular Goiter ◽  
Cross Sectional Study ◽  
Control Group ◽  
Free T4 ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Uremic Patients

Objective To investigate the prevalence of nodular goiter and thyroid dysfunction in uremic patients undergoing hemodialysis (HD) and peritoneal dialysis. Design Cross-sectional study. Setting Single dialysis unit and outpatient clinic. Patients The study included 221 patients [143 HD and 78 continuous ambulatory peritoneal dialysis (CAPD) patients] along with 135 consecutively selected outpatients as controls. Main Outcome Measures Ultrasonography was used to detect patients’ thyroid function and nodular goiter. Results Nodular goiter was detected in 54.8% of the uremic patients and in 21.5% of the controls. Uremic patients had higher prevalence of thyroid dysfunction, which included reduced serum concentration of total T3, total T4, and free T4, and increased serum level of TSH. Hypothyroidism was also observed more frequently in uremic patients than in the control group (5.4% vs 0.7%, p < 0.05). Nodular goiter was more frequently found in females than in males (63.5% vs 48%, p < 0.05). Moreover, the prevalence of nodular goiter increased with age (p < 0.02) in uremic patients. Hemodialysis patients had a higher frequency of reduced total T3 level (46.9% vs 29.5%, p < 0.02). However, CAPD patients had lower T4 levels (6.23 ± 1.82μg/dL vs 7.15± 1.99μg/dL, p < 0.05). Conclusion Because of the high incidence of hypothyroidism and nodular goiter in uremic patients, screening of thyroid function and goiter detection with ultrasound should be considered in evaluation of end-stage renal disease patients.

Adiponectin Levels and Atherosclerotic Risk Factors in Pediatric Chronic Peritoneal Dialysis Patients

2005 ◽  
Vol 25 (4) ◽  
pp. 357-361 ◽  
Author(s):  
Sevcan A. Bakkaloglu ◽  
Necla Buyan ◽  
Tohru Funahashi ◽  
Hatice Pasaoglu ◽  
Atilla H. Elhan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Apolipoprotein B ◽  
University Hospital ◽  
Chronic Peritoneal Dialysis ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Lipoprotein A ◽  
Control Subjects ◽  
Significant Difference

Background Atherosclerotic vascular diseases are the major cause of mortality in patients with end-stage renal disease (ESRD) treated with chronic peritoneal dialysis (CPD), even in children. Adiponectin (ADPN) is a recently discovered adipocyte-derived plasma protein having anti-atherogenic properties. ADPN levels are elevated in ESRD but it has been reported that ESRD patients with low plasma ADPN levels have a high risk of cardiovascular death. Objective To clarify the atherosclerotic risk and especially the significance of ADPN levels in pediatric patients on CPD. Design Cross-sectional study in the pediatric peritoneal dialysis unit of a university hospital. Patients 18 children, aged 12.6 ± 5.6 years, being treated with CPD and 20 healthy age- and sex-matched control subjects were enrolled in this study. Methods Serum ADPN levels and other risk factors, including blood pressure, blood glucose, serum lipid/lipoprotein fractions, apolipoprotein B, C-reactive protein (CRP), lipoprotein(a), and homocysteine levels, were studied in CPD patients and compared to the controls. Results Serum ADPN levels were three times higher in the CPD group compared to the control subjects, as was previously reported. Apolipoprotein B and CRP levels were also high in the CPD group. No significant difference was found in other atherosclerotic parameters, including lipoprotein(a) and homocysteine levels. Interestingly, we found a negative correlation between log ADPN and creatinine levels among the CPD patients ( r = –0.54, p < 0.05). There was no correlation between log ADPN and duration of CPD. Creatinine and low-density lipoprotein levels could account for 54% of the total variation in ADPN levels. Conclusion Among pediatric CPD patients, serum levels of the anti-atherogenic protein, ADPN, were inversely associated with creatinine. ADPN level might be a novel marker to predict prognosis in pediatric CPD patients.

Chlamydia Pneumoniae DNA in Peripheral Blood Mononuclear Cells in Peritoneal Dialysis Patients

2000 ◽  
Vol 20 (6) ◽  
pp. 722-726 ◽  
Author(s):  
Eduard A. Iliescu ◽  
Marnie F. Fiebig ◽  
Alexander R. Morton ◽  
Perin Sankar–Mistry
Keyword(s):  
Peritoneal Dialysis ◽  
Peripheral Blood ◽  
Chlamydia Pneumoniae ◽  
Mononuclear Cells ◽  
Peripheral Circulation ◽  
Cross Sectional Study ◽  
Peripheral Blood Mononuclear ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Kingston General Hospital

Objective The aim of the present study was to examine the association between infection with Chlamydia pneumoniae and symptomatic atherosclerosis in peritoneal dialysis (PD) patients. Design Cross-sectional study. Setting Peritoneal Dialysis Unit of Kingston General Hospital. Patients Fifty-five prevalent PD patients. Outcome Measures ( 1 ) Infection with C. pneumoniae diagnosed by detection of DNA in peripheral blood mono-nuclear cells (PBMCs) using polymerase chain reaction. ( 2 ) Symptomatic atherosclerosis involving the coronary, cerebral, or peripheral circulation. Results The DNA of C. pneumoniae was detected in PBMCs in 33 patients (60.0%). Atherosclerosis was present in 16 of 33 (48%) PBMC C. pneumoniae DNA–positive patients, and in 10 of 22 (45%) PBMC C. pneumoniae DNA–negative patients ( p = 0.83). Using multiple logistic regression and controlling for a number of known cardiovascular risk factors, PBMC C. pneumoniae DNA status was not predictive of atherosclerosis. The only significant independent predictors of atherosclerosis were diabetes and age. Conclusions In prevalent PD patients, a high prevalence of symptomatic atherosclerosis and of Chlamydia pneumoniae DNA in PBMCs were seen; however, the results of the present study do not support the presence of an association between infection with C. pneumoniae and atherosclerosis.

Time to Positivity of Bacteria Cultures in Peritoneal Dialysis Fluid: Evaluation of Different Laboratory Techniques

2017 ◽  
Vol 37 (3) ◽  
pp. 342-344
Author(s):  
Roberta M. Katzap ◽  
Vany Elisa Pagnussatti ◽  
Ana Elizabeth Figueiredo ◽  
Julia Gabriela Motta ◽  
Domingos O. d'Avila ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Fluid ◽  
Antibiotic Sensitivity ◽  
Positive Culture ◽  
Cross Sectional Study ◽  
Essential Elements ◽  
Coagulase Negative Staphylococcus ◽  
Cross Sectional ◽  
Peritoneal Dialysis Fluid

Patients with chronic kidney disease on peritoneal dialysis (PD) are susceptible to infections, with peritonitis being the primary cause of dropout. Peritoneal fluid culture is one of the essential elements for proper diagnosis and peritonitis treatment. The aim of this study was to compare the time required to obtain a positive culture using different laboratory methods. An in vitro cross-sectional study was conducted comparing different techniques for preparation and culture of bacteria in peritoneal fluid. The research was carried out with 21 sterile dialysis bags and 21 PD bags containing peritoneal fluid drained from patients without peritonitis. Fluids from the 42 PD bags were contaminated by injecting a coagulase-negative Staphylococcus suspension and then prepared for culture using 4 distinct techniques: A - direct culture; B - post-centrifugation culture; C - direct culture after 4 h sedimentation; and D - culture after 4 h sedimentation and centrifugation. This was followed by seeding. In the 21 contaminated sterile bags, mean times to obtain a positive culture with techniques D (19.6 h ± 2.6) and C (19.1 h ± 2.3) were longer than with technique A (15.8 h ± 3.0; p < 0.01), but not statistically different from group B (19.0 h ± 3.2). The same occurred in the 21 bags drained from patients, with mean times for techniques D (14.0 h ± 1.9) and C (14.5 h ± 1.7) being longer than technique A (12.22 h ± 1.94; p < 0.05) but not statistically different from technique B (13.2 h ± 1.3). The sedimentation and centrifugation steps seem to be unnecessary and may delay antibiotic sensitivity test results by approximately 8 hours.

scholarly journals Predictors of quality of life among patients on dialysis in southern Brazil

2008 ◽  
Vol 126 (5) ◽  
pp. 252-256 ◽  
Author(s):  
Maristela Bohlke ◽  
Diego Leite Nunes ◽  
Stela Scaglioni Marini ◽  
Cleison Kitamura ◽  
Marcia Andrade ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Short Form ◽  
Outcome Measurement ◽  
Cross Sectional Study ◽  
Southern Brazil ◽  
Cross Sectional ◽  
Sf 36 ◽  
Dialysis Facilities

CONTEXT AND OBJECTIVE: Quality of life (QoL) is considered important as an outcome measurement, especially for long-term diseases such as chronic renal failure. The present study searched for predictors of QoL in a sample of patients undergoing dialysis in southern Brazil. DESIGN AND SETTING: This was a cross-sectional study developed in three southern Brazilian dialysis facilities. METHODS: Health-related QoL of patients on hemodialysis or peritoneal dialysis was measured using the generic Short Form-36 (SF-36) health survey questionnaire. The results were correlated with sociodemographic, clinical and laboratory variables. The analysis was adjusted through multiple linear regression. RESULTS: A total of 140 patients were assessed: 94 on hemodialysis and 46 on peritoneal dialysis. The mean age was 54.2 ± 15.4 years, 48% were men and 76% were white. The predictors of higher (better) physical component summary in SF-36 were: younger age (β-0.16; 95% confidence interval, CI: -0.27 to -0.05), shorter time on dialysis (β-0.06; 95% CI: -0.09 to -0.02) and lower Khan comorbidity-age index (β 5.16; 95% CI: 1.7-8.6). The predictors of higher mental component summary were: being employed (β 8.4; 95% CI: 1.7-15.1), being married or having a marriage-like relationship (β 4.56; 95% CI: 0.9-8.2), being on peritoneal dialysis (β 4.9; 95% CI: 0.9-8.8) and not having high blood pressure (β 3.9; 95% CI: 0.3-7.6). CONCLUSIONS: Age, comorbidity and length of time on dialysis were the main predictors of physical QoL, whereas socioeconomic issues especially determined mental QoL.

scholarly journals The Association Between Self-Management Ability and Malnutrition-Inflammation-Atherosclerosis Syndrome in Peritoneal Dialysis Patients: A Cross-Sectional Study

2020 ◽  
Author(s):  
Zehui Huang ◽  
Junyang Fang ◽  
Ahui Song ◽  
Yan Tong ◽  
Hai Deng ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cross Sectional Study ◽  
Self Management ◽  
Spearman Correlation ◽  
Effect Evaluation ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Management Ability ◽  
Evaluation And Monitoring ◽  
The Relationship

Abstract BackgroundThe relationship between malnutrition-inflammation-atherosclerosis syndrome (MIAS) and self-management ability has not been previously revealed even though both play an important role in the management of peritoneal dialysis (PD) patients.Materials and methodsIn total, 93 patients were enrolled in this study. A self-management questionnaire was used for the evaluation of self-management ability. The identification of MIAS was based on one or more of the following three conditions: C-reactive protein (CRP) ≥10 mg/L, malnutrition–inflammation score (MIS) > 7, and the presence of atherosclerosis related medical records. The possible association between different self-management abilities and MIAS was analyzed with a Spearman correlation analysis.ResultsThere were 40 (43.0%) patients in the atherosclerosis group, and 38 (40.9%), 38 (40.9%), 10 (10.8%), and 7 (7.5%) patients in the MIAS0, MIAS1, MIAS2, and MIAS3 groups, respectively. The group with a score above the mean score of the Dialysis Effect Evaluation and Monitoring dimension had a fewer number of hospitalizations, higher albumin levels, lower MIS scores, lower level of IL-6, and a lower number of MIAS factors. The Pearson and Spearman correlation analyses also revealed that this dimension was negatively correlated with the MIAS, MIS, IL-6, BNP, number of hospitalizations, and age and positively associated with albumin and prealbumin. ConclusionThe Dialysis Effect Evaluation and Monitoring dimension of the self-management scale for PD patients is closely linked to the MIAS, and the better the dialysis effect evaluation and monitoring capacity, the lower the chance of exposure to malnutrition and inflammation.Trial registrationChina Clinical Trials Register: SH9H-2020-T20-2, retrospectively registered 15 January 2020.

Antioxidant Status of Patients on Peritoneal Dialysis: Associations with Inflammation and Glycoxidative Stress

2009 ◽  
Vol 29 (1) ◽  
pp. 89-101 ◽  
Author(s):  
Isabella Sundl ◽  
Johannes M. Roob ◽  
Andreas Meinitzer ◽  
Beate Tiran ◽  
Gholamali Khoschsorur ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Vitamin C ◽  
Interleukin 6 ◽  
Antioxidant Status ◽  
Low Dose ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Chronic Inflammatory Response ◽  
Plasma Ascorbate ◽  
High Doses

Background Patients on peritoneal dialysis (PD) frequently exhibit oxidant–antioxidant imbalance, advanced glycation end-product overload, and subclinical inflammation but the interrelations between these pathophysiological changes have not been fully elucidated. Subjects and Methods To study possible associations, a cross-sectional study of antioxidant status, glycoxidative stress, and inflammation, using HPLC and ELISA methods, was undertaken in 37 PD patients and age- and sex-matched healthy controls. Results Plasma ascorbate concentrations were low in patients not taking at least low-dose vitamin C supplements. In patients taking vitamin C supplements, there was a positive relation between ascorbate and pentosidine concentrations. Vitamin E and carotenoid concentrations were comparable between patients and controls, while lycopene and lutein/zeaxanthin concentrations were lower. Interleukin-6, C-reactive protein (CRP), and pentosidine concentrations were elevated in PD patients. β–Cryptoxanthin, lycopene, and lutein/zeaxanthin concentrations were inversely related to interleukin-6 concentrations. β–Cryptoxanthin concentrations were also inversely related to CRP concentrations. Pentosidine showed a low dialysate-to-plasma ratio, indicating low peritoneal clearance. Pentosidine concentrations increased with duration of PD therapy, while α– and β–carotene concentrations decreased. Malondialdehyde concentrations were elevated compared to controls but remained within the normal range. Retinol concentrations decreased with PD therapy and were inversely related to interleukin-6 and CRP concentrations. Conclusions Low-dose vitamin C supplements and a carotenoid-rich diet should be recommended for PD patients to maintain normal antioxidant status and efficiently counteract the chronic inflammatory response, rather than high doses of vitamin C, which could play a role as a precursor of pentosidine.

Disturbed Appetite Patterns and Nutrient Intake in Peritoneal Dialysis Patients

2003 ◽  
Vol 23 (6) ◽  
pp. 550-556 ◽  
Author(s):  
Mark Wright ◽  
Graham Woodrow ◽  
Siobahn O'Brien ◽  
Neil King ◽  
Louise Dye ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Food Intake ◽  
Nutrient Intake ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Diurnal Variability ◽  
Patient Reported ◽  
Dietary Records ◽  
The Mean ◽  
The Impact

Objective Malnutrition is common among peritoneal dialysis (PD) patients. Reduced nutrient intake contributes to this. It has long been assumed that this reflects disturbed appetite. We set out to define the appetite profiles of a group of PD patients using a novel technique. Design Prospective, cross-sectional comparison of PD patients versus controls. Setting Teaching hospital dialysis unit. Patients 39 PD patients and 42 healthy controls. Intervention Visual analog ratings were recorded at hourly intervals to generate daily profiles for hunger and fullness. Summary statistics were generated to compare the groups. Food intake was measured using 3-day dietary records. Main Outcome Measures Hunger and fullness profiles. Derived hunger and fullness scores. Results Controls demonstrated peaks of hunger before mealtimes, with fullness scores peaking after meals. The PD profiles had much reduced premeal hunger peaks. A postmeal reduction in hunger was evident, but the rest of the trace was flat. The PD fullness profile was also flatter than in the controls. Mean scores were similar despite the marked discrepancy in the profiles. The PD group had lower peak hunger and less diurnal variability in their hunger scores. They also demonstrated much less change in fullness rating around mealtimes, while the mean and peak fullness scores were little different. The reported nutrient intake was significantly lower for PD. Conclusion The data suggest that PD patients normalize their mean appetite perception at a lower level of nutrient intake than controls, suggesting that patient-reported appetite may be misleading in clinical practice. There is a loss of the usual daily variation for the PD group, which may contribute to their reduced food intake. The technique described here could be used to assess the impact of interventions upon the abnormal PD appetite profile.

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