Feasibility of Reinstitution of CAPD after Partial Hepatectomy in Patients with Malignant Hepatic Tumors

2003 ◽  
Vol 23 (5) ◽  
pp. 504-506 ◽  
Author(s):  
Sing Leung Lui ◽  
Pok Siu Yip ◽  
Man Fei Lam ◽  
Wai Kei Lo
Keyword(s):  
Peritoneal Dialysis ◽  
Retrospective Analysis ◽  
Partial Hepatectomy ◽  
Serum Biochemistry ◽  
The Other ◽  
University Teaching ◽  
Hepatic Tumors ◽  
Peritoneal Equilibration Test ◽  
Dialysis Unit ◽  
Before And After

Objective To determine the feasibility of reinstitution of continuous ambulatory peritoneal dialysis (CAPD) in patients with malignant hepatic tumors after partial hepatectomy. Design Retrospective analysis of 2 CAPD patients. Setting Dialysis unit of a university teaching hospital. Patients Two CAPD patients with malignant hepatic tumors who had undergone partial hepatectomy. Main Outcome Measures Serum biochemistry, Kt/V, peritoneal equilibration test (PET) results before and after hepatectomy. Results One patient was able to resume CAPD 4 weeks after partial hepatectomy. The other patient was successfully resumed on CAPD after resting the peritoneum for 3 months following partial hepatectomy. The serum biochemistry, Kt/V, and PET results of the 2 patients did not change significantly before and after partial hepatectomy. Conclusions Reinstitution of CAPD after partial hepatectomy in patients with malignant hepatic tumors is feasible.

Assessment of Dialysis Dose by Measured Clearance versus Extrapolated Data

1993 ◽  
Vol 13 (3) ◽  
pp. 184-188 ◽  
Author(s):  
John M. Burkart ◽  
Jean R. Jordan ◽  
Michael V. Rocco
Keyword(s):  
Peritoneal Dialysis ◽  
University Teaching ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Peritoneal Equilibration Test ◽  
Dialysis Dose ◽  
Dialysis Unit ◽  
Daily Dialysis ◽  
The Individual ◽  
Chronic Ambulatory Peritoneal Dialysis

Objective To determine whether estimates of daily dialysis clearance of creatinine and urea, based on data from the 4-hour peritoneal equilibration test, correlate well with daily dialysis clearance measured by 24-hour dialysate collection in chronic ambulatory peritoneal dialysis patients. Design Prospective study in which each subject collected all dialysate from a 24-hour period and then immediately thereafter underwent a standard peritoneal equilibration test (PET). Daily clearances of creatinine and urea were calculated from 24-hour dialysate collections by standard methods and then were compared with several estimates of 24-hour clearance based on PET data. Setting Single peritoneal dialysis unit of a university teaching hospital. Patients Thirty-six stable patients on continuous ambulatory peritoneal dialysis (CAPD). Main Outcome The estimated values for daily dialysis clearance both overestimated and underestimated the measured 24-hour clearance. The correlation coefficient between the extrapolations and the actual 24-hour clearances ranged from 0.63–0.68. The range of discordance for daily creatinine clearance was from -2530 mL/dayto +2199 mL/day. For daily urea clearance, the range of discordance was from -21 03 mL/ day to +1940 mL/day. The peritoneal membrane transport characteristics of the individual patient did not predict whether the extrapolation overestimated orunder estimated the measured daily clearance. Conclusion Extrapolation of PET data is not a reliable method to estimate the dose of dialysis delivered to the patient. A 24-hour collection of dialysis is necessary for this determination.

Results of Peritoneal Equilibration Test during Treatment with Polyglucose Dialysis Solution

2002 ◽  
Vol 22 (3) ◽  
pp. 357-364 ◽  
Author(s):  
Alicja E. Grzegorzewska ◽  
Danuta Antczak-Jȩdrzejczak ◽  
Magdalena Leander
Keyword(s):  
Peritoneal Dialysis ◽  
Dwell Time ◽  
Control Period ◽  
University Hospital ◽  
Control Group ◽  
Peritoneal Equilibration Test ◽  
Dialysis Unit ◽  
Dialysis Solution ◽  
Glucose Ratio ◽  
Peritoneal Permeability

Background Results of peritoneal equilibration test (PET) suggest prolonged effect of polyglucose dialysis solution (PG-DS) on peritoneal permeability. Objectives An evaluation of dialysate-to-plasma ratio (D/P) of urea, D/P creatinine, and D/D0 glucose (ratio of dialysate glucose at designated dwell time to dialysate glucose at 0 dwell time), and mass transfer area coefficients (KBD) of these solutes in PET before introduction, during administration, and after discontinuation of PG-DS in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Design Single-center prospective study with PG-DS; retrospective selection of the control group. Setting Peritoneal dialysis unit in a university hospital. Patients Fourteen patients (11 males; age 45.1 ± 8.5 years) treated with CAPD for 17.5 ± 9.9 months. 7.5% PG-DS was used for the overnight exchange. After discontinuation of the PG-DS, standard dialysis solutions, as previously used, were reintroduced. The control group was selected to match both CAPD duration and peritoneal permeability of the patients in the PG-DS group at the start of the study. Methods Standard PET was carried out at 1.6 ± 0.8 months before the introduction of PG-DS (study period I, n = 14), after 1.2 ± 0.6 months’ use of PG-DS (study period II, n = 14), after 4.4 ± 0.8 months’ use of PG-DS (study period III, n = 11), after 8.8 ± 2.2 months’ use of PG-DS (study period IV, n = 9), and at 2.0 ± 0.6 months after PG-DS discontinuation (study period V, n = 11). Patients in the control group underwent PET at similar time intervals (control periods I – V). Results In the PG-DS group, a tendency toward increased peritoneal permeability for urea and creatinine was shown during the consecutive study periods. D/D0 glucose was significantly higher only in the PET performed during use of PG-DS (periods II – IV) compared to results obtained in period I. In the control group, both D/P and KBD of both urea and creatinine remained unchanged, but KBD glucose was higher in the first 2 hours of the PET in control period V compared to respective values in control period III. Conclusion Changes in peritoneal permeability are observed in CAPD patients treated with PG-DS. These changes may be at least partially related to the administration of polyglucose.

The Impact of Increasing the Daytime Dialysis Exchange Frequency on Peritoneal Dialysis Adequacy and Nutritional Status of Chinese Anuric Patients

2002 ◽  
Vol 22 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Cheuk-Chun Szeto ◽  
Teresa Yuk-Hwa Wong ◽  
Kai-Ming Chow ◽  
Chi-Bon Leung ◽  
Angela Yee-Moon Wang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Intervention Group ◽  
The Other ◽  
University Teaching ◽  
Control Group ◽  
Dialysis Adequacy ◽  
Protein Nitrogen ◽  
Exchange Frequency ◽  
The Impact

♦ Objective To study the effect of increasing the daytime dialysis exchange frequency on dialysis adequacy and nutritional status of Chinese anuric patients. ♦ Setting University teaching hospital. ♦ Patient 100 anuric patients on continuous ambulatory peritoneal dialysis (CAPD). ♦ Design 50 patients had one additional daytime 2-L exchange (intervention group); the dialysis regimen remained unchanged in the other 50 patients (control group). ♦ Outcome Dialysis adequacy [Kt/V, weekly creatinine clearance (wCCr), and net ultrafiltration (UF)] and nutritional status [serum albumin, dietary protein intake, represented by normalized protein nitrogen appearance (nPNA), and percent lean body mass (%LBM)] were measured at 0 and 6 months. ♦ Results Baseline dialysis adequacy and nutritional indices were comparable between the two groups. In the control group, all parameters remained stable at month 6. In the intervention group, there were significant increases in UF, Kt/V, wCCr, nPNA, and %LBM from months 0 to 6. The improvement in nPNA was affected by daily exchange volume. In 30 patients, the number of exchanges was increased from 3 to 4 per day; their Kt/V and nPNA rose significantly from month 0 to month 6. In the other 20 patients, the number of exchanges was increased from 4 to 5 per day; there was a significant increase in Kt/V but nPNA remained static. The change in nPNA correlated inversely with Kt/V at month 0 (Pearson's r = –0.352, p = 0.012). Multivariate analysis with a general linear model showed that age, Kt/V at month 0, and 3 dialysis exchanges per day at month 0 (versus 4 exchanges) were independent predictors of the change in nPNA. ♦ Conclusions Increasing the number of peritoneal dialysis exchanges effectively increased Kt/V in Chinese anuric CAPD patients. However, the improvement in nPNA correlated inversely with baseline Kt/V. Although increasing the number of exchanges from 3 to 4 per day improved nPNA, increasing the number of daily exchanges beyond 4 may not improve nPNA further.

scholarly journals Clinical relevance of marginal factors on ultrafiltration in peritoneal dialysis

2020 ◽  
pp. 089686082090455 ◽  
Author(s):  
Vicente Pérez-Díaz ◽  
Alfonso Pérez-Escudero ◽  
Sandra Sanz-Ballesteros ◽  
Luisa Sánchez-García ◽  
Esther Hernández-García ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Body Size ◽  
Clinical Relevance ◽  
The Other ◽  
Clinical Settings ◽  
Osmotic Gradient ◽  
Peritoneal Equilibration Test ◽  
Intraperitoneal Pressure ◽  
Sex Influence ◽  
Peritoneal Permeability

Background: Ultrafiltration (UF) in peritoneal dialysis (PD) is mainly driven by the osmotic gradient and peritoneal permeability, but other factors—such as intraperitoneal pressure (IPP)—also have an influence. Methods: To assess the clinical relevance of these marginal factors, we studied 41 unselected PD patients undergoing two consecutive 2 h, 2.27% glucose exchanges, first with 2.5 L and then with 1.5 L. Results: IPP, higher in the 2.5 L exchange, had a wide interpatient range, was higher in obese and polycystic patients and their increase with infusion volume was higher for women regardless of body size. UF with 2.5 L correlated inversely with IPP and was higher for patients with polycystosis or hernias, while for 1.5 L we found no significant correlations. The effluent had higher glucose and osmolarity in the 2.5 L exchange than in the 1.5 L one, similar for both sexes. In spite of this stronger osmotic gradient, only 21 patients had more UF in the 2.5 L exchange, with differences up to 240 mL. The other 20 patients had more UF in the 1.5 L exchange, with stronger differences (up to 800 mL, and more than 240 mL for 9 patients). The second group, with similar effluent osmolarity and peritoneal equilibration test (PET) parameters than the first, has higher IPP and preponderance of men. The sex influence is so intense that men decreased average UF with 2.5 L with respect to 1.5 L, while women increased it. Conclusions: With 2.27% glucose, sex and IPP—modulated by obesity, polycystosis, hernias, and intraperitoneal volume—significantly affect UF in clinical settings and might be useful for its management.

Lack of Isoprene Overproduction during Peritoneal Dialysis

2002 ◽  
Vol 22 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Enrico Capodicasa ◽  
Gianfranco Trovarelli ◽  
Federica Brunori ◽  
Luigi Vecchi ◽  
Carmen Carobi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Repeated Measures ◽  
Normal Range ◽  
Fluid Exchange ◽  
Carcinogenic Agent ◽  
Dialysis Unit ◽  
Lipid Turnover ◽  
Before And After ◽  
Healthy Control ◽  
Isoprene Synthesis

Objective Isoprene is the constitutive unit of isoprenoid lipids and sterols. However, it is also a potential toxic and carcinogenic agent. Recent findings of a marked and prolonged isoprene overproduction induced by hemodialysis sessions raises the question of isoprene behavior in patients on peritoneal dialysis. Design A study with repeated measures per patient and healthy control. Setting Nephrology and Dialysis Unit and Perugia University Medical School. Patients Sixteen consecutive patients on regular continuous ambulatory peritoneal dialysis (CAPD) were evaluated. Endogenous isoprene was analyzed using gas chromatographic assay of breath isoprene, collected at set times before and after dialysis fluid exchange. Results No significant variations were found in breath isoprene concentrations in the different samples from each patient, and levels were almost stable within the normal range of healthy controls. Conclusion These results show that CAPD, unlike hemodialysis, has little or no effect on isoprene and isoprenoid-related lipid turnover. This lack of increased endogenous isoprene synthesis, in addition to being a distinctive metabolic feature of CAPD, could have important pathophysiological and clinical implications.

The Effect of Hemoglobin Concentration on Peritoneal Mass Transfer and Drain Volumes in Continuous Ambulatory Peritoneal Dialysis

1992 ◽  
Vol 12 (2) ◽  
pp. 230-233 ◽  
Author(s):  
Alastair J. Hutchison ◽  
Norma J. Ofsthun ◽  
Debbie Howarth ◽  
Ram Gokal
Keyword(s):  
Mass Transfer ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Hemoglobin Concentration ◽  
Hemoglobin Level ◽  
University Teaching ◽  
Renal Unit ◽  
Before And After ◽  
Group A ◽  
Group B

Objective To determine whether a correlation exists between hemoglobin levels and peritoneal mass transfer or drain volumes in continuous ambulatory peritoneal dialysis (CAPD) patients. Design Prospective study of two groups of CAPD patients, identified on the basis of their stable hemoglobin levels. Group A -hemoglobin less than 8.5 g/dL; Group B hemoglobin greater than 10.5 g/dL. Peritoneal mass transfer and drain volumes were measured for each patient, after which a subgroup of Group A was treated with rHuEPO (forming Group C) and measurements repeated once hemoglobin had risen by at least 2.0 g/dL. Setting Single renal unit of a university teaching hospital. Patients:Twenty-seven patients established on CAPD, selected according to their stable hemoglobin level. Group A -14 patients; Group B -13 patients; Group C (subgroup of A) -8 patients. Main outcome measures Difference between peritoneal mass transfer or drain volume in Group A versus Group B, and in Group C before and after rHuEPO therapy. Serum biochemical parameters in Group C before and after rHuEPO therapy. Results No statistically significant differences in any of the parameters measured were found between groups A and B, or before and after rHuEPO therapy in Group C. Conclusions Peritoneal transfer of small solutes and water is not influenced by hemoglobin level, and does not change following otherwise effective treatment with rHuEPO.

Adequacy of Dialysis in Automated Peritoneal Dialysis: A Clinical Experience

1997 ◽  
Vol 17 (5) ◽  
pp. 442-448 ◽  
Author(s):  
Ana Marla Fernández Rodriguez ◽  
Nicanor Vega Dlaz ◽  
Leocadia Palop Cubillo ◽  
Eduardo Baamonde Laborda ◽  
Adelaida Morales Umpierrez ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Automated Peritoneal Dialysis ◽  
Urea Clearance ◽  
Peritoneal Equilibration Test ◽  
Helpful Tool ◽  
Remarkable Improvement ◽  
Continuous Cycling ◽  
Before And After ◽  
Mean Time ◽  
Tidal Peritoneal Dialysis

Objectives To compare the peritoneal clearances of urea and creatinine in continuous ambulatory peritoneal dialysis (CAPD) with three types of automated peritoneal dialysis (APD): continuous cycling peritoneal dialysis (CCPD), 50% tidal peritoneal dialysis (TPD), and 25% TPD and to assess the usefulness of the peritoneal equilibration test (PET) in predicting peritoneal clearances in overnight APD. Patients Eleven uremic patients (mean age 44.5 ± 15.45 years with a mean time on dialysis of 42.63 ± 25.62 months) were included in the study. Measurements PET for urea and creatinine following Twardowski's method. Peritoneal clearances for urea and creatinine CAPD: samples of blood and dialysate within 24 hours. APD: blood mean levels of urea and creatinine before and after nighttime dialysis. Dialysate: urea and creatinine in nocturnal and daytime dialysate. Results Peritoneal clearance of creatinine was 38.14 ± 9.99 L/week/1.73 m2 in CAPD, 44.28 ± 12.4 L/week/1.73 m2 in CCPD, 50.07 ± 17.86 L/week/1.73 m2 in 50% TPD (p < 0.05) and 40.18 ± 6.65 L/week/1.73 m2 in 25% TPD. Peritoneal clearance of urea improved significantly in the three modalities of APD: 51.91 ± 12.58 L/week/1.73 m2 in CAPD; 66.7 ± 9.9 L/week/1. 73 m2 in CCPD (p < 0.05); 76.3 ± 14.5 L/week/1. 73 m2 in 50% TPD (p < 0.001) and 64.3 ± 11.4 L/week/1.73 m2 in 25% TPD (p < 0.05). The dialysatel plasma (DIP) ratio of creatinine at 30,60, 120,180, and 240 minutes showed significant correlation with nighttime APD clearance. Nevertheless, only the DIP ratio of urea at 30, 60, and 120 minutes correlated with overnight APD clearance. Conclusions A remarkable improvement was observed with APD regarding the clearance of urea mainly when 50% tidal peritoneal dialysis was used, whereas it was less noticeable in the clearance of creatinine. The PET is a helpful tool in predicting overnight peritoneal clearances of creatinine but it is less useful in predicting urea clearance.

Hematocrit Influence on Peritoneal Dialysis Effectiveness during Recombinant Human Erythropoietin Treatment in Patients with Chronic Renal Failure

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 550-552 ◽  
Author(s):  
Andrzej Ksiazek ◽  
Elzbieta Baranowska-Daca
Keyword(s):  
Peritoneal Dialysis ◽  
Recombinant Human Erythropoietin ◽  
Glucose Absorption ◽  
Mean Value ◽  
Protein Loss ◽  
Peritoneal Equilibration Test ◽  
Sodium Potassium ◽  
Human Erythropoietin ◽  
Before And After ◽  
Erythropoietin Treatment

Seven intermittent peritoneal dialysis (IPD) patients were investigated before and after correction of anemia with recombinant human erythropoietin (r-HuEPO). When hematocrit exceeded 300/0, the peritoneal equilibration test was performed at 1, 2, 4, 8 hours. Correction of anemia was associated with a mean value Increment In creatinine and phosphate clearance In 1 and 2-hour dwells. Differences In clearance of sodium, potassium, and urea In protein loss and glucose absorption before and after r-HuEPO therapy were not statistically significant. Increased creatinine and phosphate clearance during short dwells can be effected in IPD patients.

Peritoneal Dialysa Te Igg/C3 Levels Do Not Predict Susceptibility to Peritonitis

1996 ◽  
Vol 16 (2) ◽  
pp. 154-157 ◽  
Author(s):  
Nisar Anwar ◽  
Alastair J. Hutchison ◽  
John Manos ◽  
Linda Uttley ◽  
Paul Brenchley ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Comparative Study ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Outpatient Clinic ◽  
Serum Levels ◽  
University Teaching ◽  
Dialysis Unit ◽  
Baxter Healthcare ◽  
Prospective Longitudinal ◽  
Time Point

Objective To investigate the usefulness of dialysate IgG and C3 concentrations in predicting likelihood of developing peritonitis. Design Prospective, longitudinal, and comparative study. Setting Single university teaching hospital dialysis unit and outpatient clinic. Patients Thirty-four uremic patients were studied (20 males, 14 females: mean age 47.2, range 20 73 years). Monthly serum and overnight dialysate (eight to elevenhour dwell) samples were obtained for IgG and C3 estimations over the first six months of the study, and trimonthly samples were obtained thereafter. All patients performed exchanges using standard transfer sets (Baxter system II, Baxter Healthcare Ltd., Thetford, Norfolk, U.K.), used no hypertonic fluid (3.86%) for overnight exchanges, and were followed up for a minimum of 18 months. Outcome Measures Dialysate and serum levels of IgG and C3; peritonitis episodes. Results Forty-five episodes of peritonitis occurred in 24 patients during the study period. We examined opsonin levels in the group as a whole, and then in two subgroups of patients: those who remained peritonitis-free throughout the study, and those who did not. There were no significant differences between IgG and C3 levels in the two groups at any time point, and large interpatient and intrapatient variation in levels were seen. Conclusion Dialysate levels of IgG and C3 from the overnight dwell are not helpful in predicting the risk of developing continuous ambulatory peritoneal dialysis peritonitis in individual patients. No correlation was found between opsonin levels and onset of clinical peritonitis.

Comparison of Serum Calcium Fractions during Haemodialysis and Peritoneal Dialysis

1987 ◽  
Vol 24 (6) ◽  
pp. 585-590 ◽  
Author(s):  
P M Kelly ◽  
M R Bending ◽  
J L Barron
Keyword(s):  
Peritoneal Dialysis ◽  
Healthy Volunteers ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Serum Calcium ◽  
Reference Group ◽  
The Other ◽  
Total Calcium ◽  
Ionised Calcium ◽  
Before And After ◽  
Active Calcium

Total, ultrafiltrable and ionised calcium concentrations were determined in anaerobic serum from healthy volunteers, patients immediately before and after haemodialysis and patients on continuous ambulatory peritoneal dialysis (CAPD). Protein-bound, complexed and albumin-corrected total calcium concentrations were calculated from the results. During haemodialysis, complexed calcium did not change, whereas the other fractions increased. For patients on CAPD, the total, ionised and protein-bound calcium results were frequently lower than the reference group, whereas the ultrafiltrable and albumin-corrected total calcium results were within or higher than the reference group. Albumin-corrected total calcium for all subjects correlated better with ultrafiltrable calcium than with ionised calcium. It was concluded that low ionised calcium concentrations found in CAPD patients may be related to low albumin concentrations, and the concentration of physiologically active calcium may be normal in these patients.

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