Assisted Automated Peritoneal Dialysis (Aapd) for the Functionally Dependent and Elderly Patient

2005 ◽  
Vol 25 (3_suppl) ◽  
pp. 60-63 ◽  
Author(s):  
Johan V. Povlsen ◽  
Per Ivarsen
Keyword(s):  
Nursing Home ◽  
Peritoneal Dialysis ◽  
International Standards ◽  
University Hospital ◽  
Automated Peritoneal Dialysis ◽  
Technique Survival ◽  
Acute Peritonitis ◽  
Data Files ◽  
Stage Renal Disease ◽  
End Stage

♦ Objective To describe basic demographics and clinical outcomes among elderly end-stage renal disease (ESRD) patients physically dependent on a caregiver and maintained on an assisted automated peritoneal dialysis (AAPD) program. ♦ Design Retrospective single-center study based on patient records and data files. ♦ Setting University Hospital. ♦ Patients 64 physically dependent AAPD patients followed for 1.012 treatment months. Assistance and care was delivered by 52 briefly trained teams of visiting nurses or nursing home staff. ♦ Result Crude 1-year survival was 58% and 2-year survival was 48%. Crude 1- and 2-year survivals, excluding deaths within 90 days, were 66% and 54% respectively. We found no significant effect on survival by main causes of ESRD, gender, age, late referral, need for acute start, social isolation, physical dependency on help at inclusion, or residence in a nursing home. 10% of patient-days on AAPD were spent in hospital. 13 (20%) of the patients were converted permanently to hemodialysis due to PD technique failure. The incidence of peritonitis was 1 in every 25.3 treatment-months. ♦ Conclusions AAPD may be a feasible and safe option for renal replacement therapy for frail, elderly, and physically dependent patients with ESRD. Despite the special patient selection for this AAPD program, we achieved results of international standards for patient survival, PD technique survival, and incidence of acute peritonitis. These results do not justify withholding dialysis from this group of patients.

l-Carnitine status in end-stage renal disease patients on automated peritoneal dialysis

2014 ◽  
Vol 27 (6) ◽  
pp. 699-706 ◽  
Author(s):  
Lorenzo Di Liberato ◽  
Arduino Arduini ◽  
Claudia Rossi ◽  
Augusto Di Castelnuovo ◽  
Cosima Posari ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Automated Peritoneal Dialysis ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals PERITONEAL DIALYSIS TECHNIQUE SURVIVAL: A SINGLE-CENTER EXPERIENCE ANALYSIS OF THE PERITONEAL DIALYSIS TREATMENT IN A SINGLE CENTER

2017 ◽  
pp. 62-67
Author(s):  
O. Burdeyna ◽  
N. Stepanova ◽  
M. Kolesnyk
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiovascular Complications ◽  
Single Center ◽  
Dialysis Treatment ◽  
Technique Survival ◽  
Single Center Experience ◽  
Average Survival ◽  
Stage Renal Disease ◽  
End Stage

The aim of the study was to evaluate retrospectively the survival of the peritoneal dialysis (PD) technique survival and identify the factors that affect it. Patients and methods. A total of 38 patients with end-stage renal disease treated with PD from 2005 to May 2017 have been included in retrospective, study (average age 49.6 ± 5.6). Data were collected from medical records. Results. The average survival rate of the PD method in our center was 53.3 ± 7.4 months, and in patients with nondiabetic kidney disease it was significantly higher. During the follow-up only 11/38 (28.9 %) patients continue treatment of PD, 12/38 (31.6 %) were changed to HD, 4/38 (10.6 %) patients kidney transplantation was performed and 11/38 %) died. The main reason of the letal cases was cardiovascular complications (36.6 %). The patient mortality was significantly depended on the diuresis volume and the level of GFR at the time of PD initiation. Conclusions. PD technique survival in our center correlate with the results of the PD treatment patients worldwide.

scholarly journals Implementation of Urgent Start Peritoneal Dialysis Reduces Hemodialysis Catheter Use and Hospital Stay in Patients with Unplanned Dialysis Start

2019 ◽  
Vol 44 (6) ◽  
pp. 1383-1391 ◽  
Author(s):  
Ferruh Artunc ◽  
Sandra Rueb ◽  
Karolin Thiel ◽  
Christian Thiel ◽  
Katarzyna Linder ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Hospital Stay ◽  
Patient Flow ◽  
Venous Catheter ◽  
University Hospital ◽  
Hemodialysis Catheter ◽  
Catheter Implantation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Unplanned Dialysis

Background: Unplanned start of renal replacement therapy is common in patients with end-stage renal disease and often accomplished by hemodialysis (HD) using a central venous catheter (CVC). Urgent start using peritoneal dialysis (PD) could be an alternative for some of the patients; however, this requires a hospital-based PD center that offers a structured urgent start PD (usPD) program. Methods: In this prospective study, we describe the implementation of an usPD program at our university hospital by structuring the process from presentation to PD catheter implantation and start of PD within a few days. For clinical validation, we compared the patient flow before (2013–2015) and after (2016–2018) availability of usPD. Results: In the 3 years before the availability of usPD, 14% (n = 12) of incident PD patients (n = 87) presented in an unplanned situation and were initially treated with HD using a CVC. In the 3 years after implementation of the usPD program, 18% (n = 18) of all incident PD patients (n = 103) presented in an unplanned situation of whom n = 12 (12%) were treated with usPD and n = 6 (6%) with initial HD. usPD significantly reduced the use of HD by 57% (p = 0.0005). Hospital stay was similar in patients treated with usPD (median 9 days) compared to those with elective PD (8 days), and significantly lower than in patients with initial HD (26 days, p = 0.0056). Conclusions: Implementation of an usPD program reduces HD catheter use and hospital stay in the unplanned situation.

Rapid Decline of Residual Renal Function in Patients on Automated Peritoneal Dialysis

1996 ◽  
Vol 16 (3) ◽  
pp. 307-315 ◽  
Author(s):  
Kinya Hiroshige ◽  
Kougi Yuu ◽  
Masasuke Soejima ◽  
Masayuki Takasugi ◽  
Akio Kuroiwa
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Creatinine Clearance ◽  
Experimental Period ◽  
Residual Renal Function ◽  
University Hospital ◽  
Rapid Decline ◽  
Automated Peritoneal Dialysis ◽  
Stage Renal Disease

Objective To determine the effect of peritoneal dialysis modalities such as nightly intermittent peritoneal dialysis (NIPD), continuous cyclic peritoneal dialysis (CCPD), and continuous ambulatory peritoneal dialysis (CAPD) on residual renal function. Design A six-month prospective, nonrandomized comparison study. Setting Outpatient CAPD unit of a university hospital. Participants Eighteen end-stage renal disease patients treated by peritoneal dialysis (8 by NIPD, 5 by CCPD, and 5 by CAPD). Interventions Samples from the total dialysate, blood, and 24hour urine collection were obtained monthly. Measurements Urea, creatinine, and beta2-microglobulin concentrations were measured. Renal and peritoneal clearances of each substance and KT/V urea were calculated. Residual renal function (RRF) was estimated by renal creatinine clearance (RCcr). Results No significant differences in age, sex, and primary renal disease among the three groups were noted. In all groups, anemic and hypertensive states were controlled identically, and mean weekly total (renal + peritoneal) KT/V urea (over 2.1/wk) and total creatinine clearance (over 60 L/wk/1.73 m2) were maintained during the whole experimental period. Starting mean RCcr was near 4.0 mL/min/1.73 m2 in all groups. Thereafter, a rapid and significant decline in RRF was demonstrated on NIPD and CCPD. The declining rates of RCcr values at 6 months after starting NIPD and CCPD were -0.29 and -0.34 mL/min/month, respectively, which were much greater than those of CAPD (+0.01 mL/min/month). Conclusion Because of a possibly characteristic progressive loss of RRF in automated peritoneal dialysis (APD), strict regular assessment of RRF should be performed from the start of APD.

Status of Renal Replacement Therapy and Peritoneal Dialysis in Mexico

2007 ◽  
Vol 27 (2) ◽  
pp. 142-148 ◽  
Author(s):  
Alfonso M. Cueto-Manzano ◽  
Enrique Rojas-Campos
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Developed Countries ◽  
Technique Survival ◽  
Treatment Providers ◽  
The World ◽  
Stage Renal Disease ◽  
End Stage ◽  
Mexican Patients

Mexico is struggling to gain a place among developed countries; however, there are many socioeconomic and health problems still waiting for resolution. While Mexico has the twelfth largest economy in the world, a large portion of its population is impoverished. Treatment for end-stage renal disease (377 patients per million population) is determined by the individual's access to resources such as private medical care (approximately 3%) and public sources (Social Security System: approximately 40%; Health Secretariat: approximately 57%). With only 6% of the gross national product spent on healthcare and most treatment providers being public health institutions that are often under economic restrictions, it is not surprising that many Mexican patients do not receive renal replacement therapy. Mexico is still the country with the largest utilization of peritoneal dialysis (PD) in the world, with 18% on automated PD, 56% on continuous ambulatory PD (CAPD), and 26% on hemodialysis. Results of PD (patient morbi-mortality, peritonitis rate, and technique survival) in Mexico are comparable to other countries. However, malnutrition and diabetes mellitus are highly prevalent in Mexican patients on CAPD programs, and these conditions are among the most important risk factors for a poor outcome in our setting.

scholarly journals The Role of an Integrated Care Model for Kidney Disease in the Development of Peritoneal Dialysis: A Single-Center Experience in China

2014 ◽  
Vol 34 (2_suppl) ◽  
pp. 55-58 ◽  
Author(s):  
Xiaohui Zhang ◽  
Zhangfei Shou ◽  
Zhimin Chen ◽  
Ying Xu ◽  
Fei Han ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Integrated Care ◽  
Care Program ◽  
Integrated Treatment ◽  
Technique Survival ◽  
Single Center Experience ◽  
Stage Renal Disease ◽  
End Stage

Peritoneal dialysis plays a crucial role in the integrated care of patients with end-stage renal disease (ESRD). In this paper, we retrospectively analyzed the quality indicators of peritoneal dialysis (PD) in 712 patients from our center who underwent PD between 2004 and 2011. In 43% of patients, follow-up was undertaken every 3 months at our outpatient department, and 54% patients were followed up by both our hospital and other local hospitals. The patient survival rate at 1, 3 and 5 years was 96.3%, 85.4% and 76.2%, respectively. The technique survival (excludes death/transplantation) at 1, 3 and 5 years was 95.1%, 87.7% and 79.6%, respectively. Fluid overload occurred in 29.2% of patients and was one of the major reasons for discontinuing PD. The peritonitis rate in our center decreased to 0.16 episodes/year in 2011. In addition, since our center is one of the largest integrated-treatment centers for ESRD in China, we have developed a multilevel care program in Zhejiang Province, which resulted in rapid growth of PD in our province in recent years.

scholarly journals A Brazilian Experience in Assisted Automated Peritoneal Dialysis: A Reliable and Effective Home Care Approach

2013 ◽  
Vol 33 (3) ◽  
pp. 252-258 ◽  
Author(s):  
Marcia Regina Gianotti Franco ◽  
Natália Fernandes ◽  
Claúdia Azevedo Ribeiro ◽  
Abdul Rashid Qureshi ◽  
Jose Carolino Divino–Filho ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Total Duration ◽  
Hemodynamic Instability ◽  
Technique Survival ◽  
Care Approach ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

IntroductionAutomated assisted peritoneal dialysis (AAPD) has been shown to be successful as renal replacement therapy for elderly and physically incapable end-stage renal disease (ESRD) patients. In early 2003, a pioneer AAPD program was initiated at GAMEN Renal Clinic in Rio de Janeiro, Brazil.ObjectiveWe evaluated the results of an AAPD program offered as an option to elderly ESRD patients with physical or cognitive debilities or as last resort to patients with vascular access failure or hemodynamic instability during hemodialysis.MethodsA cohort of 30 consecutive patients started AAPD from January 2003 to March 2008 and was followed to July 2009. Demographics, clinical and laboratory parameters, causes of death, and patient and technique survival were analyzed.ResultsMedian age of the patients was 72 years (range: 47 – 93 years), with 60% being older than 65. The Davies score was greater than 2 in 73% of patients, and the Karnofsky index was less than 70 in 40%. The overall peritonitis rate was 1 episode in 37 patient–months. The total duration of AAPD ranged from 3 to 72 months. Patient survival was 80% at 12 months, 60% at 24 months, and 23.3% at 48 months. The most common cause of death was cardiovascular problems (70%).ConclusionsIn this clinical observational study, AAPD fulfilled its expected role, offering an opportune, reliable, and effective homecare alternative for ESRD patients with no other renal replacement therapy options.

scholarly journals Urgent-Start Peritoneal Dialysis: The First Year of Brazilian Experience

2017 ◽  
Vol 44 (4) ◽  
pp. 283-287 ◽  
Author(s):  
Dayana Bitencourt Dias ◽  
Marcela Lara Mendes ◽  
Vanessa Burgugi Banin ◽  
Pasqual Barretti ◽  
Daniela Ponce
Keyword(s):  
Peritoneal Dialysis ◽  
Survival Rates ◽  
High Volume ◽  
Infectious Complications ◽  
Chronic Patients ◽  
Safe Alternative ◽  
Dialysis Unit ◽  
Technique Survival ◽  
Stage Renal Disease ◽  
End Stage

Background: This study aimed to evaluate mechanical and infectious complications associated with urgent-start peritoneal dialysis (PD) and patients and technique survival in the first 180 days. Methods: It was a prospective study that evaluated chronic patients who started unplanned PD using high-volume PD (HVPD) right after (<72 h) PD catheter placement. After hospital discharge, patients were treated with intermittent PD on alternate days in a dialysis unit until family training was provided. Results: Fifty-one patients fulfilling the following criteria were included: age was 62.1 ± 15 years, with diabetes as the main etiology of end-stage renal disease (39%), and uremia as the main dialysis indication (76%). Metabolic and fluid controls were achieved after 3 sessions of HVPD, and patients remained in intermittent PD for 23.2 ± 7.2 days. Mechanical complications occurred in 25.7% and peritonitis rate was 0.5 episode/patient-year. In the first 6 months, technique and patients survival rates were 86 and 82.4% respectively. Conclusion: The PD modality was a feasible and safe alternative to hemodialysis in the urgent-start dialysis.

Inflammatory Demyelinating Neuropathy in Patients with End-Stage Renal Disease Receiving Continuous Ambulatory Peritoneal Dialysis (Capd)

1998 ◽  
Vol 18 (2) ◽  
pp. 172-176 ◽  
Author(s):  
Marcell Toepfer ◽  
Helmut Schiffl ◽  
Harald Fricke ◽  
Hans Lochmüller ◽  
Eckhard Held ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Peripheral Neuropathy ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Spinal Fluid ◽  
University Hospital ◽  
Demyelinating Neuropathy ◽  
Protein Levels ◽  
Demyelinating Peripheral Neuropathy ◽  
Stage Renal Disease ◽  
End Stage

Objective To report on 3 patients with inflammatory demyelinating peripheral neuropathy in strong temporal coincidence with the initiation of peritoneal dialysis (PD) therapy. Setting Nephrology and Neurology Department of the University Hospital, Munich, Germany. Patients Three patients with end-stage renal failure presented with the clinical picture of inflammatory demyelinating peripheral neuropathy within 4 to 10 weeks after start of continuous ambulatory peritoneal dialysis (CAPD). They had acute or subacute onset of lower extremity or generalized weakness, diminished reflexes, elevated spinal fluid protein levels, and signs of demyelinating neuropathy on electrophysiological testing. Measures Clinical follow-up, nerve conduction studies, cerebral spinal fluid (CSF). Results All patients did not improve under intensified PD therapy but took profit from immunomodulatory therapy. One bed-bound patient improved after change to hemodialysis and showed complete remission after renal transplantation. Conclusion Because of strong temporal coincidence, a causal relationship between CAPD and inflammatory demyelinating peripheral neuropathies can be suspected in these 3 patients.

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