Peritoneal Dialysis Prescription for Diabetic Patients

2005 ◽  
Vol 25 (3_suppl) ◽  
pp. 76-78 ◽  
Author(s):  
Qiang Yao ◽  
Bengt Lindholm ◽  
Olof Heimbürger
Keyword(s):  
Peritoneal Dialysis ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Advantages And Disadvantages ◽  
Patients With Diabetes ◽  
Severe Comorbidity ◽  
Systemic Problems ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

The number of end-stage renal disease (ESRD) patients with diabetes mellitus has increased dramatically during the past few years and, in many countries, diabetes has become the most important cause of ESRD in patients admitted to dialysis. Furthermore, compared to nondiabetic patients, diabetic patients continue to suffer from more frequent and severe comorbidity and complications, including cardiovascular disease, poor fluid balance, worse quality of life, as well as high morbidity and mortality after initiation of dialysis. These systemic problems in diabetic patients should influence the dialysis prescription. In addition, the structure and transport properties of the peritoneal membrane may deteriorate as a consequence of diabetes. Thus, both the systemic and the peritoneal consequences of diabetes influence the dialysis prescription in diabetic patients. In this brief review, we discuss the care of diabetic ESRD patients on peritoneal dialysis — which, compared with hemodialysis, has both advantages and disadvantages in this group of patients — focusing on the special needs for intense and integrated care involving individualized dialysis prescription as well as care of diabetic complications and comorbidity in this diseased patient group.

scholarly journals Worldwide epidemiology of diabetes-related end-stage renal disease, 2000–2015

2020 ◽  
Author(s):  
Hui-Teng Cheng ◽  
Xiaoqi Xu ◽  
Paik Seong Lim ◽  
Kuan-Yu Hung
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Annual Incidence ◽  
Western Pacific ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
The Western Pacific

Objective <p>The annual risk among diabetic patients to reach end-stage renal disease (ESRD) is largely unknown worldwide. This study aimed to compare the incidence of diabetes-related ESRD by creating a global atlas during 2000–2015.</p> <p>Research Design and Methods</p> <p>The annual incidence of ESRD among diabetic patients was calculated as the quotient of the number of incident ESRD patients with diabetes divided by the total number of patients with diabetes after subtracting the number with existing ESRD. The estimated ESRD prevalence and annual incidence were validated using the data provided by Fresenius Medical Care, Germany, and previously reported data, respectively.</p> <p>Results</p> <p>Data were obtained from 142 countries, covering 97·3% of the world population. The global percentage of the prevalent ESRD patients with DM increased from 19·0% in 2000 to 29·7% in 2015 worldwide, while the percentage of incident ESRD patients due to DM increased from 22·1% to 31·3%. The global annual incidence of ESRD among DM patients increased from 375·8 to 1016·0/million with DM during 2000–2015. The highest average rates were observed in the Western Pacific Region. Comparatively, the rates of incident ESRD among European DM patients ranged from half (309·2 vs 544·6) to a third (419·4 vs 1245·2) of the rates of the Western Pacific population during 2000–2015.</p> <p>Conclusions </p> <p>Great and nonrandom geographic variation in the annual rates among diabetic patients to reach ESRD suggests that distinct healthcare, environmental, and/or genetic factors contribute to the progression of diabetic kidney disease. Measures to prevent and treat DM-related ESRD require better patient susceptibility stratification.</p>

scholarly journals Worldwide epidemiology of diabetes-related end-stage renal disease, 2000–2015

2020 ◽  
Author(s):  
Hui-Teng Cheng ◽  
Xiaoqi Xu ◽  
Paik Seong Lim ◽  
Kuan-Yu Hung
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Annual Incidence ◽  
Western Pacific ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
The Western Pacific

Objective <p>The annual risk among diabetic patients to reach end-stage renal disease (ESRD) is largely unknown worldwide. This study aimed to compare the incidence of diabetes-related ESRD by creating a global atlas during 2000–2015.</p> <p>Research Design and Methods</p> <p>The annual incidence of ESRD among diabetic patients was calculated as the quotient of the number of incident ESRD patients with diabetes divided by the total number of patients with diabetes after subtracting the number with existing ESRD. The estimated ESRD prevalence and annual incidence were validated using the data provided by Fresenius Medical Care, Germany, and previously reported data, respectively.</p> <p>Results</p> <p>Data were obtained from 142 countries, covering 97·3% of the world population. The global percentage of the prevalent ESRD patients with DM increased from 19·0% in 2000 to 29·7% in 2015 worldwide, while the percentage of incident ESRD patients due to DM increased from 22·1% to 31·3%. The global annual incidence of ESRD among DM patients increased from 375·8 to 1016·0/million with DM during 2000–2015. The highest average rates were observed in the Western Pacific Region. Comparatively, the rates of incident ESRD among European DM patients ranged from half (309·2 vs 544·6) to a third (419·4 vs 1245·2) of the rates of the Western Pacific population during 2000–2015.</p> <p>Conclusions </p> <p>Great and nonrandom geographic variation in the annual rates among diabetic patients to reach ESRD suggests that distinct healthcare, environmental, and/or genetic factors contribute to the progression of diabetic kidney disease. Measures to prevent and treat DM-related ESRD require better patient susceptibility stratification.</p>

scholarly journals Leptin/Adiponectin Ratio is an Independent Predictor of Mortality in Nondiabetic Peritoneal Dialysis Patients

2013 ◽  
Vol 33 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Jung Tak Park ◽  
Tae-Hyun Yoo ◽  
Jwa-Kyung Kim ◽  
Hyung Jung Oh ◽  
Seung Jun Kim ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Body Mass ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Diabetic Patients ◽  
Reactive Protein ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

♦BackgroundThe leptin/adiponectin (L/A) ratio has been suggested to be an atherosclerotic index for diabetic patients and a useful marker of insulin resistance in patients with and without diabetes. Even though end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) are well characterized by abnormal adipocytokine metabolism, the significance of alterations in the L/A ratio is largely unexplored in these patients. In this prospective study, we investigated the associations of leptin, adiponectin, and the L/A ratio with clinical outcomes in nondiabetic PD patients.♦MethodsThe study included 131 stable nondiabetic ESRD patients who had been on PD for more than 3 months. Serum leptin and adiponectin levels were determined at baseline. Mortality was evaluated over a 5-year follow-up period.♦ResultsDuring the follow-up period, 22 patients died (16.8%), including 10 (45.5%) as a result of cardiovascular disease. The L/A ratio showed a significant positive correlation with body mass index [BMI ( r = 0.47, p < 0.001)], high-sensitivity C-reactive protein ( r = 0.32, p < 0.001), and triglycerides ( r = 0.43, p < 0.001). In addition, we observed significant inverse correlations between the L/A ratio and percentage lean body mass ( r = –0.30, p = 0.001) and high-density lipoprotein cholesterol ( r = –0.31, p = 0.001). In contrast to individual leptin and adiponectin levels, the L/A ratio was found to be independently associated with an increased mortality risk (relative risk: 1.15; 95% confidence interval: 1.05 to 1.27; p = 0.003) even after adjustments for age and BMI.♦ConclusionsThe L/A ratio might be better related to patient outcomes than adipocytokines are individually in nondiabetic patients undergoing PD.

Peritoneal Dialysis in Patients with Diabetes: Are the Benefits Greater than the Disadvantages?

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 190-195 ◽  
Author(s):  
Satoru Kuriyama
Keyword(s):  
Diabetic Nephropathy ◽  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Diabetic Patients ◽  
Dialysis Modality ◽  
Patients With Diabetes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Selection Of

Diabetic nephropathy has been increasing in prevalence in recent years, and it is now the dominant cause of end-stage renal disease (ESRD) worldwide. Because diabetes is frequently associated with multiple complications, nephrologists must be alert to the selection of dialysis modality so as to reduce the accompanying risks. The present review addresses whether the benefits of peritoneal dialysis are greater than its disadvantages in diabetic patients. The answer is quite positive: for most diabetic patients, peritoneal dialysis offers multiple benefits.

Peritoneal Dialysis as an Option for Unplanned Dialysis Initiation in Patients with End-Stage Renal Disease and Diabetes Mellitus

2018 ◽  
Vol 47 (1-3) ◽  
pp. 52-57 ◽  
Author(s):  
Haijiao Jin ◽  
Zhaohui Ni ◽  
Xiajing Che ◽  
Leyi Gu ◽  
Mingli Zhu ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Patient Survival ◽  
Short Term ◽  
Patients With Diabetes ◽  
Long Term Prognosis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Aims: This study aimed to compare the short-term complications and long-term prognosis between urgent-start peritoneal dialysis (PD) and hemodialysis (HD), and explore the safety and feasibility of PD in end-stage renal disease (ESRD) patients with diabetes. Methods: This retrospective study enrolled ESRD patients with diabetes who required urgent-start dialysis at a single center from January 2011 to December 2014. Short-term (30-day) dialysis-related complications and patient survival trends were compared between patients receiving PD and HD. Results: Eighty patients were included in the study, including 50 (62.5%) who underwent PD. The incidence of dialysis-related complications and complications requiring reinsertion during the first 30 days was significantly lower in PD patients. Logistic regression identified urgent-start HD as an independent risk factor for dialysis-related complications compared with urgent-start PD. The patient survival rate was higher in the PD compared to that in the HD group. Conclusions: PD may be acceptable, safe, and feasible for urgent-start dialysis in ESRD patients with diabetes.

Iron Chelation Therapy in CAPD: A New and Effective Treatment of Iron Overload Disease in Esrd Patients

1983 ◽  
Vol 3 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Glen H Stanbaugh ◽  
A. W, Holmes Diane Gillit ◽  
George W. Reichel ◽  
Mark Stranz
Keyword(s):  
Peritoneal Dialysis ◽  
Iron Overload ◽  
End Stage Renal Disease ◽  
Chelation Therapy ◽  
Iron Chelation ◽  
Iron Chelation Therapy ◽  
Peritoneal Dialysate ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

A patient with end-stage renal disease on CAPD, and with massive iron overload is reported. This patient had evidence of myocardial and hepatic damage probably as a result of iron overload. Treatment with desferoxamine resulted in removal of iron in the peritoneal dialysate. On the basis of preliminary studies in this patient it would appear that removal of iron by peritoneal dialysis in conjunction with chelation therapy is safe and effective. This finding should have wide-ranging signficance for patients with ESRD.

scholarly journals Identification of Novel Biomarker for Early Detection of Diabetic Nephropathy

Biomedicines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 457
Author(s):  
Kyeong-Seok Kim ◽  
Jin-Sol Lee ◽  
Jae-Hyeon Park ◽  
Eun-Young Lee ◽  
Jong-Seok Moon ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Early Stage ◽  
Kidney Injury ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Zucker Diabetic Fatty Rats ◽  
Kidney Injury Molecule 1 ◽  
Stage Renal Disease ◽  
End Stage

Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus. After development of DN, patients will progress to end-stage renal disease, which is associated with high morbidity and mortality. Here, we developed early-stage diagnostic biomarkers to detect DN as a strategy for DN intervention. For the DN model, Zucker diabetic fatty rats were used for DN phenotyping. The results revealed that DN rats showed significantly increased blood glucose, blood urea nitrogen (BUN), and serum creatinine levels, accompanied by severe kidney injury, fibrosis and microstructural changes. In addition, DN rats showed significantly increased urinary excretion of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL). Transcriptome analysis revealed that new DN biomarkers, such as complementary component 4b (C4b), complementary factor D (CFD), C-X-C motif chemokine receptor 6 (CXCR6), and leukemia inhibitory factor (LIF) were identified. Furthermore, they were found in the urine of patients with DN. Since these biomarkers were detected in the urine and kidney of DN rats and urine of diabetic patients, the selected markers could be used as early diagnosis biomarkers for chronic diabetic nephropathy.

scholarly journals Successful multiple-exchange peritoneal dialysis in a patient with severe hematological toxicity by methotrexate: case report and literature review

2019 ◽  
Vol 41 (3) ◽  
pp. 427-432 ◽  
Author(s):  
Arbey Aristizabal-Alzate ◽  
John Fredy Nieto-Rios ◽  
Catalina Ocampo-Kohn ◽  
Lina Maria Serna-Higuita ◽  
Diana Carolina Bello-Marquez ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Therapeutic Option ◽  
Supportive Therapy ◽  
Hematological Toxicity ◽  
High Morbidity ◽  
Multiple Exchange ◽  
Severe Pancytopenia ◽  
Stage Renal Disease ◽  
End Stage

Abstract Methotrexate is an effective medication to control several diseases; however, it can be very toxic, being myelosuppression one of its main adverse effects, which increases in severity and frequency in patients with renal failure. We present the case of a 68-year-old man with chronic, end-stage renal disease associated with ANCA vasculitis, under treatment with peritoneal dialysis, who received the medication at a low dose, indicated by disease activity, which presented as a complication with severe pancytopenia with mucositis that improved with support measures and multiple-exchange peritoneal dialysis. We reviewed 20 cases published to date of pancytopenia associated with methotrexate in patients on dialysis and found high morbidity and mortality, which is why its use in this type of patient is not recommended. However, when this complication occurs, a therapeutic option could be the use of multiple-exchange peritoneal dialysis in addition to supportive therapy for drug-related toxicity, although it is recognized that studies are required to show the role of multiple-exchange peritoneal dialysis in the removal of this medication.

Acid–Base Disturbances

2014 ◽  
pp. 594-602
Author(s):  
Julian L. Seifter
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
End Stage Renal Disease ◽  
The United States ◽  
Cardiovascular Complications ◽  
Diabetic Patients ◽  
Stage Renal Disease ◽  
End Stage

According to projections from the United States Renal Data Service (USRDS), 〉600,000 individuals in the United States will have end-stage renal disease (ESRD) by 2010. The leading cause of ESRD in the United State is diabetes, followed by hypertension. As the care of diabetic patients has improved, particularly in the area of cardiovascular disease, they are living through their cardiovascular complications long enough to develop ESRD. As a consequence, since the inception of the Medicare ESRD program. the dialysis population has gradually become older with increasing numbers of comorbid conditions. Renal replacement therapy in the form of hemodialysis or peritoneal dialysis may serve as a bridge to the best form of renal replacement, renal transplantation. The demand for suitable kidneys for transplantation far exceeds the supply, leaving many patients on dialysis for extended periods of time.

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