Peritoneal Dialysis in Iran and the Middle East

2009 ◽  
Vol 29 (2_suppl) ◽  
pp. 217-221 ◽  
Author(s):  
Iraj Najafi
Keyword(s):  
Saudi Arabia ◽  
Peritoneal Dialysis ◽  
Middle East ◽  
End Stage Renal Disease ◽  
National Income ◽  
Number Of Patients ◽  
The Mean ◽  
Per Capita ◽  
Stage Renal Disease ◽  
End Stage

The countries of the Middle East have a cumulative population of 261.1 million and a mean gross national income per capita of US$9500. The total number of patients with end-stage renal disease (ESRD) in the Middle East is almost 100000, the mean prevalence being 430 per million population (pmp). The first implementation of intermittent peritoneal dialysis (PD) in the Middle East occurred in Turkey in 1968; continuous ambulatory PD started in Saudi Arabia, Turkey, and Kuwait in the 1980s; and automated PD, in Turkey in 1998. The total active PD patients in the region number approximately 8170. With 5750 patients, Turkey ranks first, followed by Iran and Saudi Arabia with 1150 and 771 patients respectively. Penetration of PD with respect to the ESRD population is 7.5%, and with respect to dialysis overall is 10.2%. The dialysis rate in the region, 312 pmp, is almost half the European number of 581 pmp, with a PD prevalence of 32 pmp (range: 0 – 81 pmp). The number of active PD patients has risen dramatically in the main countries since the end of the 1990s: Turkey, to 5750 from 1030; Saudi Arabia, to 771 from 132; and Iran to 1150 from 0.

Characteristics and Clinical Outcomes of End-Stage Renal Disease Patients on Peritoneal Dialysis for over 15 Years: A Single-Center Experience

2017 ◽  
Vol 37 (5) ◽  
pp. 535-541 ◽  
Author(s):  
Youn Kyung Kee ◽  
Jung Tak Park ◽  
Chang-Yun Yoon ◽  
Hyoungnae Kim ◽  
Seohyun Park ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Outcomes ◽  
End Stage Renal Disease ◽  
Short Term ◽  
Factors Associated ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background Maintaining peritoneal dialysis (PD) for a long time is problematic owing to a number of factors. This study aimed to clarify the characteristics and examine the clinical outcomes of patients who received PD as a long-term dialysis modality. Methods All end-stage renal disease (ESRD) patients who initiated PD at Yonsei University Health System between 1987 and 2000 were screened. Patients who maintained PD for over 15 years were classified as the long-term PD group and those who were treated with PD for less than 5 years were included in the short-term PD group. Demographic and biochemical data and clinical outcomes were compared between the groups. Independent factors associated with long-term PD maintenance were ascertained using multivariate logistic regression analysis. Results Among 1,116 study patients, 87 (7.8%) were included in the long-term group and 293 (26.3%) were included in the short-term group. In the long-term group, the mean patient age at PD initiation was 39.6 ± 11.5 years, 35 patients (40.2%) were male, and the mean PD duration was 205.3 ± 32.7 months. Patients were younger, body weight was lower, the proportion of patients with diabetes or cardiovascular diseases was lower, and the proportion of low to low-average transporters was higher in the long-term group than in the short-term group ( p < 0.001). Multiple logistic regression analysis revealed that age, body mass index (BMI), serum creatinine, type of PD solution, and diabetes were significant independent factors associated with long-term PD maintenance. Conclusion Peritoneal dialysis can be considered as a long-term renal replacement therapy option, especially in non-diabetic, not overweight, and young ESRD patients.

scholarly journals P1159MILD BLOOD PRESSURE VARIABILITY IS ASSOCIATED WITH BETTER SURVIVAL IN PATIENTS WITH END STAGE RENAL DISEASE AND PERITONEAL DIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Hanri Afghahi ◽  
Salmir Nasic ◽  
Khaled Alhomsi ◽  
Henrik Hadimeri ◽  
Helena Rydell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Mortality Risk ◽  
End Stage Renal Disease ◽  
Laboratory Findings ◽  
Risk Of Mortality ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Recently, variability in blood pressure (BP) has been recognized as a risk factor for mortality and cardiovascular events in the general population. However, most studies included patients with normal or near normal kidney function. Aim To study the association between BP variability and the risk of all-cause mortality in patients with end stage renal disease (ESRD) and peritoneal dialysis (PD) treatment. Method From 2008 until the end of 2017, 2329 patients with ESRD and at least three months of PD (mean age: 63.8 years, men: 67.5%) were followed for 16 months in median (interquartile range: 11-28 months). Data were extracted from the Swedish Renal Register (SNR). The coefficient variation (CV = the ratio of the standard deviation (SD) to the mean value) was defined as BP variability in terms of systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) [SBP(SD)/SBP(mean), DBP(SD)/ DBP(mean), and MAP(SD)/MAP(mean), respectively]. The relationships between BP variability and mortality were examined by time-dependent Cox models to estimate hazard ratios (HR) and 95% confidence intervals (CI) in univariate and multivariate analyses, with adjustment for demographics, laboratory findings and comorbidity. Results During the follow-up period, 1054 (45%) deaths occurred. The mean level of BP variability was CV=0.10± 0.1. The highest rate of mortality was observed in the patients with the highest variability in SBP (CV&gt;0.25; 64% of those patients died). In the multivariate model, for each of the BP variables, we compared the risk of mortality in the lowest variability group (CV≤ 0.05) with that in the CV=0.10-0.15 group (reference): SBP: (HR 1.74, 95% CI 1.44- 2.09; p&lt;0.001); DBP: (HR 1.91, 95% CI 1.59- 2.23; p&lt;0.001); and MAP: (HR 1.73, 95% CI 1.44- 2.06; p&lt;0.001). Thus, for all BP variables, the lowest variability was associated with increased mortality risk. We then compared the highest variability group (CV&gt;0.25) with the CV=0.10-0.15 group (reference): SBP: (HR 1.60, 95% CI 1.14- 2.25; p&lt;0.001); DPB: (HR 1.74, 95% CI 1.44- 2.09; p&lt;0.001); and MAP: (HR 1.98, 95% CI 1.21- 3.27; p&lt;0.001). Thus, for all BP variables, the highest variability was related to increased mortality risk. Conclusion In this study, the association between BP variability and the risk of mortality was U-shaped in patients with ESRD and PD. Thus, both very low and high levels of BP variability were related to higher risk of mortality. Mild BP variability was associated with the lowest risk of mortality, which could suggest that, non-intensive and long duration of ultrafiltration (UF) with PD was probably beneficial in terms of survival

Outcomes of Simultaneous Peritoneal Dialysis and Arteriovenous Fistula Placement in End-Stage Renal Disease Patients

2017 ◽  
Vol 37 (6) ◽  
pp. 658-661 ◽  
Author(s):  
Nosratollah Nezakatgoo ◽  
Albert Ndzengue ◽  
Manhunath Ramaiah ◽  
Elvira O. Gosmanova
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Arteriovenous Fistula ◽  
End Stage Renal Disease ◽  
Catheter Insertion ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Peritoneal dialysis (PD) interruption requiring hemodialysis (HD) is not uncommon and its frequently abrupt nature prevents timely creation of permanent HD access and avoidance of central venous catheters (CVC). We retrospectively studied a cohort of 24 end-stage renal disease (ESRD) patients (mean age 50.7 years, 83.3% African-Americans, 58.3% females, time on dialysis interquartile range [IQR] 0 - 65 days) who had simultaneous PD catheter insertion and backup arteriovenous fistula (AVF) creation between January 1, 2012, and December 31, 2013. The primary outcome of interest was the percent of patients receiving HD through the backup AVF at the time of PD interruption. A median (IQR) for PD catheter use after its insertion was 10.5 (2 - 20) days. After the mean follow-up of 19.6 months, 12 patients remained on PD, 2 patients received a kidney transplant, and 1 patient died. The overall AVF patency was 66.7%. A total of 9 (37.5%) patients had PD interruption requiring permanent (8 patients) or temporary (1 patient) HD after the mean (standard deviation [SD]) follow-up of 12.3 (8.2) months. Arteriovenous fistula was used as the initial access in 4 patients, and in 3 patients the original AVF was used after additional surgical revision. Forty-four percent of patients with a backup AVF fistula avoided CVC at the time of PD interruption requiring HD. The simultaneous AVF creation at the time of PD catheter insertion reduced but did not fully eliminate CVC at the time of PD interruption. Larger studies are needed to evaluate the utility of a backup AVF in PD patients.

scholarly journals Frequency of anemia in patients with increased level of parathyroid hormone among patients on maintenance hemodialysis.

2020 ◽  
Vol 27 (06) ◽  
pp. 1255-1258
Author(s):  
Saad Muzaffar Azeem ◽  
Anita Haroon ◽  
Ishtiaque Alam ◽  
Sadia Azeem ◽  
Mahrukh Sultana ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Study Results ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Objectives: One of the most frequently occurring complication of end stage renal disease is anemia. It can be defined as decrease in red blood cells with hemoglobin concentration less than 12 g/dl in women and less than 13 g/dl in men. Parathyroid hormone levels are also raised among patients with end stage renal disease to maintain serum calcium levels. The objective of this study is to evaluate the degree of anemia in patients with end stage renal disease currently on maintenance hemodialysis and have raised PTH levels. Study Design: Cross-sectional study. Setting: Kidney Center, Karachi. Period: November 2015 to July 2016. Material & Method: Patients undergoing maintenance hemodialysis during the study duration with PTH levels greater than 300 ng/L were included in the study. Patients with other co-morbid conditions like chronic liver disease and hypersplenism were excluded from the study. Results: The total number of patients on maintenance hemodialysis in the kidney center that matched our inclusion criteria was 110. Amongst them there were 47.3% (n=52) males and 52.7% (n=58) females. The mean age of patients in our study is 50.15 ± 12.92 years. The mean PTH level of patients was found to be 642 ± 405.9U. Since all the participants of the study are on maintenance dialysis, the mean duration of hemodialysis was found to be 4.2 ± 3.19 months. The mean hemoglobin level of patients was found to be 9.75 ± 1.47 g/dl. Conclusion: Patients with hyperparathyroidism and undergoing maintenance hemodialysis frequently develops anemia. Many factors account for this including raised PTH levels causing bone marrow fibrosis, decreased production of erythropoietin and resistance of produced erythropoietin are some factors responsible for the anemia.

Various Obstacles to Peritoneal Dialysis Development in Japan: Too Much Money? Too Much Fear?

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 56-58
Author(s):  
Yoshindo Kawaguchi
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Penetration Rate ◽  
Dialysis Patients ◽  
Number Of Patients ◽  
Stage Renal Disease ◽  
Almost All ◽  
End Stage

At 31 December 2005, the number of patients on maintenance dialysis in Japan was 257,765, with 9599 patients having started dialysis that year. Kidney transplant cases in Japan number about 1000 annually. Thus, almost all end-stage renal disease patients in Japan are likely to live on dialysis for the remainder of their lives. For various reasons, peritoneal dialysis has a lower penetration rate among Japanese dialysis patients, and work to educate patients and nephrologists about PD needs to be done.

scholarly journals Opinion: Peritoneal Dialysis In Pakistan: An Insider’s View. State of Affairs and Planning?

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Ahad Qayyum
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Dialysis Patients ◽  
Number Of Patients ◽  
Maintenance Dialysis ◽  
State Of Affairs ◽  
Stage Renal Disease ◽  
End Stage ◽  
Chronic Ambulatory Peritoneal Dialysis

Pakistan has an estimated population of 212 million while the incidence of end stage renal disease in Pakistan is 100 patients per million; hence approximately 22,000 patients require maintenance dialysis to sustain life in our country. Remarkably peritoneal dialysis (PD) as a form of maintenance renal replacement is utilized in less than one per cent of these patients.  In the absence of a formal dialysis registry, we place the total number of chronic ambulatory peritoneal dialysis patients (CAPD) in Pakistan at approximately 76 excluding holiday patients who are visiting from abroad (*This figure was estimated by enquiring the total number of patients each PD units care in Pakistan. This figure was corroborated with the sole distributor of CAPD fluids in Pakistan.).

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.

Outcomes of infants <28 days old treated with peritoneal dialysis for end-stage renal disease

2009 ◽  
Vol 24 (10) ◽  
pp. 2035-2039 ◽  
Author(s):  
Michelle N. Rheault ◽  
Jurat Rajpal ◽  
Blanche Chavers ◽  
Thomas E. Nevins
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals A Treatable Encephalopathy in a Peritoneal Dialysis Patient - Cefepime- Induced Encephalopathy

2019 ◽  
Vol 10 (02) ◽  
pp. 324-326 ◽  
Author(s):  
Ching Soong Khoo ◽  
Tze Yuan Tee ◽  
Hui Jan Tan ◽  
Raymond Azman Ali
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Hospital Stay ◽  
End Stage Renal Disease ◽  
Dialysis Patient ◽  
Length Of Hospital Stay ◽  
Peritoneal Dialysis Patient ◽  
Stage Renal Disease ◽  
End Stage ◽  
Reversible Encephalopathy

ABSTRACTWe report a patient with end-stage renal disease on peritoneal dialysis, who developed encephalopathy after receiving a few doses of cefepime. He recovered clinically and electroencephalographically after having discontinued the culprit agent and undergone hemodialysis. This case highlights the importance of promptly recognizing this reversible encephalopathy, which can lead to the avoidance of unnecessary workup, reduce the length of hospital stay, and thereby improve the patients’ outcome.

Sign in / Sign up

Export Citation Format

Share Document