Recurrent Hepatic Coma in a Chronic Hemooialysis Patient: Successful Treatment by CAPO

A hemodialysis patient developed hepatic cirrhosis with subsequent portal-systemic encephalopathy. Switching from hemodialysis to CAPD prevented the recurrent episodes of hepatic coma. This observation suggests that, in combined chronic renal and hepatic failure with portal-systemic encephalo pathy, CAPD may be the treatment of choice. This paper presents evidence to support this assumption. Chronic hemodialysis patients frequently develop hepatitis B, which sometimes results in hepatic cirrhosis. Portal-systemic encephalopathy (PSE) may ensue. We describe a patient in whom mild PSE repeatedly progressed to full hepatic coma during hemodialysis sessions. Switching the patient from hemodialysis (HD) to continuous ambulatory peritoneal dialysis (CAPD) prevented the recurrent hepatic coma.

Download Full-text

Drug-Protein Binding during Continuous Ambulatory Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686088600600308 ◽

1986 ◽

Vol 6 (3) ◽

pp. 144-147 ◽

Cited By ~ 8

Author(s):

Gene D. Morse ◽

Carolyn Rowinski ◽

Patricia E. Lieveld ◽

J. Joseph Walshe

Keyword(s):

Peritoneal Dialysis ◽

Protein Binding ◽

Continuous Ambulatory Peritoneal Dialysis ◽

High Performance ◽

Equilibrium Dialysis ◽

Active Form ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Normal Volunteers ◽

Drug Protein Binding

This study of drug-protein binding in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) measured the serum and dialysate binding of cefamandole -an acidic, cephalosporin antibiotic. Ten CAPD patients, five with and five without peritonitis received a 1.0 g intraperitoneal dose of cefamandole; serum and dialysate was sampled at 4, 10, and 24 h after drug administration. Binding also was studied in serum obtained from five chronic hemodialysis patients and five normal volunteers. Equilibrium dialysis was used to determine protein binding and high performance liquid chromatography to measure cefamandole. Mean fraction unbound (fu) serum values for CAPD patients were 0.35 ± 0.04 (noninfected) and 0.37 ± 0.14 (peritonitis). In comparison, the fu values in hemodialysis patients were 0.41 ± 0.19 and 0.15 ± 0.02 in normal volunteers. Greater than 90% of cefamandole in dialysate was unbound suggesting that antibiotics, which cross the peritoneal membrane, are present in the free, microbiologically active form.

Download Full-text

Study on cellular immunity in chronic hemodialysis patients and continuous ambulatory peritoneal dialysis patients

Journal of Japanese Society for Dialysis Therapy ◽

10.4009/jsdt1985.19.1093 ◽

1986 ◽

Vol 19 (12) ◽

pp. 1093-1098

Author(s):

Yoshio Maruyama ◽

Kenichi Tsumatani ◽

Yoshiteru Kaneko ◽

Akira Moriya ◽

Kazuo Kubota ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Cellular Immunity ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Dialysis Patients

Download Full-text

Effect of Oral Levamisole Supplementation to Hepatitis B Vaccination on the Rate of Immune Response in Chronic Hemodialysis Patients

Nephron ◽

10.1159/000045598 ◽

2000 ◽

Vol 84 (3) ◽

pp. 291-292 ◽

Cited By ~ 14

Author(s):

M. Deniz Ayli ◽

Cüneyt Ensari ◽

Meltem Ayli ◽

Fahri Mandiroglu ◽

Suat Mut

Keyword(s):

Immune Response ◽

Hepatitis B ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Hepatitis B Vaccination

Download Full-text

Recombinant Hepatitis B Vaccine Use in Chronic Hemodialysis Patients

Nephron ◽

10.1159/000188935 ◽

1996 ◽

Vol 72 (4) ◽

pp. 536-543 ◽

Cited By ~ 50

Author(s):

F. Fabrizi ◽

S. Di Filippo ◽

D. Marcelli ◽

I. Guarnori ◽

L. Raffaele ◽

...

Keyword(s):

Hepatitis B ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Hepatitis B Vaccine ◽

Recombinant Hepatitis

Download Full-text

Anemia and Oxygen Affinity in Patients on Continuous Ambulatory Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686088300301s01 ◽

1983 ◽

Vol 3 (1_suppl) ◽

pp. 1-3

Author(s):

Bruce S. Spinowitz ◽

Judith Sherwood ◽

Marilyn Galler ◽

Chaim Chary Tan

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Anabolic Steroids ◽

Oxygen Affinity ◽

Hemodialysis Patients ◽

Iron Supplements

Contrary to previous reports, our patients maintained on CAPD for periods up to 25 months showed no improvement in their hematocrit. However, in comparison with a group of hemodialysis patients, our CAPD patients required transfusions, anabolic steroids and iron supplements less frequently. A small but not statistically significant increase in hematocrit was noted among patients transferred from hemodialysis to CAPD. Oxygen affinity, measured by P50, did not reveal the previously described elevation among hemodialysis patients. The reason(s) for this difference are only speculative at this time.

Download Full-text

Hepatitis B Surface Antigen and Antibody among Chronic Hemodialysis Patients in Fukuoka, Japan : A High Risk for Becoming Hepatitis B Virus Carriers

Journal of Epidemiology ◽

10.2188/jea.4.99 ◽

1994 ◽

Vol 4 (2) ◽

pp. 99-102

Author(s):

Masakazu Washjo ◽

Noritaka Tokui ◽

Seiya Okuda ◽

Akinori Nagashima ◽

Toru Sanai ◽

...

Keyword(s):

Hepatitis B Virus ◽

High Risk ◽

Hepatitis B ◽

Surface Antigen ◽

Hepatitis B Surface Antigen ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

B Virus

Download Full-text

Acquired Renal Cystic Disease and Its Complications in Continuous Ambulatory Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686089201200305 ◽

1992 ◽

Vol 12 (3) ◽

pp. 292-297 ◽

Cited By ~ 13

Author(s):

Isao Ishikawa

Keyword(s):

Renal Cell Carcinoma ◽

Peritoneal Dialysis ◽

Cell Carcinoma ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Renal Cell ◽

Hemodialysis Patients ◽

Cystic Disease ◽

Renal Cystic Disease ◽

Acquired Renal Cystic Disease ◽

Acquired Cystic Disease

Purpose To determine whether there is any difference in the prevalence of acquired cystic disease and malignancy of the kidney in patients on continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis. Data Identification Relevant studies published from January 1983 to June 1991 were identified by manual search and MEDLINE search. Study Selection We reviewed the studies in which acquired renal cystic disease and/or renal cell carcinoma developed in patients on CAPD. Data Extraction Details of the prevalence of acquired cystic disease and renal malignancy as a complication of acquired cysts in CAPD patients were tabulated with the duration of treatment. Results Acquired cystic disease was observed in 195 of 425CAPD patients(41.1%), which is comparable to the prevalence of 47.1% (520/1103) seen in hemodialysis patients. The overall prevalence of renal cell carcinoma accompanying acquired cystic disease in this series of CAPD patients was 2 of 375 (0.4%), which is comparable to the prevalence of 1.5% (17/1103) in hemodialysis patients. So far, eight other instances of renal cell carcinoma complicating acquired cystic disease in CAPD patients were described as case reports. Retroperitoneal bleeding due to the rupture of acquired cysts has been reported on a few occasions. Conclusion In this review no differences were detected in the prevalence or severity of acquired renal cystic disease in patients treated with CAPD as compared with those on hemodialysis. Therefore, the incidence of complications associated with acquired cysts may also be the same for the two treatment modalities, although reports on such complications are rare.

Download Full-text