Continuous Ambulatory Peritoneal Dialysis (CAPD) in a Developing Country

1985 ◽  
Vol 5 (1) ◽  
pp. 56-58 ◽  
Author(s):  
Jorge Dominguez ◽  
Gladys Gonzalez ◽  
Lenin Figueroa ◽  
Jose Mendez
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
End Stage Renal Disease ◽  
Admission Rate ◽  
Home Hemodialysis ◽  
Hospital Admission Rate ◽  
Economic Problems ◽  
Stage Renal Disease ◽  
End Stage ◽  
Chronic Ambulatory Peritoneal Dialysis

This paper describes our experience during the first 39 months of the CAPD program at the Miguel Perez Carreno Hospital in Caracas, Venezuela. Forty-eight patients were started on CAPD and treated for a total of 767 patient/months. Mean age was 45.8 years. Average time in the program was 15.9 months. At 39 months 87% of patients were alive and 78% were still on CAPD. The peritonitis rate was one episode per 6.39 pt/month with a probability of peritonitis of 0.70 at 25 months. Incidence of sterile peritonitis was high (41 %). Our patients had a low hospital admission rate (0.5 days per patient month) and a high percentage were rehabilitated (81%). Chronic ambulatory peritoneal dialysis (CAPD) is a widely accepted therapy for end-stage renal disease (ESRD): in Venezuela, approximately 160 patients (37%) of all those under treatment for ESRD receive this form of therapy. The Nephrology Section of the Miguel Perez Carreno Hospital in Caracas manages the largest CAPD program in the country. Here 149 patients are receiving treatment for ESRD by different techniques -hospital hemodialysis, home hemodialysis, intermittent peritoneal dialysis, CAPD and renal transplantation, under the care of five nephrologists, four nephrology residents and 30 nurses. Our CAPD program started in January 1980. This paper, which describes our three years of experience, indicates that CAPD is feasible in a country such as ours which, because of economic problems, is limited in its ability to provide other forms of treatment for ESRD.

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.

scholarly journals Comparison of Risk for End-Stage Renal Disease Between Physicians and the General Population: A Nationwide Population-Based Cohort Study

2019 ◽  
Vol 16 (12) ◽  
pp. 2211
Author(s):  
Chin-Kai Yen ◽  
Tian-Hoe Tan ◽  
I-Jung Feng ◽  
Chung-Han Ho ◽  
Chien-Chin Hsu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
General Population ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Population Based ◽  
Easy Access ◽  
Stage Renal Disease ◽  
End Stage

Physicians experience high stress and have much responsibility during a night shift, which contributes to increased sympathetic activity, the risk factor for renal disease. The risk for end-stage renal disease (ESRD) in physicians is still unclear. Therefore, we conducted a nationwide population-based cohort study to clarify this issue. Using Taiwan’s National Health Insurance Research Database, we identified 30,268 physicians and 60,536 individuals from the general population matched with a ratio of 1:2 by age and sex. All participants who had ESRD before 2006 and residents were excluded. ESRD risk between physicians and the general population and among physician subgroups was compared by following up their medical histories until 2012. We also compared the treatments between both cohorts with ESRD. Physicians had a lower ESRD risk than the general population (adjusted odds ratio (AOR): 0.5; 95% confidence interval (CI): 0.4–0.7), particularly in the middle-age subgroup (35–64 years) (AOR: 0.4; 95% CI: 0.3–0.7); however, there was no difference in the older age subgroup (≥65 years) (AOR: 1.0; 95% CI: 0.6–1.7). More physicians received peritoneal dialysis (63.0% vs. 11.1%) and renal transplantation (5.6% vs. 1.7%) than the general population after being diagnosed with ESRD. Compared with the general population, physicians had a lower ESRD risk and higher treatment selection for peritoneal dialysis and renal transplantation after being diagnosed with ESRD. Better medical knowledge, a greater awareness of diseases and their risk factors, more rigorous implementation of preventive measures, and easy access to medical care may play a role in this aspect. Further studies are warranted for elucidating the associated mechanisms.

scholarly journals Diálise Peritoneal nos Dois Primeiros Anos de Vida: Experiência de uma Unidade de Nefrologia e Transplantação Renal Pediátrica

2016 ◽  
Vol 29 (9) ◽  
pp. 525
Author(s):  
Sofia Deuchande ◽  
Tânia Mano ◽  
Cristina Novais ◽  
Rute Machado ◽  
Rosário Stone ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Term Survival ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Peritoneal dialysis is the dialytic method of choice in chronic end-stage renal disease in children. This study main purposewas to characterize the long-term survival of a pediatric population who began peritoneal dialysis within the first two years of life.Material and Methods: A descriptive and retrospective study was performed in a portuguese nephrology and renal transplantation pediatric unit, between January 1991 and August 2014. End-stage renal disease etiology, mortality, comorbidities and complications of peritoneal dialysis and end-stage renal disease, growth and psychomotor development were evaluated.Results: Twenty children started peritoneal dialysis within the first two years of life. There were six deaths, but no deaths of children with primary chronic kidney disease were registered over the past decade. The 14 living children were characterized; 13 were males. Congenital abnormalities of the kidney and urinary tract were the leading etiology of chronic kidney disease (45%). The average age start of peritoneal dialysis was 6.1 months; six children started before 30 days of life. Peritonitis was the most frequent cause of hospitalization. Ten children were transplanted at an average age of 5.3 years. All of the children who are still in peritoneal dialysis have short stature, but nine of the transplanted have final height within the expected for their mid-parental height target range. Nine (64%)had some type of neurodevelopmental delay.Discussion: Peritoneal dialysis is a technique possible and feasible since birth, as evidenced in the study, as more than half of children successfully started it before 6 months of life. It allows long-term survival until the possibility of renal transplantation despite the associated morbidity, including peritonitis and complications of chronic renal disease. The ten transplanted children improved their growth, recovered from chronic anemia and improved dyslipidemia, compared with the period of dialysis. However, the average waiting time until the renal transplant was 5.3 years higher than other international centers.Conclusion: These data support the use of peritoneal dialysis from birth, but complications and the worst growth reflect the need to develop strategies to optimize care relating to nutrition, growth and development and to reduce pre-transplant time.

scholarly journals Effects of hemodialysis, peritoneal dialysis, and renal transplantation on the quality of life of patients with end-stage renal disease

2020 ◽  
Vol 66 (9) ◽  
pp. 1229-1234
Author(s):  
Lijuan Zhang ◽  
Yannan Guo ◽  
Hua Ming
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
End Stage Renal Disease ◽  
Factors Influencing ◽  
Sf 36 ◽  
Residential Pattern ◽  
Stage Renal Disease ◽  
End Stage

SUMMARY OBJECTIVE: To evaluate the effects of hemodialysis, peritoneal dialysis, and renal transplantation on the quality of life of patients with end-stage renal disease (ESRD) and analyze the influencing factors. METHODS: A total of 162 ESRD patients who received maintenance hemodialysis, continuous ambulatory peritoneal dialysis, and renal transplantation from February 2017 to March 2018 in our hospital were divided into a hemodialysis group, a peritoneal dialysis group, and a renal transplantation group. The baseline clinical data, serum indices, as well as environmental factors such as education level, marital status, work, residential pattern, household income, and expenditure were recorded. The quality of life was assessed using the short-form 36-item (SF-36) scale reflecting the Physical Component Summary (PCS) and the Mental Component Summary (MCS). One-way analysis of variance and logistic stepwise multiple regression analysis were performed to analyze the factors influencing the quality of life. RESULTS: The renal transplantation group had the highest average scores for all dimensions of the SF-36 scale. The PCS and MCS scores of this group were higher than those of the hemodialysis and peritoneal dialysis groups. The peritoneal dialysis group had higher scores for physical functioning, physical role, bodily pain, general health, mental health, PCS, and MCS than those of the hemodialysis group. Age, HGB, GLU, and ALP were the main factors influencing PCS. Age, education level, residential pattern, medication expenditure, and monthly per capita income mainly affected MCS. CONCLUSION: In terms of quality of life, renal transplantation is superior to peritoneal dialysis and hemodialysis.

scholarly journals Recent Advances in the Management of End-Stage Renal Disease (ESRD) in Children

2019 ◽  
Vol 28 (9-10) ◽  
pp. 218-22
Author(s):  
Richard N. Fine
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
End Stage Renal Disease ◽  
Treatment Modalities ◽  
Technical Expertise ◽  
Initial Report ◽  
Stage Renal Disease ◽  
End Stage ◽  
Dialysis Time ◽  
Dual Treatment

It has been almost 20 years since the initial report were published detailing the use of the dual treatment modalities of dialysis and renal transplantation to treat children with ESRD. During this time, the outlook for the infant, child and adolescent with ESRD has changed dramatically from abject pessimism to cautious optimism. Initially, hemodialysis was the principle dialytic technique utilized; however, intermittent peritoneal dialysis was used occasionally in selected centers. The latter required less technical expertise, but necessitated considerably more dialysis time and was significantly less efficient at alleviating the clinical and biochemical consequences of uremia.

Arterial Calcifications in Patients Undergoing Chronic Peritoneal Dialysis: Incidence, Progression and Regression

1985 ◽  
Vol 5 (4) ◽  
pp. 241-245 ◽  
Author(s):  
H. Erik Meema ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Diabetes Mellitus ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Chronic Renal Failure ◽  
End Stage Renal Disease ◽  
Arterial Calcification ◽  
Chronic Peritoneal Dialysis ◽  
Stage Renal Disease ◽  
End Stage

The authors graded radiologically detectable arterial calcification (A.C.) in 168 patients with end-stage renal disease treated with peritoneal dialysis; 41 of them had diabetes mellitus (DM). Comparison of DM and nondiabetic (ND) patients showed that during an average dialysis period of more than two years, the incidence of A.C. increased from 37% before dialysis to 45% at the last examination in the ND patients, and from 90% to 100% in DM patients. Both prevalence and progression of A.C. were significantly higher in DM patients (P < 0.001 and <0.05 respectively). Regressions of A.C., unrelated to parathyroidectomy or renal transplantation, were observed in 5 ND and 4 DM patients. This 9% incidence of regressions should encourage further investigations to detect the factors responsible because severe A.C. sometimes is associated with gangrene and other complications. Although numerous publications on radiologic changes in renal osteodystrophy include descriptions of arterial calcifications (A. C.), only a few have focused on the latter (1–4). Furthermore, none have looked at the relative proportions of diabetic (DM) and non-diabetic (ND) patients with A.C. and chronic renal failure. The main purpose of this paper is to make such a comparison.

scholarly journals Scintigraphic diagnosis of infectious complications in renal failure patients undergoing hemodialysis, continuous ambulatory peritoneal dialysis or renal transplant

2005 ◽  
Vol 48 (spe2) ◽  
pp. 97-108 ◽  
Author(s):  
Ana María García Vicente ◽  
Sebastián Ruiz Solís ◽  
Angel Soriano Castrejón ◽  
Víctor Manuel Poblete García ◽  
Maria del Prado Talavera Rubio ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Infectious Complications ◽  
Nuclear Techniques ◽  
Stage Renal Disease ◽  
End Stage

Patients with end-stage renal disease have two therapeutic options, dialysis and renal transplantation. Infectious complications occurring in such patients will not only condition the effectiveness of such treatments, but are among the main causes of morbidity and mortality in such cases. Knowledge of the advantages and limitations of nuclear techniques is essential for management of these conditions.

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