Transplantation in Patients Undergoing CAPD

1985 ◽  
Vol 5 (3) ◽  
pp. 161-164 ◽  
Author(s):  
Dimitrios Tsakiris ◽  
Stephen P. Bramwell ◽  
J. Douglas Briggs ◽  
Brian J.R. Junor
Keyword(s):  
Peritoneal Dialysis ◽  
Selection Criteria ◽  
Patient Survival ◽  
Hemodialysis Patients ◽  
Renal Allografts ◽  
Differences Of Opinion ◽  
One Year ◽  
The One ◽  
Time Of Operation

Between May 1980 and December 1983, 39 patients on continuous ambulatory peritoneal dialysis (CAPD) received renal allografts, which represents 18% of the 212 transplants done during this period. The remaining 173 allografts were transplanted into 162 patients who to the time of operation had been maintained on hemodialysis. For the CAPD and hemodialysis patients respectively, the one-year graft survival for first cadaveric transplants was 61% and 59%, while, for the two groups, the one-year patient survival was identical-95%. In five of the 14 patients (36%) in whom CAPD was used immediately after the transplant peritonitis developed, but in none of the 25 patients who did not have CAPD at this time. The Tenckhoff catheters were left in situ for a mean period of 12.7 weeks after the transplant without leading directly to any complications. However, at catheter removal, organisms grew on cultures from 11 of 25 catheter tips (44%). In conclusion, graft and patient survival is as high in CAPD patients as in those maintained by hemodialysis. In patients in whom the transplant does not function immediately we now use hemodialysis because CAPD at this time is associated with peritonitis and wound infection in some of the patients. Only a few centres have described their experience with renal transplantation in CAPD patients and most have not considered CAPD to be a contraindica tion to transplantation (1–5). However, based on one case report Cramer et al (6) suggested that CAPD provides a suboptimal preparation for transplantation, and Gelfand et al (7) reported that compared with hemodialysis, patients on CAPD had inferior transplant results. The small numbers of patients and varying selection criteria in most of these studies may explain the differences of opinion. This paper describes our experience with 39 CAPD patients who received renal allografts between May 1980 and Dec. 1983.

Observing microscopic phases of lichen life cycles on transparent substrata placed in situ

2005 ◽  
Vol 37 (5) ◽  
pp. 373-382 ◽  
Author(s):  
William B. SANDERS
Keyword(s):  
Life Cycle ◽  
Developmental Stages ◽  
Life Cycles ◽  
Potential Significance ◽  
Free Living ◽  
Lichen Community ◽  
One Year ◽  
The One ◽  
Observation Period

The utility of plastic cover slips as a substratum for in situ study of lichen developmental stages is further explored in a neotropical foliicolous lichen community and in a European temperate corticolous community. Twenty-one months after placement in the tropical forest, the cover slips bore foliicolous lichen thalli with several species producing characteristic ascocarps and ascospores, indicating the suitability of the substratum for completion of the life cycle of these lichens. On cover slips placed within the temperate corticolous community, lichen propagules anchored to the substratum with relatively short attachment hyphae but did not develop further within the one year observation period. Intimately intermixed microbial communities of short-celled, mainly pigmented fungi and chlorophyte algae developed upon the transparent substratum. Among the algae, Trebouxia cells, often in groups showing cell division and without associated lichenizing hyphae, were commonly observed. The potential significance of the free-living populations in the life cycle of Trebouxia and in those of Trebouxia-associated lichen fungi is discussed.

scholarly journals Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

2020 ◽  
Author(s):  
Dayang Xie ◽  
Jianhui Zhou ◽  
Xueying Cao ◽  
Qingtao Zhang ◽  
Yanli Sun ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Insertion ◽  
Percutaneous Technique ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Catheter Survival ◽  
The Difference ◽  
One Year ◽  
The One

Abstract Background. A large body mass index (BMI) has been considered as a relative contraindication for percutaneous catheter insertion , although this technique has many advantages. Up to now, there are few studies on peritoneal catheter placement and obesity. The aim of this study was to determine whether patients with large BMI can also choose the percutaneous technique for peritoneal dialysis catheter insertion. Methods. 187 consecutive patients underwent peritoneal catheter insertions in the Chinese PLA General Hospital between January 1, 2015 and December 31, 2016, with 178 eligible cases being included in the analysis. Two groups were created based on the catheter insertion techniques, the percutaneous group (group P) and the surgical group (group S). Subgroups were created according to BMI>28 or≤28. The outcomes included catheter related complications and catheter survival. Results. Total infectious complication rates were significantly lower in group P than in group S. The late peritonitis rates tended to be lower in group P than in group S, although the difference was not significant. There were no significant differences in all other measured complications between the two groups. Though the one-year infection-free catheter survival in group P was 7.5% higher than group S, the difference was not significant. The one-year dysfunction-free catheter survival, one-year dysfunction-and-infection-free catheter survival, and overall catheter survival were similar between the two groups. Subgroup analyses showed a superior one-year infection-free catheter survival of percutaneous technique in patients with BMI>28, which was confirmed by Kaplan-Meier analysis. Conclusions. Despite the challenges that may be encountered with patients who have a large BMI, the percutaneous technique is a safe and effective approach to placing a peritoneal dialysis catheter.

scholarly journals Association between Levocarnitine Treatment and the Change in Knee Extensor Strength in Patients Undergoing Hemodialysis: A Post-Hoc Analysis of the Osaka Dialysis Complication Study (ODCS)

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 343
Author(s):  
Shota Matsufuji ◽  
Tetsuo Shoji ◽  
Suhye Lee ◽  
Masao Yamaguchi ◽  
Mari Nishimura ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Knee Extensor ◽  
Positive Association ◽  
Hemodialysis Patients ◽  
Carnitine Deficiency ◽  
Knee Extensor Strength ◽  
Effect Of Treatment ◽  
One Year ◽  
The One ◽  
Post Hoc

Carnitine deficiency is prevalent in patients undergoing hemodialysis, and it could result in lowered muscle strength. So far, the effect of treatment with levocarnitine on lower limb muscle strength has not been well described. This observational study examined the association between treatment with levocarnitine with the change in knee extensor strength (KES) in hemodialysis patients. Eligible patients were selected from the participants enrolled in a prospective cohort study for whom muscle strength was measured annually. We identified 104 eligible patients for this analysis. During the one-year period between 2014 to 2015, 67 patients were treated with intravenous levocarnitine (1000 mg per shot, thrice weekly), whereas 37 patients were not. The change in KES was significantly higher (p = 0.01) in the carnitine group [0.02 (0.01–0.04) kgf/kg] as compared to the non-carnitine group [−0.02 (−0.04 to 0.01) kgf/kg]. Multivariable-adjusted regression analysis showed the positive association between the change in KES and the treatment with levocarnitine remained significant after adjustment for the baseline KES and other potential confounders. Thus, treatment with intravenous levocarnitine was independently and positively associated with the change in KES among hemodialysis patients. Further clinical trials are needed to provide more solid evidence.

scholarly journals Depression Does Not Predict Clinical Outcome of Chinese Peritoneal Dialysis Patients After Adjusting for the Degree of Frailty

2020 ◽  
Author(s):  
Gordon Chun-Kau CHAN ◽  
Jack Kit-Chung NG ◽  
Kai-Ming CHOW ◽  
Bonnie CH Kwan ◽  
Vickie Wai-Ki KWONG ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Peritoneal Dialysis ◽  
Clinical Outcome ◽  
Patient Survival ◽  
Independent Predictor ◽  
Univariate Analysis ◽  
Adverse Clinical Outcome ◽  
Duration Of Hospitalization ◽  
One Year ◽  
Frailty Score

Abstract Background Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, dissected the internal relationship between depression and frailty, and determined their relative contribution to the adverse clinical outcome in PD patients. Methods In a prospective observational study, we recruited 267 prevalent PD patients. Depression was identified by Patient Health Questionnaire (PHQ-9). Frailty was identified by a validated Frailty Score. All cases were followed for one year. Outcome measures included number and duration of hospitalization, peritonitis rate, and all-cause mortality. Results Of the 267 patients, 197 patients (73.8%) were depressed, and 157 (58.8%) were frail. There was a substantial overlap between depression and frailty. Although depression and frailty were associated the number and duration of hospitalization by univariate analysis, the association became insignificant after adjusting for confounding factors by multivariate analysis. Both depression and frailty were associated with one-year mortality by univariate analysis. One-year patient survival was 95.9%, 86.5%, 82.4% and 71.0% for patients with nil, mild, moderate and severe frailty, respectively (p = 0.001). Frailty was an independent predictor of patient survival by multivariate analysis (adjusted hazard ratio 1.424, 95% confidence interval 1.011-2.005. p = 0.043), while the prognostic effect of depression disappears after adjusting for frailty score. Conclusion Depression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality.

scholarly journals Depression Does Not Predict Clinical Outcome of Chinese Peritoneal Dialysis Patients After Adjusting for the Degree of Frailty

2020 ◽  
Author(s):  
Gordon Chun-Kau CHAN ◽  
Jack Kit-Chung NG ◽  
Kai-Ming CHOW ◽  
Bonnie CH Kwan ◽  
Vickie Wai-Ki KWONG ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Peritoneal Dialysis ◽  
Clinical Outcome ◽  
Patient Survival ◽  
Independent Predictor ◽  
Univariate Analysis ◽  
Adverse Clinical Outcome ◽  
Duration Of Hospitalization ◽  
One Year ◽  
Frailty Score

Abstract Background Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, dissected the internal relationship between depression and frailty, and determined their relative contribution to the adverse clinical outcome in PD patients. Methods In a prospective observational study, we recruited 267 prevalent PD patients. Depression was identified by Patient Health Questionnaire (PHQ-9). Frailty was identified by a validated Frailty Score. All cases were followed for one year. Outcome measures included number and duration of hospitalization, peritonitis rate, and all-cause mortality. Results Of the 267 patients, 197 patients (73.8%) were depressed, and 157 (58.8%) were frail. There was a substantial overlap between depression and frailty. Although depression and frailty were associated the number and duration of hospitalization by univariate analysis, the association became insignificant after adjusting for confounding factors by multivariate analysis. Both depression and frailty were associated with one-year mortality by univariate analysis. One-year patient survival was 95.9%, 86.5%, 82.4% and 71.0% for patients with nil, mild, moderate and severe frailty, respectively (p = 0.001). Frailty was an independent predictor of patient survival by multivariate analysis (adjusted hazard ratio 1.424, 95% confidence interval 1.011-2.005. p = 0.043), while the prognostic effect of depression disappears after adjusting for frailty score. Conclusion Depression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality.

Patient survival and health care utilization in Medicare beneficiaries diagnosed with cancer of unknown primary

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6064-6064 ◽  
Author(s):  
K. B. Tong ◽  
K. N. Murtagh ◽  
H. Hubert ◽  
B. Santry ◽  
A. J. Layton ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Patient Survival ◽  
Malignant Neoplasm ◽  
Cancer Of Unknown Primary ◽  
Unknown Primary ◽  
Diagnosis Code ◽  
Differential Group ◽  
One Year ◽  
The One

6064 Background: For patients presenting with cancer of unknown primary (CUP), identifying the site of origin can improve survival and treatment outcomes. We analyzed outcomes in patients who present with an initial diagnosis of malignant neoplasm without specification of site (ICD-9 199.0 and 199.1). Methods: Based on a 5% Medicare beneficiary sample from 2002 through 2004, we conducted a retrospective claims data analysis identifying patients who were cancer free in 2002 and who subsequently had a claim with a CUP diagnosis (ICD-9 199.0 or 199.1) in 2003. We evaluated survival and Medicare charges by procedure and diagnosis code for four consecutive quarters following CUP diagnosis. We assigned patients to one of two groups. The “differential” group consisted of CUP patients having a subsequent claim with a differential diagnosis code (ICD-9 140–229, excluding 199.0 and 199.1). The “unknown” group consisted of CUP patients with no later change in diagnosis. We applied chi-square and t-tests to examine differences in survival, resource utilization, and Medicare charges between groups. We developed Cox survival and linear regression models for multivariate analyses. Results: Of the 388 patients, 277 (71%) did not have a claim with a differential diagnosis during the follow-up period. Both groups were similar in race (80% white) gender (60% female) and age (range 70–79). The one-year mortality of the unknown group was 32.9% compared to 19.8% in the differential group (p=0.01). First quarter charges were higher for the unknown group: $2,549 vs. $1,683 (p < 0.001). Total allowed charges were higher for the differential group over the one-year follow up period: $7,493 vs. $5,540 (p < 0.05), even when adjusted for survival. Conclusions: Following a diagnosis of CUP, patients who obtain a differential diagnosis live longer and incur higher charges over time as a result of ongoing management and intervention. Improved diagnostic tests may affect patient survival and how Medicare resources are applied. No significant financial relationships to disclose.

scholarly journals Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

2019 ◽  
Author(s):  
Dayang Xie ◽  
Jianhui Zhou ◽  
Xueying Cao ◽  
Qingtao Zhang ◽  
Yanli Sun ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Insertion ◽  
Percutaneous Technique ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Catheter Survival ◽  
The Difference ◽  
One Year ◽  
The One

Abstract Background A large body mass index (BMI) has been considered as a relative contraindication for percutaneous catheter insertion, although this technique has many advantages. Up to now, there are few studies on peritoneal catheter placement and obesity. The aim of this study was to determine whether patients with large BMI can also choose the percutaneous technique for peritoneal dialysis catheter insertion. Methods 187 consecutive patients underwent peritoneal catheter insertions in the Chinese PLA General Hospital between January 1, 2015 and December 31, 2016, with 178 eligible cases being included in the analysis. Two groups were created based on the catheter insertion techniques, the percutaneous group (group P) and the surgical group (group S). Subgroups were created according to BMI>28 or≤28. The outcomes included catheter related complications and catheter survival. Results Total infectious complication rates were significantly lower in group P than in group S. The late peritonitis rates tended to be lower in group P than in group S, although the difference was not significant. There were no significant differences in all other measured complications between the two groups. Though the one-year infection-free catheter survival in group P was 7.5% higher than group S, the difference was not significant. The one-year dysfunction-free catheter survival, one-year dysfunction-and-infection-free catheter survival, and overall catheter survival were similar between the two groups. Subgroup analyses showed a superior one-year infection-free catheter survival of percutaneous technique in patients with BMI>28, which was confirmed by Kaplan-Meier analysis. Conclusions Despite the challenges that may be encountered with patients who have a large BMI, the percutaneous technique is a safe and effective approach to placing a peritoneal dialysis catheter.

Intermittent Peritoneal Dialysis in the Treatment of Diabetics with End-stage Renal Disease

1981 ◽  
Vol 2 (1_suppl) ◽  
pp. 15-16
Author(s):  
Stavros Karanicolas ◽  
Douglas Thompson
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Patient Survival ◽  
Subcutaneous Insulin ◽  
Hospital Patients ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage

Intermittent peritoneal dialysis (IPD) in diabetics has varied outcomes. Sixteen patients with end-stage renal disease and diabetes were treated with IPD during the last four years at St. Joseph's Hospital. Patients received subcutaneous insulin besides small amounts intraperitoneally on the days of dialysis. One-year patient survival was 48%. Blood pressure, serum potassium, fluid and blood sugar control was poor compared to CAPD. However, for patients who can not be placed on CAPD, IPD still has its role. For this reason we should continue our efforts to improve the effectiveness of this mode of peritoneal dialysis.

Renal Transplantation in Patients Undergoing Chronic Peritoneal Dialysis

1996 ◽  
Vol 16 (1) ◽  
pp. 48-51 ◽  
Author(s):  
Miguel Perez Fontán ◽  
Ana Rodríguez-Carmona ◽  
Teresa García Falcon ◽  
Javier Moncalián ◽  
Juan Oliver ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Chronic Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Renal Allografts ◽  
The One ◽  
Renal Transplantations ◽  
Similar Incidence

Objective To review the outcome of renal transplantation in a group of patients treated with chronic peritoneal dialysis and to compare the results with those of a matched population on hemodialysis. Design Retrospective study. Setting Tertiary, institutional hospital, administering to a population of two million, with 100 patients on peritoneal dialysis. Six hundred and sixty renal transplantations were performed by the end of 1993. Patients Fifty-six patients on chronic peritoneal dialysis who received 58 cadaveric renal allografts were compared to 58 patients on hemodialysis who received a graft from the same donor (n = 39), or the transplant next to the one performed to the corresponding patient on peritoneal dialysis (n = 19). Results Patients on peritoneal dialysis showed a lower rate of delayed graft function (24.1 vs 50%, p < 0.05) and a similar incidence of acute rejection than patients on hemodialysis. Also, peritoneal dialysis patients received less supplementary immunosuppression, suffered a lower incidence of late infections (0.93 vs 0.58 episodes/patient), and had a similar incidence of dialysis-related complications (0.25 vs 0.20 episodes/patient). Conclusions Patients on peritoneal dialysis do well after renal transplantation. The incidence of some complications, particularly delayed graft function, is lower than in patients on hemodialysis, while the incidence of dialysis-associated complications is similar in both groups.

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