Better Preservation of Cognitive Faculty in Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 202-205 ◽  
Author(s):  
Umberto Buoncristiani ◽  
Andrea Alberti ◽  
Giampiero Gubbiotti ◽  
Giuseppe Mazzotta ◽  
Virgilio Gallai ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Attention And Memory ◽  
Normal Range ◽  
Cognitive Faculty ◽  
Neurophysiological Test ◽  
Uremic Patients ◽  
The Brain ◽  
Normal Controls ◽  
Better Than

We employed the so-called event-correlated potential (ECP) P300, a neurophysiological test which explores the circuits of attention and memory in the brain and is altered in subjects with a dismetabolic or degenerative encephalopathy, in order to evaluate the cognitive faculty in two groups of uremic patients [18 on continuous ambulatory peritoneal dialysis (CAPD), 15 on hemodialysis (HD)] comparable with respect to age and time on dialysis. The values of latency (msec) of P300 resulted in CAPD patients 356±26 in CZ (central zero electrodes) and 357.5±25 in PZ (parietal zero electrodes), not significantly different from the values in normal controls (341±14.5 in CZ and 340± 15.6 in PZ) and in HD patients postdialysis (354±24.4 in CZ and 354±25.6 in PZ). On the contrary, the predialytic values of HD patients (384±25.6 CZ and 385±25.5 in PZ) were significantly different from the postdialytic values and from the values of CAPD patients and controls (p<0.01). These results support the conclusion that HD Is able to restore a normal cognitive faculty only transiently in the postdialytic phase, while CAPD maintains this important function steadily close to the normal range, thus being clearly better than HD.

Vitamin Status in Continuous Ambulatory Peritoneal Dialysis

1984 ◽  
Vol 4 (3) ◽  
pp. 143-145 ◽  
Author(s):  
Lain S. Henderson ◽  
A.C.T. Leung ◽  
A. Shenkin
Keyword(s):  
Ascorbic Acid ◽  
Peritoneal Dialysis ◽  
Folic Acid ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Water Soluble ◽  
Vitamin Supplementation ◽  
Normal Range ◽  
Vitamin Status ◽  
Water Soluble Vitamin ◽  
Uremic Patients

The vitamin status of nine uremic patients was assessed before the institution of CAPD, after six months of CAPD with oral water-soluble vitamin supplementation (as in hemodialysis) and after a further six months without vitamin supplementation. We concluded that it is necessary to provide supplements of pyridoxine and ascorbic acid but probably not folic acid. Levels of the lipid soluble vitamins A and E were within the normal range.

Histologic Change of Peritoneal Membrane in Relation to Adequacy of Dialysis in Continuous Ambulatory Peritoneal Dialysis Patients

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 26-30 ◽  
Author(s):  
Irini Savidaki ◽  
Dionisios Karavias ◽  
Florentia Sotsiou ◽  
Sotiria Alexandri ◽  
Pantelitsa Kalliakmani ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Structural Changes ◽  
Mesothelial Cells ◽  
Peritoneal Membrane ◽  
Histologic Change ◽  
Significant Difference ◽  
Uremic Patients ◽  
Group B ◽  
Histologic Changes

Background Long-term exposure of peritoneal membrane to bioincompatible dialysis solutions leads to structural changes and loss of ultrafiltration capability. Objective We studied the possible relationship between histologic change and the transport characteristics of peritoneal membrane and adequacy of dialysis in continuous ambulatory peritoneal dialysis (CAPD) patients. Patients and Methods The study included 18 CAPD patients (11 men, 7 women) who underwent a peritoneal biopsy either at initiation of treatment (group A, n = 9) or after a mean of 4 years on CAPD (group B, n = 9). The morphologic changes in the mesothelial cells and the vascular compartment and the thickness of the submesothelial collagenous zone were estimated and compared with observations from 6 patients with normal renal function who underwent biopsy of the parietal peritoneum during abdominal surgery. The relationship of the observed changes in CAPD patients to results from a peritoneal equilibration test (PET) and to adequacy of dialysis [total weekly creatinine clearance (CCr) and Kt/V urea] were also investigated. Results The main histologic changes in both groups of patients were loss of mesothelial cells and decrease in the normal mesothelial surface, thickening of the submesothelial collagenous zone, and presence of vascular hyalinosis. The thickness of the submesothelial collagenous zone in both groups of patients was significantly greater than that found in controls (410 μm and 580 μm vs 50 μm, p < 0.05). Although no significant difference was found between morphologic change in the peritoneal membrane of uremic patients starting on CAPD and those who had been on peritoneal dialysis (PD) for a mean period of 4 years, a trend was observed toward more severe lesions in the latter patients. The PET, CCr, and Kt/V urea were not significantly different in the two groups of patients. Those parameters also showed no significant changes when examined at initiation of CAPD and after a mean of 4 years of PD in the same patients (group B). No significant correlations were observed between the histologic changes and the PET, CCr, or Kt/V in both groups of patients. Conclusions Significant structural changes are observed in the peritoneal membrane of uremic patients, and those changes become worse with CAPD treatment. Structural changes are not followed by functional changes during the first 4 years on CAPD.

Dislipemia in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis: Pharmacological Therapy (Simvastatin) versus Hemodialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 431-433 ◽  
Author(s):  
Roberto Marangoni ◽  
Fernando Civardi ◽  
Franceso Masi ◽  
Roberto Cimino ◽  
Luca Maltagliati ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Total Cholesterol ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Pharmacological Therapy ◽  
Apolipoprotein A ◽  
Previously Treated ◽  
Uremic Patients ◽  
Significant Change ◽  
Therapeutic Possibilities

Peritoneal dialysis can worsen disllpemia, which is frequent in chronically uremic patients. In order to verify the therapeutic possibilities, we retrospectively studied 20 chronically uremic patients who had been previously treated with continuous ambulatory peritoneal dialysis (CAPO) and who had developed an IV-type dislipemia. Twelve have continued CAPO treatment and have been simultaneously treated with simvastatin; 8 have withdrawn from CAPO and have begun HO, without any antidislipemic pharmacological support. The results, after 3, 6, 12, and 18 months of treatment, showed the following: In patients treated with CAPO and simvastatin, highly significant decreases were noted in total cholesterol (T-cho) and triglycerides (TG) (p<0.001), and highly significant increases were noted in HOL-cholesterol (HOL-cho) (p<0.005) and apolipoprotein-A 1 (Apo-A 1) (p<0.01). In patients treated with HO, only slightly significant decreases were noted in T-cho (p<0.01) and TG (p<0.02), a slightly significant increase in Apo-A1 (p<0.05), and no significant change in HOL-cho. Apollpoprotein-B showed no change in the two groups. Therefore, patients undergoing CAPO, with dislipemia only, can continue the treatment, because simvastatin is capable of correcting dislipemia, while those patients who have displemia as well as other complications strictly due to CAPO must abandon treatment and must be transferred to extracorporeal methods.

scholarly journals Comparative Analysis of Immunophenotypic Abnormalities in Cellular Immunity of Uremic Patients Undergoing Either Hemodialysis or Continuous Ambulatory Peritoneal Dialysis

Renal Failure ◽  
2005 ◽  
Vol 27 (3) ◽  
pp. 279-282 ◽  
Author(s):  
Ioannis Griveas ◽  
George Visvardis ◽  
Aleka Fleva ◽  
Dorothea Papadopoulou ◽  
Eftathios Mitsopoulos ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Comparative Analysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Cellular Immunity ◽  
Uremic Patients

Carbohydrate and Lipid Metabolism during Continuous Ambulatory Peritoneal Dialysis (CAPD): The Effect of a Single Dialysis Cycle

1983 ◽  
Vol 65 (5) ◽  
pp. 539-545 ◽  
Author(s):  
A. Heaton ◽  
D. G. Johnston ◽  
J. M. Burrin ◽  
H. Orskov ◽  
M. K. Ward ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Glucose ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Ketone Bodies ◽  
Serum Insulin ◽  
Dialysis Fluid ◽  
Long Term Effects ◽  
Carbohydrate And Lipid Metabolism ◽  
Normal Controls

1. The effect on hormonal status and intermediary metabolism of a single 6 h dialysis cycle at two different concentrations of dialysate glucose was investigated in six patients on continuous ambulatory peritoneal dialysis. 2. The basal blood glucose level was elevated by 0.5 mmol/l, associated with a threefold increase in basal serum insulin compared with seven normal controls. Blood glucose and serum insulin rose further during dialysis, particularly with hypertonic (215 mmol of glucose/l) dialysis fluid and levels remained high for 6 h after the onset. 3. Plasma glucagon concentrations were 2.7-fold increased and did not decrease to normal during dialysis. 4. Concentrations of the gluconeogenic precursors lactate and alanine were consistently raised, and levels of circulating non-esterified fatty acids and ketone bodies were lowered, particularly with hypertonic dialysis fluid. 5. The long-term effects of sustained hyper-insulinaemia, including suppression of lipolysis and ketogenesis, require further investigation.

Evaluation of Carnitine Levels According to the Peritoneal Equilibration Test in Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 444-447 ◽  
Author(s):  
Christos Chatzidimitriou ◽  
Theodoros Pliakogiannis ◽  
Athanasios Evangeliou ◽  
Theodora Tsalkidou ◽  
Hans Josef Böhles ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Total Cholesterol ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
High Total Cholesterol ◽  
Normal Range ◽  
Peritoneal Equilibration Test ◽  
Cholesterol Ratio ◽  
Abnormal Metabolism ◽  
Males And Females ◽  
High Triglyceride

The evidence of carnitine abnormal metabolism in patients on continuous ambulatory peritoneal dialysis (CAPO) is unclear, and previous studies have reported conflicting results. The total (TC), free (FC), and acylated (AC) carnitines were estimated in blood and dialysate, as well as the AC/FC ratio, in 29 patients on CAPO, grouped into high (H-Abs) and low (L-Abs) absorbers, according to the results of the peritoneal equilibration test (fast PE-test). Ourdata demonstrated that patients with higher peritoneal transport rates, which was the H-Abs group, males and females, showed a better carnitine metabolic status compared to the L-Abs group. Although the H-Abs group lost significantly more free carnitine than the L-Abs group, the AC/FC ratio of the H-Abs group remained within normal range. All the patients in our study showed abnormally high triglyceride (TAG) levels and an abnormally high total cholesterol/HOL cholesterol ratio. In particular, the patients In the L-Abs group showed significantly higher TAG levels and total cholesterol/HOL cholesterol ratios than the H-Abs group. Those patients who have been on CAPO for more than 2 years showed significantly abnormally higher AC/FC ratios than those with shorter periods on CAPO treatment. In patients with AC/FC ratio greater than 0.4, the supplementation of L-carnitine may have a beneficial effect on their carnitine and lipid metabolism.

scholarly journals Continuous Ambulatory Peritoneal Dialysis Improves Immunodeficiency in Uremic Patients

Nephron ◽  
1983 ◽  
Vol 35 (3) ◽  
pp. 209-210 ◽  
Author(s):  
F. Giacchino ◽  
F. Quarello ◽  
M. Pellerey ◽  
G. Piccoli
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Uremic Patients
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