Variability of Peritoneal Protein Loss in Diabetic and Nondiabetic Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 242-244 ◽  
Author(s):  
Sophia Spaia ◽  
Fotini Christidou ◽  
Panayotis Pangidis ◽  
Thomas Tsoulkas ◽  
Michalis Pazarloglou ◽  
...  
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Total Protein ◽  
Peritoneal Fluid ◽  
Protein Loss ◽  
Glucose Levels ◽  
Short Period ◽  
Group A ◽  
Group B

In order to evaluate the Influence of diabetes mellitus on peritoneal membrane permeability, we studied the peritoneal protein loss In two groups of patients. Group A consisted of 16 patients (9 nondlabetics and 7 diabetics) who were In the first month of treatment on continuous ambulatory peritoneal dialysis (CAPO). Group B consisted of 13 patients (7 nondlabetics and 6 diabetics) who had been on CAPO for approximately 15 months. In both groups we measured the body weight, serum total protein, albumin, and total protein, urea, and glucose In the peritoneal fluid. We did not find any difference In groups A and B between diabetics and nondlabetics as far as the estimated parameters were concerned. Age, body weight, serum biochemistry, and protein and urea content In peritoneal fluid were similar, when group A was compared to group B. Patients of group B hed on average higher protein losses than those who had been on the method for a short period (mean 7.9 g/dL, vs 6.09 g/dL). Six patients were followed for over 15 months and were found to have significantly Increased protein losses (p=0.02). Glucose levels In peritoneal fluid were significantly lower In patients In group B, p<0.05 (mean 51.8 g/dL vs 37.1 g/dL). Peritoneal protein loss does not seem to differ between diabetic and nondiabetic patients with end-stage renal disease treated with CAPO, at any given time of the treatment. We observed an Increase In protein loss In some patients and a tendency to Increase the protein loss In others. This, along with the fall In glucose levels, might reflect progressive alterations In structure and permeability of the elements Involved In peritoneal transport, and It should receive further evaluation.

Residual Renal Function Affects Lipid Profile in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

1997 ◽  
Vol 17 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Alexander Kagan ◽  
Eti Elimalech ◽  
Zvi Lerner ◽  
Aaron Fink ◽  
Yaacov Bar-Khayim
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Lipid Profile ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Residual Renal Function ◽  
Lipoprotein Cholesterol ◽  
Group A ◽  
Group B

Objective To determine whether lipoprotein abnormalities associated with continuous ambulatory peritoneal dialysis (CAPD) are influenced by residual renal function (RRF). Design Open, non randomized prospective and com -parative study. Setting Single university teaching hospital dialysis unit and outpatient clinic. Patients Twenty adult patients on standard CAPD (1 -38 months) were divided into two groups: group A (RRF ≤ 0.8 mL/min, n = 10) and group B (RRF ≥ 1.1 mL/ min, n = 10). Patients in the two groups were matched for age, time on dialysis, body weight, body mass index, serum urea and albumin levels, peritoneal and urinary albumin losses, and peritoneal transport characteristics such as overnight 8hour peritoneal creatinine and β2-microglobulin clearances and overnight 8-hour effluent glucose concentrations. Results The degree of uremia in patients with preserved RRF (group B) was obviously lower than in patients with negligible RRF (group A), that is, patients in group B had significantly lower serum creatinine and β2-microglobulin levels and significantly higher weekly KTN than group A patients. Despite the prevalence of allele 4 of apolipoprotein E genotype in group A patients, their levels of serum total cholesterol, low-density lipoprotein cholesterol, lipoprotein (a) [Lp(a)], apolipoprotein B (ApoB), and apolipoprotein A1 (ApoA1) were significantly lower than those of patients with preserved RRF (group B). The two groups did not differ significantly in the serum levels of triglyceride or high-density lipoprotein cholesterol. Serum concentrations of Lp(a) and ApoA1, as well as ratios of ApoA1 to ApoB, were correlated significantly with RRF (r = 0.63, r = 0.51, and r = 0.61, respectively). Conclusions The findings suggest that RRF affects the lipid profile of CAPD patients, especially serum levels of cholesterol-rich lipoproteins.

Surgical Complications during Continuous Ambulatory Peritoneal Dialysis

1985 ◽  
Vol 5 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Giovanni Valenti ◽  
Donata Cresseri ◽  
Maria Luisa ◽  
Bianchi Enzo ◽  
Corghi Marc Lorenz ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Surgical Complications ◽  
Abdominal Cavity ◽  
Temporary Change ◽  
Elderly Males ◽  
Group A ◽  
Main Factors ◽  
Group B ◽  
Diaphragmatic Hernias

In 30 patients (20 males and 10 females) undergoing CAPD, we observed 15 catheter-related complications -group A: leakage, dislodgement, slipping-out, protrusion of the external cuff, hemoperitonitis, and eight abdominal-cavity complications -group B: umbilical, inguinal, incisional and diaphragmatic hernias. Group A complications which occurred in 30% of the men and 80% of the women (mean age 47.2 ± 9) were easy to manage; group B complications developed mainly in elderly males (seven men and one woman, mean age 61.4 ± 5); these required temporary change of mode of dialysis in three, and permanent transfer from CAPD in two. From this review we have concluded that loss of anatomical integrity of the abdominal cavity is one of the main factors which prevents the continuation of CAPD.

scholarly journals P1166DOES PERITONEAL PROTEIN LOSS AFFECT CARDIOVASCULAR MORTALITY OF PERITONEAL DIALYSIS PATIENTS ?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marios Theodoridis ◽  
Stylianos Panagoutsos ◽  
Ioannis Neofytou ◽  
Konstantia Kantartzi ◽  
Efthimia Mourvati ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Peritoneal Dialysis ◽  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Dialysis Patients ◽  
Protein Loss ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Group A ◽  
Group B

Abstract Background and Aims Peritoneal protein loss (PPL) through peritoneal effluent has been a well-recognized detrimental result of peritoneal dialysis (PD). The amount of protein lost will depend on dialysis time, protein size, its serum concentration and other factors including patients’ clinical status. Peritoneal protein loss may be a manifestation of endothelial dysfunction, as with another type of capillary protein leakage, microalbuminuria, a recognized endothelial dysfunction marker. The aim of this study was to retrospectively evaluate the influence of PPL on cardiovascular mortality of peritoneal dialysis patients Method This is a single center retrospective study of 84 PD patients (m=54, f=30) with mean age of 65.2±17 years, mean PD duration of 43.2±24.9 months conducted for the time period from 2006 to 2019 (13 years). The patients were divided into two groups according to the amount of protein excreted during the modified Peritoneal Equilibration Test (PET) procedure using PD solution of 3.86% DW, 2 Lt infusion volume for total time of 4 hours. The total amount of proteins excreted was calculate from PET by multiplying the concentration of proteins at the end of the test with the total volume of PD fluid at the same time. Group A excreted a total amount of proteins &lt; 1.55 gr (median value) at the end of PET test and Group B &gt; 1.55 gr. The cumulative all-cause and cardiovascular survival of the PD patients was calculated by Kaplan Meier while the possible effect of any parameter in survival rates was evaluated by using Cox Regression analysis Results There was not any statistically significant difference between the two groups according to PD duration, age, dialysis adequacy targets, Residual Renal Function(RRF), BMI, ultrafiltration volume during PET and their transport status. The cumulative all-cause survival using Kaplan-Meier analysis revealed no statistically significant deference between the two groups (Log Rank p=0.55) even though mortality risk was adjusted for several factors (Cox Regression). When cardiovascular survival, using Cox Regression analysis, was adjusted for age, sex, Diabetes, PD modality, dialysis Kt/V and RRF we found that Group A (with protein excretion &lt; 1.55 gr) had statistically significant better cardiovascular survival (p=0.029) compared to Group B. We confirm these results while trying to find among the total of our patients the possible risk factors for cardiovascular mortality. Using Cox Regression analysis, the amount of protein excreted during PET procedure and the type of PD solutions (high or low in GDPs) used were statistically significant (p=0.019 and p=0.04 respectively) independent risk factors for cardiovascular survival in our patients. Conclusion These results indicate that protein loss during peritoneal dialysis procedure has negative impact on cardiovascular mortality and survival of PD patients. Additionally, the use of PD solutions with low Glucose Degradation Products (GDPs) and AGEs may improve PD patient’s cardiovascular survival. Randomized interventional studies are encouraged to address the pathological concern of PPL in the future, namely its effects on cardiovascular conditions or its role as marker and effort to reduce PPL using ACE inhibitors or vit D should be considered only if it diminishes cardiovascular morbidity or mortality.

scholarly journals Efficacy of Equal Volume of Ringer Lactate Versus 3.5% Polymer of Degraded Gelatine Solution (Haemaccel) as Preloading Fluid for Prevention of Hypotension after Spinal Anaesthesia for Lower Segment Cesarean Section

2012 ◽  
Vol 10 (1) ◽  
pp. 1-5
Author(s):  
BR Kunwar ◽  
P Bhattacharyya ◽  
NB KC
Keyword(s):  
Body Weight ◽  
Cesarean Section ◽  
Spinal Anaesthesia ◽  
Relative Volume ◽  
Ringer Lactate ◽  
Lower Segment ◽  
Lower Segment Cesarean Section ◽  
Short Period ◽  
Group A ◽  
Group B

Introduction: Systemic hypotension is frequently and immediately seen after spinal anaesthesia. Historically Ringer lactate is used to substitute the acute relative volume loss after spinal anesthesia, although it remains in intravenous circulation for a short period. The preloading with 5% albumin and gelatine have become popular and effective as they remain intravascular for a longer duration providing sustained normotension. The aim of this study was to assess the efficacy of equal volume of Ringer lactate and Haemaccel as a preloading fluid for the prevention of hypotension after spinal anaesthesia in patients undergoing Lower Segment Cesarean Section. Methods: This was a prospective comparative study in which Patients were randomly allocated in to Group A and group. Group A patients were preloaded with Ringer lactate 10ml/kg body weight and Group B were preloaded with Haemaccel 10 ml/kg body weight within a period of 5-10 minutes before spinal anaesthesia. After giving the block, blood pressure (systolic, diastolic and mean) were recorded every 2.5 minutes for initial 20 minutes and every 5 minutes during the rest of the period of surgery. Onset of hypotension along with other parameters were recorded and analysed using SPSS ver. 13. Results: All together 100 patients were enrolled in the study, 50 in Group A (Ringer lactate) and 50 in Group B (Haemaccel). The episodses of hypotension was higher in patients who received Ringer lactate as preloading fluid than who received haemaccel as preloading fluid (42% versus 24%). Conclusion: Preloading with Haemaccel gives better hemodynamic stability and lesser incidence of hypotension than that of Ringer lactate. DOI: http://dx.doi.org/10.3126/mjsbh.v10i1.6405 Medical Journal of Shree Birendra Hospital Jan-June 2011 10(1) 1-5

The Effect of Hemoglobin Concentration on Peritoneal Mass Transfer and Drain Volumes in Continuous Ambulatory Peritoneal Dialysis

1992 ◽  
Vol 12 (2) ◽  
pp. 230-233 ◽  
Author(s):  
Alastair J. Hutchison ◽  
Norma J. Ofsthun ◽  
Debbie Howarth ◽  
Ram Gokal
Keyword(s):  
Mass Transfer ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Hemoglobin Concentration ◽  
Hemoglobin Level ◽  
University Teaching ◽  
Renal Unit ◽  
Before And After ◽  
Group A ◽  
Group B

Objective To determine whether a correlation exists between hemoglobin levels and peritoneal mass transfer or drain volumes in continuous ambulatory peritoneal dialysis (CAPD) patients. Design Prospective study of two groups of CAPD patients, identified on the basis of their stable hemoglobin levels. Group A -hemoglobin less than 8.5 g/dL; Group B hemoglobin greater than 10.5 g/dL. Peritoneal mass transfer and drain volumes were measured for each patient, after which a subgroup of Group A was treated with rHuEPO (forming Group C) and measurements repeated once hemoglobin had risen by at least 2.0 g/dL. Setting Single renal unit of a university teaching hospital. Patients:Twenty-seven patients established on CAPD, selected according to their stable hemoglobin level. Group A -14 patients; Group B -13 patients; Group C (subgroup of A) -8 patients. Main outcome measures Difference between peritoneal mass transfer or drain volume in Group A versus Group B, and in Group C before and after rHuEPO therapy. Serum biochemical parameters in Group C before and after rHuEPO therapy. Results No statistically significant differences in any of the parameters measured were found between groups A and B, or before and after rHuEPO therapy in Group C. Conclusions Peritoneal transfer of small solutes and water is not influenced by hemoglobin level, and does not change following otherwise effective treatment with rHuEPO.

scholarly journals Antihyperglycemic effect of turmeric aqueous root extract and morphological changes in the pancreas of alloxan-induced hyperglycemic Wistar rats

2021 ◽  
Vol 11 (5-S) ◽  
pp. 19-24
Author(s):  
Samuel I. Ogenyi ◽  
Ezinne Imoko ◽  
Anthony A. Ngokere ◽  
Amalachukwu O. Ike
Keyword(s):  
Body Weight ◽  
Blood Glucose ◽  
Wistar Rats ◽  
Control Group ◽  
Root Extract ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Body Weights ◽  
Group A ◽  
Group B

Introduction: The study aims to evaluate the anti-hyperglycaemic effect of turmeric and the histological changes in the pancreas of adult Wistar rats. Materials and Methods: Forty adult Wistar rats were divided into four groups of [A-D] ten rats per group. Group A was normal control, group B was diabetic control, group C was treated with 300mg/kg weight of extract and group D was 500mg/kg body weight. All animals had access to food and water ad libitum.  Aqueous extract of turmeric was administered orally, once daily for 14 days. The rats were then anaesthetized with dichloromethane before sacrifice and sample collection. Pancreatic tissues were processed, stained using the hematoxylin and eosin (H&E) method. Blood glucose estimation was determined using the glucose oxidase method. Results: The mean body weights of the rats across groups were not statistically significant. Similarly, blood glucose levels across groups revealed a progressive statistically significant increase from group A to D and from day one to day 17. Pairwise comparison of group A with B, C and D showed a statistically significant increase but a comparison of Group B with C and D were not significant. Discussion: There was progressive body weight increase of the rats from day one to the final day across all groups and reduction in the blood glucose levels of the animals treated with 300mg/kg and 500mg/kg body weights, after seven days of treatment, but these, progressively increased with time even with treatment. The overall pancreas features indicate moderate inflammatory changes. Keywords: turmeric, anti- hyperglycemia, alloxan, Wistar rats

Serum Carnitine Levels, Lipid Profile, and Metabolic Status of Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 440-443 ◽  
Author(s):  
Theodoros Pliakogiannis ◽  
Christos Chatzidimitriou ◽  
Athanasios Evangeliou ◽  
Hans Josef Söhles ◽  
Kleonikos Kalaitzidis
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Lipid Profile ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Total Protein ◽  
Skinfold Thickness ◽  
Metabolic Status ◽  
Serum Total Protein ◽  
Relative Body Weight ◽  
Triceps Skinfold Thickness

The purpose of our study was to evaluate the influence of serum carnitine levels on the metabolic status and lipid profile of patients on continuous ambulatory peritoneal dialysis (CAPD). We studied the lipid profile, the metabolic status (triceps, skinfold thickness, midarm muscle circumference, relative body weight, serum total protein, albumin), and serum carnitine levels in 22 patients (11 male, 11 female) on CAPD. The results are summarized as follows: mean serum total camitine (TC) was normal, free carnitine (FC) was reduced, while acylcarnitine (AC) was elevated in our patients (p<0.001). A positive correlation was found between TC (p<0.02), FC (p<0.05), and serum total protein. A positive correlation was also found between TC (p<0.05), AC (p<0.02), ACIFC (p<0.02), and relative body weight, and TC (p<0.001), FC (p<0.02), AC (p<0.01), ACIFC (p<0.02), and triglycerides. No correlation was found between carnitine and midarm muscle circumference, triceps skinfold thickness, albumin, total cholesterol, and HDL. or LDL-cholesterol. Further studies are needed to confirm our results.

scholarly journals Long-term clinical effects of treatment by daytime ambulatory peritoneal dialysis with an individualized dialysis dose mode are comparable to traditional dialysis methods (hemodialysis or continuous ambulatory peritoneal dialysis) for end-stage renal failure

2014 ◽  
Vol 8 (1) ◽  
pp. 67-73
Author(s):  
Zhang Zhi-yong ◽  
Li Ming-xu ◽  
Yu Yong-wu ◽  
Zhou Chun-hua
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Clinical Effects ◽  
Dialysis Dose ◽  
End Stage Renal Failure ◽  
Group A ◽  
Group B ◽  
End Stage

Abstract Background: At present, patients with end-stage renal failure (ESRD) face the question of how to achieve adequate dialysis to maintain their survival with the best quality of life as long as possible. Therefore, the choice of suitable dialysis methods and dialysis dose is important. Objective: To find suitable dialysis methods and an appropriate dialysis dose for patients with ESRD. Methods: Our research compares the long-term clinical effects between the patients undergoing continuous ambulatory peritoneal dialysis (CAPD), daytime ambulatory peritoneal dialysis (DAPD), and hemodialysis (HD). Thirty-two patients subjected to peritoneal dialysis were selected and divided into group A (n = 16) and group B (n = 16), group A was treated by using the traditional CAPD pattern; group B was treated by using DAPD. Forty-six patients of renal failure at final stage were divided into group A (n = 23) and group B (n = 23), group A was treated by using a HD method, group B was treated by using a DAPD method. Results: When the same dialysis dose was applied, the patients with long-term DAPD treatment can obtain satisfactory clinical therapeutic efficacy for the period of maintenance dialysis, thoroughness of dialysis, maintenance of nutritional status, blood pressure regulation, reduction in incidence rate of peritoneal infection, maintenance of relatively high activity in daily life and alleviation in depression, comparable to patients treated with traditional CAPD or HD methods. Conclusion: The long-term clinical effects of DAPD are comparable to CAPD or HD.

Management of Fungal Peritonitis during Continuous Ambulatory Peritoneal Dialysis (CAPD)

1986 ◽  
Vol 6 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Vargemezis Zoe L. Vassilis ◽  
Homer Papadopoulou ◽  
Anna-Maria Liamos ◽  
Taisir Natscheh Belechri ◽  
George Vergoulas ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Peritoneal Lavage ◽  
Pathogenic Fungi ◽  
Significant Loss ◽  
The Other ◽  
Peritoneal Adhesions ◽  
Fungal Peritonitis ◽  
Group A ◽  
Group B

A group of 138 patients (pts) on CAPD for a total of 1889 patientmonths had 176 episodes of peritonitis. Eighteen (13%) had fungal peritonitis at one to 20 months after beginning CAPD. The responsible organisms were Candida albicans (nine pts), Candida parapsilosis (five), Candida torulopsis (three), and Trichosporum capitatum (one). These infections were treated by various combinations of antifungal agents using two different strategies: Removal of the Tenckhoff catheter and interruption of CAPD for 10 to 14 days in nine pts (Group A), and continuous peritoneal lavage for four to six days in the remainder -nine pts (Group B). Fourteen of the 18 were cured (seven of nine in each group). In group A, two patients died, one continues on CAPD while the other six (67%) were transferred to hemodialysis because they developed peritoneal adhesions with significant loss in peritoneal space. In group B, only two patients have been transferred to hemodialysis; the other seven continue on CAPD. In our experience, the preferred initial form of treatment is continuous peritoneal lavage in conjunction with antifungal therapy. Catheter removal should be reserved for those who fail to respond to this treatment. Continuous ambulatory peritoneal dialysis (CAPD) is now accepted as a alternative treatment for end-stage renal disease. However, despite continuous progress in this field, peritonitis still remains a major complication and results in increased morbidity and cost. Although pathogenic fungi account for only 2 7% of peritonitis in patients on CAPD (1–3), the illness is severe and represents a major clinical challenge to these patients. In addition, the therapy of fungal peritonitis is still controversial, especially with regard to the need for removal of the catheter. This paper presents a retrospective study and describes our experience during the past four years with the management of fungal peritonitis in 18 patients undergoing CAPD at our center.

Do Patients on Continuous Ambulatory Peritoneal Dialysis Need Arterio-Venous Fistula?

1986 ◽  
Vol 6 (4) ◽  
pp. 193-194 ◽  
Author(s):  
Preben Joffe ◽  
Robert Skov ◽  
Finn Olsen
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Jugular Vein ◽  
Repeated Treatment ◽  
Patient Needs ◽  
Vein Access ◽  
Group A ◽  
Group B ◽  
Subclavian Catheter ◽  
Venous Fistula

The authors studied 43 patients on continuous ambulatory peritoneal dialysis (CAPD) for 5.8 years. The patients were divided into two groups. Group A consisted of 19 patients with an arteriovenous fistula. In only four of these was it necessary to use the fistula during 269 treatment months. Group B consisted of 24 patients without fistulas. Four of these needed dialysis via a subclavianvein catheter during interruption of CAPD, and one via a jugular-vein access side. The patients in group B were observed for 455 treatment months. Permanent vascular access should be constructed only in CAPD patients with repeated treatment failure. A subclavian catheter should be used whenever the patient needs temporary hemodialysis.

Sign in / Sign up

Export Citation Format

Share Document