Measurement of Peritoneal Fluid Handling in Children on Continuous Ambulatory Peritoneal Dialysis Using Autologous Hemoglobin

1994 ◽  
Vol 14 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Roel E. Reddingius ◽  
Cornelis H. Schröder ◽  
Hans L. Willems ◽  
Frans C.A. Van Den Brandt ◽  
Gerardus C.M. Koomen ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Peritoneal Fluid ◽  
Human Albumin ◽  
Adult Patients ◽  
University Hospital ◽  
Lymphatic Absorption ◽  
Fluid Handling ◽  
Major Disadvantage ◽  
Dwell Period

Objective Previous measurements of peritoneal fluid handling in children treated by continuous ambulatory peritoneal dialysis (CAPD) were performed with human albumin as a fluid marker. A major disadvantage of this substance is that endogenous patient albumin enters the peritoneal cavity during the dwell period. For this reason perito neal fluid kinetics were measured in a group of children on CAPD, using autologous hemoglobin as a volume marker. Design Autologous hemoglobin was added to dialysate containing 1.36% glucose as a volume marker. Marker clearance (MC), which is presently the best available approximation of lymphatic absorption in the clinical setting, and transcapillary ultrafiltration (TCUF) were measured during a 4-hour dwell. Setting University hospital. Patients Children on CAPD (N=9), with a median age of 8.1 years (range 2.1–13.2 years). Results MC was 521±166 mL/4 hour/1.73 m2, which is high compared to the literature data on adult CAPD patients. TCUF was 519±92 mL/4 hour/1.73 m2, which is similar to data concerning adult patients. TCUF reached no maximum during the 4-hour dwell, and the deviation of the TCUF curve from linear was markedly less than usually seen in adult patients. Conclusions MC in children treated with CAPD is higher when compared to the literature data on adults. Difficulties to achieve sufficient ultrafiltration in children could be caused by relatively small differences between MC and TCUF from the beginning to the end of the dwell.

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.

Pharmacokinetics of Moxifloxacin in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

2009 ◽  
Vol 29 (5) ◽  
pp. 575-579 ◽  
Author(s):  
Chrysanthi Skalioti ◽  
Thomas Tsaganos ◽  
Dimitrios Stamatiadis ◽  
Evangelos J. Giamarellos–Bourboulis ◽  
John Boletis ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Peritoneal Fluid ◽  
Clinical Success ◽  
Pharmacokinetic Parameters ◽  
Maximum Plasma ◽  
Time Curve ◽  
Median Area ◽  
Fluid Penetration ◽  
End Stage

Objective To investigate the effect of continuous ambulatory peritoneal dialysis (CAPD) on plasma and peritoneal fluid concentration and pharmacokinetics of moxifloxacin after administration of one 400 mg dose orally to end-stage renal failure patients undergoing CAPD. Patients and Methods Blood and peritoneal samples were collected from 8 patients at standard time intervals and concentrations of moxifloxacin were estimated by HPLC analysis with fluorometric and ultraviolet detection. Pharmacokinetic parameters were estimated using standard noncompartmental methods. Results Median maximum plasma moxifloxacin concentration was 5.86 mg/L at a median time of 1.25 hours. In serum, median area under the concentration–time curve (AUC0→inf) was 157.95 ± 100.34 mg·hour/L, median t½ 25.00 hours, median clearance 2.54 L/hour, and median distribution volume 94.90 L. Median peritoneal fluid-to-plasma ratio of moxifloxacin ranged between 0.84 and 1.00, denoting adequate penetration and lack of considerable moxifloxacin removal during CAPD. Maximum moxifloxacin concentration/minimum inhibitory concentration (MIC) and AUC0→24/MIC ratios were above the cutoff points that indicate clinical success. Conclusion A single 400 mg oral dose of moxifloxacin is safe, presents rapid peritoneal fluid penetration, has similar plasma and peritoneal fluid pharmacokinetics, and should therefore be efficacious in the treatment of CAPD-induced peritonitis.

Quality of Life of Elderly Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

2001 ◽  
Vol 21 (3_suppl) ◽  
pp. 300-303 ◽  
Author(s):  
Jasna B. Trbojevic ◽  
Vidosava B. Nesic ◽  
Biljana B. Stojimirovic
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Marital Status ◽  
Older Adult ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Adult Patients ◽  
Fisher Test ◽  
Age Range

Objective The aim of the present study was to evaluate the impact of continuous ambulatory peritoneal dialysis (CAPD) on the lifestyle of elderly patients. Patients and Methods Aspects of health-related quality of life (QL) were studied in 48 patients (16 men, 32 women) in end-stage chronic renal failure (ESRF) undergoing CAPD at the Clinic of Nephrology, Clinical Centre of Serbia. The first group comprised 20 adult patients (8 men, 12 women; age range: 35 – 59 years). The second group consisted of 28 older adult patients (8 men, 20 women; age range: 65 – 75 years). Mean length of CAPD treatment was 5.2 years in the first group and 3.67 years in the second group. Fifteen QL variables were investigated: marital status, family relationships, working ability, sleep, tiredness, appetite, wound healing, hobby, sports, friendships, sexual activity, mood, travel, self management, and happiness. Results The results showed that, in the examined groups, marital status and relationships with family members weren't influenced at all by dialysis. In both groups, CAPD had a negative influence on ability to bear cold and to travel, but other life functions were not significantly affected. Elderly patients had a significantly worse appetite ( p = 0.03, Fisher test) and mood ( p = 0.045, Fisher test) than did younger adults. In other examined variables, no statistically significant differences were found between the groups. Conclusions Lack of large, statistically significant differences between the groups suggests that CAPD has an equal influence on quality of life in younger and older adult patients.

The Disappearance of Macromolecules from the Peritoneal Cavity during Continuous Ambulatory Peritoneal Dialysis (CAPD) is Not Dependent on Molecular Size

1990 ◽  
Vol 10 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Raymond T. Krediet ◽  
Dirk G. Struijk ◽  
Gerardus C. M. Koomen ◽  
Fransiscus J. Hoek ◽  
Lambertus Arisz
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Serum Proteins ◽  
Molecular Size ◽  
Gel Permeation Chromatography ◽  
Lymphatic Absorption ◽  
Clearance Ratio ◽  
Dextran 70 ◽  
Dextran Clearance

The transport of macromolecules from the circulation to the peritoneal cavity is a size-selective restricted process, while the transport of these solutes from the peritoneal cavity is probably mainly by lymphatic absorption. If so, it should be independent of molecular size. Therefore, we studied with a clearance technique the disappearance of intra peritoneally administered inulin and polydisperse dextran 70 in nine continuous ambulatory peritoneal dialysis (CAPD) patients and compared the results with the simultaneously measured appearance clearance of serum proteins. Using gel permeation chromatography 18 dextran fractions with different molecular radii could be analyzed. Inulin clearance (2.94 mL/min) was higher than total dextran clearance (1.30 mL/min). The maximal dextran concentration in all dialysate samples was found in the 50.4 Å fraction. The clearances of the dextran fractions were the same for different molecular sizes. All disappearance clearances were higher than the appearance clearances: the protein/dextran clearance ratio ranged from 0.15 for albumin/36 Å to 0.04 for alpha2-macroglobulin/91 Å. This confirms that the appearance of a macromolecule, but not its disappearance is dependent on molecular size. It is concluded that the disappearance of macromolecules from the peritoneal cavity is mainly a size independent convective process, possibly by lymphatic uptake. This implies that total dextran 70 clearance can be used for measurement of lymphatic absorption in CAPD patients.

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