Six-Month Prospective Cross-Over Study to Determine the Effects of 1.1% Amino Acid Dialysate on Lipid Metabolism in Patients on Continuous Ambulatory Peritoneal Dialysis

1997 ◽  
Vol 17 (3) ◽  
pp. 279-286 ◽  
Author(s):  
Madhukar Misra ◽  
David A. Reaveley ◽  
Jacqueline Ashworth ◽  
Bruce Muller ◽  
Mary Seed ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Lipid Metabolism ◽  
Amino Acid ◽  
Total Cholesterol ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Density Lipoprotein ◽  
Protein Excretion ◽  
Group A ◽  
Group B ◽  
To Receive

Objective To evaluate the effect of 1.1% amino acid dialysate (A AD) (Nutrineal, Baxter, Castlebar, Ireland) on lipid metabolism in hyperlipidemic patients on continuous ambulatory peritoneal dialysis (CAPD). Design Patients were alternately assigned to receive AAD in the first (group A), or the second (group B), 6 months of a prospective cross-over study. Setting University teaching hospital. Patients Eighteen stable CAPD patients with a serum cholesterol 5.5 mmol/L or greater. Interventions One post prandial exchange of AAD during a 24-hour period for 6 months. Main Outcome Measures A significant change in serum lipid levels. Results Patients in group A (n = 10) received a single daily exchange of AAD in place of their post prandial dextrose exchange for the first 6 months, and then crossed over to the dextrose phase. Patients in group B (n = 8) continued their usual dextrose dialysis for the first 6 months and then crossed over to receive AAD in the latter 6 months. Measurements of serum lipids and lipoproteins along with other biochemical parameters were made at regular intervals. Although a downward trend in mean serum total cholesterol was seen on AAD in group A, no significant change in total cholesterol, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol was observed in any group. Mean serum triglycerides fell on AAD in both groups, but were not statistically significant. Serum lipoprotein(a) [Lp(a)] and apolipoprotein B were elevated in both groups but did not change on AAD or with time. No change was observed in serum apoprotein A1 levels. Serum Lp(a) was not correlated to dialysate protein excretion. No change in mean serum albumin was observed, in either group, on AAD. KT/V urea, total weekly creatinine clearance, net ultrafiltration, and dialysate protein excretion remained unchanged on AAD. Conclusions The use of A AD, although clinically safe and without side effects, had no effect on the dyslipidem ia in our group of CAPD patients.

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.

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.

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.

Effects of Peritoneal Dialysis with an Overnight Icodextrin Dwell on Parameters of Glucose and LIPID Metabolism

2001 ◽  
Vol 21 (3) ◽  
pp. 275-281 ◽  
Author(s):  
Sebastian J.H. Bredie ◽  
Frank H. Bosch ◽  
Pierre N.M. Demacker ◽  
Anton F.H. Stalenhoef ◽  
Robert Van Leusen
Keyword(s):  
Fatty Acids ◽  
Peritoneal Dialysis ◽  
Lipid Metabolism ◽  
Free Fatty Acids ◽  
Total Cholesterol ◽  
Plasma Glucose ◽  
Density Lipoprotein ◽  
Lipid Profiles ◽  
Care Hospital ◽  
Plasma Total Cholesterol

Objective To examine whether a reduced daily glucose load by overnight application of the less-absorbed glucose polymer icodextrin would have favorable effects on lipid profiles of continuous ambulatory peritoneal dialysis (CAPD) patients. Study Design Randomized crossover study with two subsequent periods of 6 weeks. Setting Home PD unit of a secondary-care hospital. Patients Twenty-one nondiabetic CAPD patients (15 male, 6 female; mean age 50.3 ± 11.8 years). Intervention Participants were randomly assigned to receive an overnight dwell with either standard glucose solution or with a 7.5% icodextrin-containing solution. Main Outcome Measures Relation between reduction in the total amount of intraperitoneal infused glucose and parameters of glucose (plasma glucose, insulin, and HbA1C) and lipid metabolism [free fatty acids, plasma lip-ids, lipoproteins, and low density lipoprotein (LDL) sub-fraction profile]. Results After the icodextrin dwells, a reduction of plasma total cholesterol (from 5.43 ± 0.85 to 4.86 ± 0.70 mmol/L, p < 0.001) and LDL cholesterol (from 3.38 ± 0.87 to 2.93 ± 0.73 mmol/L, p = 0.001) was observed. Also, high density lipoprotein (HDL) cholesterol (from 0.95 ± 0.27 to 0.90 ± 0.24 mmol/L, p = 0.029) was reduced, but the plasma total cholesterol-to-HDL ratio remained similar. Plasma free fatty acids and triglyceride levels tended to decrease (from 0.16 ± 0.10 to 0.13 ± 0.08 mmol/L, p = 0.06, and from 2.14 ± 1.96 to 1.92 ± 1.03 mmol/L, respectively). Evaluation of LDL subfraction profiles after ultra-centrifugation showed a more buoyant LDL subfraction profile with fewer dense LDL particles in 6 patients and no changes in 14 patients after icodextrin. The effects on lipids were not accompanied by a decrease in fasting plasma glucose (from 5.76 ± 1.29 to 5.86 ± 0.80 mmol/L) or insulin levels (from 19.5 ± 14.4 to 20.3 ± 13.0 mU/L). Conclusion These results suggest a beneficial effect on lipid profiles of CAPD patients with the use of an overnight dwell with icodextrin.

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 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.

scholarly journals Fasting lipid in overweight and obese children: A hospital based study

2019 ◽  
Vol 45 (2) ◽  
pp. 81-85
Author(s):  
Monira Hossain ◽  
Suraiya Begum ◽  
Shahana Rahman
Keyword(s):  
Total Cholesterol ◽  
Low Density Lipoprotein ◽  
Hospital Setting ◽  
Density Lipoprotein ◽  
Normal Weight ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Obese Children ◽  
Group A ◽  
Group B

Background: Obesity has become one of the most important public health problems in recent years. Childhood obesity increases the risk of morbidities such as dyslipidemia, hypertension, type 2 diabetes (T2DM), metabolic syndrome etc. Dyslipidemia pattern consists of a combination of elevated total cholesterol, triglycerides (TG), low density lipoprotein cholesterol (LDL-C) and decreased high density lipoprotein cholesterol (HDL-C). Aim of this study was to assess fasting lipid profile and pattern of dyslipidemia in overweight and obese children in a hospital setting. Methods: It was a cross sectional study done in children, aged 5 to 16 years, attending the paediatric endocrine clinic and paediatric outpatient department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka over a period of 18 months. All overweight and obese children as well as normal weight children were selected after considering inclusion and exclusion criteria. They were categorised as group A (overweight and obese) and group B (normal weight). Results: In group A, 77.0% of children were obese and 23.0% were overweight. Total cholesterol, LDL and TG were significantly higher in group A (p<0.05). HDL was low in 58.0% of group A and 52.0% of group B which was not significantly different (p>0.05) between the groups. Most of the overweight and obese children had one or two lipid parameters abnormality but majority of normal weight children had one parameter abnormality. Dyslipidaemia was present in 80.0% and 64.0% among group A and group B respectively, which was significantly different (p<0.05). Conclusion: It was observed that 80.0% patients had dyslipidaemia among the overweight and obese children and total cholesterol, low density lipoprotein and triglyceride level were significantly higher in this group. Bangladesh Med Res Counc Bull 2019; 45: 81-85

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.

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