Pharmacokinetics of Clodronate in Peritoneal Dialysis Patients

1998 ◽  
Vol 18 (2) ◽  
pp. 204-209 ◽  
Author(s):  
Heikki H.T. Saha ◽  
Ilpo O. Ala-Houhala ◽  
Sirpa H. Liukko-Sipi ◽  
Pauli Ylitalo ◽  
Amos I. Pasternack
Keyword(s):  
Peritoneal Dialysis ◽  
University Hospital ◽  
Total Serum ◽  
Selective Detection ◽  
Hormone Concentration ◽  
Single Intravenous Dose ◽  
Dialysis Patients ◽  
Severe Renal Failure ◽  
Serum Clearance ◽  
Residual Diuresis

Objective To study the pharmacokinetics of clodronate in patients on continuous ambulatory peritoneal dialysis (CAPD). Design A single intravenous dose pharmacokinetic study. Setting University hospital. Patients Ten CAPD patients (3 female, 7 male, age 39 79 year, median 55). Methods Clodronate disodium in serum, urine, and dialysate was collected for 24 hours and analyzed by capillary gas chromatography with mass-selective detection. Results Only 7% of the infused dose of clodronate was eliminated through peritoneal dialysis during 24 hours. Clearance via CAPD (CLCAPD) was 2.4 ± 0.6 mL/min, which was less than 10% of the total serum clearance (CLtot’ 26.0 ± 19.3 mL/min). Even the kidneys were a more important route of elimination than CAPD in those patients with residual diuresis of more than 500 mL/24 hr. However, in all patients most of the clodronate serum clearance (77% ± 13%) took place via routes other than peritoneal dialysis or kidneys, that is, via nonrenal-non-CAPD clearance (CLNRD). CLNRD most likely represents the part of the drug deposited in the skeleton. There was a positive correlation between CLNRD and the plasma intact parathyroid hormone concentration. Conclusions CAPD removed clodronate poorly from the circulation. Most clearance took place via routes other than CAPD or kidneys. This CLNRD most likely represents the skeletal deposition of the drug, and this is related to the severity of hyperparathyroidism. When treating CAPD patients with hyperparathyroid bone disease, the administration of clodronate should be adjusted as in those subjects with severe renal failure.

Abdominal Wall Hernias in End-Stage Renal Disease Patients on Peritoneal Dialysis

2008 ◽  
Vol 28 (4) ◽  
pp. 391-396 ◽  
Author(s):  
Gustavo Martínez-Mier ◽  
Eduardo Garcia-Almazan ◽  
Hugo E. Reyes-Devesa ◽  
Victor Garcia-Garcia ◽  
Sergio Cano-Gutierrez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Peritoneal Dialysis ◽  
Body Mass ◽  
Small Body ◽  
Retrospective Chart Review ◽  
University Hospital ◽  
Dialysis Patients ◽  
Dialysis Unit ◽  
Mesh Hernioplasty

Objective To describe our experience with hernioplasty in peritoneal dialysis patients and to identify possible risk factors for surgical complications. Design A 4-year retrospective chart review of data. Setting Peritoneal dialysis unit of a university hospital. Patients and Methods 58 hernias in 50 patients were included. Detailed surgical technique and complications were recorded. Possible risk factors included age, gender, weight, height, body mass index, previous surgery, diabetes, time on dialysis, emergency surgery, hospital stay, type of hernia, mesh use, blood hemoglobin, and serum urea, creatinine, and potassium. Results Complications occurred in 12 hernioplasties (4 wound infections, 2 peritonitis, 4 catheter dysfunction, and 5 re-operations). Recurrence rate was 12% without mesh use and 0% with mesh hernioplasty. Dialysis was re-instituted in 96% of cases within 3 days postoperatively. Identified risk factors for complications were diabetes, low weight, low height, small body mass index, and low serum creatinine. Conclusions Mesh hernioplasty in peritoneal dialysis patients is advisable. Postoperative dialysis with low volume is feasible after surgery. Prospective studies will corroborate our risk factors for morbidity.

Single-Dose Pharmacokinetics of Intraperitoneal Ofloxacin in Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 383-385 ◽  
Author(s):  
Ignatius Kum-Po Gheng ◽  
Pak-Yin Ghau ◽  
Gyrus R. Kumana ◽  
Ghing-Ying Ghan ◽  
Maybelle Kou ◽  
...  
Keyword(s):  
High Pressure ◽  
Renal Function ◽  
Liquid Chromatography ◽  
Single Dose ◽  
Peritoneal Dialysis ◽  
Serum Concentration ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Total Serum ◽  
Serum Clearance ◽  
Time Required

The present study examines the pharmacokinetics of ofloxacin given In a single dose of 200 mg intraperitoneally (Ip) In the first bag of three 2-L 8-hour exchanges. Ofloxacin was measured using high-pressure liquid chromatography (HPLC) in the serum and peritoneal effiuent over 24 hours. Six patients without and 3 patients with peritonitis were studied. Ofloxacin given Ip was almost completely absorbed after an 8-hour dwell, and this was not affected by peritonitis. The time required to reach peak serum concentration was longer than that reported previously following oral administration. Elimination halflife (11/2) of ofloxacln was markedly prolonged compared to patients with normal renal function. Peritoneal clearance accounted for only one-tenth of total serum clearance. Peritonitis appeared to shorten the T112 of ofloxacln, but this was mainly due to an Increase In total serum clearance rather than a change In peritoneal clearance. Peritoneal drug concentration >0.5 mg/L was reached In the second and third exchange by the second hour. No Bide effects from Ip ofloxacin were observed. We concluded that ofloxacin given in a single dose of 200 mg is safe and provides adequate therapeutic serum and peritoneal concentration for more than 24 hours in patients on continuous ambulatory peritoneal dialysis (CAPD) with 8-hour exchanges.

Eryptosis Is Altered in Peritoneal Dialysis Patients

2019 ◽  
Vol 48 (4) ◽  
pp. 351-357
Author(s):  
Grazia Maria Virzì ◽  
Sabrina Milan Manani ◽  
Anna Clementi ◽  
Silvia Castegnaro ◽  
Alessandra Brocca ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Osmotic Shock ◽  
Uremic Toxins ◽  
Dialysis Patients ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
History Of ◽  
Clinical Conditions ◽  
Residual Diuresis ◽  
Made In

Background: Red blood cells (RBCs) undergo programmed cell death known as eryptosis. Triggers of eryptosis include increased cytosolic Ca(2+) concentration, oxidative stress, osmotic shock, energy depletion and several uremic toxins. Little is known about the pathogenesis of eryptosis in peritoneal dialysis (PD) patients; furthermore, its relevance in worsening clinical conditions in these patients is still not completely defined. Objectives: We investigated eryptosis levels in PD patients and its association with inflammatory and clinical parameters. Material and Methods: A total of 46 PD patients and 17 healthy subjects (CTR) were enrolled. All eryptosis measurements were made in freshly isolated RBCs using the flow cytometer. Results: Eryptosis was significantly higher in PD patients than that in CTR (p < 0.001). Eryptosis levels did not differ significantly between PD patients with and without diabetes, with and without hypertension, and with and without cardiovascular disease. Eryptosis showed no significant differences between patients treated with continuous ambulatory PD/automated PD, with Kt/Vurea value ≤1.7 and >1.7, with a negative or positive history of peritonitis. On the contrary, eryptosis showed significantly lower levels in PD patients with weekly creatinine clearance ≥45 L/week/1.73 m2 (2.8%, 1.7–4.9 vs. 5.6%, 5.0–13.5; p= 0.049). Eryptosis showed significantly lower levels in PD patients with residual diuresis (n = 23) than that in patients without (3.7%, 2.6–5.6 vs. 5%, 3.1–16; p = 0.03). In these 23 patients, significant negative correlations between percentage of eryptosis and residual glomerular filtration rate (rGFR; Spearman’s rho = –0.51, p = 0.01) and diuresis volume (Spearman’s rho = –0.43, p = 0.05) were found. Conclusions: The present study demonstrated higher eryptosis levels in PD patients compared to corresponding levels in CTR. Furthermore, important PD comorbidity and main PD parameters do not influence eryptosis. Importantly, our data have reported an increase in eryptosis levels with progressive residual diuresis and rGFR loss, probably due to decreased uremic toxins clearance.

scholarly journals The predictive value of hyperuricemia in residual diuresis decline in peritoneal dialysis patients

2019 ◽  
Vol 18 (2) ◽  
pp. e2378-e2379
Author(s):  
N. Stepanova ◽  
L. Surzhko ◽  
L. Lebed ◽  
L. Snisar ◽  
M. Kolesnyk
Keyword(s):  
Peritoneal Dialysis ◽  
Predictive Value ◽  
Dialysis Patients ◽  
Residual Diuresis

scholarly journals Hyperuricemia Predicts Residual Diuresis Decline in Peritoneal Dialysis Patients

2020 ◽  
Vol 18 (1) ◽  
pp. em270
Author(s):  
Natalia Stapanova ◽  
Lyudmyla Snisar ◽  
Larysa Lebid
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Residual Diuresis

scholarly journals Geriatric Nutritional Risk Index as a Prognostic Factor in Peritoneal Dialysis Patients

2013 ◽  
Vol 33 (4) ◽  
pp. 405-410 ◽  
Author(s):  
Seok Hui Kang ◽  
Kyu Hyang Cho ◽  
Jong Won Park ◽  
Kyung Woo Yoon ◽  
Jun Young Do
Keyword(s):  
Peritoneal Dialysis ◽  
Prognostic Factor ◽  
Risk Index ◽  
University Hospital ◽  
Nutritional Risk ◽  
Nutrition Status ◽  
Dialysis Patients ◽  
Geriatric Nutritional Risk Index ◽  
Simple Method ◽  
Nutritional Risk Index

BackgroundThe Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce.MethodsWe reviewed the medical records at Yeungnam University Hospital in Korea to identify all adults (>18 years) who received PD; 486 patients were enrolled in the study.ResultsThe initial low, middle, and high GNRI tertiles included 162, 166, and 158 patients respectively. Significant correlations were noted between the initial GNRI and body mass index, creatinine, albumin, arm circumference, fat mass index, and comorbidities. The cut-off value for the time-averaged GNRI over 1 year was 96.4, and the sensitivity and specificity for a diagnosis of a decline in lean mass were 77.1% and 40.0% respectively. A multivariate analysis adjusted for age, risk according to the Davies comorbidity index, and C-reactive protein showed that an low initial GNRI tertile was associated with mortality in PD patients.ConclusionsThe GNRI is a simple method for predicting nutrition status and clinical outcome in PD patients.

scholarly journals MO892DIALYSIS SERVICE MANAGEMENT DURING COVID-19 PANDEMIC IN EUROPEAN CITY AREA

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Laurynas Rimsevicius ◽  
Feliksas Jankevicius ◽  
Ausra Motiejuniene Bilotiene ◽  
Marius Miglinas
Keyword(s):  
Peritoneal Dialysis ◽  
Service Management ◽  
Action Plan ◽  
Chronic Hemodialysis ◽  
Public Hospitals ◽  
University Hospital ◽  
Dialysis Patients ◽  
Chronic Patients ◽  
City Area ◽  
End Stage

Abstract Background and Aims Many countries across Europe experience the second wave of CoVid-19 pandemic. Lithuania is a country situated on the eastern shore of the Baltic Sea. Until January 15, Lithuania had 165560 confirmed positive cases, 100495 recoveries, and 2376 deaths. Method In this abstract, we describe reorganization in dialysis service in Vilnius, the capital and largest city of Lithuania, with urban population of 700,275 inhabitants. Results At the pandemic start in March 2020, Vilnius had 3 public nephrology departments each running a hemodialysis unit, and 4 private hemodialysis centers, with total of 250 end-stage kidney disease patients. Vilnius University Hospital Santaros Klinikos, as the main hospital in the country and national CoVid-19 coordinator, restructured dialysis service in city area. Chronic hemodialysis programs in public hospitals were cancelled and patients were shifted to private centers. In the threat of infection and multiple outbreaks in two hospitals, nephrology units were closed and CoVid-19 negative nephrology patients were located in a satellite hospital in other city, whilst all city hospitals served as CoVid-19 centers. In Santaros Klinikos, we treated severe CoVid-19 patients who needed chronic or acute dialysis, while asymptomatic and mild to moderate-symptom patients carried their dialysis procedures in isolated shafts and/or facilities in private centers. In cases with unsatisfactory self-isolation, isolation sites were located in hotels or other premises provided by the municipal administration. Transportation to dialysis center was provided by municipality as well. Rapid antigen testing was set in a case of suspected outbreak or for all outpatient hemodialysis patients in some centers in circumstances of high community transmission. During the pandemic, we had ongoing transplant activities, continued wait-listing for kidney transplant and increased peritoneal dialysis program. Most peritoneal dialysis patients were trained at home by a mobile nurse team, also home visits we carried instead of inpatients visits. We started CoVid-19 vaccination during the first week of January for all dialysis patients and transplant recipients who had no contraindications and gave informed consent. Conclusion In conclusion, the rapid release and adoption of recommendations and action plan helped to identify and locate CoVid-19 outbreaks in dialysis facilities. Dialysis service reorganization is needed to maintain ongoing treatment for chronic patients who vitally depend on renal replacement therapy. Private dialysis centers and municipality should assist with physical resources operating the patients flow. The growth of peritoneal dialysis program serves as a significant subsidiary factor when patients need more social distancing. Vaccination data and outcomes in end-stage renal disease patients is coming soon.

scholarly journals Education and Protein Supplementation Improve Nutritional Biomarkers among Hypoalbuminemic Peritoneal Dialysis Patients: A Quasi-Experimental Design

Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 135
Author(s):  
Tuyen Van Duong ◽  
Chang-An Tsao ◽  
Evelyn Yang ◽  
Ching-Hsiu Peng ◽  
Yi-Cheng Hou ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Protein Intake ◽  
Milk Protein ◽  
Protein Supplementation ◽  
Serum Phosphorus ◽  
Total Serum ◽  
Dialysis Patients ◽  
Nutritional Education ◽  
Quasi Experimental

Protein-energy wasting is prevalent in peritoneal dialysis patients, which causes a heavy burden for individuals and healthcare systems. We aimed to investigate the effect of nutritional education, and/or protein supplementation on nutritional biomarkers in hypoalbuminemic peritoneal dialysis patients. A quasi-experimental study was conducted in two dialysis centers at Taipei Tzu Chi Hospital and Shin Kong Wu Ho-Su Memorial Hospital. Patients were allocated in three groups including control (n = 12), milk protein (n = 21) and soy protein (n = 20). All patients received dietary guidelines from dietitians and completed 3-day dietary records during monthly visits for consecutive three months. Nutrients were analyzed using Nutritionist Professional software. Blood urea nitrogen (BUN), creatinine, albumin, total protein, hemoglobin, serum calcium, phosphorus, sodium, and potassium were assessed monthly. Total cholesterol and triglycerides were measured every three months. After three-month intervention, protein intake (percent of total calories), and serum albumin were significantly increased in three groups. Protein, phosphorus intake, and BUN were increased in two intervention groups. Total serum protein increased in control and milk protein groups, and creatinine increased the control group. Serum phosphorus was not significantly changed. Nutritional education alone, or combined with protein supplementation, significantly improve protein intake, and nutritional status by increasing serum albumin, but not serum phosphorus in hypoalbuminemic peritoneal dialysis patients.

Nutritional Status of Korean Peritoneal Dialysis Patients

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 517-523 ◽  
Author(s):  
Sung Hee Chung ◽  
Myung Hee Na ◽  
Sui Hyung Lee ◽  
Sung Ja Park ◽  
Won Seck Chu ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Body Mass ◽  
University Hospital ◽  
Stepwise Multiple Regression ◽  
Severe Malnutrition ◽  
Total Serum Protein ◽  
Total Serum ◽  
Western Literature

Objectives To assess the nutritional status of Korean peritoneal dialysis (PD) patients and to compare with data from Western literature, and to elucidate independent factors determining nutritional status and death. Design Cross-sectional single-center study. Setting Kidney Center, Soon Chun Hyang University Hospital. Materials Ninety-eight CAPD patients were included. Of these, 54 patients were male, 32 patients were diabetic, mean age was 47.9 :i: 13.1 years, and mean duration of CAPD was 22.3 :i: 21.6 months. The patients were followed until death, transfer to hemodialysis (HD) or other units, transplantation, or until 3 years had elapsed after the first evaluation. Methods Nutritional status was assessed by subjective global assessment (SGA), biochemical and anthropometric measurements, fat-free edema-free (FFEF) body mass by creatinine (Cr) kinetics, protein equivalent of total nitrogen appearance (PNA), and urea kinetic studies. Results By SGA score, 53.1% of patients were classified as normal, 44.9% with mild-to-moderate malnutrition, and 2% with severe malnutrition. Patients with malnutrition were significantly older and had higher peritonitis rates, lower serum albumin (Alb), blood urea nitrogen (BUN), serum Cr, FFEF body mass, mid arm muscle circumference, and PNA (p < 0.05). On stepwise multiple regression analysis, the SGA score was negatively correlated with age and peritonitis rate (p < 0.01). At the end of the 3-year follow-up period, 11 patients were still on CAPD, 26 had died, 51 had transferred to HD and 5 to other units, 3 patients had been transplanted, and 2 patients were lost to follow-up. Patients who died during follow-up were older and had higher peritonitis rates and lower total serum protein, Alb, Cr, and FFEF body mass when compared to those who survived (p < 0.05). Independent predictors of death were age, peritonitis rate, and serum Alb (p < 0.01). Conclusion Malnutrition was as common in Korean PD patients as reported in the Western literature. Our data suggests that, to prevent malnutrition and early death, it is important to reduce the peritonitis rate, to improve protein intake, and to prescribe an adequate dose of peritoneal dialysis.

Magnesium handling in peritoneal dialysis patients with preserved residual diuresis

2015 ◽  
Vol 48 (4) ◽  
pp. 633-634 ◽  
Author(s):  
Carlos G. Musso ◽  
Konstantina Trigka ◽  
Periklis Dousdampanis
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Residual Diuresis
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