Clinical Factors Associated with Sodium Removal in Peritoneal Dialysis Patients

Peritonitis is a major reason why patients transfer from peritoneal dialysis (PD) to hemodialysis. We evaluated the peritonitis infection rates In 146 peritoneal dialysis patients who underwent dialysis at our facility between 1 January 1981 and 31 December 1989. Peritonit Is was the primary cause for changing treatment, with 24 (16.4%) of the patients transferring because of this complication. This represented 54.5% of all patients discontinuing CAPD due to method failure. A gamma-Poisson regression analysis was performed in an attempt to Identify potential risk factors associated with an increased Incidence of peritonitis. The results indicated that race, education level, and PD system used were significantly associated with the rate at which peritonitis occurred in our patient population. There was an almost twofold increase in the rate of peritonitis among blacks as compared to whites (2.2 vs 1.2 episodes/patient year). The level of education completed at the start of dialysis had a negative correlation with peritonitis rates. Patients with ≤8, 9–12, and ≥13 years of education had peritonitis rates of 2.4, 1.8, and 1.2 episodes/patient year, respectively. Finally, the system used had a significant effect with our patients on CCPD having lower peritonitis rates as compared to patients on either a connect or disconnect system (0.6 vs 2.5 vs 1.8 episodes/patient year, respectively). Recognizing potential risk factors for peritonitis will help us better understand and address this significant problem in our PD programs. Reducing peritonitis rates should facilitate a decrease in patient transfer due to method failure.

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Factors associated with systolic hypertension in peritoneal dialysis patients

Journal of Nephrology ◽

10.1007/s40620-019-00633-y ◽

2019 ◽

Vol 33 (2) ◽

pp. 365-370 ◽

Cited By ~ 1

Author(s):

Surachet Vongsanim ◽

Andrew Davenport

Keyword(s):

Peritoneal Dialysis ◽

Systolic Hypertension ◽

Dialysis Patients ◽

Factors Associated

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Factors associated with Hypokalemia in Continuous Ambulatory Peritoneal Dialysis Patients

Electrolytes & Blood Pressure ◽

10.5049/ebp.2007.5.2.102 ◽

2007 ◽

Vol 5 (2) ◽

pp. 102 ◽

Cited By ~ 12

Author(s):

Hyun-Wook Kim ◽

Jae Hyun Chang ◽

Sun Young Park ◽

Sung Jin Moon ◽

Dong Ki Kim ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Dialysis Patients ◽

Factors Associated

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Influence of Different Payment Schemes on the Clinical Outcome in Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2014.00132 ◽

2015 ◽

Vol 36 (2) ◽

pp. 205-212

Author(s):

Chun-yan Su ◽

Xin-hong Lu ◽

Tao Wang

Keyword(s):

Peritoneal Dialysis ◽

Clinical Outcome ◽

Dietary Intake ◽

Nutrition Status ◽

Volume Status ◽

Dialysis Patients ◽

Dialysis Adequacy ◽

Sodium Removal ◽

Significant Difference ◽

Payment Schemes

Background Cost is always a big issue for dialysis patients. In the present study, we analyzed the effect of different payment schemes on dialysis adequacy and clinical outcome in our peritoneal dialysis program. Methods This is a single-center cohort study. A total of 175 patients who began dialysis from January 2006 to December 2007 were included. Baseline data, including volume status, dietary intake and nutrition status, dialysis adequacy, and sodium removal were collected at 6 months after peritoneal dialysis. Based on the different payment schemes, the patients were divided into 2 groups, higher payment group (GHP, 130 cases, with more than 85% reimbursement), and lower payment group (GLP, 45 cases, with less than 50% payment or totally self-paid). Patients were followed up until dropout or until December 31, 2013. Results At baseline, patients in the 2 groups had nearly the same residual renal function. But the GLP group patients dialyzed at a lower dose (4,516.91 ± 1,768.20 mL vs 6,058.17 ± 2,013.43 mL, p < 0.001). They had lower creatinine clearance (51.64 ± 24.23 L/w vs 70.54 ± 30.27 L/w, p < 0.001), sodium removal (2.23 ± 1.29 g vs 2.77 ± 1.29 g, p = 0.027), and fluid removal (970.33 ± 545.97 mL vs 1,146.66 ± 460.93 mL, p = 0.038). Normalized by height (in meters), the GLP group patients still had a lower normalized dialysis dose (2,890.61 ± 1084.44 mL/m vs 3,761.34 ± 1,237.10 mL/m, p < 0.001). Baseline nutritional and dietary parameters were comparable except that a lower daily protein intake (42.73 ± 10.99 g vs 47.26 ± 14.30 g, p = 0.032) and higher serum urea level (23.43 ± 6.88 mmol/L vs 19.84 ± 5.92 mmol/L, p < 0.001) were presented in the GLP group. There was no difference in volume status. During the follow-up, Kaplan-Meier analysis showed that there was no significant difference in patient survival and technique survival. In multivariate Cox regression analysis, after adjusting for related factors, payment was again not a strong predictor of survival in the study population. Conclusion Our study found that GLP group patients were adherent to lifestyle modification with lower dialysis doses, and they also had nearly the same long-term clinical outcome as the GHP group patients. Thus, lower dialysis doses combined with controlled dietary intake may be an effective approach to solve the dialysis problem for the low socio-economic status (SES) population.

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Assisted peritoneal dialysis across Europe: Practice variation and factors associated with availability

Peritoneal Dialysis International ◽

10.1177/08968608211049882 ◽

2021 ◽

pp. 089686082110498

Author(s):

Anita van Eck van der Sluijs ◽

Brigit C van Jaarsveld ◽

Jennifer Allen ◽

Karmela Altabas ◽

Clémence Béchade ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Online Survey ◽

Healthcare Professionals ◽

Practice Variation ◽

Dialysis Patients ◽

Home Dialysis ◽

Factors Associated ◽

Western European ◽

End Stage ◽

Dedicated Team

Background: In Europe, the number of elderly end-stage kidney disease patients is increasing. Few of those patients receive peritoneal dialysis (PD), as many cannot perform PD autonomously. Assisted PD programmes are available in most European countries, but the percentage of patients receiving assisted PD varies considerably. Hence, we assessed which factors are associated with the availability of an assisted PD programme at a centre level and whether the availability of this programme is associated with proportion of home dialysis patients. Methods: An online survey was sent to healthcare professionals of European nephrology units. After selecting one respondent per centre, the associations were explored by χ 2 tests and (ordinal) logistic regression. Results: In total, 609 respondents completed the survey. Subsequently, 288 respondents from individual centres were identified; 58% worked in a centre with an assisted PD programme. Factors associated with availability of an assisted PD programme were Western European and Scandinavian countries (OR: 5.73; 95% CI: 3.07–10.68), non-academic centres (OR: 2.01; 95% CI: 1.09–3.72) and centres with a dedicated team for education (OR: 2.87; 95% CI: 1.35–6.11). Most Eastern & Central European respondents reported that the proportion of incident and prevalent home dialysis patients was <10% (72% and 63%), while 27% of Scandinavian respondents reported a proportion of >30% for both incident and prevalent home dialysis patients. Availability of an assisted PD programme was associated with a higher incidence (cumulative OR: 1.91; 95% CI: 1.21–3.01) and prevalence (cumulative OR: 2.81; 95% CI: 1.76–4.47) of patients on home dialysis. Conclusions: Assisted PD was more commonly offered among non-academic centres with a dedicated team for education across Europe, especially among Western European and Scandinavian countries where higher incidence and prevalence of home dialysis patients was reported.[Formula: see text]

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Trends for and Clinical Factors Associated with Choice of Oral P2Y12 Inhibitors for Patients on Chronic Dialysis

Cardiovascular Drugs and Therapy ◽

10.1007/s10557-019-06913-w ◽

2019 ◽

Vol 33 (5) ◽

pp. 511-521 ◽

Cited By ~ 1

Author(s):

Nishank Jain ◽

Suzanne L. Hunt ◽

Huizhong Cui ◽

Milind A. Phadnis ◽

Jonathan D. Mahnken ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Esrd Patient ◽

Chronic Dialysis ◽

Clinical Factors ◽

Related Factors ◽

P2y12 Inhibitors ◽

Factors Associated ◽

Prescribing Trends ◽

To Receive ◽

Esrd Patients

ABSTRACT Background Trends and clinical factors associated with prescribing choices for oral P2Y12 inhibitors (P2Y12-I) remain unknown for patients on chronic dialysis, i.e., with end-stage renal disease (ESRD). Methods From 2011–2014 U.S. Renal Data System registry, we identified 36,542 ESRD patients who received new prescriptions for P2Y12-I (median age 64.0 years and 54% males). Of the cohort, 93% were receiving hemodialysis and 7% on peritoneal dialysis. We analyzed trends and investigated clinical factors associated with specific P2Y12-I prescribed. Results Clopidogrel was prescribed for 95%, prasugrel for 3%, and ticagrelor for 2%. Clopidogrel was favored for those ≥75 years (18% of cohort). Compared to Caucasians, African Americans (36% of cohort) and Hispanics (19% of cohort) were less likely to receive prasugrel and ticagrelor (P<0.05). Patients receiving hemodialysis versus peritoneal dialysis were less likely to receive prasugrel over clopidogrel, adjusted odds ratio (aOR) 0.67 (0.55-0.82). Each additional year of dialysis decreased the odds of receiving prasugrel over clopidogrel, aOR 0.91 (0.85-0.98). History of atrial fibrillation reduced the odds of receiving ticagrelor or prasugrel over clopidogrel, aOR 0.69 (0.54-0.89) and 0.73 (0.60-0.89), respectively. Concomitant oral anticoagulant use was not associated with choice of P2Y12-I. Occurrence of non-ST segment elevation myocardial infarction or percutaneous coronary intervention within the 6-month period prior to the index date favored ticagrelor over prasugrel, aOR 1.31 (1.06-1.62) and 1.29 (1.01-1.66), respectively. However, prescribing trends favoring ticagrelor over prasugrel were not observed for deployment of drug-eluting, or multiple coronary stents. Conclusion Between 2011 and 2014, clopidogrel remained the most common P2Y12-I whereas ticagrelor and prasugrel remained underutilized in ESRD patients. Prescribing practices for these drugs were based upon clinically approved indication for their use in the general population as well as perceived complexity of an ESRD patient including demographics, dialysis-related factors and comorbidities. Comparative effectiveness studies involving ESRD patients are needed to prove that ticagrelor and prasugrel are just as safe and effective as clopidogrel before clinicians can make informed decisions for choice of P2Y12-I in this patient population.

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Factors associated with gustatory threshold for salty taste in peritoneal dialysis patients

Renal Replacement Therapy ◽

10.1186/s41100-019-0233-8 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Kenta Torigoe ◽

Yoko Obata ◽

Shimpei Morimoto ◽

Miki Torigoe ◽

Satoru Oka ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Dialysis Patients ◽

Factors Associated ◽

Salty Taste

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Factors Associated with Fibromyalgia Syndrome in Peritoneal Dialysis Patients

Physiotherapy Canada ◽

10.3138/ptc.2017-45.ep ◽

2019 ◽

Vol 71 (1) ◽

pp. 77-81

Author(s):

Ruya Ozelsancak ◽

Pınar Doruk Analan ◽

Berrin Leblebici

Keyword(s):

Peritoneal Dialysis ◽

Fibromyalgia Syndrome ◽

Dialysis Patients ◽

Factors Associated

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Comparison of sodium removal in peritoneal dialysis patients treated by continuous ambulatory and automated peritoneal dialysis

Journal of Nephrology ◽

10.1007/s40620-019-00646-7 ◽

2019 ◽

Vol 32 (6) ◽

pp. 1011-1019 ◽

Cited By ~ 1

Author(s):

Sarju Raj Singh Maharjan ◽

Andrew Davenport

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Fluid Balance ◽

Automated Peritoneal Dialysis ◽

Peritoneal Membrane ◽

Dialysis Patients ◽

Membrane Function ◽

Peritoneal Dialysate ◽

Hypertonic Glucose ◽

Sodium Removal

Abstract Background Optimal fluid balance for peritoneal dialysis (PD) patients requires both water and sodium removal. Previous studies have variously reported that continuous ambulatory peritoneal dialysis (CAPD) removes more or equivalent amounts of sodium than automated PD (APD) cyclers. We therefore wished to determine peritoneal dialysate losses with different PD treatments. Methods Peritoneal and urinary sodium losses were measured in 24-h collections of urine and PD effluent in patients attending for their first assessment of peritoneal membrane function. We adjusted fluid and sodium losses for CAPD patients for the flush before fill technique. Results We reviewed the results from 659 patients, mean age 57 ± 16 years, 56.3% male, 38.9% diabetic, 24.0% treated by CAPD, 22.5% by APD and 53.5% APD with a day-time exchange, with icodextrin prescribed to 72.8% and 22.7 g/L glucose to 31.7%. Ultrafiltration was greatest for CAPD 650 (300–1100) vs 337 (103–598) APD p < 0.001, vs 474 (171–830) mL/day for APD with a day exchange. CAPD removed most sodium 79 (33–132) vs 23 (− 2 to 51) APD p < 0.001, and 51 (9–91) for APD with a day exchange, and after adjustment for the CAPD flush before fill 57 (20–113), p < 0.001 vs APD. APD patients with a day exchanged used more hypertonic glucose dialysates [0 (0–5) vs CAPD 0 (0–1) L], p < 0.001. Conclusion CAPD provides greater ultrafiltration and sodium removal than APD cyclers, even after adjusting for the flush-before fill, despite greater hypertonic usage by APD cyclers. Ultrafiltration volume and sodium removal were similar between CAPD and APD with a day fill.

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Factors associated with increased pulse wave velocity in peritoneal dialysis patients

Open Medicine ◽

10.2478/s11536-010-0014-9 ◽

2010 ◽

Vol 5 (3) ◽

pp. 381-386 ◽

Cited By ~ 2

Author(s):

Paweł Stróżecki ◽

Rafał Donderski ◽

Magdalena Grajewska ◽

Elżbieta Marcinkowska ◽

Michał Kozłowski ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Diabetic Patients ◽

Healthy Controls ◽

Dialysis Patients ◽

Factors Associated ◽

Peritoneal Transport

AbstractElevated pulse wave velocity (PWV) reflects increased arterial stiffness. Several studies have investigated PWV in peritoneal dialysis (PD) patients, but direct comparisons with healthy controls were not done. The potential influence of peritoneal transport characteristics on arterial stiffness in PD patients was suggested in recent studies. The aims of this study were to compare PWV in PD patients and healthy volunteers, and to investigate factors associated with increased PWV. The carotid-femoral PWV was measured in 28 PD patients and 28 healthy controls, matched for age and gender. A peritoneal equilibration test (PET) was performed in all PD patients. Based on the PET, patients were classified as: high transporters (H) (n=8), high-average (HA) (n=12), low-average (LA) (n=6), and low transporters (L) (n=2). Six of the PD patients were diabetic. PWV was significantly higher in the PD patients than in the controls (9,9±2,4 vs. 8,0±0,9; p=0,0004). In the PD group, PWV was higher in H/HA than in L/LA patients (10,4 ± 2,5 vs. 8,6 ± 1,0; p=0,008), but all the diabetic patients were in the H/HA group. PWV was significantly higher in diabetic than in non-diabetic PD patients (12,8 ± 2,0 vs. 9,1 ± 1,7; p=0,004). In the PD patients, significant positive correlations were found between PWV and: age, pulse pressure, Kt/V, and duration of PD therapy. In conclusion, the carotid-femoral PWV is elevated in peritoneal dialysis patients. Increased PWV in PD patients is associated with age, diabetic status, and longer duration of PD therapy, but not with this type of peritoneal transport.

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