scholarly journals Bacterial Ecology of Peritonitis in a Sub-Saharan Peritoneal Dialysis Unit

2018 ◽  
Vol 5 (2) ◽  
pp. 01-03
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Unit ◽  
Bacterial Ecology ◽  
Sub Saharan

Results of Peritoneal Equilibration Test during Treatment with Polyglucose Dialysis Solution

2002 ◽  
Vol 22 (3) ◽  
pp. 357-364 ◽  
Author(s):  
Alicja E. Grzegorzewska ◽  
Danuta Antczak-Jȩdrzejczak ◽  
Magdalena Leander
Keyword(s):  
Peritoneal Dialysis ◽  
Dwell Time ◽  
Control Period ◽  
University Hospital ◽  
Control Group ◽  
Peritoneal Equilibration Test ◽  
Dialysis Unit ◽  
Dialysis Solution ◽  
Glucose Ratio ◽  
Peritoneal Permeability

Background Results of peritoneal equilibration test (PET) suggest prolonged effect of polyglucose dialysis solution (PG-DS) on peritoneal permeability. Objectives An evaluation of dialysate-to-plasma ratio (D/P) of urea, D/P creatinine, and D/D0 glucose (ratio of dialysate glucose at designated dwell time to dialysate glucose at 0 dwell time), and mass transfer area coefficients (KBD) of these solutes in PET before introduction, during administration, and after discontinuation of PG-DS in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Design Single-center prospective study with PG-DS; retrospective selection of the control group. Setting Peritoneal dialysis unit in a university hospital. Patients Fourteen patients (11 males; age 45.1 ± 8.5 years) treated with CAPD for 17.5 ± 9.9 months. 7.5% PG-DS was used for the overnight exchange. After discontinuation of the PG-DS, standard dialysis solutions, as previously used, were reintroduced. The control group was selected to match both CAPD duration and peritoneal permeability of the patients in the PG-DS group at the start of the study. Methods Standard PET was carried out at 1.6 ± 0.8 months before the introduction of PG-DS (study period I, n = 14), after 1.2 ± 0.6 months’ use of PG-DS (study period II, n = 14), after 4.4 ± 0.8 months’ use of PG-DS (study period III, n = 11), after 8.8 ± 2.2 months’ use of PG-DS (study period IV, n = 9), and at 2.0 ± 0.6 months after PG-DS discontinuation (study period V, n = 11). Patients in the control group underwent PET at similar time intervals (control periods I – V). Results In the PG-DS group, a tendency toward increased peritoneal permeability for urea and creatinine was shown during the consecutive study periods. D/D0 glucose was significantly higher only in the PET performed during use of PG-DS (periods II – IV) compared to results obtained in period I. In the control group, both D/P and KBD of both urea and creatinine remained unchanged, but KBD glucose was higher in the first 2 hours of the PET in control period V compared to respective values in control period III. Conclusion Changes in peritoneal permeability are observed in CAPD patients treated with PG-DS. These changes may be at least partially related to the administration of polyglucose.

scholarly journals Management of fungal peritonitis : a Moroccan single peritoneal dialysis unit experience

2019 ◽  
Vol 2 (2) ◽  
pp. 65-69
Author(s):  
Moussokoro Hadja Kone ◽  
Tarik Bouattar ◽  
Ibtissam Fares ◽  
Meryem Benbella ◽  
Naima Ouzeddoun ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Death Rate ◽  
Clinical Signs ◽  
Dropping Out ◽  
Average Delay ◽  
Dialysis Unit ◽  
Fungal Peritonitis ◽  
Individual Care ◽  
Serious Infection ◽  
Encapsulating Peritonitis

Introduction: Fungal peritonitis (PF) in peritoneal dialysis (PD) is a serious infection that involves the functional prognosis of the peritoneum and the patient's vital prognosis. It must benefit from a fast handling but nevertheless not very codified. Each center therefore ensures an individual care of its patients. Materiel and method: The purpose of our study is to describe our 10-year experience through our patients who presented FP. We performed a descriptive retrospective study of FP cases documented in the PD unit. Results: the prevalence of FP was 5,1%, which represent 9 cases. Predominant clinical signs were dialysat turbidity and abdominal pain. FP was primitive for 3 patients. The antifungal therapy used was Fluconazole, which was combined with an increased number of peritoneal exchanges. DP catheter ablation was done for 8 patients with an average delay of 5.5 days. The overall outcome was favorable and 3 patients continued PD. No death or encapsulating peritonitis was a consequence of FP. Discussion and conclusion: FP is an infectious complication in PD. Its’ death rate is elevated; dropping-out of PD rate too is elevated. The favorable evolution of our patients that stayed in PD let us think that it may be possible to maintain more patients in PD after FP.

Feasibility of Reinstitution of CAPD after Partial Hepatectomy in Patients with Malignant Hepatic Tumors

2003 ◽  
Vol 23 (5) ◽  
pp. 504-506 ◽  
Author(s):  
Sing Leung Lui ◽  
Pok Siu Yip ◽  
Man Fei Lam ◽  
Wai Kei Lo
Keyword(s):  
Peritoneal Dialysis ◽  
Retrospective Analysis ◽  
Partial Hepatectomy ◽  
Serum Biochemistry ◽  
The Other ◽  
University Teaching ◽  
Hepatic Tumors ◽  
Peritoneal Equilibration Test ◽  
Dialysis Unit ◽  
Before And After

Objective To determine the feasibility of reinstitution of continuous ambulatory peritoneal dialysis (CAPD) in patients with malignant hepatic tumors after partial hepatectomy. Design Retrospective analysis of 2 CAPD patients. Setting Dialysis unit of a university teaching hospital. Patients Two CAPD patients with malignant hepatic tumors who had undergone partial hepatectomy. Main Outcome Measures Serum biochemistry, Kt/V, peritoneal equilibration test (PET) results before and after hepatectomy. Results One patient was able to resume CAPD 4 weeks after partial hepatectomy. The other patient was successfully resumed on CAPD after resting the peritoneum for 3 months following partial hepatectomy. The serum biochemistry, Kt/V, and PET results of the 2 patients did not change significantly before and after partial hepatectomy. Conclusions Reinstitution of CAPD after partial hepatectomy in patients with malignant hepatic tumors is feasible.

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.

Symptomatic Peritoneal Calcification in a Child: Treatment with Tidal Peritoneal Dialysis

1994 ◽  
Vol 14 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Bradley A. Warady ◽  
Vicki Bahl ◽  
Uri Alan ◽  
Stanley Hellerstein
Keyword(s):  
Abdominal Pain ◽  
Peritoneal Dialysis ◽  
Symptomatic Relief ◽  
Duration Of Treatment ◽  
Child Treatment ◽  
Dialysis Unit ◽  
Case Evaluation ◽  
Fill Volume ◽  
Unique Approach ◽  
Tidal Peritoneal Dialysis

Objective To evaluate the ability of tidal peritoneal dialysis to decrease the pain and frequency of hemoperitoneum associated with peritoneal calcification. Design Prospective case evaluation. Setting The Home Peritoneal Dialysis Unit, Children's Mercy Hospital. Patient Seven-year-old male with diffuse peritoneal calcifications, daily abdominal pain, and recurrent hemoperitoneum. Intervention Tidal peritoneal dialysis was conducted with an initial fill volume of 45 mL/kg and a tidal inflow volume of 23 mL/kg. The patient also maintained a daytime pass volume of 45 mL/kg. Duration of treatment was 7 months. Results The patient's abdominal pain resolved 2 days after initiating tidal peritoneal dialysis. No episodes of hemoperitoneum or abdominal pain have occurred for 7 months. Conclusion Tidal peritoneal dialysis is a unique approach to the achievement of symptomatic relief in the patient with peritoneal calcification.

Effects of Oral Glucose on Intermediary Metabolism in Continuous Ambulatory Peritoneal Dialysis Patients versus Healthy Subjects

1998 ◽  
Vol 18 (5) ◽  
pp. 505-511 ◽  
Author(s):  
Jacques Delarue ◽  
Claude Maingourd ◽  
Charles Couet ◽  
Sophie Vidal ◽  
Philippe Bagros ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Peritoneal Dialysis ◽  
Lipid Oxidation ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Healthy Subjects ◽  
Tertiary Care ◽  
Substrate Oxidation ◽  
Oral Glucose ◽  
Dialysis Unit ◽  
Nonesterified Fatty Acids

Objective To explore the mechanisms and metabolic consequences of the insulin resistance of patients treated by continuous ambulatory peritoneal dialysis (CAPD). Design CAPD patients and healthy subjects ingested a similar mean oral glucose load per kilogram of fat-free mass (FFM) [1.20 ± 0.03 g/(kg FFM) vs 1.20 ± 0.06 g/(kg FFM); CAPD vs healthy subjects]. Substrate oxidation was monitored over 6 hours using indirect calorimetry. Setting Peritoneal dialysis unit of a tertiary-care institutional center. Outcome Measures Glycemia, insulinemia, substrate oxidation. Patients Six CAPD patients (68 ± 5 yr) and 6 healthy subjects (24 ± 1 yr). The CAPD patients had similar body mass index (21.4 ± 1.3 vs 22.9 ± 1.1 kg/m2), a higher percent fat (25.8% ± 3.7% vs 16% ± 2.2%; p < 0.05), and a lower FFM (42.2 ± 2.2 kg vs 56.5 ± 2.6 kg; p < 0.01) than healthy subjects. Results The CAPD patients displayed a higher glycemic and insulinemic responses to glucose than did healthy subjects (p < 0.05), but similar glucose oxidation and storage. Lipid oxidation and plasma nonesterified fatty acids were not increased in CAPD patients versus healthy subjects, in spite of a higher adiposity. Fat oxidation was related to fat mass in CAPD patients (r2 = 0.77, p < 0.05) but not in healthy subjects (r2 = 0.05). Conclusion CAPD patients display an insulin -resistance not explained by an increased lipid oxidation. The maintenance of intracellular glucose utilization at the expense of higher glycemic and insulinemic responses suggests a defective glucose transport.

Disturbed Appetite Patterns and Nutrient Intake in Peritoneal Dialysis Patients

2003 ◽  
Vol 23 (6) ◽  
pp. 550-556 ◽  
Author(s):  
Mark Wright ◽  
Graham Woodrow ◽  
Siobahn O'Brien ◽  
Neil King ◽  
Louise Dye ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Food Intake ◽  
Nutrient Intake ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Diurnal Variability ◽  
Patient Reported ◽  
Dietary Records ◽  
The Mean ◽  
The Impact

Objective Malnutrition is common among peritoneal dialysis (PD) patients. Reduced nutrient intake contributes to this. It has long been assumed that this reflects disturbed appetite. We set out to define the appetite profiles of a group of PD patients using a novel technique. Design Prospective, cross-sectional comparison of PD patients versus controls. Setting Teaching hospital dialysis unit. Patients 39 PD patients and 42 healthy controls. Intervention Visual analog ratings were recorded at hourly intervals to generate daily profiles for hunger and fullness. Summary statistics were generated to compare the groups. Food intake was measured using 3-day dietary records. Main Outcome Measures Hunger and fullness profiles. Derived hunger and fullness scores. Results Controls demonstrated peaks of hunger before mealtimes, with fullness scores peaking after meals. The PD profiles had much reduced premeal hunger peaks. A postmeal reduction in hunger was evident, but the rest of the trace was flat. The PD fullness profile was also flatter than in the controls. Mean scores were similar despite the marked discrepancy in the profiles. The PD group had lower peak hunger and less diurnal variability in their hunger scores. They also demonstrated much less change in fullness rating around mealtimes, while the mean and peak fullness scores were little different. The reported nutrient intake was significantly lower for PD. Conclusion The data suggest that PD patients normalize their mean appetite perception at a lower level of nutrient intake than controls, suggesting that patient-reported appetite may be misleading in clinical practice. There is a loss of the usual daily variation for the PD group, which may contribute to their reduced food intake. The technique described here could be used to assess the impact of interventions upon the abnormal PD appetite profile.

Poor Response to Oral Ciprofloxacin in the Treatment of Peritonitis in Patients on Intermittent Peritoneal Dialysis

1993 ◽  
Vol 13 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Nancy M. Waite ◽  
Michael D. Johnson ◽  
Nancy R. Webster ◽  
Ignatius W. Fong
Keyword(s):  
Peritoneal Dialysis ◽  
Tertiary Care ◽  
Poor Response ◽  
Signs And Symptoms ◽  
Resistant Bacteria ◽  
Causative Organism ◽  
Clinical Value ◽  
Gram Positive ◽  
Dialysis Unit ◽  
Oral Ciprofloxacin

Objectives To assess the clinical value of oral ciprofloxacin in the treatment of peritonitis in an intermittent peritoneal dialysis (IPD) population. Design Open nonrandomized prospective study. Setting Nephrology Peritoneal Dialysis Unit in a tertiary care, teaching hospital of the University of Toronto. Patients Subjects were participants of the IPD program with an acute episode of peritonitis defined as at least two of the following: 1. signs and symptoms of peritonitis, 2. cloudy peritoneal fluid with a white blood cell count of >100!IJl, 3. demonstration of bacteria in peritoneal effluent by gram stain or culture. Ten patients were enrolled in the study, but two were withdrawn because of side effects and growth of a resistant bacteria. Interventions Ciprofloxacin 750 mg po q12h for 2 doses, then 750 mg daily or 500 mg twice daily for 10 days. Main Outcome Measures Efficacy was determined by clinical and microbiological assessment. Cure was defined as resolution of signs and symptoms with eradication of the causative organism. Peritoneal effluent and blood samples were analyzed for ciprofloxacin concentration. Results Ciprofloxacin was effective in treating only one of ten episodes of peritonitis. Seven patients were defined as microbiological failures (persistence or relapse of organisms). The signs and symptoms of peritonitis improved in 2 patients, but the remaining 5 failed clinically. Only Gram-positive organisms were cultured. Conclusions Ciprofloxacin cannot be recommended for the treatment of intermittent peritoneal dialysis related Gram-positive bacterial peritonitis.

Sign in / Sign up

Export Citation Format

Share Document