scholarly journals Successful multiple-exchange peritoneal dialysis in a patient with severe hematological toxicity by methotrexate: case report and literature review

2019 ◽  
Vol 41 (3) ◽  
pp. 427-432 ◽  
Author(s):  
Arbey Aristizabal-Alzate ◽  
John Fredy Nieto-Rios ◽  
Catalina Ocampo-Kohn ◽  
Lina Maria Serna-Higuita ◽  
Diana Carolina Bello-Marquez ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Therapeutic Option ◽  
Supportive Therapy ◽  
Hematological Toxicity ◽  
High Morbidity ◽  
Multiple Exchange ◽  
Severe Pancytopenia ◽  
Stage Renal Disease ◽  
End Stage

Abstract Methotrexate is an effective medication to control several diseases; however, it can be very toxic, being myelosuppression one of its main adverse effects, which increases in severity and frequency in patients with renal failure. We present the case of a 68-year-old man with chronic, end-stage renal disease associated with ANCA vasculitis, under treatment with peritoneal dialysis, who received the medication at a low dose, indicated by disease activity, which presented as a complication with severe pancytopenia with mucositis that improved with support measures and multiple-exchange peritoneal dialysis. We reviewed 20 cases published to date of pancytopenia associated with methotrexate in patients on dialysis and found high morbidity and mortality, which is why its use in this type of patient is not recommended. However, when this complication occurs, a therapeutic option could be the use of multiple-exchange peritoneal dialysis in addition to supportive therapy for drug-related toxicity, although it is recognized that studies are required to show the role of multiple-exchange peritoneal dialysis in the removal of this medication.

scholarly journals Peritoneal Microbiome in End-Stage Renal Disease Patients and the Impact of Peritoneal Dialysis Therapy

2020 ◽  
Vol 8 (2) ◽  
pp. 173
Author(s):  
Liliana Simões-Silva ◽  
Ricardo Araujo ◽  
Manuel Pestana ◽  
Isabel Soares-Silva ◽  
Benedita Sampaio-Maia
Keyword(s):  
Peritoneal Dialysis ◽  
Human Microbiome ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Peritoneal Tissue ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Factors influencing the occurrence of peritoneal dialysis (PD)-related infections are still far from fully understood. Recent studies described the existence of specific microbiomes in body sites previously considered microbiome-free, unravelling new microbial pathways in the human body. In the present study, we analyzed the peritoneum of end-stage kidney disease (ESKD) patients to determine if they harbored a specific microbiome and if it is altered in patients on PD therapy. We conducted a cross-sectional study where the peritoneal microbiomes from ESKD patients with intact peritoneal cavities (ESKD non-PD, n = 11) and ESKD patients undergoing PD therapy (ESKD PD, n = 9) were analyzed with a 16S rRNA approach. Peritoneal tissue of ESKD patients contained characteristically low-abundance microbiomes dominated by Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes. Patients undergoing PD therapy presented lower species richness, with dominance by the Pseudomonadaceae and Prevotelaceae families. This study provides the first characterization of the peritoneal microbiome in ESKD patients, bringing new insight to the human microbiome. Additionally, PD therapy may induce changes in this unique microbiome. The clinical relevance of these observations should be further explored to uncover the role of the peritoneal microbiome as a key element in the onset or aggravation of infection in ESKD patients, especially those undergoing PD.

Pregnancy in End-Stage Renal Disease Patients and Treatment with Peritoneal Dialysis: Report of Two Cases

2007 ◽  
Vol 27 (3) ◽  
pp. 353-358 ◽  
Author(s):  
Jesús Alfredo Gómez Vázquez ◽  
Ignacio Eduardo Martínez Calva ◽  
Ricardo Mendíola Fernández ◽  
Verónica Escalera León ◽  
Mario Cardona ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Therapeutic Option ◽  
Fetal Loss ◽  
Pressure Control ◽  
Premature Delivery ◽  
Full Term Delivery ◽  
Stage Renal Disease ◽  
End Stage

Pregnancy in end-stage renal disease patients is infrequent and is associated with fetal loss, premature delivery, intrauterine growth restriction, and lack of control of or exacerbation of or onset of hypertension. Even after replacement of renal function, the prognosis for the patient and the fetus is poor. A point of controversy is the renal replacement therapy method. This report is based on two clinical cases of pregnancy in peritoneal dialysis patients that resulted in full-term delivery. Adequate metabolic and blood pressure control was achieved during pregnancy, the only mutual complication being the presence of polyhydramnios. However, both infants were healthy for their gestational age and without neonatal complications. We may conclude that peritoneal dialysis is an acceptable therapeutic option for pregnant patients and their fetuses.

The Role of Na, K-Atpase Inhibitors in Hypertension and End-Stage Renal Disease

1997 ◽  
Vol 17 (6) ◽  
pp. 536-540 ◽  
Author(s):  
Joanne M. Bargman
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Endstage Renal Disease ◽  
Medline Search ◽  
Atpase Inhibitors ◽  
Stage Renal Disease ◽  
End Stage ◽  
Atpase Inhibition

Objective To review the role of Na, K-ATPase inhibitors in the pathogenesis of essential hypertension and hypertension associated with end-stage renal disease. Data Sources MEDLINE search, 1966 to 1997. Results There is a suggestive physiologic and epidemiologic relationship between Na, K-ATPase inhibition and hypertension. However, clearance data cannot support the hypothesis that differential metabolism of this family of compounds explains the improved hypertensive control seen in patients on peritoneal dialysis compared to those on hemodialysis. Conclusions As a result of the complex methodologies involved, it is unclear whether Na, K-ATPase inhibitors playa significant role in the hypertension of endstage renal disease in general and peritoneal dialysis in particular.

Peritoneal Dialysis Prescription for Diabetic Patients

2005 ◽  
Vol 25 (3_suppl) ◽  
pp. 76-78 ◽  
Author(s):  
Qiang Yao ◽  
Bengt Lindholm ◽  
Olof Heimbürger
Keyword(s):  
Peritoneal Dialysis ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Advantages And Disadvantages ◽  
Patients With Diabetes ◽  
Severe Comorbidity ◽  
Systemic Problems ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

The number of end-stage renal disease (ESRD) patients with diabetes mellitus has increased dramatically during the past few years and, in many countries, diabetes has become the most important cause of ESRD in patients admitted to dialysis. Furthermore, compared to nondiabetic patients, diabetic patients continue to suffer from more frequent and severe comorbidity and complications, including cardiovascular disease, poor fluid balance, worse quality of life, as well as high morbidity and mortality after initiation of dialysis. These systemic problems in diabetic patients should influence the dialysis prescription. In addition, the structure and transport properties of the peritoneal membrane may deteriorate as a consequence of diabetes. Thus, both the systemic and the peritoneal consequences of diabetes influence the dialysis prescription in diabetic patients. In this brief review, we discuss the care of diabetic ESRD patients on peritoneal dialysis — which, compared with hemodialysis, has both advantages and disadvantages in this group of patients — focusing on the special needs for intense and integrated care involving individualized dialysis prescription as well as care of diabetic complications and comorbidity in this diseased patient group.

scholarly journals The Role of an Integrated Care Model for Kidney Disease in the Development of Peritoneal Dialysis: A Single-Center Experience in China

2014 ◽  
Vol 34 (2_suppl) ◽  
pp. 55-58 ◽  
Author(s):  
Xiaohui Zhang ◽  
Zhangfei Shou ◽  
Zhimin Chen ◽  
Ying Xu ◽  
Fei Han ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Integrated Care ◽  
Care Program ◽  
Integrated Treatment ◽  
Technique Survival ◽  
Single Center Experience ◽  
Stage Renal Disease ◽  
End Stage

Peritoneal dialysis plays a crucial role in the integrated care of patients with end-stage renal disease (ESRD). In this paper, we retrospectively analyzed the quality indicators of peritoneal dialysis (PD) in 712 patients from our center who underwent PD between 2004 and 2011. In 43% of patients, follow-up was undertaken every 3 months at our outpatient department, and 54% patients were followed up by both our hospital and other local hospitals. The patient survival rate at 1, 3 and 5 years was 96.3%, 85.4% and 76.2%, respectively. The technique survival (excludes death/transplantation) at 1, 3 and 5 years was 95.1%, 87.7% and 79.6%, respectively. Fluid overload occurred in 29.2% of patients and was one of the major reasons for discontinuing PD. The peritonitis rate in our center decreased to 0.16 episodes/year in 2011. In addition, since our center is one of the largest integrated-treatment centers for ESRD in China, we have developed a multilevel care program in Zhejiang Province, which resulted in rapid growth of PD in our province in recent years.

scholarly journals Peran Perawat Dalam Meningkatkan Kualitas Pasien Peritonial Dialisis

2007 ◽  
Vol 11 (1) ◽  
pp. 25-29
Author(s):  
Krisna Yetti
Keyword(s):  
Peritoneal Dialysis ◽  
Care Provider ◽  
End Stage Renal Disease ◽  
The Other ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Function ◽  
Role And Function

AbstrakContinuous Ambulatory Peritoneal Dialysis (CAPD) merupakan salah satu terapi pengganti pada Penyakit Ginjal Tahap Akhir (PGTA). Empat area yang menjadi tanggung jawab perawat CAPD adalah predialisis, rawat inap, sebelum dan selama pelatihan CAPD, serta pada saat pasien di rumah. Merujuk pada empat peran perawat, yaitu sebagai praktisi, pengelola, peneliti, dan pendidik, maka peran perawat CAPD mempunya peran dan fungsi yang berbeda pula pada masing-masing area ini. Tujuan utama peran dan fungsi perawat di setiap area ini adalah agar layanan keperawatan yang diterima oleh pasien menjadi prima. Pada artikel ini dibahas peran perawat sebagai praktisi dan pengelola pelayanan keperawatan. Sedangkan dua peran lagi yaitu pendidik dan peneliti tidak dibahas. AbstractContinuous Ambulatory Peritoneal Dialysis (CAPD) is one of replacement therapy of End Stage Renal Disease (ESRD). CAPD nurse takes the responsibility in four areas. Those are pre-dialysis stage, during hospitalization, before and during peritoneal dialysis training, and patient at home. Refer to the roles of the nurses, as a care provider, manager, educator and researcher, CAPD nurse has a comprehensible role and function. This comprehensible role and function is also applied in this each area in order to get the better quality of life of the CAPD patients. In this article the role of care provider and manager are discussed. However, the other two, educator and researcher roles are not discussed.

Sign in / Sign up

Export Citation Format

Share Document