scholarly journals Determination of peritoneal transport characteristics with 24-hour dialysate collections: dialysis adequacy and transport test.

1994 ◽  
Vol 5 (6) ◽  
pp. 1333-1338
Author(s):  
M V Rocco ◽  
J R Jordan ◽  
J M Burkart
Keyword(s):  
Membrane Transport ◽  
Cost Savings ◽  
Correlation Coefficients ◽  
Peritoneal Membrane ◽  
Dialysis Adequacy ◽  
Peritoneal Transport ◽  
Data Rates ◽  
The Mean

Although the 24-hour collection of dialysate provides a very accurate measure of the adequacy of dialysis, it is not known if it can also determine peritoneal membrane transport characteristics. In this prospective study, 101 24-hour dialysate collections were immediately followed by a standard peritoneal equilibration test (PET). Four- and 24-h dialysate-to-plasma (D/P) ratios were determined for creatinine and urea. The correlation coefficients between these two tests were 0.86 for the adjusted D/P creatinine and 0.71 for the D/P urea, whereas the standard errors of estimate were 0.054 and 0.060, respectively. Patients were classified into one of four transport groups on the basis of the mean and standard deviation of the adjusted D/P creatinine values, and these values were similar to those generated from the PET data. Rates of ultrafiltration were also defined for patients undergoing 2.0- and 2.5-L dwells. A survey of a subset of these patients demonstrated that the 24-h collection was preferred to the PET for determining transport characteristics. Therefore, the 24-h dialysate collection can be used to monitor both peritoneal membrane transport characteristics and adequacy. This technique, which has been named the "dialysis adequacy and transport test," has the potential for significant cost savings when it is used for the routine follow-up of both peritoneal transport and adequacy of dialysis.

24-Hour Dialysate Collection for Determination of Peritoneal Membrane Transport Characteristics: Longitudinal Follow-Up Data for the Dialysis Adequacy and Transport Test (Datt)

1996 ◽  
Vol 16 (6) ◽  
pp. 590-593 ◽  
Author(s):  
Michael V. Rocco ◽  
Jean R. Jordan ◽  
John M. Burkart
Keyword(s):  
Peritoneal Dialysis ◽  
Membrane Transport ◽  
Standard Error ◽  
Peritoneal Membrane ◽  
Dialysis Adequacy ◽  
Peritoneal Transport ◽  
The Mean ◽  
Cr Concentration ◽  
Over Time

Objective To determine the ability of the dialysis adequacy and transport test (DATT) to monitor changes in peritoneal transport characteristics over time. Setting University-based peritoneal dialysis program. Patients One hundred patients on continuous ambulatory peritoneal dialysis who underwent 226 simultaneous DATTs and peritoneal equilibration tests (PET). Methods Retrospective analysis of DA TT and PET data. Results The mean 24-hour dialysate-to-plasma creatinine (cr) concentration ratio (DIP cr) from the DATT was 0.70±0.10, and the mean four-hour DIP crfrorn the PET was 0.68 ± 0.10. The correlation coefficient between the fourhour and 24-hour DIP cr was 0.81, and the standard error of estimate was 0.065. The mean (±SD) difference between the four-hour and 24-hour DIP cr was 0.023 ± 0.061. Fifty eight patients had two or more sequential DA TTs and PETs. For these 94sets of sequential DATTs and PETs, the mean (±SD) difference between the change in the four-hour DIP cr and the change in the 24-hour DIP cr was 0.020 ± 0.024, and the standard error of estimate was 0.064. In 17 patients a change in dwell volume from 2.0 L to 2.5 L occurred between the first and second measures of peritoneal membrane transport characteristics. The mean (±SD) difference between the change in the four-hour DIP cr and the change in the 24-hour DIP cr was 0.036 ± 0.055, and the standard error of estimate was 0.087. Conclusion The DATT can be used to monitor for changes in peritoneal transport over time. It should not be used in patients receiving cycler therapy or in patients whose dwell times and dextrose concentrations vary markedly from day to day.

Peritoneal Kinetics and Mesothelial Markers in CCPD Using Icodextrin for Daytime Dwell for Two Years

2000 ◽  
Vol 20 (2) ◽  
pp. 174-180 ◽  
Author(s):  
Nynke Posthuma ◽  
Henri A. Verbrugh ◽  
Ab J.M. Donker ◽  
Wim Van Dorp ◽  
Hubertina A.Th. Dekker ◽  
...  
Keyword(s):  
Residual Renal Function ◽  
University Hospital ◽  
Type I ◽  
Clinical Effects ◽  
Local Production ◽  
Peritoneal Membrane ◽  
Membrane Markers ◽  
Related Data ◽  
Peritoneal Transport

Objective To evaluate the safety, efficacy, and biocompatibility of icodextrin (Ico), continuous cycling peritoneal dialysis (CCPD) patients were treated for 2 years with either Ico- or glucose (Glu)-containing dialysis fluid for their daytime dwell (14 – 15 hours). Prior to entry into the study, all patients used standard Glu solutions (Dianeal, Baxter BV, Utrecht, The Netherlands). Design Open, randomized, prospective two-center study. Setting University hospital and teaching hospital. Patients Both established patients and patients new to CCPD were included. A life expectancy of more than 2 years, a stable clinical condition, and written informed consent were necessary before entry. Patients aged under 18 years or with peritonitis in the previous month, and women of childbearing potential unless taking adequate contraceptive precautions, were excluded. Thirty-eight patients entered the study (19 Glu, 19 Ico). Main Outcome Measures Daytime dwell peritoneal effluents were collected every 3 months in combination with other study variables (clinical data, laboratory measurements, dialysis-related data, and urine collection). Peritoneal transport studies were carried out every 6 months. Results In Glu- and Ico-treated patients, peritoneal transport of low molecular weight solutes and protein clearances neither changed during follow-up nor differed between the two groups. Peritoneal membrane markers (CA125, interleukin-8, carboxyterminal propeptide of type I procollagen, and aminoterminal propeptide of type III procollagen) measured in effluents did not differ between the groups and did not change over time. All these markers showed a dialysate/plasma ratio of more than 1, suggesting local production. Residual renal function remained stable during follow-up and adverse clinical effects were not observed. Conclusions Peritoneal membrane transport kinetics and markers remained stable in both groups over a 2-year follow-up period. Membrane markers were higher in effluents than in serum, suggesting local production. No clinical side effects were demonstrated. Icodextrin was a well-tolerated effective treatment.

scholarly journals The Clinical Non-Motor Connectome in Early Parkinson’s Disease

2020 ◽  
Vol 10 (4) ◽  
pp. 1797-1806
Author(s):  
Nico J. Diederich ◽  
Nicolas Sauvageot ◽  
Vannina Pieri ◽  
Géraldine Hipp ◽  
Michel Vaillant
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Stage ◽  
Correlation Coefficients ◽  
P Value ◽  
The Mean ◽  
Disease Initiation ◽  
Non Motor Symptoms ◽  
Early Parkinson’S Disease

Background: Non-motor symptoms (NMS) of various anatomical origins are seen in early stage idiopathic Parkinson’s disease (IPD). Objective: To analyse when and how NMS are linked together at this stage of the disease. Methods: Prospective study recruiting 64 IPD patients with ≤3 years of disease duration and 71 age-matched healthy controls (HC). NMS were clustered in 7 non-motor domains (NMD): general cognition, executive function, visuospatial function, autonomic function, olfaction, mood, and sleep. Correlation coefficients ≥|0.3| were considered as significant. Bootstrapped correlation coefficients between the scores were generated in both groups. Fourteen IPD patients and 19 HC were available for a follow-up study two years later. Results: The mean age of both groups was similar. 58% of IPD patients and 37% of HC were male (p = 0.01). At baseline IPD patients performed less well than HC on all NMD (p value between 0.0001 and 0.02). Out of 91 possible correlations between NMD, 21 were significant in IPD patients and 14 in HC at the level of ≥|0.3|. The mean correlation level was higher in IPD patients than in HC, as evidenced by the higher box plot of correlation coefficients. Visuospatial scores at baseline were predictive of the motor deterioration at the follow-up exam. Conclusion: At early IPD stage various NMS are linked together, although not connected by anatomical networks. Such a clinical NMD connectome suggests almost synchronous disease initiation at different sites as also supported by fMRI findings. Alternatively, there may be compensation-driven interconnectivity of NMD.

SaGA S, the Short and Graphic A bility Score: an alternative scoring method for the motor components of the Multiple Sclerosis Functional C omposite

2004 ◽  
Vol 10 (2) ◽  
pp. 231-242 ◽  
Author(s):  
C Vaney ◽  
S Vaney ◽  
D T Wade
Keyword(s):  
Multiple Sclerosis ◽  
Correlation Coefficients ◽  
Scoring Method ◽  
Left Hand ◽  
Disability Status ◽  
Study Population ◽  
The Mean ◽  
One Year ◽  
Independent Assessment

The timed performances of the 10-m timed walk (TMTW) and the nine-ho le peg test (NHPT) of 881 consecutive patients with multiple sclerosis (MS) undergoing a rehabilitation stay, were expressed as a logarithmic function of time in two subscores to form a composite score called the Short and G raphic A bility Score (SaGA S). The subscores (sS) were constructed in such a way that any interval of 0.5 unit corresponds to a change of 25% in the tests. The SaGA S was computed as the mean of four subscores: SaGAS=(2×2-TMTWsS+NHPTsS right hand+NHPTsS left hand). With the aid of a nomogram, the timed values of the tests are easily transformed into the corresponding subscores, which are then displayed graphically to facilitate follow-up over time. The correlation coefficients between the SaGA S and the two motor components of the MS Functional C omposite (MSFC) (r =0.987), the Expanded Disability Status Scale (EDSS)(r = -0.83), the Nottingham EADL Index (r =0.80) and the Rivermead Mobility Index (RMI) (r =0.90) were all statistically significant (P B-0.001), supporting the validity of the measure. SaGA S had a similar sensitivity to the RMI, but was significantly more sensitive than the EDSS in detecting changes occurring during the rehabilitation stay (14.9% versus 5.0%; P B-0.001) and over a one-year follow-up (35.3% versus 19.7%; P B-0.001). C ompared with the motor components of the MSFC, with which it shares several features, SaGA S has several advantages: it does not depend on the stratification of the study population; it does not skew the results of the NHPT towards improvement at the lower end; and it offers an independent assessment of both hands. SaGA S is a simple, intuitive, nonphysician-based measure, which could provide consistent scoring in future clinical trials.

scholarly journals Adipokines and parameters of peritoneal membrane transport in newly started peritoneal dialysis patients.

2013 ◽  
Vol 60 (4) ◽  
Author(s):  
Edyta Golembiewska ◽  
Krzysztof Safranow ◽  
Kazimierz Ciechanowski ◽  
Joanna Bober ◽  
Anna Bogacka ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Membrane Transport ◽  
Laboratory Data ◽  
Residual Renal Function ◽  
Serum Adiponectin ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Dialysis Adequacy ◽  
Serum Leptin ◽  
Serum Adiponectin Concentration

Adiponectin and leptin are two adipokines playing important roles in the regulation of body weight, appetite, carbohydrate and lipid metabolism. In patients with chronic kidney disease (CKD) adipokines accumulate in serum due to reduced renal clearance. Since adipokines have pleiotropic actions, the adipokine balance may have an impact on peritoneal membrane transport. The aim of this study was to assess whether serum adiponectin and leptin levels were related to peritoneal transport and residual renal function (RRF) in newly started peritoneal dialysis patients. 25 clinically stable patients, 4 to 6 weeks after the onset of PD, were included in the study. For each patient clinical and laboratory data were reviewed and standard PET test was performed. Serum adiponectin and leptin concentrations were determined and leptin/adiponectin (L/A) ratio was calculated. Serum adiponectin correlated negatively with weight, BMI and glucose concentration. Serum leptin and L/A ratio correlated positively with BMI. Serum adiponectin correlated positively with dialysate to plasma (D/P) creatinine ratio and ultrafiltration in PET test. Serum leptin level and L/A ratio correlated strongly negatively with peritoneal creatinine clearance. Serum adiponectin concentration is positively associated with baseline solute transport. Leptin concentration and L/A ratio are negatively associated with dialysis adequacy in newly started PD patients.

scholarly journals Effects of Peritoneal Dialysis on QT Interval in ESRD Patients

2021 ◽  
Author(s):  
Wenjing Zhang ◽  
Yu Liang ◽  
Jia Lv ◽  
Yan Li ◽  
Jiping Sun
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Qt Interval ◽  
Qtc Interval ◽  
Transport Function ◽  
Qtc Prolongation ◽  
Dialysis Adequacy ◽  
Peritoneal Transport

Abstract Background: Patients with chronic kidney disease (CKD) had a high risk of fatal arrhythmias. The extended corrected QT (QTc) interval is a hallmark of ventricular arrhythmias and sudden cardiac death. Studies have shown that QT interval and QTc were prolonged with the declination in renal function. Notably, QTc prolongation is significantly increased in patients undergoing hemodialysis. However, there were no results available in patients with peritoneal dialysis (PD). This study aimed to report the changes in QT interval and QTc in PD patients.Methods: A total of 66 PD patients were enrolled. The duration of follow-up was 1 year. The demographics, and the etiology of patients were recorded. QTc of ECG and clinical biochemical indexes before dialysis and at 6 months after PD and 1year after PD were determined and analyzed. Dialysis adequacy and peritoneal transport function were assessed in each patient.Results: (1) A total of 66 PD incident patients, including 50 males and 16 females, with an average age of 43.56±15.15 years (males: 43.74±15.53 years; females: 43.00 ± 15.92 years) were enrolled. In terms of etiology, 37 patients (56.06%) had chronic nephritis, followed by diabetic nephropathy in 11 patients (16.67%), IgA nephropathy with 8 patients (12.12%). The peritoneal transport test showed that the most of the peritoneal transport function was low average transport( 25, 37.88%), the least was high transport(2, 3.03%).(2) During the follow-up period, all patients reached the standard of PD. Compared with baseline before dialysis, anemia, low albumin, blood pressure, blood urea nitrogen, creatinine, uric acid, potassium, calcium, phosphorus and parathyroid hormone were improved after PD at 6 months and 1year. The residual renal function was gradually decreases during the follow-up. There were no significant differences in clinical indexes between 6 months and 1 year after PD.(3) The mean QTc of all patients were stable during 1-year follow-up period (pre-PD: 413.49±29.95ms; 6 months: 423.05±51.96ms; 1 year: 409.29±32.32ms, P>0.05). According to gender, the QTc in male patients and in female patients had the same results (P>0.05, respectively).(4) Before PD, diastolic blood pressure (r=-0.261,P=0.039), calcium concentration (r=-0.360,P=0.004) and hemoglobin level (r=-0.432,P=0.000) were found to be the risk factors of QTc prolongation. They were negatively correlated with QTc in end-stage renal disease patients. After patients starting PD, the observed clinical indicators showed no relevance to QTc anymore.Conclusion: Different from hemodialysis induced QTc prolongation, PD did not increase the patient's QT interval and QTc interval. This phenomenon was reported for the first time, suggesting that myocardial electrical activity might be more stable in PD patients.

scholarly journals Increased peritoneal membrane transport is associated with decreased patient and technique survival for continuous peritoneal dialysis patients. The Canada-USA (CANUSA) Peritoneal Dialysis Study Group.

1998 ◽  
Vol 9 (7) ◽  
pp. 1285-1292 ◽  
Author(s):  
D N Churchill ◽  
K E Thorpe ◽  
K D Nolph ◽  
P R Keshaviah ◽  
D G Oreopoulos ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Membrane Transport ◽  
Patient Survival ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Technique Survival ◽  
Survival Probabilities ◽  
The Mean ◽  
Technique Failure

The objective of this study was to evaluate the association of peritoneal membrane transport with technique and patient survival. In the Canada-USA prospective cohort study of adequacy of continuous ambulatory peritoneal dialysis (CAPD), a peritoneal equilibrium test (PET) was performed approximately 1 mo after initiation of dialysis; patients were defined as high (H), high average (HA), low average (LA), and low (L) transporters. The Cox proportional hazards method evaluated the association of technique and patient survival with independent variables (demographic and clinical variables, nutrition, adequacy, and transport status). Among 606 patients evaluated by PET, there were 41 L, 192 LA, 280 HA, and 93 H. The 2-yr technique survival probabilities were 94, 76, 72, and 68% for L, LA, HA, and H, respectively (P = 0.04). The 2-yr patient survival probabilities were 91, 80, 72, and 71% for L, LA, HA, and H, respectively (P = 0.11). The 2-yr probabilities of both patient and technique survival were 86, 61, 52, and 48% for L, LA, HA, and H, respectively (P = 0.006). The relative risk of either technique failure or death, compared to L, was 2.54 for LA, 3.39 for HA, and 4.00 for H. The mean drain volumes (liters) in the PET were 2.53, 2.45, 2.33, and 2.16 for L, LA, HA, and H, respectively (P < 0.001). After 1 mo CAPD treatment, the mean 24-h drain volumes (liters) were 9.38, 8.93, 8.59, and 8.22 for L, LA, HA, and H, respectively (P < 0.001); the mean 24-h peritoneal albumin losses (g) were 3.1, 3.9, 4.3, and 5.6 for L, LA, HA, and H, respectively (P < 0.001). The mean serum albumin values (g/L) were 37.8, 36.2, 33.8, and 32.8 for L, LA, HA, and H, respectively (P < 0.001). Among CAPD patients, higher peritoneal transport is associated with increased risk of either technique failure or death. The decreased drain volume, increased albumin loss, and decreased serum albumin concentration suggest volume overload and malnutrition as mechanisms. Use of nocturnal cycling peritoneal dialysis should be considered in H and HA transporters.

scholarly journals SuO016AFIVE YEAR LONGITUDINAL FOLLOW-UP OF PERITONEAL MEMBRANE TRANSPORT DURING TREATMENT WITH A CONVENTIONAL AND A BIOCOMPATIBLE PD SOLUTION

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i622-i622
Author(s):  
Raymond Krediet ◽  
Anouk van Diepen ◽  
Deirisa Lopes Baretto ◽  
Annemieke Coester ◽  
Dirk Struijk
Keyword(s):  
Membrane Transport ◽  
Peritoneal Membrane

Hypoproteinemia in Patients with Diabetes Undergoing Continuous Ambulatory Peritoneal Dialysis is Attributable to High Permeability of Peritoneal Membrane

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 72-78 ◽  
Author(s):  
◽  
Hidetomo Nakamoto ◽  
Hiromichi Suzuki
Keyword(s):  
Peritoneal Dialysis ◽  
Membrane Transport ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Total Protein ◽  
Peritoneal Membrane ◽  
High Permeability ◽  
Membrane Area ◽  
Plasma Loss ◽  
The Mean ◽  
Peritoneal Function

Background The present study used the newly developed personal dialysis capacity (PDC) peritoneal function test to investigate differences in individual peritoneal membrane transport function and nutritional status in non diabetic (non DM) and diabetic (DM) patients on continuous ambulatory peritoneal dialysis (CAPD). Patients and Methods To clarify the differences in peritoneal function that determine plasma protein levels, we carried out PDC tests in non DM and DM patients. Between May 1995 and May 1999, in multicenter study in Japan, we carried out 232 PDC tests on 232 non DM patients and 47 PDC tests on 47 DM patients who had been on CAPD for 1 – 210 months. Results Plasma levels of total protein and albumin in DM patients were significantly lower than those in non DM patients (total protein: 6.5 ± 0.1 g/dL non DM vs. 5.9 ± 0.1 g/dL DM, p < 0.0001; albumin: 3.5 ± 0.1 g/dL non DM vs. 2.9 ± 0.1 g/dL DM, p < 0.0001). The mean membrane area in the DM group was significantly larger than that in the non DM group (21943 ± 608 cm/1.73 m2 non DM vs. 26 304 ± 1699 cm/1.73 m2 DM, p = 0.0076). The mean plasma loss through the large pores in the DM group was significantly greater than that in the non DM group (0.095 ± 0.004 mL/min/1.73 m2 non DM vs. 0.119 ± 0.008 mL/min/1.73 m2 DM, p = 0.0113). Protein loss into dialysate in DM patients was significantly greater than that in non DM patients. We observed a significant correlation between total protein or albumin and plasma loss from dialysis solution in non DM and DM patients on CAPD. Conclusions The study demonstrated that peritoneal function, including peritoneal membrane transport and peritoneal permeability to protein was significantly higher in DM patients than in non DM patients. Hypoproteinemia in DM patients might be associated with high permeability of peritoneal membrane in CAPD.

scholarly journals Evaluation of Peripapillary Nerve Fiber Layer after Dexamethasone Implantation (Ozurdex) in Branch Retinal Vein Occlusions

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Muhammed Nurullah Bulut ◽  
Yusuf Özertürk ◽  
Ümit Çallı ◽  
Güzide Akçay ◽  
Ulviye Kıvrak ◽  
...  
Keyword(s):  
Nerve Fiber ◽  
Fiber Layer ◽  
Nerve Fiber Layer ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Baseline Values ◽  
The Mean ◽  
Inferior Quadrant

Purpose. To evaluate the peripapillary retinal nerve fiber layer (RNFL) thicknesses of patients treated with intravitreal Ozurdex implant due to branch retinal vein occlusion (BRVO) related macular edema (ME). Methods. Thirty-three eyes of 33 patients treated with Ozurdex implant due to ME associated with BRVO were included in the study. Ophthalmic examinations including determination of best corrected visual acuity (BCVA), measurement of intraocular pressure (IOP), and central macular thickness (CMT) and peripapillary RNFL assessment with optical coherence tomography (OCT) were performed before the injection of Ozurdex implant and during the 6-month follow-up period after the injection. Results. The mean age was 55.2 ± 7.4 (range: 40–68) years. The BCVAs were significantly increased and CMTs were significantly decreased at month 3 and month 6 visits compared to baseline values. The mean IOP was significantly increased from baseline at day 1, week 1, and month 1 visits (p1=0.008, p2=0.018, and p3=0.022, resp.). The average and inferior quadrant peripapillary RNFL thicknesses were significantly reduced at month 6 control visit compared to baseline values (both p<0.001). Conclusions. Ozurdex implant improved the BCVA and reduced the CMT in the eyes with RVO related ME. However, IOP elevations occurred within the first month after the injection and the average and inferior quadrant RNFL thinning was found six months after the injection. Further controlled studies are warranted.

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