Elevation of whole-blood glutathione in peritoneal dialysis patients by L-2-oxothiazolidine-4-carboxylate, a cysteine prodrug (Procysteine).

Glutathione is a major cellular antioxidant that protects protein thiols and inhibits cellular damage due to oxygen free radicals. It has been reported previously that patients undergoing dialysis have low levels of blood glutathione, which may lead to increased susceptibility to oxidant stress. L-2-oxothiazolidine-4-carboxylic acid (OTZ) is a cysteine prodrug that raises cellular glutathione levels by increasing delivery of cysteine, the rate-limiting substrate for glutathione synthesis. This study investigates the effect of OTZ on blood glutathione in a blinded, placebo-controlled study of patients with chronic renal failure treated by peritoneal dialysis. Twenty patients were randomly selected to receive OTZ (0.5 g three times a day orally with meals) or placebo for 14 d. Patients visited the clinic for predose blood collection and safety evaluation at baseline (days 3, 7, and 14 and again at 14 d from the last dose [follow-up]). Glutathione concentrations were determined in whole blood by HPLC. OTZ resulted in a significant rise in whole-blood glutathione at days 7 (594 +/- 129 mumol/L) and 14 (620 +/- 108 mumol/L) compared with baseline (544 +/- 139 mumol/L) (P < 0.01 and P < 0.05, respectively). Glutathione was also significantly increased at days 7 and 14 when normalized by hematocrit (Hct) or hemoglobin to correct for anemic status (e.g., 20.7 +/- 5.7 mumol/L per % Hct [day 7] and 20.9 +/- 4.0 mumol/L per % Hct [day 14] versus 18.0 +/- 4.2 mumol/L per % Hct [baseline]; P < 0.05). Glutathione levels did not change in the placebo group at any patient visit, and levels in the OTZ-treated group returned to baseline at follow-up. There were no serious adverse events attributable to OTZ, and the drug appeared to be well tolerated by patients with renal failure treated by continuous ambulatory peritoneal dialysis. Our results show that OTZ increases blood glutathione levels, which may improve antioxidant status in dialysis patients.

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Encapsulating Peritoneal Sclerosis in Japan: Prospective Multicenter Controlled Study

Peritoneal Dialysis International ◽

10.1177/089686080102103s11 ◽

2001 ◽

Vol 21 (3_suppl) ◽

pp. 67-71 ◽

Cited By ~ 27

Author(s):

Hideki Kawanishi ◽

Hiroyoshi Fukui ◽

Hara Shigeko ◽

Akio Imada ◽

Yoshindo Kawaguchi ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Clinical Features ◽

Multicenter Study ◽

Mortality Rates ◽

Controlled Study ◽

Dialysis Patients ◽

Survey Period ◽

Prospective Multicenter Study ◽

Current Incidence

♦ Objective Encapsulating peritoneal sclerosis (EPS) is recognized as a serious complication of peritoneal dialysis. The aim of this study was to determine the incidence, clinical features, and variation in mortality rates for EPS. ♦ Design A prospective multicenter design was used, in which peritoneal dialysis patients were pre-registered by facilities across Japan and the incidence of EPS was observed in the registrants. The registrants were followed for a total of 4 years to accurately observe the onset of EPS. ♦ Results As of April 1999, 2216 peritoneal dialysis patients from 64 facilities were registered. By the end of March 2001, 332 patients had dropped out, and 17 of the dropouts had developed SEP. The incidence was 0.77%. After excluding 110 patients who died, the incidence in 2106 patients was 0.81%. The incidence of EPS increased with the duration of peritoneal dialysis. Of the 17 patients with EPS, 12 developed the condition after discontinuing peritoneal dialysis and changing to hemodialysis. During the 2-year survey period, 6 of the 17 EPS patients died. The interval from onset to death was 10.8 ± 5.8 months (range: 3 – 19.5 months). ♦ Conclusions From this prospective multicenter study, the current incidence of EPS is 0.77% (0.81% when dropout owing to death is censored). After a follow-up of 2 years, we conjecture that the incidence of EPS will increase. The incidence, etiology, and prognosis of EPS will be further clarified by periodic observation of dropouts until the end of March 2003.

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Overview of blood purification in uremia

The International Journal of Artificial Organs ◽

10.1177/039139888000300402 ◽

1980 ◽

Vol 3 (4) ◽

pp. 203-208

Author(s):

B.T. Burton

Keyword(s):

Renal Failure ◽

Peritoneal Dialysis ◽

Renal Transplantation ◽

Rejection Rate ◽

Blood Purification ◽

Maintenance Hemodialysis ◽

Dialysis Patients ◽

Transplant Patients ◽

Maintenance Dialysis ◽

Transplanted Kidneys

Today, management of irreversible renal failure is based primarily on maintenance hemodialysis and renal transplantation with a growing minority of patients treated by peritoneal dialysis. With regard to renal transplantation — the early promise of renal transplantation in the mid 1960's has given way to the realities of the late 1970's. There have been no major changes in the rejection rate of transplanted kidneys in recent years though today's mortality of transplant patients is considerably reduced over what it used to be. Moreover, universally the lack of availability of a sufficient number of organs for transplantation poses a formidable problem. It is all too apparent that current methods of blood purification in uremia are far from optimal. Even though the mortality in maintenance dialysis is relatively low, hemodialysis is characterized by a variety of complications and most maintenance dialysis patients are not optimally rehabilitated.

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225: Heterogeneity in the Relative Mortality of Incident Hemodialysis and Peritoneal Dialysis Patients, Across Age, Comorbid Disease Burden, and Follow-Up Year

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2009.01.246 ◽

2009 ◽

Vol 53 (4) ◽

pp. B79

Keyword(s):

Peritoneal Dialysis ◽

Disease Burden ◽

Comorbid Disease ◽

Dialysis Patients ◽

Relative Mortality

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Cinacalcet lowering of serum fibroblast growth factor-23 concentration may be independent from serum Ca, P, PTH and dose of active vitamin D in peritoneal dialysis patients: a randomized controlled study

BMC Nephrology ◽

10.1186/1471-2369-14-112 ◽

2013 ◽

Vol 14 (1) ◽

Cited By ~ 25

Author(s):

Hyo Jin Kim ◽

◽

Hyunsuk Kim ◽

Nara Shin ◽

Ki Young Na ◽

...

Keyword(s):

Vitamin D ◽

Peritoneal Dialysis ◽

Growth Factor ◽

Fibroblast Growth Factor ◽

Fibroblast Growth Factor 23 ◽

Controlled Study ◽

Fibroblast Growth ◽

Dialysis Patients ◽

Active Vitamin ◽

Randomized Controlled

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Residual renal function and blood count in patients on continuous ambulatory peritoneal dialysis

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0612503j ◽

2006 ◽

Vol 134 (11-12) ◽

pp. 503-508

Author(s):

Natasa Jovanovic ◽

Mirjana Lausevic ◽

Biljana Stojimirovic

Keyword(s):

Renal Failure ◽

Renal Function ◽

Peritoneal Dialysis ◽

Chronic Renal Failure ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Blood Count ◽

Residual Renal Function ◽

Co Morbidity ◽

Positive Correlations

Introduction:Most of patients with chronic renal failure are affected by normochromic, normocytic anemia caused by different etiological factors. Anemia causes a series of symptoms in chronic renal failure, which can hardly be recognized from the uremic signs. Anemia adds to morbidity and mortality rates in patients affected by advanced chronic renal failure. Blood count partially improves during the first months after starting the chronic renal replacement therapy, in correlation with the quality of depuration program, with extension of erythrocyte lifetime and with hemoconcentration due to reduction of plasma volume. Recent trials found that higher residual renal function (RRF) significantly reduced co-morbidity, the rate and duration of hospitalization and risk of treatment failure. Objective: The aim of the study was to follow blood count parameters in 32 patients on chronic continuous ambulatory peritoneal dialysis (CAPD) during the first six months of treatment, to evaluate the influence of demographic and clinical factors on blood count and RRF, and to examine the correlation between RRF and blood count parameters. Method: A total of 32 patients affected by end-stage renal disease of different major cause during the first six months of CADP treatment were studied. RRF and blood count were evaluated as well as their relationship during the follow-up. Results: Blood count significantly improved in our patients during the first six months of CAPD treatment even if Hb and HTC failed to reach normal values. Iron serum level slightly decreased because of more abundant erythropoiesis and iron utilization during the first six months of treatment. RRF slightly decreased. After six months of CAPD treatment, the patients with higher RRF had significantly higher Hb, HTC and erythrocyte number and a lot of positive correlations between RRF and anemia markers were observed. Conclusion: After 6-month follow-up period, the patients with higher RRF had significantly higher blood count parameters, and several positive correlations between RRF and blood count markers were confirmed.

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Ten Years’ Experience with Chronic Peritoneal Dialysis at a Community Hospital

Peritoneal Dialysis International ◽

10.1177/089686088000100705 ◽

1980 ◽

Vol 1 (7) ◽

pp. 124-129 ◽

Cited By ~ 3

Author(s):

S. Paul Handa ◽

Sheila Greer

Keyword(s):

Renal Failure ◽

Peritoneal Dialysis ◽

Chronic Renal Failure ◽

Kidney Transplant ◽

Community Hospital ◽

Patient Survival ◽

Chronic Peritoneal Dialysis ◽

Better Than

This paper describes the experience of a community hospital in the treatment of chronic renal failure with intermittent (IPD) and continuous ambulatory peritoneal dialysis (CAPD) in 61 adult patients over a 10 year period. In the earlier years of this decade, 14 patients, dialysed through temporary catheters, were transferred to hemodialysis or received a kidney transplant. Later, a long-term IPD and CAPD treatment through permanent peritoneal catheters was instituted in 25 and 22 patients respectively. Over a similar but not simultaneous follow-up period, the patient survival with CAPD was better than with IPD.

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Longitudinal Trends in Quality of Life and Physical Function in Frail Older Dialysis Patients: A Comparison of Assisted Peritoneal Dialysis and In-Center Hemodialysis

Peritoneal Dialysis International ◽

10.3747/pdi.2018.00086 ◽

2019 ◽

Vol 39 (2) ◽

pp. 112-118 ◽

Cited By ~ 5

Author(s):

Osasuyi Iyasere ◽

Edwina Brown ◽

Fabiana Gordon ◽

Helen Collinson ◽

Richard Fielding ◽

...

Keyword(s):

Quality Of Life ◽

Peritoneal Dialysis ◽

Mixed Model ◽

Rating Scale ◽

Depression Scale ◽

Dialysis Patients ◽

The Impact ◽

Assisted Peritoneal Dialysis

Background In-center hemodialysis (HD) has been the standard treatment for older dialysis patients, but reports suggest an associated decline in physical and cognitive function. Cross-sectional data suggest that assisted peritoneal dialysis (aPD), an alternative treatment, is associated with quality of life (QoL) outcomes that are comparable to in-center HD. We compared longitudinal changes in QoL between modalities. Methods We enrolled 106 aPD patients, matched with 100 HD patients from 20 renal centers in England and Northern Ireland. Patients were assessed quarterly for 2 years using the Hospital Anxiety and Depression Scale (HADS), SF-12 physical and mental scores, symptom score, Illness Intrusiveness Rating Scale (IIRS), Barthel's score, and the Renal Treatment Satisfaction Questionnaire (RTSQ). Mixed model analysis was used to assess the impact of dialysis modality on these outcomes during follow-up. P values were adjusted for multiple significance testing. Results Multivariate analysis showed no difference in any of the outcome measures between aPD and HD. Longitudinal trends in outcomes were also not significantly different. Higher age at baseline was associated with lower IIRS and RTSQ scores during follow-up. One-hundred and twenty-five (60.6%) patients dropped out of the study: 59 (28.6%) died, 61 (29.6%) withdrew during follow-up, and 5 (2.5%) were transplanted. Conclusions Quality of life outcomes in frail older aPD patients were equivalent to those receiving in-center HD. Assisted PD is thus a valid alternative to HD for older people with end-stage kidney disease (ESKD) wishing to dialyze at home.

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P1547THE EFFECT OF INTERNET-BASED CLOSED-LOOP MANAGEMENT ON QUALITY OF LIFE IN PATIENTS ON PERITONEAL DIALYSIS, A SELF-CONTROL STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1547 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Fang Cao

Keyword(s):

Quality Of Life ◽

Peritoneal Dialysis ◽

Management System ◽

Closed Loop ◽

Health Management ◽

Management Model ◽

Self Management ◽

Dialysis Patients

Abstract Background and Aims With the continuous advancement of information technology, mobile Internet has entered every family and shown its unique advantages. The development of hospital's information construction on the management of chronic disease, the continuous improvement of hospital APP and Wechat public number functions have provided intelligent services for patients throughout the process. Along with this process, the way of hospital patient follow-up has gradually expanded and improved, and the automation and intellectualization of follow-up work has become a reality. However, The establishment of peritoneal dialysis health management professional team and the implementation of closed-loop health management model, which is based on the Internet closed-loop management model has no clear impact on the self-management ability, quality of life and treatment effect of peritoneal dialysis patients. To explore the effectiveness of Internet based in-hospital and out of hospital closed loop management on the quality of life of patients with peritoneal dialysis, it is necessary to establish a set of closed loop management system for chronic diseases patients with promotion and practical significance. Method From July 2017 to July 2018, 214 patients with continuous peritoneal dialysis were followed up regularly in the Department of Nephrology of our hospital, and voluntarily participated in this study. The mean follow-up time was 12.6 ± 1.5 months. The differences of blood electrolytes, quality control indexes, self-management ability, quality of life of renal disease and hospital satisfaction were observed before and after closed-loop management. Results Ability of self-management behavior (p < 0.001), quality of life (p < 0.001), satisfaction (p < 0.001), the incidence of infection (p < 0.05), serum albumin (p < 0.05), hemoglobin (p < 0.05)were improved after participating in the closed-loop management. Conclusion The closed-loop management system based on Internet closed-loop management model is effective for the quality of life and treatment effect of peritoneal dialysis patients, which integrates the core functions of follow-up records, intelligent early warning, doctor-patient communication and health education. Through this closed-loop management, medical staff can digitally collect, store, transmit and process the information of in-hospital and out-of-hospital conditions through follow-up analysis, health guidance and remote assistance to achieve the purpose of patient health management. This study shows that this closed-loop management system can effectively manage the health of peritoneal dialysis patients, and provides a replicable model for the management of chronic diseases. Therefore, a comprehensive closed-loop management system based on mobile Internet and information technology, with clinical care as the leading factor and peritoneal dialysis patients as the terminal is a feasible and acceptable follow-up management method for peritoneal dialysis patients and hospitals.

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