Results of Differential Treatment of Tenckhoff Catheter Exit Site/Tunnel Infection during Peritoneal Dialysis in Patients with End-Stage Chronic Kidney Disease

Introduction: Peritoneal dialysis is the dialytic method of choice in chronic end-stage renal disease in children. This study main purposewas to characterize the long-term survival of a pediatric population who began peritoneal dialysis within the first two years of life.Material and Methods: A descriptive and retrospective study was performed in a portuguese nephrology and renal transplantation pediatric unit, between January 1991 and August 2014. End-stage renal disease etiology, mortality, comorbidities and complications of peritoneal dialysis and end-stage renal disease, growth and psychomotor development were evaluated.Results: Twenty children started peritoneal dialysis within the first two years of life. There were six deaths, but no deaths of children with primary chronic kidney disease were registered over the past decade. The 14 living children were characterized; 13 were males. Congenital abnormalities of the kidney and urinary tract were the leading etiology of chronic kidney disease (45%). The average age start of peritoneal dialysis was 6.1 months; six children started before 30 days of life. Peritonitis was the most frequent cause of hospitalization. Ten children were transplanted at an average age of 5.3 years. All of the children who are still in peritoneal dialysis have short stature, but nine of the transplanted have final height within the expected for their mid-parental height target range. Nine (64%)had some type of neurodevelopmental delay.Discussion: Peritoneal dialysis is a technique possible and feasible since birth, as evidenced in the study, as more than half of children successfully started it before 6 months of life. It allows long-term survival until the possibility of renal transplantation despite the associated morbidity, including peritonitis and complications of chronic renal disease. The ten transplanted children improved their growth, recovered from chronic anemia and improved dyslipidemia, compared with the period of dialysis. However, the average waiting time until the renal transplant was 5.3 years higher than other international centers.Conclusion: These data support the use of peritoneal dialysis from birth, but complications and the worst growth reflect the need to develop strategies to optimize care relating to nutrition, growth and development and to reduce pre-transplant time.

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A metabolomics approach for predicting the response to intravenous iron therapy in peritoneal dialysis patients with anemia

RSC Advances ◽

10.1039/c6ra24152b ◽

2017 ◽

Vol 7 (4) ◽

pp. 1915-1922 ◽

Cited By ~ 1

Author(s):

Qiong Wu ◽

Xue-li Lai ◽

Hong-xia Zhao ◽

Zhen-yu Zhu ◽

Zhan-ying Hong ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

End Stage Renal Disease ◽

Intravenous Iron ◽

Dialysis Patients ◽

Receive Treatment ◽

Intravenous Iron Therapy ◽

Stage Renal Disease ◽

End Stage

Anemia is an almost universal complication of chronic kidney disease (CKD), and nearly all patients with end-stage renal disease (ESRD) and approximately 70% of those with earlier stages of CKD receive treatment for anemia.

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Higher Fibrinogen Levels Among Patient With End-Stage Kidney Disease Post Initiation Of Peritoneal Dialysis: Cardiovascular Risk Attenuation

Nephrology & Renal Therapy ◽

10.24966/nrt-7313/100043 ◽

2020 ◽

Vol 6 (4) ◽

pp. 1-10

Author(s):

Issa Al Salmi ◽

Keyword(s):

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Cardiovascular Risk ◽

Kidney Disease ◽

End Stage Kidney Disease ◽

End Stage

Defects in both coagulation initiation and fibrinolysis have been identified in Chronic Kidney Disease (CKD) patients and patients on dialysis may have higher rates of Cardiovascular Disease (CVD) events.

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Surgical Management of Refractory Exit-Site/Tunnel Infection of Tenckhoff Catheter: Technical Innovations of Partial Replantation

Peritoneal Dialysis International ◽

10.1177/089686089901900508 ◽

1999 ◽

Vol 19 (5) ◽

pp. 451-454 ◽

Cited By ~ 19

Author(s):

Yao-Ming Wu ◽

Meng-Kun Tsai ◽

Seh-Huang Chao ◽

Tun-Jun Tsai ◽

King-Jen Chang ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Site Infection ◽

Absolute Contraindication ◽

Exit Site ◽

Exit Site Infection ◽

Tenckhoff Catheter ◽

Tunnel Infection ◽

Technical Innovations ◽

Subcutaneous Tunnel ◽

Infected Catheter

Objective Catheter-related infection has been the major cause of catheter removal for peritoneal dialysis (PD) patients. A salvage technique — partial replantation of the infected catheter — was developed in our hospital to rescue catheters with refractory exit-site or tunnel infection. Patients We performed 26 partial replantations of Tenckhoff catheters for 23 patients with refractory exitsite or tunnel infection and 2 patients with near-cuff perforation of the catheter. Their problems were all resolved successfully without interruption of PD. Interventions We removed the infected portion of the catheter and preserved the still-functioning internal conduit, connecting it to a divided new catheter. All of the patients resumed PD immediately after the advancement of the new catheter through a new subcutaneous tunnel and exit site on the opposite side. Results No technical complications such as disconnection of the catheter or leakage of dialysate were noted. Repeated partial replantation of the catheter was done for 1 patient with a new refractory exit-site infection. Tunnel infection was not an absolute contraindication for this procedure. About one third (34.6%) of our patients had preoperative tunnel infection. Conclusion Partial replantation of a Tenckhoff catheter is a simple and effective procedure for patients with refractory exit-site/tunnel infection and patients with near-cuff perforation of the catheter. Repeated partial replantation is also feasible for repeat exit-site infections.

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Chronic kidney disease and dialysis

10.1093/med/9780199659579.003.0128 ◽

2017 ◽

Author(s):

Richard J Haynes ◽

James A Gilbert

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

Abdominal Cavity ◽

Kidney Injury ◽

Well Being ◽

Prosthetic Graft ◽

Dialysis Access ◽

Stage Renal Disease ◽

End Stage

Chronic kidney disease (CKD) is a common disorder as currently defined. Patients with CKD face two major hazards: cardiovascular disease and—in a minority—progression to end-stage renal disease (ESRD). Advanced CKD also causes numerous metabolic and other complications. The management of CKD involves excluding acute kidney injury, diagnosing the cause of CKD, slowing progression, and detecting and treating complications. If patients do reach ESRD, then renal replacement therapy (RRT) options must be considered. These include haemodialysis, peritoneal dialysis, or transplantation. Haemodialysis requires creation of an arteriovenous fistula or insertion of a prosthetic graft while peritoneal dialysis necessitates the insertion of a catheter into the abdominal cavity. All forms of dialysis access are associated with complications both in the short and long term. However, they remain vital and central to the life and the well-being of the end-stage renal patient on dialysis.

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Multiple primary cancer: prostate cancer Т3NхMх and melanoma ТхNхM1 in patient with end-stage of chronic kidney disease on peritoneal dialysis

Health of Man ◽

10.30841/2307-5090.2(61).2017.115954 ◽

2017 ◽

Vol 0 (2(61)) ◽

pp. 25-28

Author(s):

В. М. Лісовий ◽

Н. М. Андон’єва ◽

О. А. Гуц ◽

М. Я. Дубовик ◽

М. М. Поляков

Keyword(s):

Prostate Cancer ◽

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

Multiple Primary Cancer ◽

Primary Cancer ◽

Multiple Primary ◽

Cancer Prostate ◽

End Stage

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Successful Treatment of Calciphylaxis in a Young Female With End-Stage Renal Disease on Peritoneal Dialysis With Parathyroidectomy, Intensification of Dialysis, and Sodium Thiosulphate—A Case Report and Literature Review

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/23247096211060580 ◽

2021 ◽

Vol 9 ◽

pp. 232470962110605

Author(s):

Sasmit Roy ◽

Sohil Narasimha Reddy ◽

Amarinder Singh Garcha ◽

Praveena Vantipalli ◽

Sumit S Patel ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Young Female ◽

The Body ◽

Sodium Thiosulphate ◽

Stage Renal Disease ◽

End Stage

Calcific uremic arteriolopathy, commonly referred to as “calciphylaxis,” is a rare life-threatening condition observed in patients with chronic kidney disease and end-stage renal disease on dialysis. This results in necrotic, ischemic, tender dermal lesions anywhere in the body, but mainly on the abdominal wall and lower extremities, where subcutaneous tissue is abundant. Histologically, it is defined by calcification in dermal capillaries, arterioles, and subcutaneous adipose tissues. It can occur in all advanced stages of chronic kidney disease as well as end-stage renal disease patients on hemodialysis or peritoneal dialysis. Our case highlights a successful case of calciphylaxis in a young female patient who underwent parathyroidectomy and intensification of peritoneal dialysis regimen along with the infusion of sodium thiosulphate injection resulting in complete resolution of the lesion in 3 months. With limited evidence of treatment options and increased frequency of this condition in a dialysis patient, our case highlights the key aspects of calciphylaxis management in a young end-stage renal disease patient who didn’t need a change of dialysis modality. We also review the risk factors and current practiced management options of this condition in our article.

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The Continuum of Chronic Kidney Disease and End-Stage Renal Disease: Challenges and Opportunities for Chronic Peritoneal Dialysis in the United States

Peritoneal Dialysis International ◽

10.1177/089686080702700204 ◽

2007 ◽

Vol 27 (2) ◽

pp. 125-130 ◽

Cited By ~ 9

Author(s):

Rajnish Mehrotra

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Chronic Peritoneal Dialysis ◽

The Usa ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

End-stage renal disease (ESRD) patients undergoing renal replacement therapy have a high mortality rate and suffer from considerable morbidity. Degree of nutritional decline, disordered mineral metabolism, and vascular calcification are some of the abnormalities that predict an adverse outcome for ESRD patients. All these abnormalities begin early during the course of chronic kidney disease (CKD), long before the need for maintenance dialysis. Thus, CKD represents a continuum of metabolic and vascular abnormalities. Treatment of these abnormalities early during the course of CKD and a timely initiation of dialysis have the potential of improving patient outcomes. However, the thesis that successful management of these abnormalities will favorably modify the outcomes of dialysis patients remains untested. The proportion of incident USA ESRD patients starting chronic peritoneal dialysis (CPD) has historically been low. Limited physician training and inadequate predialysis patient education appear to underlie the low CPD take-on in the USA. Furthermore, two key changes have occurred in the USA: steep decline in CPD take-on and progressive increase in the use of automated peritoneal dialysis. The decline in CPD take-on has afflicted virtually every subgroup examined and has occurred, paradoxically, when the CPD outcomes in the country have improved. Understanding the reasons for historically low CPD take-on and recent steep declines in utilization may allow the development of plans to reverse these trends.

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Erythropoietin dose and survival of hemodialysis patients

Biomedical Research and Therapy ◽

10.15419/bmrat.v4i7.195 ◽

2017 ◽

Vol 4 (07) ◽

pp. 1432

Author(s):

Mahdi Mohammadian ◽

Hamid Salehiniya ◽

Salman Khazaei ◽

Abdollah Mohammadian-Hafshejani

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

Kidney Function ◽

End Stage Renal Disease ◽

Hemodialysis Patients ◽

Major Health Problem ◽

Major Health ◽

Stage Renal Disease ◽

End Stage

Chronic kidney disease (CKD) is known as a major health problem worldwide (Levey et al., 2007). The CKD is defined as a stage of disease in which the patient's kidney function is less than a half of normal capacity (2). If the kidney function is 10% to 15% less than the normal capacity, the patient has reached the End Stage Renal Disease (ESRD). At this stage, the kidney transplant or dialysis with hemodialysis or peritoneal dialysis is necessary for patient's survival (Levey et al., 2002).

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