scholarly journals Dynamic changes in calcium and phosphate plasma concentrations in the patients on peritoneal dialysis

2006 ◽  
Vol 63 (1) ◽  
pp. 27-30
Author(s):  
Natasa Jovanovic ◽  
Mirjana Lausevic ◽  
Biljana Stojimirovic
Keyword(s):  
Vitamin D ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Calcium Concentration ◽  
Phosphate Binders ◽  
Active Vitamin ◽  
Active Vitamin D ◽  
Stage Renal Disease ◽  
End Stage

Background/Aim. The disturbances of active forms of vitamin D synthesis and disturbances in calcium and posphate metabolism develop early in chronic renal failure, when creatinine clearance is about 30 ml/min. Chronic hemodialysis and peritoneal dialysis only partially correct the biochemical environment of patients on chronic renal replacement therapy because of end-stage renal disease. These dialysis modalities can?t significantly affect the endocrine disturbances of chronic renal failure and they have minimal modulatory effect. The management of disturbed calcium (Ca) and phosphate (P) metabolism and the maintainance of Ca ? P product below 4.4 mmol/l thanks to the use of dialysate solutions with the appropriate calcium concentration and the careful dosage of phosphate binders, calcium and active vitamin D metabolits, are extremely important for the prevention of renal osteodystrophy, secondary hyperparathyroidism as well as low-bone turnover disease. The aim of the study was to analyze the plasma levels of calcium, phosphate, albumin, alkaline phosphatase and parathormon (PTH) in 58 patients who were treated with continuous ambulatory peritoneal dialysis (CAPD) from March to August 2003. The use of phosphate binders and the substitution with active vitamin D metabolits were also analyzed. Methods. We examined 58 patients, 30 males and 28 female, mean-age 52 years (range, 26-78 years), affected by end-stage renal disease of the different leading cause. The average time on peritoneal dialysis program was 20 months (2-66 months). Most of the patients were treated by CAPD, while only few of them performed automatic, cyclic or intermittent peritoneal dialysis. Most of the patients used a dialysate with 1.75 mmol/l calcium concentration. Results. The study showed that our patients on chronic CAPD program during several months had normal calcemia, phosphatemia and the level of alkaline phosphatase, and that they had Ca ? P product in the recommended range. PTH serum level ranged from 16 to 490 pg/l in our patients. Conclusion. The study showed that a balanced diet and a correct dosage of phosphate binders, as well as a careful substitution with active vitamin D metabolits render a good control of calcium and phosphate serum balance, as well as an effective prevention of renal osteodystrophy development in the patients on chronic peritoneal dialysis treatment.

Calcimimetics for the Treatment of Secondary Hyperparathyroidism in Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (2_suppl) ◽  
pp. 42-46 ◽  
Author(s):  
Jean Francis ◽  
David B. Simon ◽  
Peter Jeurgensen ◽  
Fredric O. Finkelstein
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
Secondary Hyperparathyroidism ◽  
Hormone Secretion ◽  
Phosphate Binders ◽  
Serum Phosphate Level ◽  
Dialysis Patients ◽  
Intravenous Vitamin ◽  
Stage Renal Disease ◽  
End Stage

Secondary hyperparathyroidism is a common complication in patients with end-stage renal disease. It has been associated with increased cardiovascular events and mortality. Traditional therapy has been based on vitamin D analogs and phosphate binders; but these therapies often do not control secondary hyperparathyroidism, particularly in peritoneal dialysis patients for whom phosphate clearances are limited and intravenous vitamin D is impractical. Cinacalcet, a calcimimetic, suppresses parathormone secretion by interacting with the calcium-sensing receptor on the surface of parathyroid gland cells. The resulting suppression of parathyroid hormone secretion produces a reduction in serum phosphate level and CaxPO4 product. The present paper reviews the efficacy of cinacalcet in the management of secondary hyperparathyroidism in peritoneal dialysis patients.

Reactivation of Systemic Lupus in three Patients Undergoing CAPD

1986 ◽  
Vol 6 (1) ◽  
pp. 6-9 ◽  
Author(s):  
George G. Wu ◽  
D.R. Gelbart ◽  
James A. Hasbargen ◽  
Robert Inman ◽  
Peter McNamee ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Immune System ◽  
Chronic Renal Failure ◽  
Lupus Nephritis ◽  
End Stage Renal Disease ◽  
Systemic Lupus ◽  
Immunological Changes ◽  
Stage Renal Disease ◽  
End Stage

Generally patients with end-stage renal disease (ESRD) due to lupus nephritis, have minimal extrarenal disease activity <Juring hemodialysis. This may be related to immunological changes secondary to chronic renal failure or the dialysis procedure itself, or both. This paper describes three patients with lupus nephritis undergoing continuous ambulatory peritoneal dialysis (CAPD) in whom we observed reactivation of SLE, by both clinical and serological criteria. This may suggest that in patients undergoing CAPD the immune system is more nearly intact than in hemodialysis. These cases should heighten awareness that patients may suffer flare-ups of SLE during CAPD even long after the onset of renal failure.

scholarly journals Lipid status association with 25-hydroxy vitamin D: Cross sectional study of end stage renal disease patients

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Neda Milinković ◽  
Marija Sarić ◽  
Snežana Jovičić ◽  
Duško Mirković ◽  
Višnja Ležaić ◽  
...  
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Density Lipoprotein ◽  
Dialysis Patients ◽  
25 Hydroxy Vitamin D ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Lipid Parameters

SummaryBackgroundSome observational studies indicate an association of 25-hydroxy vitamin D (25(OH)D) insufficiency and atherogenic cholesterol concentrations. The aim of this study was to investigate relationship between 25(OH)D concentrations and lipid parameters in end stage renal disease (ESRD) patients, separately for predialysis, hemodialysis and peritoneal dialysis patients.MethodsWe have adjusted 25(OH)D concentrations for seasonal variability with cosinor analysis, and performed all further analysis using these corrected 25(OH)D concentrations. Concentrations of 25(OH)D and the lipid parameters were determined in 214 ESRD patients and 50 control group participants. The analysis included the measurement of 25(OH)D by HPLC, apolipoprotein (Apo) AI, ApoB and Lp(a) by nephelometry, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) by spectrophotometry and manually calculated ApoB/ApoAI and LDL-C/HDL-C ratio.ResultsESRD patients with adjusted 25(OH)D concentrations of ≤ 50 nmol/L had significantly higher TC (P = 0.005) and ApoAI (P = 0.049). Significantly higher HDL-C (P = 0.011) and ApoAI (P = 0.020) were found in hemodialysis patients with the 25(OH)D concentrations of ≤ 50 nmol/L. The other analyzed lipid parameters differed significantly between predialysis, hemodialysis and peritoneal dialysis patients with 25(OH)D concentrations of < 50 nmol/L.ConclusionsOur study indicate the significant relationship between 25(OH)D repletion and optimal concentrations of lipid parameters in ESRD patients. Further research is necessary to explain whether joint evaluation of vitamin D status and lipid abnormalities could improve cardiovascular outcome in ESRD patients.

scholarly journals Incidence of end stage renal disease on renal replacement therapy in Nepal

1970 ◽  
Vol 7 (3) ◽  
pp. 301-305 ◽  
Author(s):  
R Hada ◽  
S Khakurel ◽  
RK Agrawal ◽  
RK Kafle ◽  
SB Bajracharya ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Female Ratio ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: End stage renal disease patients are treated with dialysis in Nepal. But there is no renal registry to indicate the burden of disease in the country. Objectives: The objective of this study is to find out the incidence of ESRD on renal replacement therapy and their out come. Materials and methods: It is a retrospective analysis (audit) of all ESRD patients who had received dialysis inside Nepal and had under gone transplantation from 1990 to 1999. The haemodialysis (HD) registry, HD patients file, intermittent peritoneal dialysis (IPD) registry of Bir Hospital, Shree Birendra Hospital, Tribhuwan University Teaching hospital and National Kidney Center were reviewed. Acute renal failure and acute on chronic renal failure were excluded and the demographic profile, dialysis session, dialysis duration and outcome of all ESRD patients were computed. One patient was counted only once in spite of attending more than one center for dialysis. SPSS package was used for analysis. Results: Total number of 1393 ESRD patients received renal replacement therapy (RRT) in the decade. Mean age of patients were 46.7 ± 16.7 with 70% of ESRD were between 20-60 years age with male: female ratio of 1.8:1. Initial mode of RRT was IPD in 58.2%, HD in 41.7% and pre-emptive transplantation in 0.1% patients. Records of 189 patients could not be found and out of remaining 1208 patients, 85.8% received dialysis for < 3 months, 6% received dialysis for more than a year and 9.5% had undergone kidney transplantation. The incidence of ESRD had increased gradually with 3.4 per million populations (pmp) in 1990 to 11.89 pmp in 1999 with an average annual incidence of 6 pmp and only 0.31% of expected ESRD patients received RRT. Conclusion: The incidence of ESRD is increasing but majority discontinue or die within 3 months. Dialysis centers needs to be expanded to different parts of country and prospective studies have to be carried out to find out of cause of ESRD and to institute preventive measures.Key words: End stage renal disease; Renal replacement therapy; Haemodialysis; Intermittent peritoneal dialysis; Incidence of end stage renal disease; Nepal. DOI: 10.3126/kumj.v7i3.2742 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 302-305

Renal therapy techniques

2011 ◽  
Author(s):  
Carl Waldmann ◽  
Neil Soni ◽  
Andrew Rhodes
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Replacement Treatment ◽  
Post War ◽  
The 1960S ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Haemodialysis 64Haemo(dia)filtration 68Peritoneal dialysis (PD) 70The first human haemodialysis was performed in 1943 by Willem Kolff in The Netherlands for the treatment of acute renal failure. Following this, haemodialysis was adopted for the treatment of acute renal failure in the immediate post-war years and then for chronic renal failure from the 1960s. Currently haemodialysis is the most common form of replacement treatment for end-stage renal disease (ESRD). Haemodialysis is one method used for treatment of acute renal failure, and ESRD patients will develop critical illness. An understanding of the principles of haemodialysis and how it is carried out is therefore essential....

Gastroenterology and renal medicine

2018 ◽  
Author(s):  
Rishi M. Goel ◽  
Kamal V. Patel ◽  
Terry Wong
Keyword(s):  
Renal Failure ◽  
Glomerular Filtration Rate ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Filtration Rate ◽  
Therapeutic Anticoagulation ◽  
Bowel Cleansing ◽  
Gi Symptoms ◽  
Stage Renal Disease ◽  
End Stage

Gastrointestinal (GI) symptoms are a major feature of very low glomerular filtration rate and may be the presenting feature in some patients presenting late with renal failure. GI haemorrhage is increased in frequency inpatient with renal failure, even more so in those given therapeutic anticoagulation. There are some differences in likely causes. Oral bowel cleansing preparations that contain phosphate are dangerous in patients with CKD as they may cause phosphate crystallization in the kidneys: the resulting AKI may have limited reversibility. Patients with end stage renal disease have an increased incidence of bowel and other malignancies, best studied after transplantation. Those on peritoneal dialysis present particular issues for colonoscopy.

Arterial Calcifications in Patients Undergoing Chronic Peritoneal Dialysis: Incidence, Progression and Regression

1985 ◽  
Vol 5 (4) ◽  
pp. 241-245 ◽  
Author(s):  
H. Erik Meema ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Diabetes Mellitus ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Chronic Renal Failure ◽  
End Stage Renal Disease ◽  
Arterial Calcification ◽  
Chronic Peritoneal Dialysis ◽  
Stage Renal Disease ◽  
End Stage

The authors graded radiologically detectable arterial calcification (A.C.) in 168 patients with end-stage renal disease treated with peritoneal dialysis; 41 of them had diabetes mellitus (DM). Comparison of DM and nondiabetic (ND) patients showed that during an average dialysis period of more than two years, the incidence of A.C. increased from 37% before dialysis to 45% at the last examination in the ND patients, and from 90% to 100% in DM patients. Both prevalence and progression of A.C. were significantly higher in DM patients (P < 0.001 and <0.05 respectively). Regressions of A.C., unrelated to parathyroidectomy or renal transplantation, were observed in 5 ND and 4 DM patients. This 9% incidence of regressions should encourage further investigations to detect the factors responsible because severe A.C. sometimes is associated with gangrene and other complications. Although numerous publications on radiologic changes in renal osteodystrophy include descriptions of arterial calcifications (A. C.), only a few have focused on the latter (1–4). Furthermore, none have looked at the relative proportions of diabetic (DM) and non-diabetic (ND) patients with A.C. and chronic renal failure. The main purpose of this paper is to make such a comparison.

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