Hyperuricemia Predicts Residual Diuresis Decline in Peritoneal Dialysis Patients

Background: Red blood cells (RBCs) undergo programmed cell death known as eryptosis. Triggers of eryptosis include increased cytosolic Ca(2+) concentration, oxidative stress, osmotic shock, energy depletion and several uremic toxins. Little is known about the pathogenesis of eryptosis in peritoneal dialysis (PD) patients; furthermore, its relevance in worsening clinical conditions in these patients is still not completely defined. Objectives: We investigated eryptosis levels in PD patients and its association with inflammatory and clinical parameters. Material and Methods: A total of 46 PD patients and 17 healthy subjects (CTR) were enrolled. All eryptosis measurements were made in freshly isolated RBCs using the flow cytometer. Results: Eryptosis was significantly higher in PD patients than that in CTR (p < 0.001). Eryptosis levels did not differ significantly between PD patients with and without diabetes, with and without hypertension, and with and without cardiovascular disease. Eryptosis showed no significant differences between patients treated with continuous ambulatory PD/automated PD, with Kt/Vurea value ≤1.7 and >1.7, with a negative or positive history of peritonitis. On the contrary, eryptosis showed significantly lower levels in PD patients with weekly creatinine clearance ≥45 L/week/1.73 m2 (2.8%, 1.7–4.9 vs. 5.6%, 5.0–13.5; p= 0.049). Eryptosis showed significantly lower levels in PD patients with residual diuresis (n = 23) than that in patients without (3.7%, 2.6–5.6 vs. 5%, 3.1–16; p = 0.03). In these 23 patients, significant negative correlations between percentage of eryptosis and residual glomerular filtration rate (rGFR; Spearman’s rho = –0.51, p = 0.01) and diuresis volume (Spearman’s rho = –0.43, p = 0.05) were found. Conclusions: The present study demonstrated higher eryptosis levels in PD patients compared to corresponding levels in CTR. Furthermore, important PD comorbidity and main PD parameters do not influence eryptosis. Importantly, our data have reported an increase in eryptosis levels with progressive residual diuresis and rGFR loss, probably due to decreased uremic toxins clearance.

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The predictive value of hyperuricemia in residual diuresis decline in peritoneal dialysis patients

European Urology Supplements ◽

10.1016/s1569-9056(19)32076-7 ◽

2019 ◽

Vol 18 (2) ◽

pp. e2378-e2379

Author(s):

N. Stepanova ◽

L. Surzhko ◽

L. Lebed ◽

L. Snisar ◽

M. Kolesnyk

Keyword(s):

Peritoneal Dialysis ◽

Predictive Value ◽

Dialysis Patients ◽

Residual Diuresis

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Pharmacokinetics of Clodronate in Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686089801800210 ◽

1998 ◽

Vol 18 (2) ◽

pp. 204-209 ◽

Cited By ~ 5

Author(s):

Heikki H.T. Saha ◽

Ilpo O. Ala-Houhala ◽

Sirpa H. Liukko-Sipi ◽

Pauli Ylitalo ◽

Amos I. Pasternack

Keyword(s):

Peritoneal Dialysis ◽

University Hospital ◽

Total Serum ◽

Selective Detection ◽

Hormone Concentration ◽

Single Intravenous Dose ◽

Dialysis Patients ◽

Severe Renal Failure ◽

Serum Clearance ◽

Residual Diuresis

Objective To study the pharmacokinetics of clodronate in patients on continuous ambulatory peritoneal dialysis (CAPD). Design A single intravenous dose pharmacokinetic study. Setting University hospital. Patients Ten CAPD patients (3 female, 7 male, age 39 79 year, median 55). Methods Clodronate disodium in serum, urine, and dialysate was collected for 24 hours and analyzed by capillary gas chromatography with mass-selective detection. Results Only 7% of the infused dose of clodronate was eliminated through peritoneal dialysis during 24 hours. Clearance via CAPD (CLCAPD) was 2.4 ± 0.6 mL/min, which was less than 10% of the total serum clearance (CLtot’ 26.0 ± 19.3 mL/min). Even the kidneys were a more important route of elimination than CAPD in those patients with residual diuresis of more than 500 mL/24 hr. However, in all patients most of the clodronate serum clearance (77% ± 13%) took place via routes other than peritoneal dialysis or kidneys, that is, via nonrenal-non-CAPD clearance (CLNRD). CLNRD most likely represents the part of the drug deposited in the skeleton. There was a positive correlation between CLNRD and the plasma intact parathyroid hormone concentration. Conclusions CAPD removed clodronate poorly from the circulation. Most clearance took place via routes other than CAPD or kidneys. This CLNRD most likely represents the skeletal deposition of the drug, and this is related to the severity of hyperparathyroidism. When treating CAPD patients with hyperparathyroid bone disease, the administration of clodronate should be adjusted as in those subjects with severe renal failure.

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Magnesium handling in peritoneal dialysis patients with preserved residual diuresis

International Urology and Nephrology ◽

10.1007/s11255-015-1164-0 ◽

2015 ◽

Vol 48 (4) ◽

pp. 633-634 ◽

Cited By ~ 1

Author(s):

Carlos G. Musso ◽

Konstantina Trigka ◽

Periklis Dousdampanis

Keyword(s):

Peritoneal Dialysis ◽

Dialysis Patients ◽

Residual Diuresis

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Beta-trace protein as a potential biomarker of residual renal function in patients undergoing peritoneal dialysis

BMC Nephrology ◽

10.1186/s12882-021-02287-0 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Sebastian Schwab ◽

Carola Ellen Kleine ◽

Dominik Bös ◽

Sylvie Bohmann ◽

Christian P. Strassburg ◽

...

Keyword(s):

Renal Function ◽

Peritoneal Dialysis ◽

Creatinine Clearance ◽

Residual Renal Function ◽

Dialysis Patients ◽

Potential Biomarker ◽

Weight Protein ◽

Low Molecular Weight Protein ◽

Residual Diuresis

Abstract Background Residual renal function is closely linked to quality of life, morbidity and mortality in dialysis patients. Beta-trace protein (BTP), a low molecular weight protein, has been suggested as marker of residual renal function, in particular in patients on hemodialysis. We hypothesized that BTP also serves as a marker of residual renal function in pertioneal dialysis patients. Methods In this study 34 adult patients on peritoneal dialysis were included. BTP, creatinine, cystatin C and urea concentrations were analyzed simultaneously in serum and dialysate to calculate renal and peritoneal removal of the analytes. Results In peritoneal dialysis patients with residual diuresis, mean serum BTP was 8.16 mg/l (SD ± 4.75 mg/l). BTP correlated inversely with residual diuresis (rs = − 0.58, p < 0.001), residual creatinine clearance (ClCr) (rs = − 0.69, p < 0.001) and total urea clearance (Clurea) (rs = − 0.56, p < 0.001). Mean peritoneal removal of BTP was 3.36 L/week/1.73m2 (SD ± 1.38) and mean renal removal 15.14 L/week/1.73m2 (SD ± 12.65) demonstrating a significant renal contribution to the total removal. Finally, serum BTP inversely correlated with alterations in residual diuresis (r = − 0.41, p = 0.035) and renal creatinine clearance over time (r = − 0.79, p = p < 0.001). Conclusion BTP measurement in the serum may be a simple tool to assess residual renal function in peritoneal dialysis patients.

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Hypertension in peritoneal dialysis patients

Medicinski pregled ◽

10.2298/mpns0604130l ◽

2006 ◽

Vol 59 (3-4) ◽

pp. 130-134 ◽

Cited By ~ 1

Author(s):

Mirjana Lausevic ◽

Natasa Jovanovic ◽

Ana Bontic ◽

Biljana Stojimirovic

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Peritoneal Dialysis ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Blood Pressure Control ◽

Pressure Control ◽

Residual Renal Function ◽

Dialysis Patients ◽

Residual Diuresis

Introduction. Continuous ambulatory peritoneal dialysis (CAPD) is effective in reducing blood pressure. Mean arterial pressure falls within 6 months of starting CAPD in the majority of patients. This improved blood pressure control reflects removal of excess fluid volume and body sodium. However, after several years, there is a decline in the efficacy of CAPD in controlling blood pressure. High incidence of hypertension in long-term CAPD patients may be related to hypervolemia as a consequence of loss of residual renal function (RRF), loss of ultrafiltration (UF) due to functional or structural changes in the peritoneal membrane, to a more liberated intake of sodium and fluid, or to administration of erythropoietin. The aim of the present study was to compare the efficacy in blood pressure control in peritoneal dialysis patients depending on the dialysis modality and duration, RRF and dialysis adequacy. Material and methods. This study was a retrospective analysis of 67 patients who attended our Clinic monthly in 2003. All patients received antihy?pertensive therapy (monotherapy-16 pts, two drugs-27 pts, three drugs-22 pts and four-2 pts.). Results. The prevalence of hypertension (TA > 140/90 mmHg) was 73.13%. Most of them (50.75%) had mild hypertension (mean value TA < 160/100 mmHg). There was no statistically significant difference in hypertension prevalence between diabetic (78.27%) and non-diabetic patients (75%). The prevalence of hypertension in patients with residual diuresis of more than 1000 ml was 36.6%, but there were 80.64% patients with residual diuresis less than 500 ml. A statistically significant negative correlation was found between D/DO, UF volume and systolic blood pressure and RRF, D/DO and Ccr and diastolic blood pressure. A statistially significant positive correlation was found between age, body weight, duration of dialysis and systolic blood pressure and age and diastolic blood pressure. Conclusion. We can conclude that duration of PD treatment has a negative effect on blood pressure control. Residual renal function plays an important role in volume and blood pressure control. High and high average transporters are the two groups of patients at increased risk of developing hypertension, especially if they are anuric. .

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The association of serum soluble Klotho levels and residual diuresis and overhydration in peritoneal dialysis patients

Advances in Clinical and Experimental Medicine ◽

10.17219/acem/104552 ◽

2019 ◽

Vol 28 (10) ◽

pp. 1345-1349

Author(s):

Dorota Sikorska ◽

Krzysztof Pawlaczyk ◽

Ewa Baum ◽

Maria Wanic-Kossowska ◽

Natasza Czepulis ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Dialysis Patients ◽

Residual Diuresis

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Which Method Should Be Used to Assess Protein Intake in Peritoneal Dialysis Patients? Assessment of Agreement Between Protein Equivalent of Total Nitrogen Appearance and 24-Hour Dietary Recall

Journal of Renal Nutrition ◽

10.1053/j.jrn.2020.08.003 ◽

2020 ◽

Author(s):

Maryanne Zilli Canedo Silva ◽

Barbara Perez Vogt ◽

Nayrana Soares Carmo Reis ◽

Rogerio Carvalho Oliveira ◽

Jacqueline Costa Teixeira Caramori

Keyword(s):

Peritoneal Dialysis ◽

Total Nitrogen ◽

Protein Intake ◽

Dialysis Patients ◽

Dietary Recall

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Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study

Brazilian Journal of Nephrology ◽

10.1590/10.1590/2175-8239-jbn-2020-0018 ◽

2020 ◽

Author(s):

Firas Ajam ◽

Arda Akoluk ◽

Anas Alrefaee ◽

Natasha Campbell ◽

Avais Masud ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Cardiac Conduction ◽

Future Research ◽

Dialysis Patients ◽

Bundle Branch Block ◽

Conduction Abnormality ◽

Ckd Stage ◽

Stage 1 ◽

Electrocardiogram Ecg ◽

Ecg Abnormalities

ABSTRACT Background: The electrocardiogram (ECG) can aid in identification of chronic kidney disease (CKD) patients at high risk for cardiovascular diseases. Cohort studies describe ECG abnormalities in patients on hemodialysis (HD), but we did not find data comparing ECG abnormalities among patients with normal kidney function or peritoneal dialysis (PD) to those on hemodialysis. We hypothesized that ECG conduction abnormalities would be more common, and cardiac conduction interval times longer, among patients on hemodialysis vs. those on peritoneal dialysis and CKD 1 or 2. Methods: Retrospective review of adult inpatients’ charts, comparing those with billing codes for “Hemodialysis” vs. inpatients without those charges, and an outpatient peritoneal dialysis cohort. Patients with CKD 3 or 4 were excluded. Results: One hundred and sixty-seven charts were reviewed. ECG conduction intervals were consistently and statistically longer among hemodialysis patients (n=88) vs. peritoneal dialysis (n=22) and CKD stage 1 and 2 (n=57): PR (175±35 vs 160±44 vs 157±22 msec) (p=0.009), QRS (115±32 vs. 111±31 vs 91±18 msec) (p=0.001), QT (411±71 vs. 403±46 vs 374±55 msec) (p=0.006), QTc (487±49 vs. 464±38 vs 452±52 msec) (p=0.0001). The only significantly different conduction abnormality was prevalence of left bundle branch block: 13.6% among HD patients, 5% in PD, and 2% in CKD 1 and 2 (p=0.03). Conclusion: To our knowledge, this is the first study to report that ECG conduction intervals are significantly longer as one progresses from CKD Stage 1 and 2, to PD, to HD. These and other data support the need for future research to utilize ECG conduction times to identify dialysis patients who could potentially benefit from proactive cardiac evaluations and risk reduction.

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