scholarly journals Complications of continuous ambulatory peritoneal dialysis: An early experience in tertiary hospital of Western region of Nepal

2017 ◽  
Vol 5 (2) ◽  
pp. 34-37
Author(s):  
Abhishek Maskey ◽  
Niraj Dhakal ◽  
Chirayu Regmi
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Diseases ◽  
Tertiary Hospital ◽  
Infectious Complications ◽  
Catheter Survival ◽  
End Stage ◽  
Complications Rate

Background and Aims: Chronic ambulatory peritoneal dialysis (CAPD) has been established form of therapy in adults patients with end stage kidney diseases and has emerged as a feasible modality of renal replacement therapy. The aim of the study was to evaluate the complications of CAPD and its contributing factor in order to improve the patient survival and reduce morbidity and mortality.Methods: A hospital based retrospective study of 35 patients who opted for CAPD at Manipal teaching hospital, Pokhara from 1st June 2015 to 31st May 2016 was carried out.Results: Total 35 CAPD patients were included in study. The mean age of the patients was 45.78±16.34 years. Nineteen (54%) patients were male. The total follow up was 533 patients months with mean follow up of 15.22 ±5.02 months. There were 41 episodes of different complications that occurred during the study period with rate of 0.9 episodes/patient years. There were 18 (43%) episodes of peritonitis including 5 recurrence of peritonitis in 5 patients, 6 (15%) exit site infections, 6 (15%) failure of drainage, 2 (5%) pericatheter leakage, 2 (5%) catheter displacement , 2 (5%) omental wrapping, 2 (5%) catheter removal, 2 (5%) mortality. The commonest pathogen for peritonitis was staphylococcus aureus in 5 (22%) episodes.Conclusion: Overall complications rate was comparable to other studies. Peritonitis rate has been declined in our study. The majority of non-infectious complications are treatable and do not interfere with the catheter survival. CAPD is a safe and viable mode of renal replacement therapy alternative to hemodialysis.Journal of Advances in Internal Medicine Vol.5(2) 2016: 34-37

scholarly journals MO028AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE: REGISTRY OF NORTHERN CYPRUS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Simge Bardak ◽  
Düriye Deren Oygar ◽  
Ahmet Behlul
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Family History ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Kidney Diseases ◽  
Polycystic Kidney ◽  
North Cyprus ◽  
Northern Cyprus

Abstract Background and Aims Autosomal dominant polycystic kidney disease (ADPCK) is the most prevelant inherited kidney disease in adults, and the fourth common cause for renal replacement therapy worldwide and preventive measures should be taken to slow the decline in renal functions. From previous studies we already know that hereditary kidney diseases such as medullary kidney disease and tubular kidney diseases are frequent in Cyprus. In this study, we aim to find out the situation for ADPKC in North Cyprus and declare the overall magnitude of the problem in our region. Method From January 2004 to January 2021, we collected data from all patients with ADPCK irrespective of whether they were on RRT or not and who were followed in nephrology departments within Northern Cyprus. Clinical and demographic data of all the patients aged above 18 were collected. The affected families and their route of inheritance were determined. Need for renal replacement therapy (RRT) and types of RRT were noted. RRT rate and death rate were calculated. Results We collected information from a total of 79 patients with the diagnosis of ADPCK; 3 patients were excluded due to lost to follow up. There was no family history in 11% of patients. Inheritence was maternal in 53% and paternal in 42% whereas both maternal and paternal inheritence route were identified in 5%. 68 patients with family history were grouped in 24 families (2.8 patients/ family). The demographic and clinical data can be seen on Table 1. At some point during follow up 31 patients started with RRT. Mean age for RRT was 55 years (23-81). 5 (16%) patients initiated RRT with peritoneal dialysis, wheras 23 (74%) with hemodialysis, and 3 (10%) had preemptive renal transplantation. At the end of follow up period we found out that 35% (11/31) of patients who had RRT had transplantation, 32% (10/31) experienced peritoneal dialysis whereas 77% (24/31) experienced hemodialysis. 18 out of 76 (24%) patients died during the follow up period. The mean age of death was 71 years (53-81). Conclusion The prevalance of the disease when living patients were considered was 1.3 cases/10000 inhabitants which is low when compared with other studies. Hence ADPCK was not a common diagnosis in North Cyprus as other hereditary kidney diseases. This may show that some patients are underdiagnosed in the population. The frequency of patients without family history was high and also the number of patients per family was low when compared with other studies; these findings may also indicate an underdiagnosed problem. The patients were diagnosed late at a mean age of 47 Hence we need to perform further studies on ADPCK in our population since identifiying ADPCK patients and their families may help to adress the needs adequately, to plan lifelong supportive measures and to decrease high mortality rate of these patients.

Peritoneal Dialysis Access

2020 ◽  
Author(s):  
David Shaffer ◽  
Rachel Forbes
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Dialysis Access ◽  
Catheter Survival ◽  
Flexible Schedule ◽  
Key Words Peritoneal Dialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Laparoscopic Techniques

Currently approximately 10% of the 650,000 ESRD patients in the U.S. requiring renal replacement therapy are on peritoneal dialysis (PD).  Although equally efficacious as hemodialysis (HD), advantages of PD may include a more flexible schedule allowing greater freedom to work or travel, better tolerability in patients with cardiovascular compromise, and decreased costs.   PD requires an intact peritoneal membrane and abdominal wall and the ability to perform at home, either by the patient  or by a caregiver.  Although PD catheters can be inserted via open or laparoscopic techniques, laparoscopic insertion allows for direct visualization and placement of the tip of the catheter, as well as the ability to secure the tip of the dialysis catheter in the pelvis.  Laparoscopic insertion improves catheter survival, reduces the incidence of mechanical complications, and allows for additional procedures, such as repair of umbilical hernias, lysis of adhesions, or omentopexy. Laparoscopy is also ideal for secondary procedures for catheter salvage.  Infections remain the most frequent complication of peritoneal dialysis catheters and the most common reason for catheter removal or conversion from PD to HD.   This review contains 16 figures, 6 tables, and 40 references. Key Words: Peritoneal dialysis; End-stage renal disease; renal replacement therapy; dialysis; laparoscopy; catheter-associated peritonitis; exit site infections; catheterpexy; omental wrapping; catheter outflow obstruction.

scholarly journals Renal Replacement Therapy in Children in the Developing World: Challenges and Outcome in a Tertiary Hospital in Southeast Nigeria

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Odutola Israel Odetunde ◽  
Henrietta Uche Okafor ◽  
Samuel Nkachukwu Uwaezuoke ◽  
Bertilla Uzoma Ezeonwu ◽  
Oluchi Mildred Ukoha
Keyword(s):  
Renal Transplantation ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Tertiary Hospital ◽  
Chronic Hemodialysis ◽  
Chronic Dialysis ◽  
End Stage ◽  
Lost To Follow Up

A 5-year observational, retrospective study was conducted to evaluate the indications, the availability, the accessibility, the sustainability, and the outcome of children managed for acute kidney injury (AKI) and end stage kidney disease (ESKD) who required renal replacement therapy RRT in Enugu, southeast Nigeria. A total of 64 patients aged 5 months to 16 years required RRT, of which only 25 underwent RRT, giving an RRT accessibility rate of 39.1%. Eleven (44%) patients required chronic dialysis program/ renal transplant, of which only 1 (9.1%) accessed and sustained chronic hemodialysis, giving a dialysis acceptance rate of 9.1%. Fifty (78%) of the patients belonged to the low socioeconomic class. Thirty-three (51.5%) could not access RRT because of financial constraints and discharge against medical advice (DAMA); 6 (9.4%) died on admission while sourcing for funds to access the therapy; 5 (7.8%) died while on RRT; 9 (14.1%) improved and were discharged for follow-up; 1 (1.6%) improved and was discharged to be on chronic dialysis program while awaiting renal transplantation outside the country/clinic follow-up, while the remaining 10 (15.6%) were unable to sustain chronic dialysis program or access renal transplantation and were lost to follow-up. We conclude that RRT remains unaffordable within the subregion.

scholarly journals Successful Renal Replacement Therapy for a Patient with Severe Hemophilia after Surgical Treatment of Intracranial Hemorrhage and Hydrocephalus

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Noriko Kato ◽  
Masami Chin-Kanasaki ◽  
Yuki Tanaka ◽  
Mako Yasuda ◽  
Yukiyo Yokomaku ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Hemophilia A ◽  
Severe Hemophilia ◽  
End Stage Renal Failure ◽  
Japanese Male ◽  
Old Japanese ◽  
End Stage

A 21-year-old Japanese male with severe hemophilia A was developed end-stage renal failure. He was placed on combination therapy with peritoneal dialysis (PD) and hemodialysis (HD). Eight months later, he developed a hypertensive cerebral hemorrhage. After emergency surgery, he was managed with PD without HD to avoid cerebral edema. One month later, his renal replacement therapy was switched to HD (three times a week) from PD, since a ventriculoperitoneal shunt catheter was placed to treat his hydrocephalus. HD could be performed safety without anticoagulant agents on condition that factor VIII is given after every HD.

scholarly journals Diabetic nephropathy: what should cardiologist remember

2021 ◽  
Vol 23 (1) ◽  
pp. 20-24
Author(s):  
Natalia P. Trubitsyna ◽  
◽  
Natalia V. Zaitseva ◽  
Anastasia S. Severinа ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Kidney Diseases ◽  
Renin Angiotensin Aldosterone System ◽  
Stage Renal Disease ◽  
End Stage

Prevalence of diabetes mellitus (DM) progressively increases around the world. Diabetic nephropathy (DN) is significant reason of end-stage renal disease and it is associated with high risk of cardiovascular disease and mortality. Necessity of expensive renal replacement therapy for patients with prominent vascular diabetic complications and end-stage renal disease has significant socio-economic impact. DM, as a one of leading causes of kidney diseases, competes for stricted resources of public health. Renal replacement therapy in patients with DM does not solve the whole problem, because survival of such patients is low, comparing with another kidney diseases, first of all because of cardiovascular diseases. Good control of glycaemia, blood pressure and cholesterol level and prescription of renin-angiotensin-aldosterone system inhibitors and statins decrease cardiovascular risk and slow down DN progression, as it was shown in many clinical trials. So patients with DM and DN should receive complex therapy for risk reduction of kidney disease and cardiovascular disorders progression. Keywords: diabetes mellitus type 2, diabetic nephropathy, nephroprotection, cardioprotection, SGLT-2 inhibitors, GLP-1 agonists, renin-angiotensin-aldosterone system For citation: Trubitsyna NP, Zaitseva NV, Severinа AS. Diabetic nephropathy: what should cardiologist remember. Consilium Medicum. 2021; 23 (1): 20–24. DOI: 10.26442/20751753.2021.1.200712

Incidence of Atrial Fibrillation in Haemodialysis Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed El-Tayeb Nasser ◽  
Adham Ahmed Abdeltawab ◽  
Raafat Boshra Mehany ◽  
Mostafa Abd El-Nassier Abd El-Gawad
Keyword(s):  
Diabetes Mellitus ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Heart Diseases ◽  
Ischemic Heart ◽  
Ischemic Heart Diseases ◽  
Study Population ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Chronic kidney disease patients usually experience several comorbid conditions including cardiovascular disorders and at final end-stage renal disease (ESRD) stage, cardiovascular mortality accounts for about 50% of total mortality. End-stage renal disease (ESRD) patients commonly have a higher risk of developing cardiovascular diseases than general population. Chronic kidney disease is an independent risk factor for atrial fibrillation (AF); however, little is known about the AF risk among ESRD patients with various modalities of renal replacement therapy. Aim of the Work To detect the incidence of AF in hemodialysis patients during six months. Patients and Methods The study was a prospective cohort study for six months included 250 adult patients with end stage renal diseases on regular hemodialysis sessions in National Institute of Urology and Nephrology in CAIRO, EGYPT for at least six months with no past history suggestive of any arrhythmias and normal holter ECG at the start of the study. Results The study includes 250 patients from whom 37 patients refuse follow up after 6 months and 18 patients was died before our follow up holter ECG so mortality rate 14.4% .1n our study population there were 102 male patients (52.3%) and 93 female patients (47.7%) with mean age 54.39 ± 9.98 (19:73) and BMI 29.01±1.28 (24.5:34). In study population 96 patients were diabetic (49.2%), 84 patients were hypertensive (43.1%), 100patients were with ischemic heart diseases (51.3%) with median renal replacement duration 4 (3 — 6) with range (1 — 13). The main etiological causes of dialysis were diabetes mellitus, hypertension and analgesic nephropathy and other different causes of dialysis 35 patients (45%).The study showed association between incidence of AF in hemodialysis patients and different factors as increased BMI (0.006), prolonged duration of renal replacement therapy (0.017), diabetes mellitus (0.005), hypertension (0.000), ischemic heart diseases (0.02) and left atrium dilation (0.000). Conclusion The incidence of AF in patients with ESRD is 16.4%. The risk factors for increased incidence of AF in hemodialysis are; increased BMI, increased duration of renal replacement therapy, hypertension, diabetes mellitus, ischemic heart diseases and left atrium dilation by echocardiography.

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

Status of Renal Replacement Therapy and Peritoneal Dialysis in Mexico

2007 ◽  
Vol 27 (2) ◽  
pp. 142-148 ◽  
Author(s):  
Alfonso M. Cueto-Manzano ◽  
Enrique Rojas-Campos
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Developed Countries ◽  
Technique Survival ◽  
Treatment Providers ◽  
The World ◽  
Stage Renal Disease ◽  
End Stage ◽  
Mexican Patients

Mexico is struggling to gain a place among developed countries; however, there are many socioeconomic and health problems still waiting for resolution. While Mexico has the twelfth largest economy in the world, a large portion of its population is impoverished. Treatment for end-stage renal disease (377 patients per million population) is determined by the individual's access to resources such as private medical care (approximately 3%) and public sources (Social Security System: approximately 40%; Health Secretariat: approximately 57%). With only 6% of the gross national product spent on healthcare and most treatment providers being public health institutions that are often under economic restrictions, it is not surprising that many Mexican patients do not receive renal replacement therapy. Mexico is still the country with the largest utilization of peritoneal dialysis (PD) in the world, with 18% on automated PD, 56% on continuous ambulatory PD (CAPD), and 26% on hemodialysis. Results of PD (patient morbi-mortality, peritonitis rate, and technique survival) in Mexico are comparable to other countries. However, malnutrition and diabetes mellitus are highly prevalent in Mexican patients on CAPD programs, and these conditions are among the most important risk factors for a poor outcome in our setting.

scholarly journals A Brazilian Experience in Assisted Automated Peritoneal Dialysis: A Reliable and Effective Home Care Approach

2013 ◽  
Vol 33 (3) ◽  
pp. 252-258 ◽  
Author(s):  
Marcia Regina Gianotti Franco ◽  
Natália Fernandes ◽  
Claúdia Azevedo Ribeiro ◽  
Abdul Rashid Qureshi ◽  
Jose Carolino Divino–Filho ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Total Duration ◽  
Hemodynamic Instability ◽  
Technique Survival ◽  
Care Approach ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

IntroductionAutomated assisted peritoneal dialysis (AAPD) has been shown to be successful as renal replacement therapy for elderly and physically incapable end-stage renal disease (ESRD) patients. In early 2003, a pioneer AAPD program was initiated at GAMEN Renal Clinic in Rio de Janeiro, Brazil.ObjectiveWe evaluated the results of an AAPD program offered as an option to elderly ESRD patients with physical or cognitive debilities or as last resort to patients with vascular access failure or hemodynamic instability during hemodialysis.MethodsA cohort of 30 consecutive patients started AAPD from January 2003 to March 2008 and was followed to July 2009. Demographics, clinical and laboratory parameters, causes of death, and patient and technique survival were analyzed.ResultsMedian age of the patients was 72 years (range: 47 – 93 years), with 60% being older than 65. The Davies score was greater than 2 in 73% of patients, and the Karnofsky index was less than 70 in 40%. The overall peritonitis rate was 1 episode in 37 patient–months. The total duration of AAPD ranged from 3 to 72 months. Patient survival was 80% at 12 months, 60% at 24 months, and 23.3% at 48 months. The most common cause of death was cardiovascular problems (70%).ConclusionsIn this clinical observational study, AAPD fulfilled its expected role, offering an opportune, reliable, and effective homecare alternative for ESRD patients with no other renal replacement therapy options.

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