scholarly journals Multi-Method Complex Approach for Hydration Assessment Does Not Detect a Hydration Difference in Hemodialysis versus Peritoneal Dialysis Patient

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 767
Author(s):  
Anna Adamska-Wełnicka ◽  
Marcin Wełnicki ◽  
Paweł Krzesiński ◽  
Stanisław Niemczyk ◽  
Arkadiusz Lubas
Keyword(s):  
Peritoneal Dialysis ◽  
Physical Examination ◽  
Peritoneal Dialysis Patient ◽  
Chronic Hemodialysis ◽  
Hydration Status ◽  
Complex Approach ◽  
Electrical Bioimpedance ◽  
Echocardiographic Parameters ◽  
Ultrasound Assessment ◽  
Residual Diuresis

Assessment of hydration status is essential in monitoring the effectiveness of renal replacement therapy and is usually based on physical examination. However, comparisons of hydration status achieved with different dialysis methods are not conclusive. We compared the hydration status of patients on chronic hemodialysis (HD, n = 60) and peritoneal dialysis (PD, n = 20) in a comprehensive assessment including physical examination and additional methods. The mean age of the 80 chronically dialyzed patients (53 males, 27 females) was 58.1 ± 13.9 years. The clinical evaluation took into account the presence of peripheral edema, dyspnea, and crackling over the lung fields. Additional tests included lung ultrasound, electrical bioimpedance (performed in 79 patients), impedance cardiography, ultrasound assessment of large abdominal vessels (performed in 79 patients), select echocardiographic parameters (obtained in 78 patients), and serum NT-proBNP concentration. Residual diuresis volume was significantly higher in the PD group. We found no significant differences between the two groups in any other baseline characteristics or in the results of the clinical examination or additional tests. The use of different methods for assessing hydration does not allow differentiation of patients treated with dialysis in terms of the dialysis technique used. Therefore, it seems reasonable to use common algorithms to objectify the hydration status of these patients.

Factors associated with overhydration in peritoneal dialysis patients

2017 ◽  
Vol 86 (1) ◽  
pp. 7
Author(s):  
Dorota Sikorska ◽  
Krzysztof Pawlaczyk ◽  
Anna Olewicz-Gawlik ◽  
Magdalena Roszak ◽  
Włodzimierz Samborski ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Protective Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Hydration Status ◽  
Peritoneal Equilibration Test ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Residual Diuresis

Aim. Overhydration is a prevalent problem in peritoneal dialysis (PD) patients. The aim of the study was to evaluate the effect of several factors on the development of overhydration in PD patients. Material and Methods. The study was performed on 74 PD patients, who were divided into two groups according to bioimpedance analysis hydration status (OHBIA): Group A OHBIA < 1.1 L (n = 40) and Group B OHBIA ≥ 1.1 L (n = 34). The assessments of the adequacy of the dialysis dosage were based on the Kt/V ratio as well as weekly creatinine clearance. To evaluate the permeability of the peritoneal membrane a standard peritoneal equilibration test was used.Results. A statistically significant difference between the groups was found in: the average age of patients (53 ± 18 vs. 62 ± 14 years; p < 0.03), the prevalence of diabetes (27.5% vs. 55.9%; p < 0.02) and residual diuresis (1.7 ± 0.8 vs 1.2 ± 0.9 L; p < 0.05). There was no statistically significant difference in gender distribution, although attention is paid to the greater participation of male in overhydrated group. The study found no statistically significant differences between PD vintage, type of PD, assessment of adequacy of PD and other parameters describing the PD method. Logistic regression model selected diabetes (p < 0.03) as a significant risk factor for the occurrence of hypervolemia.Conclusions. Diabetes and older age are potential predisposing factors for the development of overhydration in PD patients. Overhydrated PD patients may have relatively high parameters regarding adequacy of dialysis therapy. Probably the most important protective factor in PD patients is residual diuresis

scholarly journals Delayed bowel perforation after instilling over warmed peritoneal dialysate

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xueli Lai ◽  
Mingming Nie ◽  
Xiaodong Xu ◽  
Yuanjie Chen ◽  
Zhiyong Guo
Keyword(s):  
Peritoneal Dialysis ◽  
Bowel Perforation ◽  
Exploratory Laparotomy ◽  
Peritoneal Dialysis Patient ◽  
Case Presentation ◽  
Abdominal Organs ◽  
Home Based ◽  
Dialysis Solution ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Peritoneal dialysis (PD) is a safe and home-based treatment for end-stage renal disease (ESRD) patients. The direct thermal damage of abdominal organs is very rare. Case presentation We report a peritoneal dialysis patient presented abdominal pain and feculent effluent 3 weeks after he instilled hot dialysis solution. In spite of emergency exploratory laparotomy and active treatment, the patient died of septic shock. Biopsy revealed necrosis and perforation of the intestines. Conclusions Delayed bowel perforation by hot fluid is very rare. Standardized performance is of the first importance for peritoneal dialysis patients.

scholarly journals Physical Examination and Ultrasound Evaluation of Patients with Superficial Venous Disease

2021 ◽  
Vol 38 (02) ◽  
pp. 167-175
Author(s):  
Leigh C. Casadaban ◽  
John M. Moriarty ◽  
Cheryl H. Hoffman
Keyword(s):  
Physical Examination ◽  
Venous Insufficiency ◽  
Duplex Ultrasonography ◽  
Venous Disease ◽  
Venous Anatomy ◽  
Ultrasound Evaluation ◽  
Clinical Presentations ◽  
Ultrasound Assessment ◽  
Anatomic Variants ◽  
Tools And Techniques

AbstractSystematic and standardized evaluation of superficial venous disease, guided by knowledge of the various clinical presentations, venous anatomy, and pathophysiology of reflux, is essential for appropriate diagnosis and optimal treatment. Duplex ultrasonography is the standard for delineating venous anatomy, detecting anatomic variants, and identifying the origin of venous insufficiency. This article reviews tools and techniques essential for physical examination and ultrasound assessment of patients with superficial venous disease.

scholarly journals A Treatable Encephalopathy in a Peritoneal Dialysis Patient - Cefepime- Induced Encephalopathy

2019 ◽  
Vol 10 (02) ◽  
pp. 324-326 ◽  
Author(s):  
Ching Soong Khoo ◽  
Tze Yuan Tee ◽  
Hui Jan Tan ◽  
Raymond Azman Ali
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Hospital Stay ◽  
End Stage Renal Disease ◽  
Dialysis Patient ◽  
Length Of Hospital Stay ◽  
Peritoneal Dialysis Patient ◽  
Stage Renal Disease ◽  
End Stage ◽  
Reversible Encephalopathy

ABSTRACTWe report a patient with end-stage renal disease on peritoneal dialysis, who developed encephalopathy after receiving a few doses of cefepime. He recovered clinically and electroencephalographically after having discontinued the culprit agent and undergone hemodialysis. This case highlights the importance of promptly recognizing this reversible encephalopathy, which can lead to the avoidance of unnecessary workup, reduce the length of hospital stay, and thereby improve the patients’ outcome.

scholarly journals Severe Hyperkalemia in a Peritoneal Dialysis Patient after Consumption of Salt Substitute

2012 ◽  
Vol 32 (2) ◽  
pp. 206-208 ◽  
Author(s):  
Terence Yip ◽  
Winnie Wan ◽  
Pui-Chi Hui ◽  
Sing-Leung Lui ◽  
Wai-Kei Lo
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patient ◽  
Peritoneal Dialysis Patient ◽  
Salt Substitute ◽  
Severe Hyperkalemia

Klebsiella pneumoniae Renal Abscess and Peritonitis in a Peritoneal Dialysis Patient: A Novel Route of Infection

2017 ◽  
Vol 37 (6) ◽  
pp. 654-656
Author(s):  
Miten J. Dhruve ◽  
Joanne M. Bargman
Keyword(s):  
Peritoneal Dialysis ◽  
Klebsiella Pneumoniae ◽  
Renal Biopsy ◽  
Peritoneal Cavity ◽  
Successful Treatment ◽  
Dialysis Patient ◽  
Peritoneal Dialysis Patient ◽  
Renal Abscess ◽  
Biopsy Site ◽  
Route Of Infection

We present a peritoneal dialysis (PD) patient who had a renal biopsy performed during an episode of urosepsis and subsequently presented with a renal abscess at the biopsy site along with concurrent peritonitis. Microbiology from the PD effluent and from the renal abscess were both positive for Klebsiella pneumoniae. We propose that the PD peritonitis was the result of seeding of the peritoneal cavity with bacteria from the renal abscess. Successful treatment was achieved through drainage of the abscess and intraperitoneal antibiotics.

scholarly journals Melanosis coli in a peritoneal dialysis patient: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nor Fadhlina Zakaria ◽  
Nurul Izah Ahmad ◽  
Elmina Mokhtar ◽  
Wan Zul Haikal Hafiz Wan Zukiman ◽  
Anim Md Shah
Keyword(s):  
Peritoneal Dialysis ◽  
Chronic Diarrhea ◽  
Histopathological Examination ◽  
Hypovolemic Shock ◽  
Peritoneal Dialysis Patient ◽  
Electrolyte Imbalance ◽  
Case Presentation ◽  
Melanosis Coli ◽  
Life Threatening ◽  
Black Discoloration

Abstract Background Patients who undergo peritoneal dialysis (PD) are at risk of gut bacteria translocation leading to peritonitis when there is chronic diarrhea. Chronic diarrhea is defined as any course of diarrhea that lasts at least 4 weeks, which can be continuous or intermittent. Chronic diarrhea of any duration may cause dehydration, electrolyte imbalance, and life-threatening hypovolemic shock. In PD patients, excessive ultrafiltration from the exchanges, combined with severe gastrointestinal loss, may cause hypovolemic shock, electrolyte imbalance, and metabolic acidosis. There are multiple causes of chronic diarrhea in PD patients including infective causes, mitotic lesions, and rarely the regular and excessive use of laxatives, which is a diagnosis of exclusion. Case presentation We report a case of Melanau lady with chronic diarrhea secondary to laxative usage in a patient being treated with automated peritoneal dialysis (APD). The patient went into hypovolemic shock, but luckily did not contract peritonitis. A colonoscopy revealed brown to black discoloration of the colon, a feature suggestive of melanosis coli. A biopsy of the intestine further confirmed the diagnosis by histopathological examination. Withdrawal of laxatives and the introduction of probiotics improved the symptoms tremendously. Conclusions The chronic use of laxatives in PD patients can potentially lead to a devastating problem; thus, the management team must monitor treatment commencement appropriately.

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