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.

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 The cost of dialysis renal replacement therapy for end-stage renal disease patients in Ukraine

2019 ◽  
pp. 4-10
Author(s):  
M. Kolesnyk ◽  
L. Liksunova ◽  
T. Selezneva ◽  
T. Maistrenko
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
The State ◽  
State Budget ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Expenses for the treatment of end-stage renal disease (ESRD) patients with dialysis renal replacement therapy (DRRT) during the 2018 year constituted 2 billion 922 million 460 thousand UAH. Reimbursement from the state budget constituted 1 billion 44 million 800 thousand UAH. Expendable materials were the main component of DRRT. The share of the expendable materials price from total cost for hemodialysis and hemodiafiltration constituted 66%, for continuous ambulatory peritoneal dialysis and automatic peritoneal dialysis was 86.3% and 92.2%, respectively. The results of the investigation can be used for the development of a diversification model (state budget – local budgets – other sources) of financial expenses for the provision of dialysis treatment in ESRD patients as a part of the state program (strategy) health care finance and service delivery.

P0273THE EFFECT OF END STAGE RENAL DISEASE AND RENAL REPLACEMENT THERAPY ON B LYMPHOCYTE SUBPOPULATIONS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Dimitra Vasileia Daikidou ◽  
MARIA STANGOU ◽  
Erasmia Sampani ◽  
Vasiliki Nikolaidou ◽  
Despoina Asouchidou ◽  
...  
Keyword(s):  
B Cells ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
B Cell ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact ◽  
Esrd Patients

Abstract Background and Aims End-stage renal disease (ESRD) is linked to immunodeficiency, which makes a significant contribution to morbidity and mortality. Disturbances in innate and adaptive immunity have been described in patients on dialysis, although their association with the therapy itself is yet to be defined. The present study aimed to assess the impact of dialysis on B cell subpopulations Method B cells (CD19+) and their subsets B1a (CD19+CD5+), naive (CD19+CD27−), memory (CD19+CD27+), (CD19+BAFFR+) and (CD19+IgM+), were quantified using flow-cytometry of in the peripheral blood of ESRD patients, the first day on dialysis (T0), and repeated 6 months later (T6). The results were compared to age-matched healthy control group. Exclusion criteria were age &lt;18 or&gt;75 years, active autoimmune or chronic inflammatory disease, medical history of malignancy, corticosteroids or immunosuppresive treatment for the last 12 months Results Pre dialysis ESRD patients had reduced lymphocyte count (1527±646μ/L vs. 2459±520μ/L, p&lt;0.001) and B cell (CD19+) count (82.7±59.5μ/L vs. 177.6±73.8μ/L, p&lt;0.001) compared to controls, whereas the percentages of B cell subsets were not particularly affected, except for B1a subset which presented a significant increase (4.1±3.6% vs. 0.7±0.7% p&lt;0.001). In 17 patients who had a follow-up sample 6 months later, the percentage of most subsets was reduced (CD19+CD5+: 1.02±0.8% from 3.6±4.6%, p=0.015, Naive: 40±22.3% from 61±17.4%, p=0.001, CD19+BAFF+:75.8±12.6% from 82.1±9.1%, p=0.04,), apart from memory B cells percentage, which was increased (49.4±52.1% from 32,9±35,5%, p=0.01) and CD19+ IgM+ percentage, which was unaffected . Conclusion A significant reduction of almost all subsets of B cells was noticed in patients with ESRD on pre-dialysis stage. Furthermore, the initiation of renal replacement therapy may be linked to further alterations in B cells subpopulations, especially at their early stages.

In Vitro Closure Times (PFA-100) Are Different Between Peritoneal Dialysis and Hemodialysis

2020 ◽  
Vol 40 (05) ◽  
pp. 671-678
Author(s):  
Cenk Gokalp ◽  
Fatma Keklik Karadag ◽  
Matthias Christoph Braunisch ◽  
Christoph Schmaderer ◽  
Emrah Gunay ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Adenosine Diphosphate ◽  
Significant Difference ◽  
Function Analyzer ◽  
The Difference ◽  
Stage Renal Disease ◽  
End Stage

Abstract Introduction Platelet dysfunction is not uncommon in patients with end-stage renal disease (ESRD). Type of renal replacement therapy may have an effect on platelet functions, which has not been well investigated. We evaluated in vitro closure time (CT) differences between peritoneal dialysis (PD) and hemodialysis (HD) patients using platelet function analyzer (PFA-100)and observed a significant difference between these renal replacement therapies. Methods Patients with ESRD undergoing PD (n = 24) or HD (n = 23) for more than 6 months were included. Blood samples for collagen/epinephrine (Col/EPI) and collagen/adenosine diphosphate (Col/ADP) measurements were obtained before HD at a mid-week session for HD patients and at an outpatient control time for PD patients. Results Three of 24 (12.5%) PD patients and 16 of 23 (69.5%) HD patients had prolonged PFA-100 Col/EPI, p< 0.001. Likewise, 4.2% of PD patients and 87.0% of HD patients had prolonged PFA-100 Col/ADP, p< 0.001. Moreover, the median times of PFA-Col/EPI and PFA-100 Col/ADP were significantly lower in PD patients compared with those of HD patients (p< 0.001). Multivariate analysis showed that the type of renal replacement was a risk factor for both elevated PFA-100 Col/ADP and PFA-100 Col/EPI after adjusted for platelets, hematocrit, and urea (p< 0.001). Conclusions The type of renal replacement therapy may have an effect on in vitro CTs; therefore, studies including more patients with long-term follow-up are needed to investigate if the difference has any impact on clinical outcomes.

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.

Comparison of Continuous Ambulatory Peritoneal Dialysis and Hemodialysis for Diabetics

1985 ◽  
Vol 5 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Gonzalo Mejia ◽  
Stephen W. Zimmerman
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Systemic Disease ◽  
Diabetic Patients ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage ◽  
Hospital Days

To determine the relative efficacy of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) we compared all diabetic patients starting these treatments between April 1978 and August 1983. There were 37 HD patients and 34 CAPD patients who were comparable in age and degree of systemic disease. In the CAPD group survival was 81% at one and three years, and in the HD group 76% and 400/() at one and three years (P < 0.05) respectively. Initially CAPD patients spent more days in the hospital for catheter placement and training but subsequently had fewer hospital days. Infections other than peritonitis and catheter related were more frequent in HD (P < .05) patients, as were access repairs (P < .05). Also we compared at one year 12 patients on CAPD to eight patients on HD. Although they were comparable in all respects at the start of therapy, at the end of follow-up (24 ± 3 mo HD, 27 ± 3.5 mo CAPD) all CAPD patients remained on CAPD while only three remained on HD. Also HD patients had spent more than twice as many hospital days/patient months as did CAPD patients (P < .01). We have concluded that CAPD compares favorably with HD as a renal replacement therapy for diabetic patients at our institution. In the last decade increasing numbers of diabetic patients with end-stage renal disease (ESRD) have been accepted for various types of renal replacement therapy (1–17). Of these, hemodialysis (HD) has been carried out for the longest period and although results have improved, the mortality rates in diabetics are still higher than in nondiabetic populations (14–16). Continuous ambulatory peritoneal dialysis (CAPD) is a new and reportedly efficacious therapy for diabetic patients with ESRD. While some studies have suggested that CAPD has an advantage over HD, definite proof is lacking because many reports (1,2,7) included patients who were transferred from one form of dialysis to another or were started on dialysis after a renal transplant. Furthermore, few studies have compared CAPD with hemodialysis in the same institution. For these reasons at our affiliated institutions we did a retrospective study, which compared HD and CAPD as the primary form of therapy for ESRD due to diabetic nephropathy.

scholarly journals A Qualitative Assessment of Mismatch between Dialysis Modality Selection and Initiation

2016 ◽  
Vol 36 (4) ◽  
pp. 463-466 ◽  
Author(s):  
Susan Ziolkowski ◽  
Scott Liebman
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Qualitative Assessment ◽  
Dialysis Modality ◽  
Home Dialysis ◽  
Stage Renal Disease ◽  
End Stage

At our institution, we have noted that end-stage renal disease patients choosing a home dialysis modality after education often initiate renal replacement therapy with in-center hemodialysis (HD) instead. We interviewed 24 such patients (23 choosing peritoneal dialysis [PD], one choosing home HD) to determine reasons for this mismatch. The most common reasons cited for not starting home dialysis were: lack of confidence/concerns about complications, lack of space or home-related issues, a feeling of insufficient education, and perceived medical or social contraindications. We propose several potential strategies to help patients start with their preferred modality.

scholarly journals Covid-19 in end-stage renal disease patients with renal replacement therapies: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Tanawin Nopsopon ◽  
Jathurong Kittrakulrat ◽  
Kullaya Takkavatakarn ◽  
Thanee Eiamsitrakoon ◽  
Talerngsak Kanjanabuch ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Case Fatality ◽  
Global Average ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

AbstractIntroductionThe novel coronavirus (COVID-19), caused by SARS-CoV-2, showed various prevalence and case-fatality rates (CFR) among patients with different pre-existing chronic conditions. End-stage renal disease (ESRD) patients with renal replacement therapy (RRT) might have a higher prevalence and CFR due to reduced immune function from uremia and kidney tropism of SARS-CoV-2, but there was no systematic study on the infection and mortality of the SARS-CoV-2 infection in ESRD patients who are on RRT.MethodsWe searched five electronic databases and performed a systematic review and meta-analysis up to June 30, 2020, to evaluate the prevalence and case fatality rate (CFR) of the COVID-19 infection among ESRD patients with RRT. The global COVID-19 data were retrieved from the international database on June 30, 2020, for estimating the prevalence and CFR of the general population as referencing points.ResultsOf 3,272 potential studies, 34 were eligible studies consisted of 1,944 COVID-19 confirmed cases in 21,873 ESRD patients with RRT from 12 countries in four WHO regions. The overall pooled prevalence in ESRD patients with RRT was 3.10% [95% confidence interval (CI) 1.25–5.72] which was higher than referencing 0.14% global average prevalence. The overall estimated CFR of COVID-19 in ESRD patients with RRT was 18.06% (95%CI 14.09– 22.32) which was higher than the global average at 4.98%.ConclusionsThis meta-analysis suggested high COVID-19 prevalence and CFR in ESRD patients with RRT. ESRD patients with RRT should have their specific protocol of COVID-19 prevention and treatment to mitigate excess cases and deaths.Author summaryChronic kidney disease (CKD) was associated with increasing severity and mortality of COVID-19. End-stage renal disease (ESRD) patients were at the terminal stage of CKD and had reduced immune function due to uremia. Additionally, ESRD patients with kidney transplantation had a diminished immune system from immunosuppressive agents. Kidneys might be the secondary target of SARS-CoV-2 after the respiratory tract regardless of the previous history of kidney disease, preferably the glomerulus, which was associated with the richness of some specific protein-coding genes in the kidney. The overall pooled prevalence in ESRD patients with renal replacement therapy was approximately 22 times of the referencing global average prevalence. The overall estimated case fatality rate of COVID-19 in ESRD patients with renal replacement therapy was approximately 3.6 times the global average. ESRD patients with renal replacement therapy had high COVID-19 prevalence and case fatality rate. We suggested that ESRD patients with renal replacement therapy should have their specific protocol of COVID-19 prevention and treatment to mitigate excess cases and deaths.

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