scholarly journals The Role of an Integrated Care Model for Kidney Disease in the Development of Peritoneal Dialysis: A Single-Center Experience in China

2014 ◽  
Vol 34 (2_suppl) ◽  
pp. 55-58 ◽  
Author(s):  
Xiaohui Zhang ◽  
Zhangfei Shou ◽  
Zhimin Chen ◽  
Ying Xu ◽  
Fei Han ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Integrated Care ◽  
Care Program ◽  
Integrated Treatment ◽  
Technique Survival ◽  
Single Center Experience ◽  
Stage Renal Disease ◽  
End Stage

Peritoneal dialysis plays a crucial role in the integrated care of patients with end-stage renal disease (ESRD). In this paper, we retrospectively analyzed the quality indicators of peritoneal dialysis (PD) in 712 patients from our center who underwent PD between 2004 and 2011. In 43% of patients, follow-up was undertaken every 3 months at our outpatient department, and 54% patients were followed up by both our hospital and other local hospitals. The patient survival rate at 1, 3 and 5 years was 96.3%, 85.4% and 76.2%, respectively. The technique survival (excludes death/transplantation) at 1, 3 and 5 years was 95.1%, 87.7% and 79.6%, respectively. Fluid overload occurred in 29.2% of patients and was one of the major reasons for discontinuing PD. The peritonitis rate in our center decreased to 0.16 episodes/year in 2011. In addition, since our center is one of the largest integrated-treatment centers for ESRD in China, we have developed a multilevel care program in Zhejiang Province, which resulted in rapid growth of PD in our province in recent years.

scholarly journals PERITONEAL DIALYSIS TECHNIQUE SURVIVAL: A SINGLE-CENTER EXPERIENCE ANALYSIS OF THE PERITONEAL DIALYSIS TREATMENT IN A SINGLE CENTER

2017 ◽  
pp. 62-67
Author(s):  
O. Burdeyna ◽  
N. Stepanova ◽  
M. Kolesnyk
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiovascular Complications ◽  
Single Center ◽  
Dialysis Treatment ◽  
Technique Survival ◽  
Single Center Experience ◽  
Average Survival ◽  
Stage Renal Disease ◽  
End Stage

The aim of the study was to evaluate retrospectively the survival of the peritoneal dialysis (PD) technique survival and identify the factors that affect it. Patients and methods. A total of 38 patients with end-stage renal disease treated with PD from 2005 to May 2017 have been included in retrospective, study (average age 49.6 ± 5.6). Data were collected from medical records. Results. The average survival rate of the PD method in our center was 53.3 ± 7.4 months, and in patients with nondiabetic kidney disease it was significantly higher. During the follow-up only 11/38 (28.9 %) patients continue treatment of PD, 12/38 (31.6 %) were changed to HD, 4/38 (10.6 %) patients kidney transplantation was performed and 11/38 %) died. The main reason of the letal cases was cardiovascular complications (36.6 %). The patient mortality was significantly depended on the diuresis volume and the level of GFR at the time of PD initiation. Conclusions. PD technique survival in our center correlate with the results of the PD treatment patients worldwide.

MO302ACUTE POST-INFECTIOUS GLOMERULONEPHRITIS IN ADULTS: A TUNISIAN SINGLE CENTER EXPERIENCE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Imen El Meknassi ◽  
Mrabet Sanda ◽  
Guedri Yosra ◽  
Zellema Dorsaf ◽  
Azzabi Awatef ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Acute Glomerulonephritis ◽  
Industrialized Countries ◽  
Single Center Experience ◽  
Nephritic Syndrome ◽  
Stage Renal Disease ◽  
End Stage ◽  
Post Infectious

Abstract Background and Aims Acute post-infectious glomerulonephritis (APIGN) is a reactive immunological disease. Its prevalence in industrialized countries is declining contrasting with developed ones. It is uncommon in adults but the prognosis may be reserved. The aim of our study was to evaluate the epidemiological, clinical and histological features of APIGN as well as its prognosis. Method A retrospective and descriptive study was conducted in our department. Were included all cases of histologically proven APIGN between December 2006 and December 2017. Results We had collected 38 cases. The mean age was 37.7 ± 17.8 years. The sex ratio was 1.92. Twelve (31.6%) patients were diabetic and four of them had already a chronic kidney disease (CKD). APIGN was preceded by an infection in 27 cases with an average interval of 10 ± 5 days. The most common site of infection was the respiratory tract (15 cases). At presentation, 27 patients had nephritic syndrome and 13 had nephrotic-range proteinuria. Hematuria was observed in 97.4%, peripheral edema in 84.2% and hypertension in 73.7% of cases. Most patients (78.9%) had acute kidney injury and 10 (26.3%) patients required dialysis. Renal biopsy had shown benign acute glomerulonephritis in 31 cases and malignant form in 7 cases. An underlying nephropathy was found in 12 cases with mostly a diabetic nephropathy. Corticosteroids were used in 3 cases of benign APIGN and 5 cases of malignant form. During the follow-up, CKD was noted in 14(36.8%) patients including 7(18.4%) patients who progressed to end-stage renal disease. Poor prognostic factors were diabetes, the presence of an underlying nephropathy in the biopsy, acute kidney injury and the need for dialysis. Conclusion The APIGN is uncommon in adults, yet its prognosis may be reserved with progression to CKD.

scholarly journals Successful multiple-exchange peritoneal dialysis in a patient with severe hematological toxicity by methotrexate: case report and literature review

2019 ◽  
Vol 41 (3) ◽  
pp. 427-432 ◽  
Author(s):  
Arbey Aristizabal-Alzate ◽  
John Fredy Nieto-Rios ◽  
Catalina Ocampo-Kohn ◽  
Lina Maria Serna-Higuita ◽  
Diana Carolina Bello-Marquez ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Therapeutic Option ◽  
Supportive Therapy ◽  
Hematological Toxicity ◽  
High Morbidity ◽  
Multiple Exchange ◽  
Severe Pancytopenia ◽  
Stage Renal Disease ◽  
End Stage

Abstract Methotrexate is an effective medication to control several diseases; however, it can be very toxic, being myelosuppression one of its main adverse effects, which increases in severity and frequency in patients with renal failure. We present the case of a 68-year-old man with chronic, end-stage renal disease associated with ANCA vasculitis, under treatment with peritoneal dialysis, who received the medication at a low dose, indicated by disease activity, which presented as a complication with severe pancytopenia with mucositis that improved with support measures and multiple-exchange peritoneal dialysis. We reviewed 20 cases published to date of pancytopenia associated with methotrexate in patients on dialysis and found high morbidity and mortality, which is why its use in this type of patient is not recommended. However, when this complication occurs, a therapeutic option could be the use of multiple-exchange peritoneal dialysis in addition to supportive therapy for drug-related toxicity, although it is recognized that studies are required to show the role of multiple-exchange peritoneal dialysis in the removal of this medication.

Life After Capo

1983 ◽  
Vol 3 (3_suppl) ◽  
pp. 51-53
Author(s):  
Clair C. Williams
Keyword(s):  
Peritoneal Dialysis ◽  
Treatment Options ◽  
Drop Out ◽  
Advanced Age ◽  
Dialysis Modality ◽  
Short History ◽  
Drop Out Rate ◽  
Stage Renal Disease ◽  
End Stage

Of 508 patients trained for CAPD during the first five years, 115 (22.6%) were transferred to an alternative dialysis modality. Of these 87% were transferred to centre dialysis programs, equally divided between hemodialysis and intermittent peritoneal dialysis. Advanced age favoured transfer to intermittent peritoneal dialysis and failure due to peritonitis, transfer to hemodialysis. Three year survival after transfer from CAPD was 38%. The presence of diabetes and advanced age adversely affected survival after transfer. Dialysis modality and peritonitis as the cause of CAPD failure did not affect survival. Other treatment options are available to patients who fail CAPD. A relatively high drop-out is therefore acceptable and preferable to continuing CAPD in patients encountering complications which might ultimately influence their survival. Since its introduction in Toronto in 1977, continuous ambulatory peritoneal dialysis (CAPD) has achieved increasing prominence in the management of end-stage renal disease. Throughout its comparatively short history, one of the major criticisms of this technique has been the relatively high drop-out rate. This report provides a follow-up of patients transferred from CAPD to alternative dialysis modalities.

scholarly journals Peritoneal Microbiome in End-Stage Renal Disease Patients and the Impact of Peritoneal Dialysis Therapy

2020 ◽  
Vol 8 (2) ◽  
pp. 173
Author(s):  
Liliana Simões-Silva ◽  
Ricardo Araujo ◽  
Manuel Pestana ◽  
Isabel Soares-Silva ◽  
Benedita Sampaio-Maia
Keyword(s):  
Peritoneal Dialysis ◽  
Human Microbiome ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Peritoneal Tissue ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Factors influencing the occurrence of peritoneal dialysis (PD)-related infections are still far from fully understood. Recent studies described the existence of specific microbiomes in body sites previously considered microbiome-free, unravelling new microbial pathways in the human body. In the present study, we analyzed the peritoneum of end-stage kidney disease (ESKD) patients to determine if they harbored a specific microbiome and if it is altered in patients on PD therapy. We conducted a cross-sectional study where the peritoneal microbiomes from ESKD patients with intact peritoneal cavities (ESKD non-PD, n = 11) and ESKD patients undergoing PD therapy (ESKD PD, n = 9) were analyzed with a 16S rRNA approach. Peritoneal tissue of ESKD patients contained characteristically low-abundance microbiomes dominated by Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes. Patients undergoing PD therapy presented lower species richness, with dominance by the Pseudomonadaceae and Prevotelaceae families. This study provides the first characterization of the peritoneal microbiome in ESKD patients, bringing new insight to the human microbiome. Additionally, PD therapy may induce changes in this unique microbiome. The clinical relevance of these observations should be further explored to uncover the role of the peritoneal microbiome as a key element in the onset or aggravation of infection in ESKD patients, especially those undergoing PD.

Effect of Liver Cirrhosis on the Outcomes of Peritoneal Dialysis

2019 ◽  
Vol 39 (6) ◽  
pp. 502-508 ◽  
Author(s):  
Young Lee Jung ◽  
Jae Yoon Park ◽  
Chung Sik Lee ◽  
Dong Ki Kim ◽  
Chun-Soo Lim ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Peritoneal Dialysis ◽  
Exit Site Infection ◽  
Common Causes ◽  
Dialysis Outcomes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Event Rates ◽  
Technique Failure

Background Peritoneal dialysis (PD) has become an increasingly important treatment modality for end-stage renal disease. However, application of PD in patients with liver cirrhosis (LC) and subsequent outcomes have not been thoroughly evaluated. Methods A total of 1,366 patients (≥ 18 years old) who started PD at 4 tertiary referral centers between January 2000 and December 2015 were initially reviewed. Among them, 45 patients with LC were finally analyzed (LC-PD). Using the multivariate Cox hazard ratio (HR) model, outcomes such as technique failure, infection, and mortality in patients with LC-PD were compared with those in non-LC-PD patients (non-LC-PD) or patients with LC who received hemodialysis (LC-HD). All of the patients were selected by 1:1 matching of age, sex, catheter insertion date, and diabetes mellitus. Results During the mean follow-up duration of 43 ± 35.8 months, 12 patients with LC-PD experienced technique failure, and this rate was similar to that of non-LC-PD patients. In evaluating infection episodes, the most common causes for peritonitis and exit-site infection were Escherichia coli (5.8%) and Staphylococcus aureus (19.3%), respectively; these event rates of LC-PD did not differ from those of non-LC-PD. The all-cause mortality rate of the LC-PD group was not different from that of the non-LC-PD and LC-HD groups. Conclusion Dialysis outcomes such as technique failure, infection, and mortality are not affected by the presence of LC. Accordingly, PD therapy is a good option in patients with LC.

scholarly journals Five-year experience of continuous ambulatory peritoneal dialysis in children: a single center experience in a developing country

2019 ◽  
Vol 28 (4) ◽  
pp. 329-37 ◽  
Author(s):  
Cahyani Gita Ambarsari ◽  
Partini Pudjiastuti Trihono ◽  
Agustina Kadaristiana ◽  
Taralan Tambunan ◽  
Lily Mushahar ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Survival Rates ◽  
Published Data ◽  
Hospital Data ◽  
Technique Survival ◽  
Single Center Experience ◽  
Number Of Patients ◽  
Stage Renal Disease

BACKGROUND The pediatric peritoneal dialysis (PD) program in Cipto Mangunkusumo Hospital, Indonesia was started in 2014. However, there has been no published data on the patients’ outcome. This study was aimed to report the characteristics and outcomes of a continuous ambulatory peritoneal dialysis (CAPD) program for children. METHODS This retrospective study was conducted in Cipto Mangunkusumo Hospital as a national referral hospital. Data were collected from medical records of patients aged ≤18 years with end-stage renal disease who underwent CAPD in 2014–2019. The baseline characteristics, PD-related infection rate, as well as patient and technique survivals were analyzed. RESULTS Out of 60 patients who underwent CAPD, 36 (60%) were boys on the age range of 4 months–18 years. The mean follow-up duration was 12 (95% confidence interval [CI] = 9.4–15.3) months. The number of PD related infections increased along with the growing number of patients on CAPD. The peritonitis rate was 0.42 episodes per year at risk, and the most common etiology was alpha-hemolytic Streptococcus (5/24, [20.8%]). The 1- and 3-year technique survival rates were 60.3% (95% CI = 44.5–72.9) and 43.9% (95% CI = 23.2–62.9). The 1- and 3-year patient survival rates were 69.6% (95% CI = 52.5–81.5) and 58% (95% CI = 31.2–77.5). CONCLUSIONS In this unit, CAPD could be performed in children as young as 4 months of age. The peritonitis rate was relatively low which was likely caused by skin-derived microorganisms. Both technique survival and patient survival were also relatively low.

Assisted Automated Peritoneal Dialysis (Aapd) for the Functionally Dependent and Elderly Patient

2005 ◽  
Vol 25 (3_suppl) ◽  
pp. 60-63 ◽  
Author(s):  
Johan V. Povlsen ◽  
Per Ivarsen
Keyword(s):  
Nursing Home ◽  
Peritoneal Dialysis ◽  
International Standards ◽  
University Hospital ◽  
Automated Peritoneal Dialysis ◽  
Technique Survival ◽  
Acute Peritonitis ◽  
Data Files ◽  
Stage Renal Disease ◽  
End Stage

♦ Objective To describe basic demographics and clinical outcomes among elderly end-stage renal disease (ESRD) patients physically dependent on a caregiver and maintained on an assisted automated peritoneal dialysis (AAPD) program. ♦ Design Retrospective single-center study based on patient records and data files. ♦ Setting University Hospital. ♦ Patients 64 physically dependent AAPD patients followed for 1.012 treatment months. Assistance and care was delivered by 52 briefly trained teams of visiting nurses or nursing home staff. ♦ Result Crude 1-year survival was 58% and 2-year survival was 48%. Crude 1- and 2-year survivals, excluding deaths within 90 days, were 66% and 54% respectively. We found no significant effect on survival by main causes of ESRD, gender, age, late referral, need for acute start, social isolation, physical dependency on help at inclusion, or residence in a nursing home. 10% of patient-days on AAPD were spent in hospital. 13 (20%) of the patients were converted permanently to hemodialysis due to PD technique failure. The incidence of peritonitis was 1 in every 25.3 treatment-months. ♦ Conclusions AAPD may be a feasible and safe option for renal replacement therapy for frail, elderly, and physically dependent patients with ESRD. Despite the special patient selection for this AAPD program, we achieved results of international standards for patient survival, PD technique survival, and incidence of acute peritonitis. These results do not justify withholding dialysis from this group of patients.

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