scholarly journals Peritoneal Dialysis Catheter Increases Leukocyte Recruitment in the Mouse Parietal Peritoneum Microcirculation and Causes Fibrosis

2016 ◽  
Vol 36 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Paulina M. Kowalewska ◽  
Peter J. Margetts ◽  
Alison E. Fox-Robichaud
Keyword(s):  
Peritoneal Dialysis ◽  
Endothelial Cell ◽  
Solution Treatment ◽  
Cell Interactions ◽  
Parietal Peritoneum ◽  
Peritoneal Dialysis Catheter ◽  
Peritoneal Fibrosis ◽  
Peritoneal Catheter ◽  
Dialysis Treatment ◽  
Dialysis Solution

♦BackgroundThe objective of this study was to examine the effects of a conventional dialysis solution and peritoneal catheter on leukocyte- endothelial cell interactions in the microcirculation of the parietal peritoneum in a subacute peritoneal dialysis (PD) mouse model.♦MethodsAn intraperitoneal (IP) catheter with a subcutaneous injection port was implanted into mice and, after a 2-week healing period, the animals were injected daily for 6 weeks with a 2.5% dextrose solution. Intravital microscopy (IVM) of the parietal peritoneum microcirculation was performed 4 hours after the last injection of the dialysis solution. Leukocyte-endothelial cell interactions were quantified and compared with catheterized controls without dialysis treatment and naïve mice.♦ ResultsThe number of rolling and extravascular leukocytes along with peritoneal fibrosis and neovascularization were significantly increased in the catheterized animals compared with naïve mice but did not significantly differ between the 2 groups of catheterized animals with sham injections or dialysis solution treatment.♦ConclusionThe peritoneal catheter implant increased leukocyte rolling and extravasation, peritoneal fibrosis and vascularization in the parietal peritoneum independently from the dialysis solution treatment.

scholarly journals The importance of the peritoneal dialysis catheter material in orderto perform optimum dialysis in veterinary medicine

2020 ◽  
Vol 71 (06) ◽  
pp. 596-599
Author(s):  
BOGDAN ALEXANDRU VIŢĂLARU ◽  
RAZVAN SCARLAT
Keyword(s):  
Veterinary Medicine ◽  
Peritoneal Dialysis ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
The Third ◽  
Dialysis Solution ◽  
Peritoneal Dialysis Solution

This study was conducted on 44 dogs, aged between 10 months and 15 years, weighing between 0.9 and 8.5 kilograms,during 72 months. We created four batches of 11 dogs each. First batch received silicone peritoneal catheters with twoDacron cuffs, second batch received silicone peritoneal catheters without Dacron cuffs, third batch receivedpolypropylene peritoneal catheters with two Dacron cuffs and fourth batch received polypropylene peritoneal catheterswithout Dacron cuffs. All the dogs were treated with the same peritoneal dialysis solution, at the same interval, in thesame doses and at the same temperature and all the peritoneal catheters were straight Blake. In dogs from the firstbatch, we experienced minimum subcutaneous leaks of peritoneal dialysis solution and the catheters were permeablefor at least 90 days. In the second batch, we experienced constant and reduced subcutaneous leaks of peritonealdialysis solution and the catheters were permeable for at least 90 days. In the third batch, we experienced mediumsubcutaneous leaks of peritoneal dialysis solution and the catheters were permeable for at least 45 days. In the fourthbatch, we experienced important subcutaneous leaks of peritoneal dialysis solution and the catheters were permeablefor at most 15 days. The study conclusion is that the best peritoneal catheter it is represented by the silicone peritonealcatheters with two Dacron cuffs.

scholarly journals The importance of the peritoneal dialysis catheter material in orderto perform optimum dialysis in veterinary medicine

2020 ◽  
Vol 71 (06) ◽  
pp. 596-599
Author(s):  
BOGDAN ALEXANDRU VIŢĂLARU ◽  
RAZVAN SCARLAT
Keyword(s):  
Veterinary Medicine ◽  
Peritoneal Dialysis ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
The Third ◽  
Dialysis Solution ◽  
Peritoneal Dialysis Solution

This study was conducted on 44 dogs, aged between 10 months and 15 years, weighing between 0.9 and 8.5 kilograms,during 72 months. We created four batches of 11 dogs each. First batch received silicone peritoneal catheters with twoDacron cuffs, second batch received silicone peritoneal catheters without Dacron cuffs, third batch receivedpolypropylene peritoneal catheters with two Dacron cuffs and fourth batch received polypropylene peritoneal catheterswithout Dacron cuffs. All the dogs were treated with the same peritoneal dialysis solution, at the same interval, in thesame doses and at the same temperature and all the peritoneal catheters were straight Blake. In dogs from the firstbatch, we experienced minimum subcutaneous leaks of peritoneal dialysis solution and the catheters were permeablefor at least 90 days. In the second batch, we experienced constant and reduced subcutaneous leaks of peritonealdialysis solution and the catheters were permeable for at least 90 days. In the third batch, we experienced mediumsubcutaneous leaks of peritoneal dialysis solution and the catheters were permeable for at least 45 days. In the fourthbatch, we experienced important subcutaneous leaks of peritoneal dialysis solution and the catheters were permeablefor at most 15 days. The study conclusion is that the best peritoneal catheter it is represented by the silicone peritonealcatheters with two Dacron cuffs.

Role of the Renin–angiotensin System in the Pathogenesis of Peritoneal Fibrosis

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 83-87
Author(s):  
Hidetomo Nakamoto ◽  
Hiroe Imai ◽  
Rie Fukushima ◽  
Yuji Ishida ◽  
Yasuhiro Yamanouchi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Oral Administration ◽  
Renin Angiotensin System ◽  
Peritoneal Fibrosis ◽  
Peritoneal Adhesions ◽  
Angiotensin System ◽  
Daily Group ◽  
Renin Angiotensin ◽  
Group I ◽  
Dialysis Solution

⋄ Background Although the effects of angiotensin type 1 receptor blocker (ARB) have been studied, little is known about ARBs in hypertensive patients undergoing dialysis. In the present study, we evaluated the effect of an ARB, olmesartan medoxomil (CS866), on the progression of peritoneal fibrosis in peritoneal dialysis by examining its effect in a model of peritoneal fibrosis in hypertensive rats. ⋄ Materials and Methods W e all ocated 40 male Wistar rats with 2-kidney, 1-clip renovascular hypertension (2K1C-RVH) to 4 groups (each n = 10) that were dialyzed using various solutions for 42 days as follows: • Group I—10 mL pH 3.5 dialysis solution containing 1.35% glucose • Group II—10 mL pH 3.5 dialysis solution, plus oral administration of CS866 5 mg/kg daily • Group III—10 mL pH 3.5 dialysis solution, plus oral administration of the calcium channel blocker (CCB) amlodipine 3 mg/kg daily • Group IV—10 mL pH 7.0 dialysis solution Dialysis solution was injected every day for 42 days. ⋄ Results Treatment with CS866 and amlodipine induced a significant reduction of blood pressure in 2K1C-RVH rats. In rats treated with pH 3.5 dialysis solution, necropsy findings revealed features identical to those of encapsulating peritoneal sclerosis (EPS). The typical appearance was multiple surfaces covered with granulation tissue or fibrosic tissue or both. Multiple adhesions were present. Microscopic findings revealed that acidic dialysis solution induced peritoneal fibrosis and loss of mesothelium. Treatment with CS866 prevented the progression of peritoneal fibrosis and adhesions. However amlodipine did not improve the progression of peritoneal fibrosis and peritoneal adhesions. In CS866-treated rats, no signs of EPS were present. ⋄ Conclusions Long-term intraperitoneal exposure to acidic dialysis solution produced features typical of EPS. Acidic dialysis solution induces activation of the peritoneal renin– angiotensin system and progression of peritoneal fibrosis. For the peritoneum undergoing peritoneal dialysis, ARB protects against progression of peritoneal fibrosis and peritoneal adhesions.

scholarly journals Valsartan ameliorates high glucose-induced peritoneal fibrosis by blocking mTORC1 signaling

2020 ◽  
Vol 245 (11) ◽  
pp. 983-993 ◽  
Author(s):  
Jing Liu ◽  
Yuan Feng ◽  
Cheng Sun ◽  
Wei Zhu ◽  
Qing-Yan Zhang ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Peritoneal Dialysis ◽  
Protein Expression ◽  
High Glucose ◽  
Collagen I ◽  
Peritoneal Fibrosis ◽  
Dialysis Solution ◽  
Mtorc1 Pathway ◽  
Peritoneal Dialysis Solution

Our previous study demonstrated that the mammalian target of rapamycin complex 1 (mTORC1) pathway is activated in peritoneal fibrosis under high glucose condition. This study aimed to investigate whether valsartan inhibits high glucose-induced peritoneal fibrosis via decreasing the activity of the mTORC1 pathway. We used high glucose peritoneal dialysis solution in a mouse peritoneal dialysis model to induce peritoneal fibrosis in vivo and high glucose in human peritoneal mesothelial cells (HPMCs) to stimulate extracellular matrix accumulation in vitro. After injections of peritoneal dialysis solution containing 4.25% glucose for four weeks, mice showed typical features of peritoneal fibrosis, including markedly increased peritoneal thickness, excessive matrix deposition, increased peritoneal permeability, and higher expression of extracellular matrix proteins, such as α-smooth muscle actin (α-SMA) and collagen I. Oral gavage of valsartan significantly ameliorated these pathological changes at both week 6 and week 8. These effects of valsartan were closely correlated with a decrease in the activation of the mTORC1 signal, which was mediated by the downregulation of the protein expression of phosphorylated (p)-mTOR, p-eukaryotic initiation factor 4E-binding protein 1, and p-p70 S6 kinase 1. Further research showed that the protein expression of mTORC1 signal was positively correlated with the expression of both α-SMA and collagen I in the peritoneum. In vitro, high glucose increased the protein expression of α-SMA and collagen I in a dose-dependent manner, while valsartan significantly inhibited high glucose-induced extracellular matrix accumulation in HPMCs. The effect was also accompanied by a decrease in the activation of the mTORC1 signal. Furthermore, the mTOR agonist MHY1485 reversed the downregulation of extracellular matrix components in HPMCs, even in the presence of valsartan. We conclude that valsartan exerts a protective effect against high glucose-induced peritoneal fibrosis via suppressing the activity of the mTORC1 pathway. Impact statement Our study provided new insight into the mechanism underlying the preservation of the peritoneum by valsartan. The results demonstrated that the mice receiving chronic high glucose (HG) peritoneal dialysis solution infusion showed a typical feature of peritoneal fibrosis (PF), as well as higher expression of α-smooth muscle actin (α-SMA) and collagen I. In vitro, HG increased the protein expression of α-SMA and collagen I in a dose-dependent manner, while valsartan significantly ameliorated these pathological changes. Interestingly, there was a parallel decrease in the activity of mammalian target of rapamycin complex 1 (mTORC1) and the protein expression levels of α-SMA and collagen I upon treatment with valsartan in vivo and in vitro. Moreover, the mTOR agonist MHY1485 reversed the downregulation of α-SMA and collagen I in vitro, even in the presence of valsartan. Altogether, our findings reported for the first time that valsartan exerts a protective effect against HG-induced PF by inhibiting the activity of the mTORC1 pathway.

scholarly journals Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

2020 ◽  
Author(s):  
Dayang Xie ◽  
Jianhui Zhou ◽  
Xueying Cao ◽  
Qingtao Zhang ◽  
Yanli Sun ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Insertion ◽  
Percutaneous Technique ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Catheter Survival ◽  
The Difference ◽  
One Year ◽  
The One

Abstract Background. A large body mass index (BMI) has been considered as a relative contraindication for percutaneous catheter insertion , although this technique has many advantages. Up to now, there are few studies on peritoneal catheter placement and obesity. The aim of this study was to determine whether patients with large BMI can also choose the percutaneous technique for peritoneal dialysis catheter insertion. Methods. 187 consecutive patients underwent peritoneal catheter insertions in the Chinese PLA General Hospital between January 1, 2015 and December 31, 2016, with 178 eligible cases being included in the analysis. Two groups were created based on the catheter insertion techniques, the percutaneous group (group P) and the surgical group (group S). Subgroups were created according to BMI>28 or≤28. The outcomes included catheter related complications and catheter survival. Results. Total infectious complication rates were significantly lower in group P than in group S. The late peritonitis rates tended to be lower in group P than in group S, although the difference was not significant. There were no significant differences in all other measured complications between the two groups. Though the one-year infection-free catheter survival in group P was 7.5% higher than group S, the difference was not significant. The one-year dysfunction-free catheter survival, one-year dysfunction-and-infection-free catheter survival, and overall catheter survival were similar between the two groups. Subgroup analyses showed a superior one-year infection-free catheter survival of percutaneous technique in patients with BMI>28, which was confirmed by Kaplan-Meier analysis. Conclusions. Despite the challenges that may be encountered with patients who have a large BMI, the percutaneous technique is a safe and effective approach to placing a peritoneal dialysis catheter.

scholarly journals Cutaneous abscess related to peritoneal catheter tunnel infection

2021 ◽  
Author(s):  
Yoshihiro Nakamura ◽  
Tsuyoshi Watanabe ◽  
Naoho Takizawa ◽  
Yoshiro Fujita
Keyword(s):  
Peritoneal Dialysis ◽  
Physical Examination ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Tunnel Infection ◽  
Catheter Infections

Some peritoneal dialysis catheter infections cannot be detected via a physical examination. Ultrasonography can aid in the diagnosis of such infections.

MO718ROLE OF CT-PERITONEOGRAPHY IN THE PATIENT WITH GENITAL EDEMA AND PERITONEAL DIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Francisco Javier Centellas Pérez ◽  
Agustin Ortega Cerrato ◽  
Juan Pérez Martínez ◽  
Francisco Llamas Fuentes
Keyword(s):  
Peritoneal Dialysis ◽  
Diagnostic Technique ◽  
Abdominal Pressure ◽  
Inguinal Hernioplasty ◽  
Peritoneal Catheter ◽  
Iodinated Contrast ◽  
Dialysis Solution ◽  
Subcutaneous Edema ◽  
Scrotal Edema

Abstract Background and Aims Genital edema is a frequent complication in those patients who are on peritoneal dialysis, generally secondary to the increase in intra-abdominal pressure that it entails. It occurs late after the implantation of the peritoneal catheter (after 30 days of implantation). The typical clinical manifestation of this condition is basically subcutaneous edema in the genital area, accompanied by pain and UF failure. The diagnosis must be made by using an imaging test, mainly CT-peritoneography. Method A series of clinical cases of PD patients who consulted for genital edema is reviewed, analyzing the role of peritoneography Results CASE 1 A 76-year-old male, 15 days after the start of the technique, consulted for right scrotal edema. It was decided to suspend CAPD and start hospital intermittent IPD with low volumes. A CT-peritoneography was requested, which revealed a right peritoneal-vaginal duct and a left inguino-scrotal leak. Surgical correction of the anatomical defect was performed without incident, with subsequent return of the patient to CAPD. CASE 2 A 78-year-old man, 15 days after the start of the technique, consulted for bilateral scrotal edema. A CT-peritoneography was performed, which showed that the leak of peritoneal fluid to the scrotum was due to bilateral inguinal hernia. Subsequently, inguinal hernioplasty of the surgical defect was performed without complications. Conclusion Genital edema, as a complication of patients with CAPD, appears in approximately 4-10% of them. CT-peritoneography is the diagnostic technique of choice. To do this, 150 ml of nonionic iodinated contrast, with a concentration of 300 mg/ml, are diluted in approximately 2 liters of dialysis solution, which are introduced into the peritoneal cavity of the patient 2 h before performing the CT. Subsequently, a CT scan of the abdomen and pelvis including the perineum is performed, in the supine position and craniocaudal direction.

A Double-Walled Assistive Holder Used in Peritoneal Dialysis Connection

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
I-En Lin ◽  
Hao-Ting Chiang
Keyword(s):  
Peritoneal Dialysis ◽  
Low Cost ◽  
Dialysis Treatment ◽  
The Road ◽  
Solution Exchange ◽  
Dialysis Solution ◽  
Substantial Risk ◽  
On The Road ◽  
Ideal Method ◽  
At Home

Abstract When compared with conventional kidney hemodialysis, peritoneal dialysis (PD) has advantages such as maintaining stable physiological blood status and blood pressure, alleviating anemia, and improving mobility, which make it an ideal method for at-home (even on the road) dialysis treatment. However, a serious drawback of PD is the potential for infection of the abdominal lining (peritonitis), which can discourage people from using PD. Since PD can involve up to 4–5 fluid exchanges per day that require connection and disconnection of a tube to a catheter, there can be a substantial risk of infection. This infection risk creates a barrier to the use of PD and prevents people from enjoying the benefits of convenience and portability that PD can provide. This study proposes an assistive holder for PD patients that helps reduce the possibility of contamination during connection and disconnection of dialysis solution exchange bags. This PD assistive holder is low-cost, lightweight, and disposable. The holder is compatible with existing PD procedures and it can be used by touch only, for people with impaired vision. The PD assistive holder enables patients to care for themselves at home and improves the functionality and portability of standard PD systems.

Synchronous Laparoscopic Insertion of Peritoneal Dialysis Catheter and Cholecystectomy in Patients with End-Stage Renal Disease and Gallstones – Our Experience

2019 ◽  
Vol 39 (5) ◽  
pp. 489-491
Author(s):  
Jurij Janež
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Peritoneal Dialysis Catheter ◽  
Peritoneal Catheter ◽  
Gallbladder Polyps ◽  
Stage Renal Disease ◽  
End Stage ◽  
Infective Complications ◽  
Gallbladder Removal

In patients with end-stage renal disease who are candidates for peritoneal dialysis (PD) and have gallstones or gallbladder polyps, it is advised to perform synchronous insertion of PD catheter and cholecystectomy. With gallbladder removal at the time of peritoneal catheter insertion we can avoid infective complications, such as acute cholecystitis and possible PD failure. This article presents our experience with synchronous laparoscopic cholecystectomy and insertion of a PD catheter.

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