Impact of prolonged duration of different types of renal replacement therapies on serum levels of endothelin-1 and pulmonary function tests

Introduction: This study was carried out to investigate the impact of duration of different renal replacement therapies such as hemodialysis and continuous ambulatory peritoneal dialysis on potential overproduction of endothelin-1 (ET-1) and pulmonary function tests in these patients. Materials and methods: The study included 26 patients (14 males, mean age 54.9±16.2 years) with end stage renal diseases (ESRD) receiving regular hemodialysis (HD) and 23 patients (10 males, mean age 55.8±15.8 years) with ESRD treated with continuous ambulatory peritoneal dialysis (CAPD). The spirometry values were recorded before the onset of HD and prior to emptying the peritoneal cavity in CAPD patients and ET-1 was measured using the enzyme immunoassay (EIA) methodology. Two groups of patients (groups 1 and 2) were further divided into subgroups (group A and group B). Groups A (1-A and 2-A) included patients treated with any type of renal replacement therapy (RRT) (HD or CAPD) less than 5 years, and groups B (1-B and 2-B) included patients treated with any type of RRT (HD or CAPD) longer than 5 years. Results: Patients treated with HD or CAPD for more than five years were found to have significantly higher serum levels of ET-1 (HD = 41.49±21.28 vs. 185.13±73.67, p<0.01; PD = 51.24±32.11 vs. 139.53±42.42, p<0.01, respectively). Values of most pulmonary function parameters differed significantly between groups treated longer or shorter than 5 years: FVC (HD = 108.4±13.34 vs. 80.82±11.26, p<0.01; CAPD = 97.20±18.99 vs. 73.25±10.73, p<0.01, respectively), FEV1 (HD = 108.33±15.8 vs. 76.73±4.9, p<0.01; CAPD = 100.67±18.31 vs. 66.75±6.25, p<0.01, respectively). Conclusions: Prolonged duration of any type of renal replacement therapy is associated with higher serum levels of ET-1 and with lower pulmonary function tests in ESRD patients.

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Continuous Ambulatory Peritoneal Dialysis and Pulmonary Function

Scottish Medical Journal ◽

10.1177/003693308302800409 ◽

1983 ◽

Vol 28 (4) ◽

pp. 355-356 ◽

Cited By ~ 2

Author(s):

W. G. J. Smith ◽

K. R. Patel ◽

J. D. Briggs ◽

B. J. R. Junor

Keyword(s):

Peritoneal Dialysis ◽

Pulmonary Function ◽

Lung Disease ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Respiratory System ◽

Respiratory Function ◽

Pulmonary Function Tests ◽

Lung Volumes ◽

Function Tests ◽

Supine Posture

Pulmonary function tests were performed in ten patients established on continuous ambulatory peritoneal dialysis. A decrease in all lung volumes was observed after instillation of dialysate and a further decrease on change from the erect to the supine posture. This change was small and unlikely to have a functionally significant effect in patients with a healthy respiratory system. However, in patients with pre-existing lung disease, respiratory function might be further compromised.

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Continuous Ambulatory Peritoneal Dialysis is Better than Automated Peritoneal Dialysis as First-Line Treatment in Renal Replacement Therapy

Peritoneal Dialysis International ◽

10.1177/089686080702702s26 ◽

2007 ◽

Vol 27 (2_suppl) ◽

pp. 153-157

Author(s):

Philip Kam-Tao Li ◽

Kwok Yi Chung ◽

Kai Ming Chow

Keyword(s):

Peritoneal Dialysis ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Large Scale ◽

Residual Renal Function ◽

Health Care Economics ◽

Automated Peritoneal Dialysis ◽

First Line ◽

Randomized Controlled Studies

This article examines the roles of continuous ambulatory peritoneal dialysis (CAPD) versus automated peritoneal dialysis (APD) as first-line renal replacement therapy. To date, no high-quality large-scale randomized controlled studies have compared CAPD with APD as first-line therapy. However, a discussion on this issue is important so that nephrologists can decide and patients can have a choice of modality on which to start dialysis, especially in the context of health care economics. We review the literature and present Hong Kong as the model of a “CAPD first” policy, an appealing, cost-effective approach for any country. An ideal renal replacement therapy should provide optimal survival, lowest possible risk for comorbidity, highest level of quality of life, and equally important, acceptable cost to society. When we consider this subject in the context that all patients should be started on one first-line modality, the data suggest that a “CAPD first” policy has all these advantages, with APD probably having the edge only with regard to patient preference. The present review highlights preservation of residual renal function, removal and balancing of sodium, incidence of peritonitis, peritoneal membrane transport status, patient rehabilitation, and financial issues in demonstrating that a “CAPD first” policy is the model that should be adopted.

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Serum Levels of Anti-αGalactosyl Antibodies Predict Survival and Peritoneal Dialysis–Related Enteric Peritonitis Rates in Patients Undergoing Renal Replacement Therapy

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2006.08.027 ◽

2006 ◽

Vol 48 (6) ◽

pp. 972-982 ◽

Cited By ~ 3

Author(s):

Miguel Pérez Fontán ◽

Rafael Máñez ◽

Ana Rodríguez-Carmona ◽

Javier Peteiro ◽

Verónica Martínez ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Serum Levels

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Peritoneal Dialysis in Renal Replacement Therapy for Patients with Acute Kidney Injury

International Journal of Nephrology ◽

10.4061/2011/739794 ◽

2011 ◽

Vol 2011 ◽

pp. 1-10 ◽

Cited By ~ 16

Author(s):

Naheed Ansari

Keyword(s):

Acute Kidney Injury ◽

Developing Countries ◽

Peritoneal Dialysis ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Kidney Injury ◽

Hemodynamic Instability ◽

Renal Replacement Therapies ◽

Continuous Renal Replacement Therapies ◽

Trained Staff

Peritoneal dialysis (PD) was the first modality used for renal replacement therapy (RRT) of patients with acute kidney injury (AKI) because of its inherent advantages as compared to Hemodialysis. It provides the nephrologist with nonvascular alternative for renal replacement therapy. It is an inexpensive modality in developing countries and does not require highly trained staff or a complex apparatus. Systemic anticoagulation is not needed, and it can be easily initiated. It can be used as continuous or intermittent procedure and, due to slow fluid and solute removal, helps maintain hemodynamic stability especially in patients admitted to the intensive care unit. PD has been successfully used in AKI involving patients with hemodynamic instability, those at risk of bleeding, and infants and children with AKI or circulatory failure. Newer continuous renal replacement therapies (CRRTs) are being increasingly used in renal replacement therapy of AKI with less use of PD. Results of studies comparing newer modalities of CRRT versus acute peritoneal dialysis have been conflicting. PD is the modality of choice in renal replacement therapy in pediatric patients and in patients with AKI in developing countries.

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Chronic Peritoneal Dialysis—A Single-Center Experience

Peritoneal Dialysis International ◽

10.1177/089686080302302s39 ◽

2003 ◽

Vol 23 (2_suppl) ◽

pp. 188-191 ◽

Cited By ~ 1

Author(s):

Ghulam H. Malik ◽

Ali Swaid Al-Harbi ◽

Suleiman A. Al-Mohaya ◽

Raed Al-Awaishe ◽

Mohammad C. Kechrid ◽

...

Keyword(s):

Saudi Arabia ◽

Peritoneal Dialysis ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Site Infection ◽

Exit Site ◽

Exit Site Infection ◽

Single Center Experience ◽

Age Range

Objective In Saudi Arabia, experience with continuous ambulatory peritoneal dialysis (CAPD) as a renal replacement therapy is limited, and publications are scanty. The present study was undertaken to evaluate CAPD in the Saudi population. Patients and Methods All patients managed by CAPD from May 1993 to September 2002 were included in the study. Tenckhoff indwelling silicone-rubber double-cuff catheters were surgically implanted. Peritoneal dialysis (PD) was started 2 weeks after catheter insertion. Generally, 2-L exchanges 4 times daily were used. Our total of 91 PD patients included 50 men in the age range 13 – 80 years (mean: 48 ± 18 years), and 41 women in the age range 16 – 76 years (mean: 52 ± 18 years). Forty-nine patients performed dialysis by themselves; 42 patients needed a helper. Results Between April 2001 and September 2002, we noted, on average, 1 episode of peritonitis per 21 patient–months and 1 episode of exit-site infection per 24 patient–months. The most common causative organisms for peritonitis were Pseudomonas (16%), Staphylococcus epidermidis (16%), and Staphylococcus aureus (7%). No organisms were grown in 13% of peritonitis episodes. The organisms most commonly responsible for exit-site infection were Pseudomonas aeruginosa (50%) and Staphylococcus (31%). We removed catheters from 32 patients, 12 of those for mechanical reasons. Of the 20 patients whose catheter was removed for infection, P. aeruginosa was cultured in 11 cases. Nine of 23 patients switched to hemodialysis were switched for refractory peritonitis. By the end of the study, 38 patients were still on CAPD, 23 had been switched to hemodialysis, 10 had undergone renal transplantation, and 20 had died. The major causes of death were peritonitis with sepsis ( n = 6), cardiovascular causes ( n = 5), and sudden death at home or in other hospitals ( n = 5). Conclusion Continuous ambulatory peritoneal dialysis is a viable option of renal replacement therapy in Saudi Arabia. The main problem encountered was peritonitis.

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Renal replacement therapy

10.1093/med/9780199568741.003.0168 ◽

2018 ◽

Author(s):

William G. Herrington ◽

Aron Chakera ◽

Christopher A. O’Callaghan

Keyword(s):

Vitamin D ◽

Peritoneal Dialysis ◽

Renal Transplantation ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Acute Setting ◽

Renal Replacement Therapies

Renal replacement therapies provide a substitute for the function of normal kidneys. Options include haemofiltration, haemodialysis, peritoneal dialysis, and renal transplantation. Haemofiltration is only used in the acute setting. Endocrine functions of the kidney are replaced with erythropoietin and vitamin D therapy. This chapter provides an overview of renal replacement therapies.

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Comparison of Continuous Ambulatory Peritoneal Dialysis and Hemodialysis for Diabetics

Peritoneal Dialysis International ◽

10.1177/089686088500500103 ◽

1985 ◽

Vol 5 (1) ◽

pp. 7-11 ◽

Cited By ~ 14

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.

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