A Case of Encapsulated Peritoneal Sclerosis in a Patient without a History of Peritoneal Dialysis

An 86-year-old man who had been treated with peritoneal dialysis for 14°months due to end-stage kidney disease secondary to hypertensive nephrosclerosis presented with a recent history of malaise, abdominal discomfort, and anorexia. An endoscopic evaluation revealed an elevated, ulcerated, and friable lesion around the lesser curvature of the stomach. The concurrent gastric biopsy specimens revealed moderately differentiated adenocarcinoma, while a cytological examination of the dialysis fluid revealed clusters of malignant cells. This is the first report illustrating a case of a Borrmann type 3 gastric cancer with synchronous peritoneal involvement in which the assessment of the disease state was aided by the cytological analysis of peritoneal effluent. Several concerns relating to this pathology are also discussed.

Download Full-text

SP522A RARE COMPLİCATİON OF PERİTONEAL DİALYSİS: ENCAPSULATED PERİTONEAL SCLEROSİS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz103.sp522 ◽

2019 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Nihan Tekkarismaz ◽

Dilek Torun ◽

Ruya Ozelsancak ◽

Hasan Micozkadioglu ◽

Gürcan Erbay

Keyword(s):

Peritoneal Dialysis ◽

Rare Complication ◽

Encapsulated Peritoneal Sclerosis

Download Full-text

Eryptosis Is Altered in Peritoneal Dialysis Patients

Blood Purification ◽

10.1159/000501541 ◽

2019 ◽

Vol 48 (4) ◽

pp. 351-357

Author(s):

Grazia Maria Virzì ◽

Sabrina Milan Manani ◽

Anna Clementi ◽

Silvia Castegnaro ◽

Alessandra Brocca ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Osmotic Shock ◽

Uremic Toxins ◽

Dialysis Patients ◽

Spearman's Rho ◽

Spearman’S Rho ◽

History Of ◽

Clinical Conditions ◽

Residual Diuresis ◽

Made In

Background: Red blood cells (RBCs) undergo programmed cell death known as eryptosis. Triggers of eryptosis include increased cytosolic Ca(2+) concentration, oxidative stress, osmotic shock, energy depletion and several uremic toxins. Little is known about the pathogenesis of eryptosis in peritoneal dialysis (PD) patients; furthermore, its relevance in worsening clinical conditions in these patients is still not completely defined. Objectives: We investigated eryptosis levels in PD patients and its association with inflammatory and clinical parameters. Material and Methods: A total of 46 PD patients and 17 healthy subjects (CTR) were enrolled. All eryptosis measurements were made in freshly isolated RBCs using the flow cytometer. Results: Eryptosis was significantly higher in PD patients than that in CTR (p < 0.001). Eryptosis levels did not differ significantly between PD patients with and without diabetes, with and without hypertension, and with and without cardiovascular disease. Eryptosis showed no significant differences between patients treated with continuous ambulatory PD/automated PD, with Kt/Vurea value ≤1.7 and >1.7, with a negative or positive history of peritonitis. On the contrary, eryptosis showed significantly lower levels in PD patients with weekly creatinine clearance ≥45 L/week/1.73 m2 (2.8%, 1.7–4.9 vs. 5.6%, 5.0–13.5; p= 0.049). Eryptosis showed significantly lower levels in PD patients with residual diuresis (n = 23) than that in patients without (3.7%, 2.6–5.6 vs. 5%, 3.1–16; p = 0.03). In these 23 patients, significant negative correlations between percentage of eryptosis and residual glomerular filtration rate (rGFR; Spearman’s rho = –0.51, p = 0.01) and diuresis volume (Spearman’s rho = –0.43, p = 0.05) were found. Conclusions: The present study demonstrated higher eryptosis levels in PD patients compared to corresponding levels in CTR. Furthermore, important PD comorbidity and main PD parameters do not influence eryptosis. Importantly, our data have reported an increase in eryptosis levels with progressive residual diuresis and rGFR loss, probably due to decreased uremic toxins clearance.

Download Full-text

Survival of 138 Surgically Placed Straight Double-Cuff Tenckhoff Catheters in Patients on Continuous Ambulatory Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686089301300312 ◽

1993 ◽

Vol 13 (3) ◽

pp. 224-227 ◽

Cited By ~ 19

Author(s):

Jochen Weber ◽

Thomas Mettang ◽

Eugen Hübel ◽

Thomas Kiefer ◽

Ulrich Kuhlmann

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Infectious Complications ◽

Catheter Survival ◽

Tenckhoff Catheter ◽

Mechanical Complications ◽

Unselected Patient ◽

Kaplan Meier ◽

History Of ◽

The Difference

Objective To determine the natural history of a surgically placed Tenckhoff catheter in patients on continuous ambulatory peritoneal dialysis (CAPD). Design Prospective 7–year study analyzing catheter survival of all catheters using the Kaplan-Meier life table methodology. Setting Teaching hospital, department of nephrology. Patients One hundred and fifteen unselected patients beginning CAPD. Interventions Removal of the catheter required for the following complications: exit-site or tunnel infections or relapsing peritonitis, outflow obstruction, pericatheter leak, and development of hernias. Main Outcome Measures Period between insertion and removal of the catheter. Results The cumulative survival of all catheters after 1,2, and 3 years of CAPD was 87%, 69% and 65%. Catheter survival of the first versus the second catheter after 1 year was significantly longer (p=0.03). The difference was not significant in relation to diabetes, age, and sex. Infectious complications caused 61% (n=19) of all 31 catheter failures, mainly due to tunnel infections caused by Staphylococcus aureus (n=12). “Mechanical” complications accounted for 49% (n=12) of catheter failures. Eight of 12 mechanical complications were outflow failures. Seven patients had to be transferred to hemodialysis. Conclusions The straight Tenckhoff catheter is a reliable peritoneal access device for CAPD in an unselected patient population.

Download Full-text

Continuous Ambulatory Peritoneal Dialysis Connection Systems

Peritoneal Dialysis International ◽

10.1177/089686089301302s08 ◽

1993 ◽

Vol 13 (2_suppl) ◽

pp. 34-40 ◽

Cited By ~ 1

Author(s):

Umberto Buoncristiani

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

State Of The Art ◽

Ease Of Use ◽

Future Trends ◽

Operating Characteristics ◽

History Of ◽

Pros And Cons

The history of the various connection systems proposed and tried during the first 15 years of clinlcal application of continuous ambulatory peritoneal dialysis (CAPD) is reviewed. In order to understand the reasons for their success or lack of success, the main technical and operating characteristics regarding their efficacy In preventing peritonitis are examined in detail, together with a range of other pros and cons (I.e., reliability, simplicity, ease of use, cost, aesthetlcal aspects). The result Is an updated state-of-the-art review In the field of CAPD connectology, with a look at future trends.

Download Full-text

Subcutaneous Cuff Migrates after Initiation of Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.3747/pdi.2017.00196 ◽

2018 ◽

Vol 38 (3) ◽

pp. 229-231

Author(s):

Tsutomu Sakurada ◽

Hitoshi Kotake ◽

Kenichiro Koitabashi ◽

Yugo Shibagaki

Keyword(s):

Diabetes Mellitus ◽

Peritoneal Dialysis ◽

Retrospective Study ◽

Site Infection ◽

Background Characteristics ◽

Single Center ◽

Exit Site ◽

Exit Site Infection ◽

Factors Affecting ◽

History Of

The aim of this study was to determine whether subcutaneous cuffs migrate toward the exit site after initiation of peritoneal dialysis (PD) and to clarify the factors affecting such migration. Subcutaneous cuff migration was defined as extension of the length of the external catheter. In this single-center, retrospective study, the external catheter lengths at initiation and 1 year later were compared in 33 PD patients (median age 62 years; 64% men; 49% with diabetes mellitus). The correlations between patient background characteristics at initiation and extension of catheter length were also examined. The external catheter length was significantly extended at 1 year later (13.5 vs 15.0 cm, p < 0.001). There was no relationship between a history of exit-site infection and extension of catheter length ( p = 0.250). Hemoglobin (r = -0.447, p = 0.009), serum albumin (r = -0.377, p = 0.031), and external catheter length at initiation (r = -0.350, p = 0.046) showed negative correlations with extension. In conclusion, subcutaneous cuff migration was observed in just 1 year and may be associated with malnutrition, anemia, and short external catheter length at initiation of PD.

Download Full-text

An experience with colistin applied in treatment of imunocompromised patients with peritonitis on peritoneal dialysis

Vojnosanitetski pregled ◽

10.2298/vsp131228062d ◽

2015 ◽

Vol 72 (4) ◽

pp. 379-382 ◽

Cited By ~ 1

Author(s):

Tatjana Djurdjevic-Mirkovic ◽

Ljiljana Gvozdenovic ◽

Gordana Majstorovic-Strazmester ◽

Violeta Knezevic ◽

Dejan Celic ◽

...

Keyword(s):

Multiple Myeloma ◽

Peritoneal Dialysis ◽

Complete Recovery ◽

First Episode ◽

Exit Site ◽

Causative Agents ◽

Life Threatening ◽

History Of ◽

Acinetobacter Spp ◽

Hospital Acquired

Introduction. Immunocompromised patients, such as those with multiple myeloma on peritoneal dialysis, are particularly susceptible to the occurrence of peritonitis. Case report. We presented a 56-year-old female patient with a 10-year history of multiple myeloma. The patient was on peritoneal dialysis since 2010. During 2012 the patient had the first episode of peritonitis that was successfully managed, but in 2013 the second episode of peritonitis occured. Analysis of dialysate culture and exit site swab revealed the presence of multiresistant Acinetobacter spp., which was susceptible only to colistin. Prompt colistin therapy was administered at the doses of 100,000 units/day during six days, which resulted in complete recovery of the patient, as well as improvement of local abdominal findings. Gram-negative bacteria (genus Acinetobacter) are common causative agents in hospital-acquired infections. Studies confirmed susceptibility of Acinetobacter to colistin, which was also the case with the presented patient. Intravenous administration of colistin resulted in a complete remission of this severe, life-threatening peritonitis. Conclusion. Patients with multiple myeloma and renal failure are highly prone to severe life-threatening infections.

Download Full-text