Study on cellular immunity in chronic hemodialysis patients and continuous ambulatory peritoneal dialysis patients

A hemodialysis patient developed hepatic cirrhosis with subsequent portal-systemic encephalopathy. Switching from hemodialysis to CAPD prevented the recurrent episodes of hepatic coma. This observation suggests that, in combined chronic renal and hepatic failure with portal-systemic encephalo pathy, CAPD may be the treatment of choice. This paper presents evidence to support this assumption. Chronic hemodialysis patients frequently develop hepatitis B, which sometimes results in hepatic cirrhosis. Portal-systemic encephalopathy (PSE) may ensue. We describe a patient in whom mild PSE repeatedly progressed to full hepatic coma during hemodialysis sessions. Switching the patient from hemodialysis (HD) to continuous ambulatory peritoneal dialysis (CAPD) prevented the recurrent hepatic coma.

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Atherosclerosis Risk Is Higher in Continuous Ambulatory Peritoneal Dialysis Patients Than in Hemodialysis Patients

Artificial Organs ◽

10.1046/j.1525-1594.2001.025006448.x ◽

2001 ◽

Vol 25 (6) ◽

pp. 448-452 ◽

Cited By ~ 14

Author(s):

Fatma Nurhan Ozdemir ◽

Galip Guz ◽

Siren Sezer ◽

Zubeyde Arat ◽

Munire Turan ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Hemodialysis Patients ◽

Dialysis Patients ◽

Atherosclerosis Risk

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MP566SERUM CHROMIUM LEVEL IN CHRONIC PERITONEAL DIALYSIS PATIENTS IS HIGHER THAN IN CHRONIC HEMODIALYSIS PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfx176.mp566 ◽

2017 ◽

Vol 32 (suppl_3) ◽

pp. iii638-iii638

Author(s):

Leonid Feldman ◽

Ilia Beberashvili ◽

Ramzia Abu Hamad ◽

Iris Yakov-Hai ◽

Elena Abramov ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Chronic Peritoneal Dialysis ◽

Dialysis Patients ◽

Chromium Level

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Reproductive Function in Dialysis Patients: CAPD vs Hemodialysis

Peritoneal Dialysis International ◽

10.1177/089686088300301s10 ◽

1983 ◽

Vol 3 (1_suppl) ◽

pp. 30-32 ◽

Cited By ~ 8

Author(s):

Marilyn Galler ◽

Bruce Spinowitz ◽

Chaim Chary Tan ◽

Mahesh Kabadi ◽

Ruth Freeman

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Reproductive Function ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Dialysis Patients ◽

Vaginal Estrogen ◽

Regular Menses ◽

Estrogen Effect

A variety of hormonal disturbances and reproductive abnormalities occur in women on chronic maintenance hemodialysis. Recently, it has been noted that, when transferred from hemodialysis to continuous ambulatory peritoneal dialysis (CAPD), some women have resumed normal menses with ovulatory cycles. We compared menstrual histories, vaginal hormonal smears and ovulatory curves in 12 women on hemodialysis vs. seven women on CAPD under the age of 45. Eightysix per cent of the CAPD patients and 25% of the hemodialysis patients had regular menses. Upon transfer to CAPD, two amenorrheic females resumed regular menses within 21 months. Only two patients (one in each group) had ovulatory cycles. All patients had a vaginal estrogen effect. The return of regular menses in CAPD patients may be due to improved middle-molecule clearances with secondary normalization of the hormonal imbalances.

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Prevalence of constipation in continuous ambulatory peritoneal dialysis patients and comparison with hemodialysis patients

American Journal of Kidney Diseases ◽

10.1053/ajkd.2002.33407 ◽

2002 ◽

Vol 39 (6) ◽

pp. 1292-1299 ◽

Cited By ~ 56

Author(s):

Gen Yasuda ◽

Kazuhiko Shibata ◽

Toshikazu Takizawa ◽

Yumiko Ikeda ◽

Yasuo Tokita ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Hemodialysis Patients ◽

Dialysis Patients

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Drug-Protein Binding during Continuous Ambulatory Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686088600600308 ◽

1986 ◽

Vol 6 (3) ◽

pp. 144-147 ◽

Cited By ~ 8

Author(s):

Gene D. Morse ◽

Carolyn Rowinski ◽

Patricia E. Lieveld ◽

J. Joseph Walshe

Keyword(s):

Peritoneal Dialysis ◽

Protein Binding ◽

Continuous Ambulatory Peritoneal Dialysis ◽

High Performance ◽

Equilibrium Dialysis ◽

Active Form ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Normal Volunteers ◽

Drug Protein Binding

This study of drug-protein binding in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) measured the serum and dialysate binding of cefamandole -an acidic, cephalosporin antibiotic. Ten CAPD patients, five with and five without peritonitis received a 1.0 g intraperitoneal dose of cefamandole; serum and dialysate was sampled at 4, 10, and 24 h after drug administration. Binding also was studied in serum obtained from five chronic hemodialysis patients and five normal volunteers. Equilibrium dialysis was used to determine protein binding and high performance liquid chromatography to measure cefamandole. Mean fraction unbound (fu) serum values for CAPD patients were 0.35 ± 0.04 (noninfected) and 0.37 ± 0.14 (peritonitis). In comparison, the fu values in hemodialysis patients were 0.41 ± 0.19 and 0.15 ± 0.02 in normal volunteers. Greater than 90% of cefamandole in dialysate was unbound suggesting that antibiotics, which cross the peritoneal membrane, are present in the free, microbiologically active form.

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Beta-2 Microglobulin in Peritoneal Dialysis Patients: Serum Levels and Peritoneal Clearances

Peritoneal Dialysis International ◽

10.1177/089686088800800110 ◽

1988 ◽

Vol 8 (1) ◽

pp. 43-47 ◽

Cited By ~ 14

Author(s):

Carol R. DiRaimondo ◽

Patricia McCarley ◽

William J. Stone

Keyword(s):

Peritoneal Dialysis ◽

Serum Levels ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Bone Lesions ◽

Dialysis Patients ◽

Urea Nitrogen ◽

Pathologic Fractures ◽

Beta 2 ◽

Beta 2 Microglobulin

Beta-2 microglobulin (B2M) is amyloidogenic in long-term hemodialysis patients, with amyloid deposition manifesting as lytic bone lesions, carpal tunnel syndrome, destructive arthropathies, tenosynovitis, and pathologic fractures. To study the behavior of this protein in the peritoneal dialysis population, serum levels of B2M from 14 chronic peritoneal dialysis (CPD) patients (4IPD, 10 CAPD) were compared to those of 15 chronic hemodialysis patients, and peritoneal clearances were measured in 9 CAPD patients. Standard cuprophan dialyzers were used for hemodialysis. Serum B2M levels were significantly lower in the peritoneal dialysis group (mean ± SD 73.2 ± 20.9 mg/L) than in the hemodialysis group (100.3 ± 24.7 mg/L, p < .004). When CAPD patients alone were compared to the hemodialysis patients, lower serum B2M levels were again apparent, with mean 68.7 ± 16.4 mg/L (p ≤ .002). Mean serum B2M in IPD patients (84.6 ± 28.9 mg/L) did not differ statistically from either the CAPD or the hemodialysis group. Peritoneal clearance of B2M, urea nitrogen, and creatinine over a 6 h exchange were obtained in 9 CAPD patients without peritonitis. Mean clearance (±SD) of B2M was 0.9 ± 0.4 ml/min/1.73 m2, urea nitrogen 5.3 ± 0.3 ml/min/1.73 m2, and creatinine 4.2 ± 0.8 ml/min/1.73 m2. Mean loss of B2M via the peritoneal cavity was 19.9 ± 6.6 mg/2 L-exchange/1.73 m2 (range 7.7 to 26.2 mg/2 L-exchange/1.73 m2). Decreased serum B2M in peritoneal dialysis patients is consistent with increased clearance by the peritoneal membrane versus standard cellulosic hemodialysis membranes. Whether use of CPD rather than hemodialysis can prevent or even treat dialysis-associated amyloidosis (AB2M) remains speculative.

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The effect of increasing hematocrit on peritoneal transport kinetics.

Journal of the American Society of Nephrology ◽

10.1681/asn.v491726 ◽

1994 ◽

Vol 4 (9) ◽

pp. 1726-1732

Author(s):

J M Burkart ◽

B I Freedman ◽

M V Rocco

Keyword(s):

Blood Flow ◽

Peritoneal Dialysis ◽

Solute Transport ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Hemodialysis Patients ◽

Dialysis Patients ◽

Peritoneal Equilibration Test ◽

Peritoneal Transport ◽

Significant Change ◽

Solute Clearance

Although it is well established that an increase in hematocrit results in a small decrease in solute transport in hemodialysis patients, the effect of hematocrit on solute transport in peritoneal dialysis patients remains controversial. In hemodialysis patients, the inverse relationship between hematocrit and the transport of small solutes may be explained by the dependence of solute clearance on the rapidity of solute movement from the red blood cell to the dialysate. This movement is determined by several in vivo factors, the most important of which is blood flow. However, in peritoneal dialysis, the effective peritoneal capillary blood flow is several times the maximal urea clearance. Therefore, clearances are usually considered to be independent of blood flow rate and variations in hematocrit should not affect solute transport across the peritoneal membrane. In this study, the effect of an increase in hematocrit on the transport of small solutes in peritoneal dialysis patients is analyzed. The peritoneal equilibration test was performed in 25 continuous ambulatory peritoneal dialysis patients before and after an increase in hematocrit of at least seven points. No significant change was found in ultrafiltration rate or in peritoneal transport characteristics as measured by the peritoneal equilibration test or by mass transfer area coefficients for creatinine, urea, or glucose. In addition, there was no change in these parameters in a control group of 13 continuous ambulatory peritoneal dialysis patients with no significant change in hematocrit. These findings are consistent with the observation that solute clearance for urea and creatinine in peritoneal dialysis is not blood flow dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

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The Impact of Dialysis Modality on Left Ventricular Function in Patient with End Stage Kidney Disease

Nepal Journal of Medical Sciences ◽

10.3126/njms.v5i2.36704 ◽

2020 ◽

Vol 5 (2) ◽

pp. 2-9

Author(s):

Abhishek Maskey ◽

Navaraj Paudel ◽

Subash Sapkota ◽

Pooja Jha

Keyword(s):

Peritoneal Dialysis ◽

Kidney Disease ◽

Left Ventricular Function ◽

Ventricular Function ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Hemodialysis Patients ◽

Left Ventricular ◽

Dialysis Patients ◽

End Stage Kidney Disease ◽

End Stage

Introduction: Cardiovascular disease is frequent in end-stage kidney disease patients, and is a major cause of morbidity and mortality. This study was carried out to assess the comparative cardiac effects of hemodialysis and continuous ambulatory peritoneal dialysis on left ventricular function.Methods: A prospective observational study was carried out in patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis at least for 6 months. The duration of the study was from June 2019 to May 2020. CAPD consists of 3 to 4 exchanges/day and haemodialysis 2-3 times/week for 4 hours. Baseline characteristics age, gender, dialysis duration, hypertension, diabetes and hyperlipidaemia were collected. The same cardiologist performed all echocardiography at the end of hemodialysis session in hemodialysis patients and after the drain of dialysate in peritoneal dialysis patients.Results: Sixty patients (40 hemodialyses, 20 peritoneal dialyses) were enrolled. The mean age of the patient was 53.71±13.00 years (range 25-76). There was a slightly higher number of male in the hemodialysis group (p= 0.065). Systolic and diastolic blood pressure were significantly higher in hemodialysis groups (p<0.001). Regarding left ventricular parameters, hemodialysis patients had a higher prevalence of left ventricular diastolic dysfunction, left ventricular hypertrophy, left ventricular mass compared to peritoneal dialysis patients. Pericardial effusion and thickening were present higher in hemodialysis patients and was statistically significant (p<0.05).Conclusion: The modality of dialysis influence left ventricular function. Left ventricle dysfunction is prevalent among hemodialysis patients compared to peritoneal dialysis. Echocardiographic follow up is essential as this could improve the management of cardiovascular complications in dialysis patients.

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