Clearance and Safety of the Radiocontrast Medium Iopamidol in Peritoneal Dialysis Patients

Although the characteristics and safety of radiocontrast media in peritoneal dialysis (PD) patients are not yet well defined, their use in PD patients is considered generally safe. In this study, we evaluated clearance and adverse events of iopamidol in PD patients. We measured the iopamidol concentration in the plasma, dialysate, and urine of 11 patients. Iopamidol clearance from patient plasma was delayed with a half-life of 33.3 h, and the elimination ratio was 83.6% for 96 h. We retrospectively investigated adverse events occurring in a total of 50 stable PD patients who underwent a total of 64 angiographic computed tomography (CT) scans. In 64 angiographic CT scans, two cases of adverse events were observed. Our results suggest that iopamidol can be eliminated by regular PD and careful observation for adverse events are necessary for the safe use of radiocontrast media.

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Assessment of Peritoneal Thickness Using Computed Tomography in Relation to Dialysis Adequacy in Peritoneal Dialysis Patients

Therapeutic Apheresis and Dialysis ◽

10.1111/1744-9987.13719 ◽

2021 ◽

Author(s):

Dilek Barutcu Atas ◽

Ozlem Demircioglu ◽

Canan Cimsit ◽

Arzu Velioglu ◽

Hakki Arikan ◽

...

Keyword(s):

Computed Tomography ◽

Peritoneal Dialysis ◽

Dialysis Patients ◽

Dialysis Adequacy

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Pharmacokinetics of Once Daily Intraperitoneal Cefazolin in Continuous Ambulatory Peritoneal Dialysis Patients

Journal of the American Society of Nephrology ◽

10.1681/asn.v1161117 ◽

2000 ◽

Vol 11 (6) ◽

pp. 1117-1121

Author(s):

CHAI LUAN LOW ◽

KAMANI GOPALAKRISHNA ◽

WAI CHOONG LYE

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Half Life ◽

Volume Of Distribution ◽

Hplc Method ◽

Dialysis Patients ◽

Suitable Alternative ◽

Once Daily ◽

Cefazolin Sodium ◽

Plasma Half Life

Abstract. This study determined the pharmacokinetic characteristics of once daily intraperitoneal (IP) cefazolin in continuous ambulatory peritoneal dialysis (CAPD) patients. Each of the 10 volunteer CAPD patients without active peritonitis received a single IP dose of 1 g of cefazolin sodium for a 6-h dwell. All patients underwent a fixed CAPD regimen comprising a first 6-h dwell followed by two 3-h dwells and a final 12-h overnight dwell. Blood and dialysate samples were collected at 0, 0.5, 1, 2, 3, 6 (end of first dwell), and 24 h after the administration of IP cefazolin. Any urine produced was collected over the 24-h study period. A validated HPLC method was used to analyze cefazolin in plasma, dialysate, and urine. The bioavailability was found to be 77.9 ± 3.1%, volume of distribution 0.20 ± 0.05 L/kg, and plasma half-life 39.9 ± 25.4 h. Mean total, renal, and peritoneal clearances were 4.5 ± 2.3, 1.4 ± 1.1, and 3.5 ± 1.8 ml/min, respectively. Mean plasma and dialysate concentrations at 24 h were 42.8 ± 14.3 and 31.8 ± 11.7 mcg/ml, respectively, well above the minimum inhibitory concentrations (MIC) of susceptible organisms. A once daily IP cefazolin dose of 500 mg/L gave desirable pharmacokinetic attributes for use as a suitable alternative to vancomycin for empiric treatment of CAPD-associated peritonitis.

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Intravenous and Intraperitoneal Pharmacokinetics of Dalbavancin in Peritoneal Dialysis Patients

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02089-19 ◽

2020 ◽

Vol 64 (5) ◽

Cited By ~ 1

Author(s):

E. T. Van Matre ◽

I. Teitelbaum ◽

T. H. Kiser

Keyword(s):

Peritoneal Dialysis ◽

Half Life ◽

Peritoneal Fluid ◽

Area Under The Curve ◽

Terminal Phase ◽

Dialysis Patients ◽

Time Data ◽

Open Label ◽

Gram Positive ◽

Clinical Pharmacokinetics

ABSTRACT Dalbavancin offers a possible treatment option for infectious peritonitis associated with peritoneal dialysis (PD) due to its coverage of Gram-positive bacteria and pharmacokinetic properties. We aimed to evaluate the clinical pharmacokinetics (PK) and pharmacodynamics of dalbavancin in a prospective, randomized, open-label, crossover PK study of adult patients with end-stage renal disease ESRD who were receiving PD. Sampling occurred prior to a single 30-min infusion of dalbavancin at 1,500 mg and at 1, 2, 3, 4, and 6 h and 7 and 14 days postadministration. Concentration-time data were analyzed via noncompartmental analysis. Pharmacodynamic parameters against common infectious peritonitis-causing pathogens were evaluated. Ten patients were enrolled. Patients were a median of 55 years old and had a median weight of 78.2 kg, 50% were female, and 70% were Caucasian. The terminal plasma half-life of dalbavancin was 181.4 ± 35.5 h. The day 0 to day 14 dalbavancin mean area under the curve (AUC) was 40,573.2 ± 9,800.3 mg·h/liter. The terminal-phase half-life of dalbavancin within the peritoneal fluid was 4.309 × 108 ± 1.140 × 109 h. The day 0 to day 14 dalbavancin mean peritoneal fluid AUC was 2,125.0 ± 1,794.3 mg·h/liter. The target plasma AUC/MIC was attained with the intravenous dose in all 10 patients for all Staphylococcus and Streptococcus species at the recommended MIC breakpoints. The intraperitoneal arm of the study was stopped early, because the first 3 patients experienced moderate to severe pain and bloating within 1 h following the administration of dalbavancin. Dalbavancin at 1,500 mg administered intravenously can be utilized without dose adjustment in peritoneal dialysis patients and will likely achieve the necessary peritoneal fluid concentrations to treat peritonitis caused by typical Gram-positive pathogens.

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Computed tomography for the management of exit-site and tunnel infections in peritoneal dialysis patients

Clinical Nephrology ◽

10.5414/cn108928 ◽

2016 ◽

Vol 86 (12) ◽

pp. 328-332 ◽

Cited By ~ 1

Author(s):

Keina Nozaki ◽

Yuka Kamijo ◽

Mineo Nakatsuka ◽

Takeshi Azuma ◽

Tohru Nakagawa ◽

...

Keyword(s):

Computed Tomography ◽

Peritoneal Dialysis ◽

Dialysis Patients ◽

Exit Site

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Computed Tomographic Findings Characteristic for Encapsulating Peritoneal Sclerosis: A Case-Control Study

Peritoneal Dialysis International ◽

10.1177/089686080902900508 ◽

2009 ◽

Vol 29 (5) ◽

pp. 517-522 ◽

Cited By ~ 48

Author(s):

Anniek Vlijm ◽

Jaap Stoker ◽

Shandra Bipat ◽

Anje M. Spijkerboer ◽

Saffire S.K.S. Phoa ◽

...

Keyword(s):

Computed Tomography ◽

Peritoneal Dialysis ◽

Ct Scan ◽

Case Control Study ◽

Case Control ◽

Ct Scans ◽

Computed Tomographic ◽

Ct Findings ◽

Control Study

Background Computed tomography (CT) is often used to confirm the diagnosis of encapsulating peritoneal sclerosis (EPS) but there is no consensus on specific CT abnormalities. To establish CT findings characteristic for EPS, we compared CT findings between EPS patients and long-term peritoneal dialysis (PD) patients without EPS. Methods We included as cases all EPS patients in our center from 1996 to 2008 that underwent a CT scan at the time of diagnosis. Controls were all other long-term PD patients (PD duration ≥ 4 years) without EPS that had a CT scan for different reasons. The CT scans were blindly and independently reviewed by 3 radiologists: 2 abdominal radiologists with PD knowledge (Observers 1 and 2) and 1 radiologist without PD experience (Observer 3). Results We included 15 EPS patients and 16 controls. Observer 1 found 6 CT findings that were significantly more often present in EPS than in controls ( p ≤ 0.05): peritoneal enhancement, thickening, and calcifications; adhesions of bowel loops; signs of obstruction; and fluid loculation/septation. Observer 2 scored almost identically but Observer 3 scored differently. The sensitivity and specificity of a combination of specific CT findings were, respectively, 100% and 94% for Observers 1 and 2, and 79% and 88% for Observer 3. Conclusion CT scans showed characteristic abnormalities that were significantly more often present in EPS patients compared to long-term PD control patients. CT can be used to confirm the diagnosis of EPS when experienced radiologists apply a combination of specific CT findings.

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Steady-State Pharmacokinetics of Oral Ciprofloxacin in Continuous Cycling Peritoneal Dialysis Patients: Brief Report

Peritoneal Dialysis International ◽

10.3747/pdi.2017.00052 ◽

2018 ◽

Vol 38 (1) ◽

pp. 73-76

Author(s):

Colin Lee ◽

Sandra A.N. Walker ◽

Lesley Palmay ◽

Scott E. Walker ◽

Sheldon Tobe ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Steady State ◽

Serum Concentration ◽

Half Life ◽

Dialysis Patients ◽

Maximum Serum ◽

Continuous Cycling Peritoneal Dialysis ◽

Continuous Cycling ◽

Maximum Serum Concentration ◽

Oral Ciprofloxacin

Steady-state pharmacokinetics of oral ciprofloxacin in 3 continuous cycling peritoneal dialysis (CCPD) outpatients given ciprofloxacin 750 mg b.i.d. for 5 doses was determined. Mean steady-state maximum serum concentration and half-life were 4.4 ±1.5 mg/L and 10.3 ± 2.6 hours, respectively. Mean maximum dialysate concentration in the daytime long dwell and overnight continuous cycling dwell were 7.4 ± 1.2 mg/L and 3.3 ± 1.2 mg/L, respectively. Oral ciprofloxacin 750 mg b.i.d. may be reasonable for bloodstream and peritoneal infections caused by susceptible bacteria in CCPD patients.

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