Overhydration, A New Risk Factor for Peritonitis in Peritoneal Dialysis

2021 ◽  
Vol 15 (4) ◽  
Author(s):  
Ana Rita Valerio Alves ◽  
Hernani Ricardo Martins Goncalves ◽  
Rachele Silva Escoli ◽  
Francisco Alexandre Monteiro Ferrer ◽  
Ana Maria Vila Lobos
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis

scholarly journals Low serum parathyroid hormone is a risk factor for peritonitis episodes in incident peritoneal dialysis patients: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuqi Yang ◽  
Jingjing Da ◽  
Yi Jiang ◽  
Jing Yuan ◽  
Yan Zha
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Proportional Hazard ◽  
Serum Parathyroid Hormone ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Gram Negative Organisms ◽  
Serum Pth

Abstract Background Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear. Methods We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH < 150 pg/mL; middle-PTH group, PTH 150-300 pg/mL; high-PTH group, PTH > 300 pg/mL. Results During a median follow-up of 29.5 (interquartile range 16–49) months, the incidence rate of peritonitis was 0.10 episodes per patient-year. Gram-positive organisms were the most common causative microorganisms (36.2%), and higher percentage of Gram-negative organisms was noted in patients with low PTH levels. Low PTH levels were associated with older age, higher eGFR, higher hemoglobin, calcium levels and lower phosphate, alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014–2.663, P = 0.044]. Conclusions Low PTH levels are independently associated with peritonitis in incident PD patients.

The Iron Biology Status of Peritoneal Dialysis Patients May be a Risk Factor for Development of Infectious Peritonitis

2019 ◽  
Vol 39 (4) ◽  
pp. 362-374 ◽  
Author(s):  
Marwh Aldriwesh ◽  
Noura Al-Dayan ◽  
Jonathan Barratt ◽  
Primrose Freestone
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Stress Hormones ◽  
Infection Risk ◽  
Mortality And Morbidity ◽  
Peritoneal Dialysate ◽  
Susceptibility To Infection ◽  
Infection Risk Factors

Background Infectious peritonitis is a clinically important condition contributing to the significant mortality and morbidity rates observed in peritoneal dialysis (PD) patients. Although some of the socioeconomic risk factors for PD-associated peritonitis have been identified, it is still unclear why certain patients are more susceptible than others to infection. Methods We examined the molecular components of human peritoneal dialysate (HPD) in an attempt to identify factors that might increase patient susceptibility to infection. Characterization studies were performed on initial and follow-up dialysate samples collected from 9 renal failure patients on PD. Results Our in vitro data showed that peritonitis-causing bacteria grew differently in the patient dialysates. Proteomic analysis identified an association between transferrin presence and infection risk, as peritoneal transferrin was discovered to be iron-saturated, which was in marked contrast to transferrin in blood. Further, use of radioactive iron-labeled transferrin showed peritoneal transferrin could act as a direct iron source for the growth of peritonitis-causing bacteria. We also found catecholamine stress hormones noradrenaline and adrenaline were present in the dialysates and were apparently involved in enhancing the growth of the bacteria via transferrin iron provision. This suggests the iron biology status of the PD patient may be a risk factor for development of infectious peritonitis Conclusions Collectively, our study suggests transferrin and catecholamines within peritoneal dialysate may be indicators of the potential for bacterial growth in HPD and, as infection risk factors, represent possible future targets for therapeutic manipulation.

Use of gastric-acid suppressants may be a risk factor for enteric peritonitis in patients undergoing peritoneal dialysis: A meta-analysis

2018 ◽  
Vol 44 (2) ◽  
pp. 209-215 ◽  
Author(s):  
Hao-Jie Zhong ◽  
Da Lin ◽  
Zhi-Yong Lu ◽  
Wan-Ying Yang ◽  
Yu Chen
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Gastric Acid ◽  
Meta Analysis

scholarly journals Peritoneal dialysis - associated peritonitis during treatment with continuous ambulatory peritoneal dialysis

2019 ◽  
pp. 47-52
Author(s):  
M. Malasaiev ◽  
I. Dudar ◽  
A. Shymova
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Infectious Complications ◽  
First Year ◽  
Significant Progress ◽  
Main Risk Factor ◽  
Common Cause ◽  
Hemodialysis Treatment ◽  
Methodological Approaches ◽  
Peritoneal Function

 Infections associated with peritoneal dialysis (infection of the catheter, tunnel infection and peritonitis) are the most common complications of this method. Despite significant progress in the methodological approaches to the prevention, diagnosis and treatment of PD associated infections, peritonitis remains the main risk factor for mortality in PD patients (up to 6%) and plays a significant role in more than 1/6 of the deaths associated with non-infectious complications such as cardiovascular and / or cerebrovascular disease. Besides, PD-associated infections are the most common cause of loss of peritoneal function and the patients’ transition to hemodialysis treatment. About 5% of PD patients are converted to hemodialysis treatment in the first year after postponed peritonitis.

scholarly journals SP483EXCESS WEIGHT GAIN DURING THE FIRST YEAR OF PERITONEAL DIALYSIS IS A RISK FACTOR FOR A RAPID DECREASE IN RESIDUAL RENAL FUNCTION

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii539-iii539
Author(s):  
Hyung Jik Kim ◽  
Sung Gyun Kim ◽  
Jwa-Kyung Kim ◽  
Chan Ho Kim ◽  
Seung Jun Kim ◽  
...  
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Weight Gain ◽  
Residual Renal Function ◽  
Rapid Decrease ◽  
First Year

scholarly journals SP514IS DIABETES A RISK FACTOR FOR TECHNICAL FAILURE AND MORTALITY IN PERITONEAL DIALYSIS PATIENTS?

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii549-iii549
Author(s):  
Merita Rroji (Molla) ◽  
Saimir Seferi ◽  
Genc Burazeri ◽  
Erjola Likaj ◽  
Nereida Spahia ◽  
...  
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Technical Failure ◽  
Dialysis Patients

Long-Term Peritoneal Dialysis is a Risk Factor of Sclerosing Encapsulating Peritonitis for Children

2000 ◽  
Vol 20 (4) ◽  
pp. 445-451 ◽  
Author(s):  
Yoshinori Araki ◽  
Hiroshi Hataya ◽  
Yuriko Tanaka ◽  
Ryuji Fukuzawa ◽  
Masahiro Ikeda ◽  
...  
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Ct Scan ◽  
Clinical Syndrome ◽  
Peritoneal Fibrosis ◽  
Abdominal Ct ◽  
Sclerosing Encapsulating Peritonitis ◽  
Abdominal Ct Scan ◽  
Encapsulating Peritonitis

Objective Sclerosing encapsulating peritonitis (SEP) is a clinical syndrome with a high mortality rate and is a serious complication of peritoneal dialysis (PD). Peritoneal sclerosis (PS) is a histological diagnosis. PS is usually observed in the peritoneal specimens of patients with SEP. Avoiding SEP is considered to be extremely important for pediatric patients who may require long-term PD. In this study, the characteristics of patients with PS were investigated to determine when to perform peritoneal biopsies and how long PD can be performed safely. Design A retrospective single-center study. Setting Tokyo Metropolitan Kiyose Children's Hospital. Patients A total of 109 children younger than 16 years have received chronic PD in our unit since 1981. Among these children, 16 patients had been on PD for more than 5 years (mean 7.4 ± 2.5 years) from May 1992 to March 1999. Peritoneal biopsies were performed in 14 of the 16 patients, who were divided into two groups based on the histological diagnoses: a PS and a peritoneal fibrosis (PF) group. Results The 14 patients were on PD for a mean of 7.8 ± 2.5 years. There were 8 patients with PS and 6 patients with PF. SEP was observed in 2 patients in the PS group. The risk of PS increased with the duration of PD: 57% (8/14) > 5 years, 80% (4/5) > 8 years, and 100% (3/3) > 10 years. All patients in the PS group showed both peritoneal calcifications on abdominal CT scan and poor ultra-filtration at the time of diagnoses. Conclusion Long-term PD was the important risk factor of SEP. If both peritoneal calcification on abdominal CT scan and poor ultrafiltration are observed in a patient on PD more than 5 years, a peritoneal biopsy should be performed. If PS is detected, PD should be discontinued.

scholarly journals Peritoneal dialysis related peritonitis as a risk factor for cardiovascular events

2020 ◽  
Author(s):  
Kirsten S. Hepburn ◽  
Kelly Lambert ◽  
Judy Mullan ◽  
Brendan McAlister ◽  
Maureen Lonergan ◽  
...  
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Cardiovascular Events

Calcium Use Increases Risk of Calciphylaxis: A Case-Control Study

1999 ◽  
Vol 19 (3) ◽  
pp. 248-252 ◽  
Author(s):  
James M. Zacharias ◽  
Bunny Fontaine ◽  
Adrian Fine
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Calcium Carbonate ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Laboratory Data ◽  
Case Control ◽  
Calcium Deposition ◽  
Increased Risk ◽  
Control Study

Objective To investigate the risk factors for the development of calciphylaxis in renal failure, a poorly understood and often fatal condition characterized by calcium deposition in tissues. Design Retrospective case-control study. Setting University hospital peritoneal dialysis center. Patients Eight continuous ambulatory peritoneal dialysis (CAPD) patients with calciphylaxis were identified in a 3-year period. We matched up to five controls for dialysis modality and length of time on dialysis with each case. Statistics Multivariate conditional logistic regression analysis for matched case-controls. Main Outcome Measures Laboratory data and demographics were collected as well as cumulative calcium and vitamin D ingestion over the year prior to disease onset. Results All the patients were female, versus only 38% (14/37) of controls ( p < 0.0001). While not statistically significant, a majority of the patients were diabetic [62.5% (5/8) vs 32% (12/37)]. Peak and average levels of serum calcium, phosphate, calcium x phosphate product, parathyroid hormone (PTH), albumin, iron, total iron-binding capacity (TIBC), and ferritin were not significantly different in cases compared with controls. The use of calcitriol alone or with calcium carbonate was not found to be a significant risk factor for the development of calciphylaxis. In a multivariate analysis, iron intake seemed to be protective, contrary to previous reports, while the use of calcium carbonate was associated with a strong trend to increased risk of calciphylaxis development (odds ratio = 1.029/g and 1.011/g calcium ingested per month, at 1 and 2 – 3 months prior to calciphylaxis development; p = 0.0556 and 0.0565, respectively). Conclusion These data, although limited by the small numbers of index cases, suggest that calcium ingestion is a risk factor for calciphylaxis. The increased use of calcium salts as a phosphate binder in recent years might explain the apparent increased incidence of calciphylaxis in our and other centers. The preponderance of female diabetics among cases reported elsewhere was confirmed in our study.

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