Peritoneal Dialysis
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2021 ◽  
Vol 41 ◽  
pp. 101133
Lei Zhou ◽  
Xiaoyang Wang ◽  
Xiaojiang Zhan ◽  
Xiaoran Feng ◽  
Niansong Wang ◽  

2021 ◽  
Vol 33 ◽  
pp. 99-101
Walter Lunardi ◽  
Sonia Bianchi

Introduction: Exit-site (ES) and tunnel infections are the main infectious complication in peritoneal dialysis (PD); they also are risk factors for the development of peritonitis, for catheter removal and for dialysis drop-out. Up to now, besides the recommendations of the Guidelines there is no uniformity, nor on the classification, nor on the treatment strategies of the infected ES. Recent experiences are reported with alternative types of dressings that aim to reduce the incidence of ES infection and consequently of the subcutaneous tunnel. Methods: The Tuscan group conducted a retrospective observational study of 10 patients on PD who, showing signs of a suspected but not ascertained infection (negative microbiological culture), such as redness, edema, secretion, scab, had been medicated with silver-ions releasing Exit-Pad Ag. The aim was to evaluate and classify the evolution of ES lesions, in order to confirm the preventive efficacy of the silver-ions releasing dressing compared to the traditional ones. Results: After 4 weeks of treatment with Exit Pad Ag maintained in situ for 72 h, 6 patients no longer had any signs of inflammation. In 2 cases, several weeks of treatment were necessary to achieve a complete recovery, while in 2 other cases the signs of inflammation became negative in less time (2 weeks, 1 week). Conclusions: With the utilization of an alternative dressing such as Exit-Pad Ag on PD patients showing early signs of inflammation, the onset of a true infection can be prevented, with a progressive improvement of the ES.

2021 ◽  
Vol 4 (3) ◽  
pp. 193-226
Christian Verger ◽  
Max Dratwa

Informations concernant cette traductionDans le cadre d’un accord de partenariat entre l’ISPD et le RDPLF, le RDPLF est le traducteur français officiel des recommandations de l’ISPD. La traduction ne donne lieu à aucune compensation financière de la part de chaque société et le RDPLF s’est engagé à traduire fidèlement le texte original sous la responsabilité de deux néphrologues connus pour leur expertise dans le domaine. Avant publication le texte a été soumis à l’accord de l’ISPD. La traduction est disponible sur le site de l’ISPD et dans le Bulletin de la Dialyse à Domicile.Le texte est, comme l’original, libremement téléchargeable sous licence copyright CC By 4.0 traduction est destinée à aider les professionnels de la communauté francophone à prendre connaissance des recommandations de l’ISPD dans leur langue maternelle. Toute référence dans un article doit se faire au texte original en accès libre :Peritoneal Dialysis International Dans les articles rédigés pour des revues françaises, conserver la référence à la version originale anglaise ci dessus, mais ajouter «version française"»TraducteursDr Christian Verger, néphrologue, président du RDPLFRDPLF, 30 rue Sere Depoin, 95300 Pontoise – FranceProfesseur Max Dratwa, néphrologueHôpital Universitaire Brugmann – Bruxelles – Belgique

2021 ◽  
Vol 9 (26) ◽  
pp. 7682-7692
Xin-Wang Zhu ◽  
Cong-Xiao Zhang ◽  
Tian-Hua Xu ◽  
Guan-Nan Jiang ◽  
Li Yao

2021 ◽  
Vol 8 ◽  
Nirong Gong ◽  
Chun Zhou ◽  
Jianxia Hu ◽  
Xiaohong Zhong ◽  
Zhixiu Yi ◽  

Objective: This study aims to investigate the relationship between dietary salt intake and residual renal function in peritoneal dialysis (PD) patients.Methods: The daily salt intake of the patients was calculated based on a 3 day dietary record. Sixty-two patients were divided into three groups: 33 patients in the low salt intake group (salt intake <6.0 g/day), 17 in the medium salt intake group (salt intake 6.0 to <8.0 g/day), and 12 in the high salt intake group (salt intake ≥8.0 g/day). Regular follow-up was conducted every 3 months. Urine volume, peritoneal ultrafiltration volume, and other clinical indicators were recorded. Biochemical indexes were detected to evaluate the changes in residual renal function and peritoneal function during follow-up.Results: A positive correlation between dietary sodium intake and sodium excretion was found. During 12-month follow-up, a decrease of residual renal function showed a significant difference among the three groups (p = 0.041) (15.3 ± 27.5 vs. 12.5 ± 11.5 vs. 32.9 ± 18.4 L/W/1.73 m2 in the low-, medium-, and high salt intake groups, respectively). Consistently, a higher decline of residual renal function (adjusted β, 20.37; 95% CI, 2.83, 37.91) was found in participants with high salt intake (salt intake ≥8 g/day) compared with those in non-high salt intake.Conclusion: Our study showed that the sodium excretion by peritoneal dialysis was positively correlated with dietary sodium intake in PD patients. The high salt intake diet (salt intake ≥8 g/day) may lead to a faster decline of residual renal function in PD patients.

2021 ◽  
pp. 281-285
Gaetano Alfano ◽  
Monica Frisina ◽  
Niccolò Morisi ◽  
Elisabetta Ascione ◽  
Francesco Fontana ◽  

<i>Staphylococcus aureus</i> is a Gram-positive bacterium commonly associated with severe infections in hospitalized patients. <i>S. aureus</i> produces many virulence factors leading to local and distant pathological processes. Invasiveness of <i>S. aureus</i> generally induces metastatic infections such as bacteremia, infective endocarditis, osteomyelitis, arthritis, and endophthalmitis. Peritoneal localization from extra-abdominal infection can be a potential consequence of <i>S. aureus</i> infection. Two cases of metastatic peritonitis have been described in patients on peritoneal dialysis with concomitant peripheral vascular catheter-related bloodstream infection. We reported a case of peritoneal metastatic infection caused by methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) in a patient on maintenance hemodialysis. A 37-year-old man was admitted with fever and chill due to jugular central vascular catheter (CVC)-related bloodstream infection caused by MRSA<i>.</i> CVC was placed after switching the patient from peritoneal dialysis to hemodialysis for scarce adherence to fluid restriction. Detection of MRSA on the peritoneal effluent combined with a total white blood cell count of 554 cells/mm<sup>3</sup> prompted the diagnosis of satellite MRSA peritonitis. Antibiotic treatment with daptomycin and simultaneous CVC and peritoneal catheter removal resolved the infectious process. No further metastatic localizations were detected elsewhere. In conclusion, <i>S. aureus</i> can induce metastatic infections far from the site of primary infection. As reported in this case, peritonitis can be secondary to the hematogenous dissemination of <i>S. aureus</i> especially in hospitalized patients having a central line.

2021 ◽  
pp. 089686082110396
Clémence Béchade ◽  
Antoine Lanot ◽  
Sonia Guillouët ◽  
Maxence Ficheux ◽  
Annabel Boyer ◽  

Background: Diabetic patients often have physical impairment that could lead to manipulation errors in peritoneal dialysis (PD) and touch contamination. Nurse assistance in diabetic PD patients is known to help prevent peritonitis. We made the hypothesis that this lower risk of peritonitis was observed thanks to prevention of breach in aseptic procedure. We evaluated the impact of nurse-assisted PD on specific causes of peritonitis, especially on peritonitis due to a breach in aseptic procedure. Methods: This was a retrospective observational study of the data from the French Language Peritoneal Dialysis Registry. All diabetic patients older than age 18 years starting PD in France between 1 January 2012 and 31 December 2015 were included in the study. The event of interest was the first peritonitis event due to a breach in aseptic procedure. Death, kidney transplantation and peritonitis due to another mechanism were considered as competing events. We examined the association of the covariates with all the possible outcomes using a subdistribution hazard model developed for survival analysis in the presence of competing risks. Results: Four thousand one hundred one diabetic patients incident in PD were included in the study. At least one peritonitis event occurred in 1611 patients over the study period. A breach in aseptic procedure was reported in 441/1611 cases (27.3%): 209/575 (36.3%) in the self-care PD group, 56/217 (25.8%) in the family-assisted PD group and 176/819 (21.5%) in the nurse-assisted PD group. Both nurse and family assistance were associated with a lower risk of peritonitis due to breach in aseptic procedure in bivariate analysis. After adjustment on age, modified Charlson index, sex and diabetic nephropathy, patients treated by nurse-assisted PD (subdistribution hazard ratio (sd-HR) 0.52, 95% confidence interval (CI) 0.40–0.67) and those treated by family-assisted PD (sd-HR 0.70, 95% CI 0.51–0.95) had a lower likelihood of peritonitis due to a connection error compared to self-care PD in multivariate analysis. The modality of assistance was not associated with other causes of peritonitis in the multivariate analysis. Conclusion: While both nurse-assisted PD and family-assisted PD were associated with lower risk of peritonitis due to a breach in aseptic procedure compared to self-care PD in our study, the protective effect was greater with nurse assistance.

2021 ◽  
Vol 4 (3) ◽  
Max Dratwa ◽  
Christian Verger

We are pleased to announce with this new issue of the Bulletin de la Dialysis à Domicile (BDD), the bilingual journal of the RDPLF, the recent signing of a partnership agreement between the International Society of Peritoneal Dialysis (ISPD) and the RDPLF. The RDPLF now officially ensures the French translation of international open access recommendations published by the ISPD. The goal is to allow better distribution to French-speaking professionals who have difficulty accessing English-language medical literature.   In addition a webinar in French will be organized on an annual basis, in collaboration with the ISPD which will ensure logistics management. The dates will be communicated later. We warmly thank Professor Xueqing Yu, President of ISPD, and the members of the ISPD Board, for this agreement which will promote communication between health professionals who speak different languages. Max Dratwa, Christian Verger and the editorial committee.   Contents of this issue: - Assessment of Patient Experience of Care in Home Dialysis around the World: Enhancing the Patient’s Voice in Home Dialysis Care and Research - Narrative interviews to assess quality of life in Peritoneal Dialysis -Chylous peritonitis in peritoneal dialysis - Peritoneal dialysis in indigenous Australians - French translation of ISPD Recommendations for the evaluation of peritoneal membrane dysfunction in adults: classification, measurement, interpretation and rationale for intervention - Home dialysis and Covid-19 in French speaking countries (RDPLF data-base) - Literature review (in French only) by the Young Nephrologists Club      

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