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Peritoneal Phosphate Clearance: The Effect of Peritoneal Dialysis Modality and Peritoneal Transport Status.
Authors: Davenport A Abstract Hyper- and hypophosphatemia are recognized risk factors for all-cause mortality in peritoneal dialysis (PD) patients. Recent changes have now focused PD solute clearance targets on urea clearance, rather than on larger solutes, including phosphate. We therefore studied peritoneal phosphate clearance in a cohort of PD patients to determine which factors were clinically relevant.We reviewed results from 451 adult PD patients who were attending for their first assessment of peritoneal membrane function [31.2% treated by continuous ambulatory PD (CAPD); 24.2.%, by automated PD (AP...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

No Relation Between Peritoneal Fibrosis and Free Water Transport in a Rat Model.
Authors: Krediet RT, Vlahu CA, Barreto DL, Struijk DG Abstract Free water transport (FWT) during peritoneal dialysis (PD) can easily be measured by Na+ kinetics. In long-term PD, FWT might reflect peritoneal fibrosis, but morphologic or functional relationships have not been investigated. Nonconventional dialysis solutions might be associated with better preservation of peritoneal tissues and function. We developed a long-term peritoneal exposure model in rats with impaired kidney function and investigated peritoneal morphology and function in that model after exposure to conventional and nonconventional s...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Peritoneal Dialysis Preserves Residual Renal Function and Reduces Oxidative Stress During the Initial Period of Dialysis Therapy.
Authors: Ueda A, Nagai K, Hirayama A, Saito C, Yamagata K Abstract Patients with end-stage renal failure are believed to have an increase of oxidative stress. However, any variation in oxidative stress between patients receiving hemodialysis (HD) and those receiving peritoneal dialysis (PD) are still unclear. In the present study, we investigated variation in oxidative stress in 54 HD and 23 PD patients during their initial dialysis period.We measured serum pentosidine and indoxylsulfuric acid as markers of oxidative stress every 6 months from the start of the dialysis therapy to 30 months of treatment. Se...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Successful Peritoneal Dialysis Catheter Placement in a New End-Stage Renal Disease Patient with Combined Antiphospholipid Syndrome and Factor XI Deficiency.
We present the case of a 68-year-old woman with combined antiphospholipid syndrome and factor XI deficiency, with chronic prolongation of activated partial thromboplastin time that was not correctable with fresh-frozen plasma (FFP).The patient had a history of stroke, but was not on antiplatelet therapy because of mucocutaneous bleeding events. She had progressive renal failure attributed to her autoimmune disease, and a decision was made to pursue peritoneal dialysis (PD) when she reached end-stage kidney disease. She was admitted to the hospital the day before her planned PD catheter placement and was transfused with FFP...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Early Postoperative Complications of Peritoneal Dialysis Catheter Surgery Conducted by Nephrologists: A Single-Center Experience Over an Eight-Year Period.
Authors: Osako K, Sakurada T, Koitabashi K, Sueki S, Shibagaki Y Abstract The results of several recent studies indicate that the practice of peritoneal dialysis catheter (PDC) insertion by nephrologists is safe. However, few studies have addressed the important issue of safety in surgeries related to PD, including PDC removal and other types of surgery. In the present study, we aimed to verify whether the incidence of early postoperative complications for surgical procedures related to PD and performed by nephrologists meets the audit standards of clinical practice guidelines for peritoneal access.Between...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Long-Term Prognosis of Peritoneal Dialysis Patients with a Re-embedded Catheter.
Authors: Sakurada T, Kaneshiro N, Taki Y, Kojima S, Koitabashi K, Sueki S, Shibagaki Y Abstract Upon peritoneal dialysis (PD) discontinuation in frail patients, we have re-embedded the catheter and left it subcutaneously buried. However, we have not evaluated the long-term prognosis of those patients after the procedure or the complications associated with buried catheters. We therefore aimed to clarify the long-term prognosis of patients with a re-embedded catheter and to identify any associated complications.The outcomes of 10 patients having a catheter that was re-embedded between February 2010 and May ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Incisional Hernia After Peritoneal Dialysis Catheter Placement in a Patient on Sirolimus.
We report a rare occurrence of incisional hernia attributable to internal wound dehiscence after PD catheter placement in a patient on sirolimus.A 34-year-old Latino American man was started on PD training 4 weeks after placement of a PD catheter. Soon after completing training, he developed a large soft bulge close to the PD catheter, with expansile cough impulse suggestive of an incisional hernia filled with peritoneal dialysate. The size of the bulge would decrease after the dialysate was drained. No external leak of dialysate was evident along the exit site.Because of the size of the hernia and the history of it fillin...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Peritoneal Dialysis in Patients with Abdominal Surgeries and Abdominal Complications.
Authors: Aziz F, Chaudhary K Abstract Peritoneal dialysis (PD) is an excellent treatment option for the patients with end-stage renal disease, having been shown to yield improved patient satisfaction and economic benefit. Many surgeons and physicians believe that patients with prior abdominal surgeries or other abdominal complications are not viable candidates for PD and that prevalent PD patients needing abdominal surgery should be switched to hemodialysis. The purpose of the present review is to address those misconceptions.Our review of literature shows that, when appropriately planned, PD can still be ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Diagnostic Dilemma: A Case of Endogenous Peritonitis.
Authors: Edo-Ohonba O, Khanna R, Misra M Abstract Endogenous peritonitis resulting from inflammation or perforation of an abdominal viscus-a result, for example, of diverticulitis, cholecystitis, or acute appendicitis-can be a complication in patients undergoing peritoneal dialysis (PD), with significant morbidity and a high incidence of catheter loss.Here, we describe an end-stage renal disease patient on PD who presented with acute abdominal pain and who was diagnosed with uncomplicated PD peritonitis. His clinical course was complicated by development of eosinophilic peritonitis because of an allergy to...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Bleeding Peritoneum During Peritoneal Dialysis: A Case of Early Encapsulating Peritoneal Sclerosis?
Authors: Banoth P, Khanna R Abstract Complications of peritoneal dialysis (PD) create a significant burden for patients and providers. Some complications, such as infections and leaks, are preventable or easily treatable; however, potential fatal complications, such as encapsulating peritoneal sclerosis (EPS), cost patients their lives. Here, we present the case of a PD patient who might have had early, subtle, but ominous symptoms and signs of EPS, diagnosed in its early stages and promptly managed.A 57-year-old man who had been receiving PD for 6 years began having recurrent episodes of abdominal pain, b...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Antibiotic Prophylaxis in Peritoneal Dialysis Patients.
Authors: Dhruve MJ, Bargman JM Abstract Peritonitis is an important cause of morbidity, mortality, and technique failure in patients on peritoneal dialysis (PD). The most effective approach to peritonitis is prevention, which includes careful patient training and follow-up. Although peritonitis as a result of contiguous spread of bacteria or fungi during invasive procedures, or as a result of seeding of the peritoneum during bacteremia, is uncommon, the likelihood of such spread is often predictable, and the risk can be mitigated with antibiotic prophylaxis. Here, we describe the rationale for, and approac...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis: What, Who, Why, and How? Review and Case Study.
This article uses a practical case study to highlight the intricacies of the calculations behind PD prescription to achieve clearance goals. The objective is to demonstrate that all modalities of PD should be considered in the spectrum of clinical tools for achieving adequate dialysis. PMID: 29668434 [PubMed - in process] (Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis)
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Pilot Study: Improving Patient Outcomes with Healing Touch.
Authors: Hendricks K, Wallace KF Abstract Healing Touch therapies use a practitioner's intentional placement of hands to influence the patient's energy fields to promote self-healing. In the changing climate of health care, in which the patient experience increasingly drives reimbursements, it is vital to find unique and meaningful ways beyond traditional medical therapies to ensure positive patient experiences. To that end, our peritoneal dialysis clinic staff adopted Jean Watson's theoretical framework, by which patients are treated as whole unique individuals with a "multidimensional system of energy, w...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Predictive Factors for Withdrawal from Peritoneal Dialysis: A Retrospective Cohort Study at Two Centers in Japan.
Authors: Taki Y, Sakurada T, Koitabashi K, Imai N, Shibagaki Y Abstract Peritoneal dialysis (PD) is recognized as an excellent method of dialysis because the therapy is gentle, continuous, and cost-effective. However, a large number of patients must unfortunately transfer from PD to hemodialysis because of peritonitis or fluid overload in the early phase after PD initiation. In the present study, we reviewed clinical indicators before PD initiation to try to identify predictive factors for early withdrawal from PD.For this retrospective cohort study at two hospitals between March 2003 and October 2016, we ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Combination Therapy with Peritoneal Dialysis and Hemodialysis from the Initiation of Renal Replacement Therapy Preserves Residual Renal Function and Serum Albumin.
Authors: Ueda A, Nagai K, Hirayama A, Saito C, Yamagata K Abstract Peritoneal dialysis (PD) and hemodialysis (HD) combination therapy is considered for the improvement of ultrafiltration failure and uremic symptoms in PD patients with loss of residual renal function (RRF). However, a rapid decline in RRF is one of the critical drawbacks to such therapy. In contrast, we started patients on combination therapy as a proactive option at the initiation of dialysis.In patients on HD (n = 52), PD (n = 21), and combination dialysis (n = 13), we studied changes in RRF, blood parameters, and peritoneal permeability ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research