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Myocardial dysfunction and pulmonary edema post parathyroidectomy: the role of hypocalcemia.
Authors: Lekas P, Goldenstein PT, Bargman JM Abstract Cardiac disease is a common cause of morbidity in dialysis patients. Traditional and unique risk factors have both been incriminated in the pathogenesis of abnormal cardiac function in these patients. In the present report, we focus on the role of hypocalcemia post parathyroidectomy as a cause of abnormal myocardial function leading to pulmonary edema in a young peritoneal dialysis patient with angiographically-proven normal coronary arteries. The pulmonary edema reversed with correction of the hypocalcemia. Hypocalcemia should be added to the different...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Bowel bacterial overgrowth as another cause of malnutrition, inflammation, and atherosclerosis syndrome in peritoneal dialysis patients.
Authors: Aguilera A, Gonzalez-Espinoza L, Codoceo R, Jara Mdel C, Pavone M, Bajo MA, Del Peso G, Celadilla O, Martínez MV, López-Cabrera M, Selgas R Abstract Bowel bacterial overgrowth syndrome (BBOS) is an important cause of gastrointestinal (GI) abnormalities. Proinflammatory cytokines (PICs) are excessively produced and accumulate because of kidney failure in dialysis patients who experience chronic infections such as BBOS. We explored the association between GL function, BBOS, and the malnutrition, inflammation, and atherosclerosis (MIA) syndrome. We studied GI malabsorption and maldigestion by analy...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Prothrombin fragment 1 + 2 (F1 + 2) in effluent is a useful marker for peritoneal permeability in peritoneal dialysis patients using neutral dialysate.
Authors: Sakurada T, Kojima S, Oishi D, Koitabashi K, Miyamoto M, Shirai S, Shibagaki Y, Yasuda T, Sato T, Kimura K Abstract To clarify the influence of neutral dialysate (ND) on peritoneum, we examined changes in peritoneal permeability and in various markers of the coagulation and fibrinolytic system in effluent and the correlations between peritoneal permeability and those markers in peritoneal dialysis (PD) patients using ND. We evaluated 14 patients (8 men, 6 women; mean age: 58.6 +/- 12.0 years) who started PD using ND. The peritoneal equilibration test (PET) was performed to assess dialysate-to-plas...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

What does the dialysate level of matrix metalloproteinase 2 tell us?
Authors: Ertilav M, Timur O, Hür E, Bozkurt D, Nar H, Kologlu T, Sen S, Duman S Abstract Long-term peritoneal dialysis leads to encapsulating peritoneal sclerosis (EPS), which is a rare but often fatal complication. The pathogenesis of EPS is characterized by increased inflammation, neoangiogenesis, epithelial-mesenchymal transition (EMT), and fibrosis. Matrix metalloproteinase 2 (MMP-2), which degrades type IV collagen, plays an important role in pathogenesis. Clinical trials report that dialysate levels of MMP-2 can be used as an early marker of peritoneal sclerosis. We aimed to determine the associatio...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

DNA microarray analysis of the epithelial-mesenchymal transition of mesothelial cells in a rat model of peritoneal dialysis.
In conclusion, a rat model of peritoneal injury by GDPs induced mesothelial cells to redifferentiate and proliferate, with upregulation of Cdc42, the Evl Ena/VASP, and Arp2/3, suggesting that GDPs induce fibrous thickening of the peritoneal membrane by redifferentiation of mesothelial cells, resulting in hyperpermeability of the peritoneum. PMID: 22073821 [PubMed - indexed for MEDLINE] (Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis)
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Influence of osmotic and oncotic factors on gentamicin and insulin transport across the peritoneal membrane in vitro.
Authors: Grzelak T, Wojciechowska K, Szary B, Czyzewska K Abstract Glucose or its polymer is usually added to dialysis solution for the development of sufficient ultrafiltration during peritoneal dialysis. The aim of the present study was to determine the influence of glucose and icodextrin on the transport of gentamicin and insulin from the mesothelial to the interstitial side of the peritoneal membrane. Transfer values are expressed as a coefficient of diffusive permeability, P, in centimeters per second. Each of the molecules was tested in 3 series of experiments using rabbit parietal peritoneum, a modi...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

GDPs and AGEs: impact on cardiovascular toxicity in dialysis patients.
Authors: Himmele R, Sawin DA, Diaz-Buxo JA Abstract Glucose degradation products (GDPs) are highly reactive precursors of advanced glycation end-products (AGEs). High glucose concentrations, GDPs, and AGEs can activate specific pathways, including inflammatory and oxidative stress response pathways, which may adversely affect the cardiovascular system. This review discusses the impact and possible mechanisms of action of GDPs and AGEs with regard to cardiovascular toxicity in chronic kidney disease patients. The AGE-RAGE pathway appears to be particularly important in the pathogenesis of cardiovascular dis...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Markers of inflammation before and during peritoneal dialysis.
In this study, we compared changes in inflammatory markers-C-reactive protein (CRP), pentraxin 3 (PTX3), serum component of amyloid A (SAA), and procalcitonin (PCT)-in 182 subjects: 69 from the general population (GP), 47 with CKD, 19 with an implanted intra-abdominal catheter for peritoneal dialysis ("prePD"), and 47 on peritoneal dialysis (PD). These were the results [median (95% confidence interval)] for the GP CKD, prePD, and PD groups respectively: CRP: 1.40 mg/L (1.15-2.10 mg/L), 5.30 mg/L (3.04-8.06 mg/L), 3.33 mg/L (2.15-12.58 mg/L), 7.25 mg/L (4.43-15.16 mg/L). SAA: 3.10 mg/L (2.90-3.53 mg/L), 7.77 mg/L (4.17-15.8...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Inflammation markers, chronic kidney disease, and renal replacement therapy.
Authors: Lavín-Gómez BA, Palomar-Fontanet R, Gago-Fraile M, Quintanar-Lartundo JA, Gómez-Palomo E, González-Lamuño D, García-Unzueta MT, Arias-Rodríguez MA, Gómez-Gerique JA Abstract Chronic kidney disease (CKD) is associated with a proinflammatory state and an excess of cardiovascular risk. In this work, we describe changes in inflammatory markers-C-reactive protein (CRP), pentraxin 3 (PTX3), serum component of amyloid A (SAA), and procalcitonin (PCT)--in CKD patients compared with a control group of subjects with a normal estimated glomerular filtration rate (eGFR). Blood samples were obtained fr...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Microbiological profile of peritoneal dialysis peritonitis and predictors of hospitalization.
Authors: Quintanar Lartundo JA, Palomar R, Dominguez-Diez A, Salas C, Ruiz-Criado J, Rodrigo E, Martinez De Francisco AL, Arias M Abstract Peritonitis, the major complication of peritoneal dialysis (PD), is associated with high morbidity and mortality. It is a major cause of hospitalization and transfer to hemodialysis. In the present study, we aimed to identify predictors of hospitalization in PD-related peritonitis and to examine its microbiology profile over time in our unit to determine the best therapeutic approach. We studied all peritonitis episodes that occurred in a 6-year period (January 1, 2004,...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

The utility of prolonged culture of peritoneal dialysis effluent in the diagnosis and management of peritonitis.
Authors: Siccion Z, Poutanen SM, Perl J, Bargman JM Abstract In this prospective study we examined the effect of prolonging cultures of peritoneal dialysis fluid to 21 days. The extended culture period did not lead to any new or clinically important findings, although late culture findings were obtained in a small number of cases. Prolonged culture of the effluent does not appear to be necessary, although it can lead to extended duration of antibiotic therapy if time on therapy is guided by the first negative effluent culture. PMID: 22073827 [PubMed - indexed for MEDLINE] (Source: Advances in Perit...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Xenophilus aerolatus Peritonitis in a six-year-old boy on maintenance eritoneal dialysis.
Authors: Tsampalieros AK, Gooden M, Thampi N, Yau YC, Harvey EA Abstract Peritonitis remains a significant complication of peritoneal dialysis (PD). Although most patients can be treated successfully with antibiotics and continue PD, the poorest outcomes are noted in patients with peritonitis secondary to gram-negative organisms, which may lead to temporary or permanent technique failure. Biofilm formation may result in. failure of appropriate antibiotic therapy to eradicate infection, necessitating catheter replacement or a switch to hemodialysis. Here, we report the first case of gram-negative peritoniti...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Tuberculosis in peritoneal dialysis patients in an endemic region.
Authors: Gursu M, Tayfur F, Besler M, Kaptanogullari O, Kucuk M, Aydin Z, Basturk T, Uzun S, Karadag S, Tatli E, Sumnu A, Ozturk S, Kazancioglu R Abstract Tuberculosis has been paid more attention in recent years because of the increase in the number of patients with immune suppression-such as those with renal failure. In the present study, we analyzed patients on peritoneal dialysis (PD) in our city to determine the prevalence and clinical characteristics of tuberculosis in those patients. Patients who had been on a PD program for more than 3 months were reviewed. Demographic characteristics, primary rena...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Seventeen years' experience of surgical options for encapsulating peritoneal sclerosis.
In conclusion, we present favorable outcomes with EPS surgery in 181 patients encountered over a period of 17years. These data reconfirm that surgical treatment is essential for EPS patients. Encapsulating peritoneal sclerosis may no longer be a fatal complication and can be improved with accurate diagnosis and treatment. PMID: 22073830 [PubMed - indexed for MEDLINE] (Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis)
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Testing a single monthly dose of darbepoetin alpha to maintain hemoglobin levels in continuous ambulatory peritoneal dialysis patients.
Authors: Suzuki H, Inoue T, Watanabe Y, Kikuta T, Sato T, Tsuda M, Uchida K Abstract The newly developed erythropoiesis agent darbepoetin alpha (DA) allows for once-monthly dosing in the treatment of anemia in patients on dialysis. This dosing schedule has prompted some studies to examine the efficacy of DA in patients on continuous ambulatory peritoneal dialysis (CAPD). In the present study, we assessed whether intravenous (IV) administration of DA once monthly is effective for maintaining hemoglobin levels near 10.5 g/dL in patients on CAPD. This single-center prospective cohort study included 52 clinica...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research