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Selected papers from the 32nd Annual Conference on Peritoneal Dialysis, February 25, 2012, San Antonio, Texas.
Authors: PMID: 23383431 [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

Patients initiating peritoneal dialysis started on two icodextrin exchanges daily.
Authors: Awuah KT, Gorban-Brennan N, Yalamanchili HB, Finkelstein FO Abstract Patients with end-stage renal disease treated with peritoneal dialysis (PD) are often put on standard one size fits all" regimens, despite having varying degrees of residual renal function (RRF). The present study reports our experience with initiation of PD using 2 icodextrin exchanges daily in patients with RRF corresponding to a weekly Kt/Vurea of at least 1.0. Peritoneal and RRF Kt/Vurea were tracked closely, and total Kt/Vurea was maintained between 1.7 and 2.0. One patient developed a rash and was changed to 3 dextrose exch...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

When should icodextrin be started to improve atherosclerosis in peritoneal dialysis patients?
Authors: Hiramatsu T, Hayasaki T, Hobo A, Furuta S, Kabu K, Tonozuka Y, Iida Y Abstract Icodextrin-based peritoneal dialysis (PD) has many advantages over glucose-based PD. The present study aimed to investigate when icodextrin should be started for better management of cardiovascular status (as defined by echocardiography findings) and residual renal function (RRF). We retrospectively analyzed 40 patients treated with continuous ambulatory PD or automated PD. The patients were divided into these groups: Group A: started icodextrin within 2 weeks after PD onset. Group B: started icodextrin 1 year after PD ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Icodextrin eliminates phosphate and ameliorates cardiac hypertrophy and valvular calcification in patients with end-stage renal disease and diabetes mellitus undergoing peritoneal dialysis.
Authors: Hiramatsu T, Hayasaki T, Hobo A, Furuta S, Kabu K, Tonozuka Y, Iida Y Abstract Among end-stage renal disease (ESRD) patients, cardiovascular disease is a common comorbidity and one of most important factors affecting clinical prognosis. Calcium deposition has been reported to correlate with plasma phosphate. Icodextrin (Ico)-based peritoneal dialysis (PD) has many advantages over glucose (Glu)-based PD. We aimed to identify factors that suppress arteriosclerosis and valvular disease in patients with ESRD and diabetes mellitus (DM) undergoing Ico-based PD. In this retrospective study, we evaluated ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Icodextrin-based continuous ambulatory peritoneal dialysis therapy effectively reduces left ventricular mass index and protects cardiac function in patients with end-stage renal disease.
Authors: Oba I, Shinozaki M, Harada K, Mori T, Kanai H Abstract Increased left ventricular mass index (LVMI) is commonly observed in patients undergoing peritoneal dialysis (PD). The present study aimed to determine the effect of icodextrin (Ico) on LVMI in PD patients with maintained residual renal function (RRF). This retrospective study included 18 patients (12 men, 6 women; average age: 62 +/- 10 years) diagnosed with indications for PD therapy and divided into two groups: those treated with Ico (Ico group) and without Ico (non-Ico group). Echocardiography was performed at the beginning of continuous a...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

The importance of residual renal function in peritoneal dialysis patients.
Authors: Diaz-Buxo JA, White SA, Himmele R Abstract Increased peritoneal clearance can compensate for reductions in renal solute removal in patients receiving peritoneal dialysis (PD); however there is abundant evidence to suggest that renal rather than peritoneal clearance contributes to clinical outcomes. We review the evidence investigating the impact of residual renal function (RRF) and peritoneal solute clearances on survival and quality of life in PD patients. We also provide a comparison of the relative contribution of RRF and peritoneal clearance to patient survival. In addition, mechanisms of surv...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

The outcome of nephrectomy in peritoneal dialysis patients.
We examined mechanical complications including incisional hernia, peritoneal leak, and wound infection or dehiscence. Among biochemical outcomes (group B only), we analyzed serum creatinine, albumin, potassium, and phosphate for 1 year pre- and post-nephrectomy. Among the 8 patients identified (4 in group A, 4 in group B), 7 underwent unilateral nephrectomy, and 1, bilateral nephrectomy. Surgery was laparoscopic in 1 patient and open in 7 patients. The approach was transperitoneal in 5 patients, and retroperitoneal in 3 patients. Incisional hernia occurred in 4 patients (2 in each group), and retroperitoneal leak was seen ...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Excellent ultrafiltration and clearance after more than 12 years of peritoneal dialysis: two case reports.
Authors: Delano BG, Joseph M, Luboa A, Richard N, Joseph AJ Abstract Because of a higher (but improving) incidence of technique failure, peritoneal dialysis (PD) is not thought to equal hemodialysis (HD) for long-term use. Other than death and transplantation, the reasons that patients leave PD include peritonitis, catheter problems, patient burnout, and (in long-duration patients) the development of encapsulating peritoneal sclerosis or ultrafiltration failure. Here, we report 2 patients who have been on continuous ambulatory PD continuously for more than 12 years, maintaining good ultrafiltration and cle...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Beneficial role of tolvaptan in the control of body fluids without reductions in residual renal function in patients undergoing peritoneal dialysis.
Authors: Mori T, Oba I, Koizumi K, Kodama M, Shimanuki M, Tanno M, Chida M, Saito M, Kiyomoto H, Miyazaki M, Ogawa S, Sato H, Ito S Abstract The V2 receptor antagonist tolvaptan has been approved for volume control in heart-failure patients in Japan. Tolvaptan increases renal blood flow, and so the present study was designed to ascertain whether tolvaptan could be a useful diuretic for volume control without reducing residual renal function (RRF) in peritoneal dialysis (PD) patients. Tolvaptan was administered in 15 PD patients (15 mg daily). Urine volume, body weight, and blood pressure were monitored Uri...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Hepatorenal syndrome treated for eight months with continuous-flow peritoneal dialysis.
Authors: Charen E, Dadzie K, Sheth N, Siktel H, Dubrow A, Harbord N, Winchester J, Ronco C, Amerling R Abstract The case documented here represents the longest course of continuous-flow peritoneal dialysis (PD) reported in the literature. A 61-year-old man with hepatorenal syndrome type 1 and ascites presented with hypotension and bright red blood per rectum and was found to be in acute renal failure with severe anemia. Continuous-flow PD was initiated, and the patient improved clinically. The patient died of a jejunal bleed 8 months later, before discharge. Acute PD or continuous-flow PD is a viable alter...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Clinical outcomes in elderly (more than 80 years of age) peritoneal dialysis patients: five years' experience at two centers.
Authors: Otowa T, Sakurada T, Nagasawa M, Shimizu S, Yokoyama T, Kaneshiro N, Konno Y, Shibagaki Y, Kimura K Abstract The proportion of elderly people requiring renal replacement therapy has been increasing in Japan. Although several studies have shown the benefits of peritoneal dialysis (PD) in the elderly, few have reported on outcomes, including prognosis, in elderly PD patients, especially those more than 80 years of age. The purpose of the present study was to evaluate clinical outcomes in elderly (more than 80 years of age) PD patients. We retrospectively evaluated the medical records of elderly PD p...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

The experience of dialysis therapy among younger adults.
Authors: Yalamanchili HB, Murray P, Awuah KT, Harden P, Finkelstein SH, Finkelstein FO Abstract The present study was undertaken to examine the experience of younger dialysis patients with end-stage renal disease (ESRD) care. Structured tape-recorded interviews focusing on perceptions of ESRD care and how that care could be improved were initially conducted with 25 dialysis patients [16 on conventional hemodialysis (HD), 6 on nocturnal in-center HD, 2 on home peritoneal dialysis (PD), and 1 on home HD]. The mean age of the patients was 43.8 +/- 12.2 years, and their mean dialysis duration was 4.6 +/- 3. Oy...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Changing the paradigm from contraction of peritoneal dialysis programs to increasing prevalent peritoneal dialysis numbers.
Authors: Cross J, Davenport A Abstract Compared with other European and North American countries, the United Kingdom traditionally had proportionally more dialysis patients treated by peritoneal dialysis. However as in many economically developed countries, peritoneal dialysis numbers have fallen in the United Kingdom, particularly since the early 2000s. In an effort to increase home-based dialysis therapies, the U.K. Department of Health introduced a new system of reimbursement tariffs favoring peritoneal dialysis and home hemodialysis compared with standard hospital-based hemodialysis. Here, we report ho...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Hypoalbuminemia in peritoneal dialysis patients.
Authors: Guest S Abstract Clinicians caring for patients on peritoneal dialysis (PD) have relied on a variety of laboratory measures to assess the health of patients and their response to treatment. Traditionally, serum albumin has been an indicator of nutrition status and has therefore been included in monthly blood testing in most centers. The development of hypoalbuminemia in dialysis patients has been associated with increased mortality and often leads to interventions such as trials of nutritional supplements. In PD, hypoalbuminemia combined with ongoing losses of protein into effluent raise particula...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Relationship between alkaline phosphatase and all-cause mortality in peritoneal dialysis patients.
We examined the association of serum AlkPhos with all-cause mortality in our PD patients. The study enrolled 90 PD patients beginning in 1995. On enrollment, demographics and clinical and biochemical data were recorded. Patients were followed to September 2011. Mean age of the enrollees was 52 years, with 61% being women, and most (81%) being of African descent. Mean and median AlkPhos were 135 U/L and 113 U/L respectively. Mean and maximum follow-up were 2.61 and 16 years respectively. As expected, AlkPhos correlated directly with serum intact parathyroid hormone (r = 0.36, p = 0.003). In a Cox multivariate regression ana...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - November 19, 2015 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research