-
Peritoneal Dialysis International :... Nov 2021
Topics: Humans; Kidney Failure, Chronic; Peritoneal Dialysis; Peritonitis
PubMed: 34743614
DOI: 10.1177/08968608211054374 -
Peritoneal Dialysis International :... Jul 2020
Review
Topics: Acute Kidney Injury; COVID-19; Comorbidity; Coronavirus Infections; Female; Global Health; Humans; Infection Control; Male; Nephrology; Occupational Health; Pandemics; Patient Safety; Peritoneal Dialysis; Pneumonia, Viral; Risk Assessment; Societies, Medical
PubMed: 32552550
DOI: 10.1177/0896860820931235 -
Reviews in Cardiovascular Medicine Sep 2021Heart failure is a significant health problem worldwide. Despite all the new therapies available nowadays, many patients will reach advanced stages of the disease.... (Review)
Review
Heart failure is a significant health problem worldwide. Despite all the new therapies available nowadays, many patients will reach advanced stages of the disease. Diuretic resistance, kidney dysfunction, and refractory congestion, all highly prevalent in advanced heart failure, frequently complicate the situation, making it more challenging to manage. Ultrafiltration through hemodialysis or peritoneal dialysis can be alternative options to treat fluid overload. Peritoneal dialysis has gained increased interest in the last decades due to several benefits such as functional class improvement, reduction in hospital admissions, improvement in quality of life, and even a reduction in mortality shown by numerous cohort studies. However, the majority of the studies were observational and with a limited number of patients. In addition, the optimal timing for the initiation of this type of therapy and the subgroup of patients who would benefit the most from it is unknown. Hence, randomized controlled trials in this subject are urgently needed. We aim to review the contemporary evidence of peritoneal dialysis in patients with heart failure and diuretic resistance across the spectrum of ventricular dysfunction and degree of renal dysfunction.
Topics: Heart Failure; Humans; Kidney; Peritoneal Dialysis; Quality of Life; Ventricular Dysfunction
PubMed: 34565067
DOI: 10.31083/j.rcm2203075 -
Blood Purification 2021Peritoneal dialysis (PD) is underutilized in many parts of the world despite pro-PD health policies. The physical and cognitive demands of PD means that over half of... (Review)
Review
BACKGROUND
Peritoneal dialysis (PD) is underutilized in many parts of the world despite pro-PD health policies. The physical and cognitive demands of PD means that over half of eligible patients require some form of assistance. As such, many countries now offer assisted PD (aPD) programs to help patients start or stay on PD as opposed to in-center hemodialysis (HD). In order to evaluate the potential scope of aPD, it is important to review the outcomes and cost considerations of aPD.
SUMMARY
We reviewed available data from different countries and regions for health outcomes between aPD and in-center HD, with a focus on quality of life (QoL), mortality, hospitalization, and technique survival. We also evaluated studies discussing the overall costs of delivering aPD, including training, operating costs, and indirect costs and compared these to in-center HD costs for the same regions. Key Messages: aPD patients are older and more frail than either self-care PD patients and many in-center HD patients. We found no evidence for any difference in QoL, mortality, or hospitalization between aPD and in-center HD after adjustment for these differences. There is some evidence for an association between nurse assistance and improved technique survival as compared to family assistance or self-care PD. Despite increased cost of providing assistance in PD, it is still significantly less expensive than in-center HD in Western Europe and Canada.
Topics: Hospitalization; Humans; Kidney Failure, Chronic; Outcome Assessment, Health Care; Peritoneal Dialysis; Quality of Life
PubMed: 33626546
DOI: 10.1159/000512839 -
Journal of Nephrology Sep 2023This systematic review summarises the stability of less commonly prescribed antibiotics in different peritoneal dialysis solutions that could be used for... (Review)
Review
BACKGROUND
This systematic review summarises the stability of less commonly prescribed antibiotics in different peritoneal dialysis solutions that could be used for culture-directed therapy of peritonitis, which would be especially useful in regions with a high prevalence of multidrug antibiotic-resistant strains.
METHODS
A literature search of Medline, Scopus, Embase and Google Scholar for articles published from inception to 25 January, 2023 was conducted. Only antibiotic stability studies conducted in vitro and not recently reviewed by So et al. were included. The main outcomes were chemical, physical, antimicrobial and microbial stability. This protocol was registered in PROSPERO (registration number CRD42023393366).
RESULTS
We screened 1254 abstracts, and 28 articles were included in the study. In addition to those discussed in a recent systematic review (So et al., Clin Kidney J 15(6):1071-1078, 2022), we identified 18 antimicrobial agents. Of these, 9 have intraperitoneal dosing recommendations in the recent International Society for Peritoneal Dialysis (ISPD) peritonitis guidelines, and 7 of the 9 had stability data applicable to clinical practice. They were cefotaxime, ceftriaxone, daptomycin, ofloxacin, and teicoplanin in glucose-based solutions, tobramycin in Extraneal solution only and fosfomycin in Extraneal, Nutrineal, Physioneal 1.36% and 2.27% glucose solutions.
CONCLUSIONS
Physicochemical stability has not been demonstrated for all antibiotics with intraperitoneal dosing recommendations in the ISPD peritonitis guidelines. Further studies are required to determine the stability of antibiotics, especially in icodextrin-based and low-glucose degradation products, pH-neutral solutions.
Topics: Humans; Anti-Bacterial Agents; Dialysis Solutions; Glucose; Icodextrin; Peritoneal Dialysis; Peritonitis
PubMed: 37548827
DOI: 10.1007/s40620-023-01716-7 -
Blood Purification 2021For dialysis patients with end-stage kidney disease, infectious diseases (IDs) are the most common causes of hospitalization and death. However, the association between... (Observational Study)
Observational Study
INTRODUCTION
For dialysis patients with end-stage kidney disease, infectious diseases (IDs) are the most common causes of hospitalization and death. However, the association between dialysis modality and IDs remains unclear. We aimed to determine the association between the dialysis modality and IDs.
METHODS
This retrospective observational cohort study compared the emergency hospitalization and mortality for IDs between peritoneal dialysis (PD) and hemodialysis (HD) patients. After propensity score matching, the risk factors were evaluated by the Cox proportional hazard regression models.
RESULTS
A total of 260 patients were compared - 130 of 135 PD and 130 of 706 HD patients. When the modality-specific ID (PD-catheter ID/peritonitis- and vascular access-related ID) was excluded, no significant differences in emergency hospitalization and mortality rates for overall IDs were observed between the PD and HD groups. Serum ferritin (HR, 2.17; CI, 1.06-4.43; p = 0.03) and Charlson Comorbidity Index (CCI) (HR, 1.24; CI, 1.01-1.52; p = 0.04) were significant predictors of emergency hospitalization for IDs, whereas age (HR, 1.12; CI, 1.05-1.19; p < 0.001), male (HR, 3.38; CI, 1.01-11.3; p = 0.048), serum alkaline phosphatase (ALP) (HR, 6.87; CI, 2.18-21.7; p = 0.001), C-reactive protein (CRP) (HR, 10.7; CI, 3.55-32.1; p < 0.001), and CCI (HR, 1.79; CI, 1.27-2.52; p < 0.001) were significant predictors of ID mortality. When modality-specific ID was included, the emergency hospitalization rate for overall IDs was higher in the PD groups, and PD was a significant predictor of emergency hospitalization for IDs, whereas no significant difference in mortality rate for overall IDs was found between the PD and HD groups.
CONCLUSIONS
ID events were not associated with dialysis modality when modality-specific ID was excluded, whereas the risk of modality-specific IDs was higher in PD than HD. Serum ferritin and ALP as well as age, male sex, CRP, and CCI were the risk factors for ID events.
Topics: Aged; Communicable Diseases; Female; Hospitalization; Humans; Kidney Failure, Chronic; Male; Middle Aged; Peritoneal Dialysis; Propensity Score; Proportional Hazards Models; Renal Dialysis; Retrospective Studies; Risk Factors
PubMed: 33120394
DOI: 10.1159/000511041 -
Therapeutic Apheresis and Dialysis :... Jun 2023Recent evidence suggests that automated peritoneal dialysis (APD) might be a feasible alternative to hemodialysis (HD) in urgent-start peritoneal dialysis.
BACKGROUND
Recent evidence suggests that automated peritoneal dialysis (APD) might be a feasible alternative to hemodialysis (HD) in urgent-start peritoneal dialysis.
METHODS
This prospective study enrolled end-stage renal disease (ESRD) patients who had started APD as an urgent-start dialysis modality at a single center. Dialysis-related complications were recorded. Dialysis adequacy and electrolytes imbalance were compared between baseline, 14 and 42 days after catheter insertion. Technique survival and patient survival were also recorded.
RESULTS
A total of 36 patients were included in the study. Mean follow-up duration was 22 months. During the follow-up, 11 PD patients (30.6%) developed dialysis-related complications. Only two patients (5.6%) required re-insertion and one patients (2.8%) transfer to HD. The 2-year technique survival rate and patient survival rate were 94.4% and 97.2%, respectively.
CONCLUSION
In considering safety and dialysis adequacy, APD could be a feasible dialysis modality for urgent-start dialysis in ESRD patients, using a standard procedure.
Topics: Humans; Renal Dialysis; Prospective Studies; Time Factors; Kidney Failure, Chronic; Peritoneal Dialysis
PubMed: 36263921
DOI: 10.1111/1744-9987.13943 -
Clinical Oral Investigations Apr 2021To study the influence of peritoneal dialysis (PD) on the salivary metabolite profile of children and adolescents with renal failure.
OBJECTIVE
To study the influence of peritoneal dialysis (PD) on the salivary metabolite profile of children and adolescents with renal failure.
MATERIALS AND METHODS
Healthy children/adolescents (n = 31; mean age: 12.18 ± 3.76) and children/adolescents subjected to PD (n = 12; mean age: 10.10 ± 4.25) were recruited. Oral health status assessed by the dmft/DMFT and Volpe-Manhold calculus indices. The H spectra were acquired in a 600-MHz Bruker nuclear magnetic resonance spectrometer and were subjected to multivariate analysis using partial least squares discriminant analysis (PLS-DA), orthogonal PLS-DA (O-PLS-DA), and univariate analysis through chi-square and t tests (SPSS 20.0, IL, USA), with a significance level of p < 0.05.
RESULTS
A similar caries pattern (p = 0.57; chi-square test) was observed between the healthy (dmft = 0.72 ± 1.28 and DMFT 0.93 ± 2.30) and PD groups (dmft = 2.14 ± 3.67, DMFT 0.33 ± 0.71) and dental calculus (p > 0.05, t test). PLS-DA and O-PLS-DA were able to distinguish both groups (ACC = 0.85, R = 0.80, Q = 0.15). Salivary metabolites decrease in creatine, propionate, and sugar levels in the PD group and an increase in creatinine, butyrate, and lactate levels when compared with the healthy group.
CONCLUSIONS
Children and adolescents subjected to PD have a different salivary metabolic profile from that of their healthy subjects.
CLINICAL RELEVANCE
Complications of peritoneal dialysis procedures could be monitored by proper knowledge of saliva characteristics as predictors of peritonitis-related outcome. The use of metabolomics in pediatric nephrology may be an innovative methodology for the early diagnosis and monitoring of kidney diseases.
Topics: Adolescent; Child; Child, Preschool; Dental Caries; Humans; Metabolome; Metabolomics; Peritoneal Dialysis; Saliva
PubMed: 32880015
DOI: 10.1007/s00784-020-03557-1 -
NeoReviews Dec 2019Acute kidney injury (AKI) is a highly prevalent disease entity in the NICU, affecting nearly one-quarter of critically ill neonates by some reports. Though medical... (Review)
Review
Acute kidney injury (AKI) is a highly prevalent disease entity in the NICU, affecting nearly one-quarter of critically ill neonates by some reports. Though medical management remains the mainstay in the treatment of AKI, renal replacement therapy (RRT) is indicated when conservative measures are unable to maintain electrolytes, fluid balance, toxins, or waste products within a safe margin. Several modalities of RRT exist for use in neonatal populations, including peritoneal dialysis, hemodialysis, and continuous RRT. It is the aim of this review to introduce each of these RRT modalities, as well as to discuss their technical considerations, benefits, indications, contraindications, and complications.
Topics: Acute Kidney Injury; Continuous Renal Replacement Therapy; Critical Illness; Humans; Infant, Extremely Low Birth Weight; Infant, Newborn; Infant, Very Low Birth Weight; Intensive Care Units, Neonatal; Peritoneal Dialysis; Renal Dialysis; Renal Replacement Therapy
PubMed: 31792157
DOI: 10.1542/neo.20-12-e697 -
Clinical and Experimental Nephrology Jan 2023Traditional training (Home Training) in peritoneal dialysis (PD) is based on the physical presence of nurse and patient/caregiver. These "space-time" constraints can...
OBJECTIVES
Traditional training (Home Training) in peritoneal dialysis (PD) is based on the physical presence of nurse and patient/caregiver. These "space-time" constraints can influence the training's duration, methodology and results. A remote caregiving system (Videodialysis) in our Center has proved to be effective and safe in remotely guiding patients/caregivers with cognitive/psychological barriers to self-care-PD. Since 08/01/2016, to overcome the limitations of Home Training, Videodialysis has also been used to carry out remote patients/caregivers training (Video Training). Retrospective comparison between Video Training (08/01/2016-05/31/2020) and Home Training (01/01/2014-07/31/2016).
METHODS
Following initial home-visit Video Training is performed via telemedicine from the Center, whereas Home Training is carried out at the patient's home. Only first trainings for all incident PD patients/caregivers were considered. The following patients were excluded: 9 in nursing homes, 13 kept on Videodialysis due to barriers to self-care, 6 uncompleted procedures, 4 other. Total duration, home visits, exchanges/procedures, peritonitis, technique survival were compared between Home Training and Video Training.
RESULTS
46 trainings were considered (median; IQR): 21 Home Training (CAPD/APD: 11/10) in 17 patients (74.3 years (58.8-78.0; assisted PD: 64.7%) and 25 Video Training (CAPD/APD: 8/17) in 21 patients (65.9 years (56.9-76.4) N.S.; assisted PD: 52.4%). Duration (days): Home Training: CAPD 4.0 (4.0-5.5); APD 8.0 (5.3-10.5); Video Training: CAPD 4.5 (3.8-5.0) (N.S.); APD 8.0 (6.0-13.0) (N.S.). Home-visit (number): Home Training: CAPD 9.0 (7.0-10.0); APD 11.0 (7.8-15.5); Video Training: CAPD 2.0 (2.0-3.5) (p < 0.001); APD 5.0 (4.0-6.0) (p < 0.001). Peritonitis (episodes): Home Training: 5 (Follow-up: 471 pts/months); Video Training: 0 (Follow-up 280 pts/months). 2-Year technique survival. Home Training: 56.3%; Video Training: 76.9% (N.S.).
CONCLUSIONS
Video Training is as effective as Home Training, while significantly reducing the number of home visits.
Topics: Humans; Peritoneal Dialysis, Continuous Ambulatory; Retrospective Studies; Peritoneal Dialysis; Peritonitis; Caregivers
PubMed: 36129554
DOI: 10.1007/s10157-022-02276-z