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PloS One 2024End-stage renal disease (ESRD) patients often experience accelerated bone turnover, leading to osteoporosis and osteopenia. This study aimed to determine the prevalence...
BACKGROUND
End-stage renal disease (ESRD) patients often experience accelerated bone turnover, leading to osteoporosis and osteopenia. This study aimed to determine the prevalence of osteoporosis in Peritoneal Dialysis (PD) patients using bone mineral density (BMD) measurements obtained through dual-energy X-ray absorptiometry (DEXA) scan and to explore any possible associations with clinical and biochemical factors.
METHODS
In this cross-sectional study, we enrolled 76 peritoneal dialysis patients from the dialysis center at An-Najah National University Hospital in Nablus, Palestine. We used the DEXA scan to measure BMD at the lumbar spine and hip, with values expressed as T-scores. We conducted a multivariate analysis to explore the relationship between BMD and clinical and biochemical parameters.
RESULTS
Over half (52.6%) of the PD patients had osteoporosis, with a higher prevalence observed among patients with lower BMI (p<0.001). Higher alkaline phosphatase levels were found among osteoporotic patients compared to non-osteoporotic patients (p = 0.045). Vitamin D deficiency was also prevalent in this population, affecting 86.6% of patients. No significant correlation was found between 25 vitamin D levels and BMD. No significant correlation was found between Parathyroid hormone (PTH) levels and BMD.
CONCLUSION
A notable proportion of PD patients experience reduced BMD. Our study found no correlation between vitamin D levels and BMD, but it highlighted the significant vitamin D deficiency in this population. Furthermore, our analysis indicated a positive correlation between BMI and BMD, especially in the femoral neck area. This underscores the significance of addressing bone health in PD patients to mitigate the risk of fractures and improve their overall well-being.
Topics: Humans; Bone Density; Peritoneal Dialysis; Female; Male; Middle Aged; Osteoporosis; Cross-Sectional Studies; Absorptiometry, Photon; Adult; Kidney Failure, Chronic; Parathyroid Hormone; Prevalence; Aged; Vitamin D; Vitamin D Deficiency; Lumbar Vertebrae
PubMed: 38753845
DOI: 10.1371/journal.pone.0301814 -
International Journal of Nursing... Dec 2023Inadequate training on how to care for haemodialysis and peritoneal dialysis catheters can lead to mechanical issues with the catheters and infectious complications... (Review)
Review
BACKGROUND
Inadequate training on how to care for haemodialysis and peritoneal dialysis catheters can lead to mechanical issues with the catheters and infectious complications (such as peritonitis) that could endanger patient safety, reduce the effectiveness of the dialysis treatment, and have a negative impact on patient morbidity and mortality. Such incidents can be prevented as they are mostly dependant on controllable factors - proper dialysis catheter care, which can be addressed through effective patient education. Effective patient education is crucial in ensuring that patients are equipped with the knowledge and skills necessary for both peritoneal and haemodialysis catheter care.
AIMS
To synthesise evidence on the: (1) patient educational interventions on haemodialysis and peritoneal dialysis catheter care; and (2) reported learning and clinical outcomes of the educational interventions provided for patients with haemodialysis and peritoneal dialysis catheter.
DESIGN
Integrative review.
METHODS
This review followed the framework by Whittemore and Knafl. The literature search was performed using four electronic databases: PubMed, CINAHL, Cochrane Library and ProQuest Nursing and Allied Health. The Joanna Briggs Institute Critical Appraisal Tool was used to appraise the articles that fit the inclusion and exclusion criteria. Studies published in the English language were retrieved.
RESULTS
A total of 14 studies were included. All the studies focused on educating patients who were on either tunnelled (permanent) haemodialysis catheters or peritoneal dialysis catheters. The findings identified: (1) teaching strategies used for educating patients on haemodialysis catheter care (2) teaching strategies for educating peritoneal dialysis patients on peritoneal dialysis catheter care and (3) outcomes of patient education on both haemodialysis and peritoneal dialysis catheters. Written materials and educational videos were used to instruct patients on haemodialysis catheters care. Different educational strategies for educating patients on peritoneal dialysis catheter care were also reported. They varied in terms of the composition and experience of the implementation care team members, educational approach, training duration, training location, timing relative to catheter placement, assessment method and follow-up support. The various teaching strategies were assessed and compared based on the patients' knowledge levels, catheter-related mechanical issues, and catheter-related infectious consequences (such as peritonitis).
CONCLUSION
This review highlighted various education materials and compared different educational practices on tunnelled (permanent) haemodialysis catheter and peritoneal dialysis catheter care that healthcare providers used to increase knowledge and reduce catheter-related blood stream infections and peritonitis rates.
PubMed: 38746579
DOI: 10.1016/j.ijnsa.2023.100156 -
Clinical Kidney Journal May 2024
PubMed: 38742207
DOI: 10.1093/ckj/sfae118 -
Medical Mycology Case Reports Jun 2024peritonitis is a rare but highly severe complication of peritoneal dialysis with a high mortality rate. We report a case of peritonitis. Despite early removal of the...
peritonitis is a rare but highly severe complication of peritoneal dialysis with a high mortality rate. We report a case of peritonitis. Despite early removal of the catheter and oral voriconazole antifungal treatment for 3 weeks, the treatment effect was unsatisfactory, resulting in prolonged hospital stay and affecting the patient's quality of life. After switching to liposomalAmphotericin B, inflammation indicators rapidly decreased and infection was controlled. Liposomalamphotericin B provides an option for treatment of peritonitis.
PubMed: 38737129
DOI: 10.1016/j.mmcr.2024.100651 -
Frontiers in Neuroscience 2024This study aims to compare gray matter volume changes in patients with chronic kidney disease (CKD) undergoing peritoneal dialysis (PD) and hemodialysis (HD) using...
OBJECTIVE
This study aims to compare gray matter volume changes in patients with chronic kidney disease (CKD) undergoing peritoneal dialysis (PD) and hemodialysis (HD) using voxel-based morphometry (VBM).
METHODS
A total of 27 PD patients, 25 HD patients, and 42 healthy controls were included. VBM analysis was performed, and cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment Scale (MoCA). The correlation between cognitive function and changes in brain gray matter volume was analyzed.
RESULTS
Both peritoneal dialysis and hemodialysis patients had partial gray matter volume reduction compared to the controls, but the affected brain regions were not uniform. The hemodialysis patients had greater volume reduction in certain brain regions than the PD patients. The MMSE and MoCA scores were positively correlated with gray matter volume changes.
CONCLUSION
Different dialysis modalities cause damage to specific areas of the brain, which can be detected using VBM. VBM, combined with cognitive function assessment, can help detect structural brain changes and cognitive impairment in patients with different dialysis modalities. The comprehensive application of VBM in the field of neurological function deserves further exploration.
PubMed: 38737098
DOI: 10.3389/fnins.2024.1394169 -
BMC Nephrology May 2024Peritonitis is a common and severe complication of peritoneal dialysis (PD). For comparative analysis standardized definitions as well as measurements and outcomes are...
BACKGROUND
Peritonitis is a common and severe complication of peritoneal dialysis (PD). For comparative analysis standardized definitions as well as measurements and outcomes are crucial. However, most PD-related peritonitis studies have been using heterogenous definitions and variable methods to measure outcomes. The ISPD 2022 guidelines have revised and clarified numerous definitions and proposed new peritonitis categories and outcomes.
METHODS
Between 1st January 2009 and 31st May 2023, 267 patients who started PD at our institution were included in the study. All PD-related peritonitis episodes that occurred in our unit during the study period were collected. The new definitions and outcomes of ISPD 2022 recommendations were employed.
RESULTS
The overall peritonitis rate was 0.25 episode/patient year. Patient cumulative probability of remaining peritonitis-free at one year was 84.2%. The medical cure and refractory peritonitis rates were equal to 70.3 and 22.4%, respectively. Culture-negative peritonitis accounted for 25.6% of all specimens. The rates of peritonitis associated death, hemodialysis transfer, catheter removal and hospitalization were 6.8%, 18.3%, 18.7% and 64.4%, respectively. Relapsing, repeat, recurrent and enteric peritonitis accounted for 7.8%, 6.8%, 4.1% and 2.7% of all episodes, respectively. Catheter insertion, catheter related and pre-PD peritonitis were 4.2, 2.1 and 0.5%.
CONCLUSIONS
The implementation of PD-related peritonitis reports using standardized definitions and outcome measurements is of paramount importance to enhance clinical practice and to allow comparative studies.
Topics: Humans; Peritonitis; Male; Peritoneal Dialysis; Female; Middle Aged; Italy; Aged; Retrospective Studies; Adult; Kidney Failure, Chronic; Hospitalization
PubMed: 38734613
DOI: 10.1186/s12882-024-03594-y -
International Journal of Molecular... Apr 2024Chronic kidney disease (CKD) is a global health concern affecting approximately one billion individuals worldwide. End-stage kidney disease (ESKD), the most severe form...
Chronic kidney disease (CKD) is a global health concern affecting approximately one billion individuals worldwide. End-stage kidney disease (ESKD), the most severe form of CKD, is often accompanied by anemia. Peritoneal dialysis (PD), a common treatment for ESKD, utilizes the peritoneum for solute transfer but is associated with complications including protein loss, including transferrin (Tf) a key protein involved in iron transport. This study investigated Tf characteristics in ESKD patients compared to healthy individuals using lectin microarray, spectroscopic techniques and immunocytochemical analysis to assess Tf interaction with transferrin receptors (TfRs). ESKD patients exhibited altered Tf glycosylation patterns, evidenced by significant changes in lectin reactivity compared to healthy controls. However, structural analyses revealed no significant differences in the Tf secondary or tertiary structures between the two groups. A functional analysis demonstrated comparable Tf-TfR interaction in both PD and healthy samples. Despite significant alterations in Tf glycosylation, structural integrity and Tf-TfR interaction remained preserved in PD patients. These findings suggest that while glycosylation changes may influence iron metabolism, they do not impair Tf function. The study highlights the importance of a glucose-free dialysis solutions in managing anemia exacerbation in PD patients with poorly controlled anemia, potentially offering a targeted therapeutic approach to improve patient outcomes.
Topics: Humans; Transferrin; Glycosylation; Kidney Failure, Chronic; Male; Female; Middle Aged; Receptors, Transferrin; Peritoneal Dialysis; Aged; Adult; Iron
PubMed: 38731843
DOI: 10.3390/ijms25094625 -
Journal of Clinical Medicine Apr 2024A properly functioning peritoneal catheter is an essential element of effective peritoneal dialysis (PD). Currently, there are three techniques available for PD catheter...
A properly functioning peritoneal catheter is an essential element of effective peritoneal dialysis (PD). Currently, there are three techniques available for PD catheter placement, which include open surgery, laparoscopic surgery, and percutaneous catheter placement (PCP). Currently, no particular catheter placement approach has been proven with certainty to provide superior outcomes. We present a new modified PCP method with the use of the Veress needle covered with an intravascular catheter (IC) and preliminary clinical results of PD catheter placements with this new technique. The endpoints used in the study were 1-year technical survival of the catheter, and the incidence of early (1 month) mechanical as well as infection complications. The catheter was implanted in 24 patients. The catheter survival rate was 100%; however, in two cases, the catheters were removed due to complications not associated with PD treatment. No early mechanical complications such as bleeding, hematoma, perforations, internal organ damage, exit site leaks, or hernia in the place of insertion were observed. Similarly, no early infectious complications were observed. During the 1-year follow-up, no catheter migration occurred. Our results showed that the new PCP technique is a safe and easy procedure that minimizes the occurrence of both mechanical and infectious complications and ensures good catheter survival.
PubMed: 38731147
DOI: 10.3390/jcm13092618 -
Renal Failure Dec 2024Laparoscopic techniques are being widely applied for peritoneal dialysis (PD) catheter (PDC) placement. The suture passer is a novel fixation tool that aims to reduce...
BACKGROUND
Laparoscopic techniques are being widely applied for peritoneal dialysis (PD) catheter (PDC) placement. The suture passer is a novel fixation tool that aims to reduce catheter migration. We compared the clinical value of the suture passer combined with two-hole laparoscopic PDC placement to open surgical placement by evaluating preoperative and postoperative conditions, as well as the onset of complications in both groups.
METHODS
A retrospective study was conducted including 169 patients who underwent PDC placement surgery from January 2021 to May 2023. Based on the method employed, patients were divided into two groups: the suture passer combined with a two-hole laparoscopy group (SLG) and the open surgical group (SG). Comprehensive patient information, including general data, preoperative and postoperative indicators, peritoneal function after surgery, and the incidence rate of complications, were collected and analyzed.
RESULTS
The SLG showed a statistically significant decrease in operative time, intraoperative blood loss, and 6-month postoperative drift rate compared to the SG ( < 0.05). No statistically significant differences were observed between the two groups in terms of sex, age, primary disease, hospitalization time, hospitalization costs, preoperative and postoperative examination indicators, peritonitis, and omental wrapping.
CONCLUSIONS
Suture passer combined with two-hole laparoscopic PDC placement, characterized by simplicity and facilitating secure catheter fixation, was deemed safe and effective for patients undergoing PD. It reduces the catheter migration rate and improved surgical comfort. Overall, this technique demonstrates favorable outcomes in clinical practice.
Topics: Humans; Male; Female; Laparoscopy; Retrospective Studies; Middle Aged; Peritoneal Dialysis; Aged; Catheterization; Adult; Catheters, Indwelling; Operative Time; Postoperative Complications; Kidney Failure, Chronic; Suture Techniques
PubMed: 38727002
DOI: 10.1080/0886022X.2024.2349123 -
Saudi Journal of Kidney Diseases and... Nov 2023Hemodialysis (HD) and peritoneal dialysis (PD) treatments impact the economic burden and psychological distress faced by end-stage kidney disease (ESKD) patients and... (Review)
Review
Hemodialysis (HD) and peritoneal dialysis (PD) treatments impact the economic burden and psychological distress faced by end-stage kidney disease (ESKD) patients and their caregivers. This review aimed to discuss the concept of an economic burden and the economic burden of different treatment options, and to highlight research gaps regarding the scarcity of previous studies relating economic burden to psychological well-being. We searched five electronic databases for papers published in 2010-2020. Papers focusing on measures of the economic burden from the government's perspective and diseases other than ESKD were excluded. Out of the 6635 publications identified, 10 publications were included. Three categories of economic burden were identified, namely, direct medical costs, direct non-medical costs, and indirect costs. Direct medical costs required the highest expenditure, whereas the lowest economic burden was for indirect costs. HD patients incurred a higher economic burden than PD patients. Most of the studies were carried out in Asia. The results of the research suggest that the economic burden may affect patients and caregivers, but it is unclear whether the economic burden affects the psychological well-being of the patients and caregivers. Very few studies have assessed the relationship between economic burden and psychological well-being, and further research is needed to gain further insight into the relationship between these two variables.
Topics: Humans; Cost of Illness; Kidney Failure, Chronic; Caregivers; Health Care Costs; Renal Dialysis; Peritoneal Dialysis; Caregiver Burden
PubMed: 38725213
DOI: 10.4103/sjkdt.sjkdt_81_22