bluuebunny/crossref_metadata_2025 huggingface dataset:
Calcium and Strontium Metabolic Studies in Patients on Capd
Authors: Apostolidis Nicholas , Paradellis Themis , Karydas Andreas , Manouras Andreas , Katirtzoglou Nicholas , Mayopoulou-Symvoulidou Dora
Published: February 2020

Background

Strontium is known to affect calcium metabolism both experimentally and in clinical studies on conditions other than end-stage renal failure (ESRF) and continuous ambulatory peritoneal dialysis (CAPD).

Objective

To investigate Sr metabolism in relation to that of Ca in ESRF patients undergoing CAPD, and the possible influence of the duration of treatment.

Design

Cross-sectional observational study.

Setting

University medical center and Institute of Nuclear Physics.

Patients

Twenty-four patients on CAPD; 14 chronic renal failure (CRF) patients not on dialysis, and 52 healthy controls.

Measurements

Calcium and Sr content of serum, urine or dialysate effluent, and selected dietary products.

Results

Calcium and Sr are absorbed by the intestinal tract of healthy subjects with equal efficiency. Serum Ca levels were considerably lower in CRF patients than in healthy subjects and patients on CAPD (p < 0.001). Serum Sr was significantly higher in both CAPD and CRF patients than in healthy controls (p < 0.001). The Sr/Ca ratio in the sera of the healthy subjects was defined by the preferential excretion of Sr over Ca by the kidney. This preferential excretion was lost during renal failure. During treatment there was a tendency for the uptake of both Ca and Sr to increase.

Conclusions

Strontium is accumulated in the body during renal failure and CAPD cannot restore normal levels. Considering the varying effects of different doses of Sr on bone metabolism experimentally, it would be interesting to determine by further studies the possible significance of the observed Sr accumulation for renal bone disease.
Tenckhoff Catheter Salvage by Closed Stiff-Wire Manipulation without Fluoroscopic Control
Authors: Jones Bryn , McLaughlin Kevin , Mactier Robert A. , Porteous Colin
Published: February 2020

Objective

To describe the results of Tenckhoff catheter salvage by a modified, closed, stiff-wire manipulation technique without the use of general anesthesia or fluoroscopy, and compare this with previously described techniques.

Design

Retrospective study in patients treated with continuous ambulatory peritoneal dialysis (CAPD) over a 41-month period.

Setting

Renal unit in an inner city hospital.

Patients

Eighteen patients using CAPD who had 22 episodes of outflow failure due to radiologically confirmed malposition of straight two-cuff Tenckhoff catheters.

Interventions

Closed stiff-wire manipulation of malpositioned Tenckhoff catheter without the use of general anesthesia or fluoroscopy.

Main Outcome Measures

Initial success rate of manipulation, catheter and technique (CAPD) survival, and procedure-related complications.

Results

Catheter manipulation was technically successful in 21 of 22 cases. An additional six episodes of malposition occurred ranging from 2 to 630 days after the primary manipulation (median 7 days). A second manipulation was carried out in four cases that resulted in long-term success in two. Three patients were forced to discontinue CAPD for reasons other than catheter malposition, and the overall success rate at 1 month (patient successfully performing CAPD) was 59.1% (±0.1 %). No major complications were experienced during the procedure and no episodes of peritonitis occurred.

Conclusion

The technique described is relatively straightforward, does not require fluoroscopy or general anesthetic, and its success is comparable to previously reported methods of Tenckhoff catheter salvage. We would recommend this technique of catheter salvage in patients with Tenckhoff catheter malposition in whom conservative treatment has failed.
Capd in Patients with Autosomal Dominant Polycystic Kidney Disease
Authors: Hadimeri Henrik , Johansson Ann-Cathrine , Haraldsson Börje , Nyberg Gudrun
Published: February 2020

Objective

To investigate whether there are specific complications to continuous ambulatory peritoneal dialysis (CAPD) in patients with autosomal dominant polycystic kidney disease (ADPKD) due to defects in various wall structures -causing hernia and diverticulitis -and to enlarged kidneys.

Design

The clinical experience of CAPD in 26 patients with ADPKD, treated for 11 ± 6 months, was studied in retrospect and compared with that of 26 contemporary controls. Medical records were reviewed with respect to survival in this treatment form and any complication. Peritoneal dialysis capacity (PDC), as measured in 21 ADPKD patients and 20 controls, was also evaluated.

Setting

University Hospital.

Results

Before initiation of CAPD, enlarged kidneys necessitated nephrectomy in 2 of 26 ADPKD patients; both cases were registered as preparation tor transplantation, not for CAPD. Survival in CAPD was similar in ADPKD patients and controls. Hernia was present in 4 ADPKD patients and 2 controls, and required transfer to hemodialysis in 1 patient from each group, temporarily. The incidence of peritonitis was 1 per 20 months in ADPKD patients versus 1 in 27 months in the controis, not significantly different. Peritonitis was caused by colonic bacteria in similar numbers. Residual renal function was 1.9 ± 2.1 mL/min per 1.73 m2 in ADPKD patients versus 1.9 ± 1.4 mL/min per 1.73 m2 in the controls. No difference was detected in any of the variables measured by PDC.

Conclusion

There were no specific problems related to ADPKD.
Early Continuous Cycling Peritoneal Dialysis Failure in Infants: Rescue Tidal Peritoneal Dialysis
Authors: Ramage Ian J. , Bradbury Mark G. , Braj Bet Tina , Balfe J.Williamson , Geary Denis F.
Published: February 2020

Failure of peritoneal dialysis (PD) immediately following soft catheter insertion is well recognized and may be manifest by dialysate leakage, early peritonitis, or early inadequate outflow (1,2), the latter of which requires catheter replacement in up to 50% of cases (1). We describe 3 infants with failure of continuous cyclic peritoneal dialysis CCPD) following PD catheter insertion, as a result of poor dialysate outflow. In each case adequate dialysis was achieved using tidal PD.
A Survey of Home Visits at Peritoneal Dialysis Centers in the United States
Authors: Bernardini Judith , Dacko Carol
Published: February 2020

Objective

To determine the frequency and characteristics of home visits in centers that provide training for peritoneal dialysis (PD).

Design

Mail survey sent to all dialysis centers in the United States providing home PD, using the Health Care Federal Administration (HCFA) Renal Provider list.

Results

Surveys were mailed to 1247 centers; 13 were undeliverable, resulting in 1234 surveys successfully delivered; 670 (54%) of those surveyed responded. Of those responding, 525 (78.4%) reported home visits were part of the care of home PD patients: 11% made a single home visit, 52% made an initial home visit with at least one followup visit, and 16% made visits only as needed. No home visits were made by 21% of responding centers. A registered nurse (RN) alone made the home visit in 61% of the centers, while a multidisciplinary team accompanied the RN in 35% of centers; 3% of visits were made by a licensed practical nurse, and 1% by the physician. Half of the visits required 0.5 -1 hour, while 41% required 1 -2 hours. Travel time was most often an hour or less one way. Staff were reimbursed for travel expenses by 90% of the centers. The 525 centers making home visits were not different than the 145 centers not making home visits in number of patients per center, number of RNs, rural or urban location, or affiliation with a university. Interpretation of the HCFA regulations concerning home visits was the most important factor influencing centers making home visits.

Conclusions

Home visits to continuous ambulatory PD and continuous cycling PD patients in the United States are common. Nearly 80% of centers responding to the survey include home visits in the care of their home peritoneal dialysis patients.
Influence of Age, Time, and Peritonitis on Peritoneal Transport Kinetics in Children
Authors: Hölttä Tuula M. , Rönnholm Kai A.R. , Holmberg Christer
Published: February 2020

Objective

To evaluate peritoneal transport kinetics and its changes over time in children with and without peritonitis, and to record possible differences between children under and over 5.0 years of age.

Design

A prospective study. The patients underwent a 4hour peritoneal equilibration test (PET) comprising 2.27% dextrose with a dialysate fill volume of 1000 mL/m2 of body surface area (BSA), at baseline and after a mean of 0.8: I: 0.4 years of uninterrupted dialysis.

Patients

We investigated 28 patients on maintenance peritoneal dialysis at baseline; 10 were under 5.0 years of age. The final PET was performed in 21 patients.

Main Outcome Measures

Peritoneal equilibration rates for urea (U), creatinine (C), glucose (G), sodium, potassium, phosphate, and albumin (A) were measured. Initial and final peritoneal equilibration rates were compared. Mass transfer area coefficients (MTAC) were calculated for urea, creatinine, glucose, and albumin. Residual dialysate volume was determined.

Results

Median age at first PET was 7.6 years (range 0.3 -16.6 yr). The mean (±1 SD) 4-hour dialysate-to-plasma (DIP) ratios for U, C, and A were 0.92:1: 0.05,0.70 ± 0.12, and 0.014: I: 0.007, respectively. The mean 4-hour DIDo ratio for G was 0.32: I: 0.10. DIP and DIDo results were similar in the two age groups, and peritoneal membrane function remained stable over the study period. Mean MTAC (:1:1 SD) values were: U, 22.3: I: 4.8; C, 10.9: I: 4.1; G, 11.1: I: 3.3; and A, 0.07: I: 0.03. MTAC data were similar in the two age groups and no significant changes occurred during the study period.

Conclusions

When the volume tested in children is proportional to BSA, the solute DIP ratios seem to be age-independent. Our data provide evidence that in pediatric patients MTAC is also age-independent.
Six-Year Experience with Swan Neck Presternal Peritoneal Dialysis Catheter
Authors: Twardowski Zbylut J. , Prowant Barbara F. , Nichols W. Kirt , Nolph Karl D. , Khanna Ramesh
Published: February 2020

Background

The presternal peritoneal catheter is composed of two silicone rubber tubes joined by a titanium connector at the time of implantation, and has an exit on the chest.

Objective

Comparison of survival and complication rates of Swan neck abdominal catheters with those of the presternal catheter.

Design

Nonrandomized study with prospective collection of data between August 1991 and October 1997.

Setting

Tertiary referral center.

Patients

In 57 patients, 58 presternal catheters and, in 81 patients, 86 abdominal catheters were implanted. Patients chose the type of catheter; however, obese individuals and those with ostomies and previous catheter problems were encouraged to opt for the presternal catheter. Others chose the presternal catheter in order to take tub baths or use a whirlpool.

Main Outcome Measures

Life-table analyses of catheter survival censored for transplant, transfer, and death; reasons for catheter removal due to complications; and patient satisfaction.

Results

Two-year survival probabilities were 0.95 and 0.75 for presternal and abdominal catheters, respectively. Nine abdominal catheters were removed due to exit/tunnel infections (including five with peritonitis), and four due to peritonitis. External cuff shaving in four presternal catheters has extended survival for more than 1 year. Four presternal catheters were removed due to peritonitis. No catheters in either group were lost due to leakage or obstruction. The peritonitis rate was 1 episode per 37.4 patient-months and 1/20.5 patient-months for presternal and abdominal catheters, respectively. These differences are not significant. Patient acceptance of the presternal catheters was excellent; in the latest period, from January to October 1997, presternal catheters were chosen by 15/24 patients.

Conclusions

The trend to improved outcomes in presternal catheters continues to validate the rationale for presternal catheter design. Decreased frequency of exit/ tunnel infection may be due to more effective immobilization on the chest, less trauma, and avoidance of submersion in stagnant water. No specific contraindications to use of the presternal catheter have been identified.
Effect of Hypertonic Stress on Amino Acid Levels and System a Activity in Rat Peritoneal Mesothelial Cells
Authors: Horio Masaru , Yamauchi Atsushi , Matsuoka Yasuko , Moriyama Toshiki , Fukunaga Megumu , Imai Enyu , Orita Yoshimasa
Published: February 2020

Objective

Peritoneal mesothelial cells (PMC) are exposed to a hypertonic environment during peritoneal dialysis. When exposed to a hypertonic medium, many types of cells accumulate small osmotically active organic solutes, which are called osmolytes, to match the higher external osmolality. However, no information has been available concerning the osmolytes in PMC. To investigate osmoregulation in rat PMC, the levels of amino acids in the cells and the activity of system A, a major neutral amino acid transport, were measured after switching to a medium made hypertonic by the addition of NaCl. System A was measured by Na+-dependent [14C]-2-methylamino-isobutyric acid (MeAIB) uptake.

Results

Total amount of 20 amino acids increased from 306 to 757 nmol/mg protein after 12 hours of hypertonicity. The amount of neutral amino acids accounted for 81% of the increase in total amino acids. Glutamine, alanine, glycine, threonine, and serine were the major neutral amino acids that accumulated in the hypertonic mesothelial cells. The amount of neutral amino acids increased 2.9-fold after 12 hr of hypertonicity, and decreased thereafter. MeAIB uptake increased 36-fold relative to the uptake in isotonic cells after 4 – 8 hr of hypertonicity. When the culture medium was made hypertonic by adding raffinose or glucose, the activity of system A was also stimulated (raffinose > glucose > NaCl). System A was located on both the apical and basal sides of isotonic PMC, and extracellular hypertonicity stimulated the MeAIB uptake on both sides.

Conclusions

These data indicate that neutral amino acids and system A transport play an important role in earlyphase osmoregulation in rat peritoneal mesothelial cells.
Suppression of Nε-(Carboxymethyl)Lysine Generation by the Antioxidant N-Acetylcysteine
Authors: Nakayama Masaaki , Izumi Giichi , Nemoto Yasushi , Shibata Koji , Hasegawa Toshio , Numata Miwako , Wang Kengmin , Kawaguchi Yoshindo , Hosoya Tatsuo
Published: February 2020

Objective

Accumulated evidence suggests that Nε-(carboxymethyl)lysine (CML), which is a dominant antigen of advanced glycation end-products (AGEs), is generated in the peritoneal cavity of patients undergoing continuous ambulatory peritoneal dialysis (CAPD), and that this process may be involved in the pathophysiology of the peritoneal injury found with CAPD treatment. Since CML is a sequential product of glycation and oxidation processes, CML generation could be suppressed by antioxidants. The aim of this in vitro study was to clarify the effect of N-acetylcysteine (NAC), an antioxidant, on CML generation from proteins under high glucose settings mimicking peritoneal dialysis solutions.

Design

Test proteins (bovine serum albumin/type I collagen) were incubated continuously for 16 weeks in glucose solutions (200 mmol/L) with or without NAC (2 mmol/L), and the generation time courses (8 and 16 weeks) of CML and furosine (the biomarker of the glycation products of the early Maillard reaction) were determined.

Results

In both proteins, furosine and CML were progressively generated in accordance with the duration of the incubation period. No apparent differences were found between solutions with and without NAC in furosine levels at the 8th and 16th weeks. However, the generation of CML was lower in the solution with NAC throughout the test periods.

Conclusion

The results showed that NAC could suppress the generation of CML. This indicates the therapeutic potential of antioxidants for the glycoxidative stress-related peritoneal injury occurring during CAPD.
Induction of 1,2-Dicarbonyl Compounds, Intermediates in the Formation of Advanced Glycation End-Products, during Heat-Sterilization of Glucose-Based Peritoneal Dialysis Fluids
Authors: Schalkwijk Casper G. , Posthuma Nynke , Ten Brink Herman J. , Ter Wee Pieter M. , Teerlink Tom
Published: February 2020

Objective

To study the presence of 1,2-dicarbonyl compounds in peritoneal dialysis (PD) fluids, their concentration in effluents with increasing dwell time, and their role in the formation of advanced glycation end-products (AGEs).

Measurements

Dicarbonyl compounds in heat- and filter-sterilized PD fluids were quantified by reverse-phase high performance liquid chromatography (HPLC) after derivatization to dimethoxyquinoxaline derivatives. Kinetics of the in vitro formation of AGEs upon incubation of 1,2-dicarbonyl compounds or PD fluids with albumin, with or without aminoguanidine, were measured by AGE fluorescence (excitation/emission wavelengths of 350 nm/430 nm).

Patients

AGEs and dicarbonyl compounds were measured in effluents collected from standardized 4-hour dwells from 8 continuous cycling peritoneal dialysis patients.

Results

In PD fluids, 3-deoxyglucosone (3-DG) has been identified as the major dicarbonyl compound formed during the process of heat sterilization. The process also formed glyoxal (GO) and methylglyoxal (MGO), with the amount of 3-DG being approximately 25 – 60 times higher than GO and MGO. When incubated with albumin, the identified 1,2-dicarbonyl compounds rapidly formed AGEs. The formation of AGEs was more pronounced in conventional heat-sterilized PD fluids compared with filter-sterilized PD fluids, and was completely inhibited by aminoguanidine. In effluents, the concentration of MGO, GO, and 3-DG decreased with increasing dwell time, with a concomitant increase in AGE fluorescence.

Conclusions

The dicarbonyl compounds 3-DG, MGO, and GO are potent promoters of AGE formation. The presence of these and possibly other dicarbonyl compounds formed during heat sterilization of glucose-based PD fluids is, to a large extent, responsible for the in vitro AGE formation by these fluids, as evidenced by the speed of AGE formation in PD fluids and the complete inhibition by aminoguanidine. Because 3-DG, MGO, and GO are rapidly cleared from PD fluids during dialysis, these compounds may contribute to the in vivo AGE formation in PD patients.
Once-Daily Intraperitoneal Gentamicin is Effective Therapy for Gram-Negative Capd Peritonitis
Authors: Lye Wai-Choong , Van Der Straaten Jane C. , Leong See-Odd , Sivaraman Pary , Tan Seng-Ho , Tan Chorh-Chuan , Lee Evan J.C.
Published: February 2020

Objective

To report our 3-year experience with the use of once-daily intraperitoneal (IP) gentamicin in the treatment of gram-negative continuous ambulatory peritoneal dialysis (CAPD) peritonitis.

Design

A prospective cohort study in prevalent CAPD patients.

Setting

A tertiary care institution.

Patients

All CAPD patients who presented with new episodes of peritonitis were studied. At presentation with peritonitis, IP vancomycin and gentamicin were administered as empirical therapy. IP gentamicin was given at a single daily dose of 40 mg/2 L in the overnight bag. The antimicrobial agents were reviewed when the culture results became available. Intraperitoneal ceftazidime was added for the treatment of pseudomonas peritonitis.

Main Outcome Measures

Results of microbiological cultures and clinical outcomes of peritonitis were analyzed.

Results

Over a 36-month period, 190 episodes of peritonitis were recorded, of which 62/190 episodes (32.6%) isolated gram-negative organisms. The gram-negative organisms isolated were Escherichia coli, 15/62 episodes (24.1%); Pseudomonas aeruginosa, 12/62 episodes (19.4%); Acinetobacter spp, 12/62 episodes (19.4%); Klebsiella spp, 10/62 episodes (16.1%); and others, 13/62 episodes (21.0%). The overall treatment success rate was 66.1%. The treatment success rates were 74.0% if pseudomonas infections were excluded, 76.1% if gentamicin-resistant pathogens were excluded, and 80.5% if both pseudomonas infections and gentamicin-resistant pathogens were excluded.

Conclusions

Once-daily IP gentamicin appears to be effective in the treatment of gram-negative CAPD peritonitis.
A Prospective, Randomized Multicenter Study Comparing APD and CAPD Treatment
Authors: Bro Susanne , Bjorner Jakob B. , Tofte–Jensen Pernille , Klem Susanne , Almtoft Birte , Danielsen Henning , Meincke Margot , Friedberg Michael , Feldt–Rasmussen Bo
Published: February 2020

Objective

The goals for maintenance dialysis treatment are to improve patient survival, reduce patient morbidity, and improve patient quality of life. This is the first randomized prospective study comparing automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) treatment with respect to quality of life and clinical outcomes in relation to therapy costs.

Design

A prospective, randomized multicenter study.

Setting

Three Danish CAPD units.

Patients

Thirty-four adequately dialyzed patients with high or high-average peritoneal transport characteristics were included in the study. Twenty-five patients completed the study.

Interventions

After randomization, 17 patients were allocated to APD treatment and 17 patients to CAPD treatment for a period of 6 months. Medical and biochemical parameters were evaluated at monthly controls in the CAPD units. Quality-of-life parameters were assessed at baseline and after 6 months by the self-administered short-form SF-36 generic health survey questionnaire supplemented with disease- and treatment-specific questions. Therapy costs were compared by evaluating dialysis-related expenses.

Main Outcome Measures

Quality-of-life parameters, dialysis-related complications, dialysis-related expenses.

Results

The quality-of-life studies showed that significantly more time for work, family, and social activities was available to patients on APD compared to those on CAPD ( p < 0.001). Although the difference was not significant, there was a tendency for less physical and emotional discomfort caused by dialysis fluid in the APD group. Sleep problems, on the other hand, tended to be more marked in the APD group. Any positive effect of APD compared to CAPD on dialysis-related hospital days or complication rates could not be confirmed. With larger patient samples, it is possible, however, that a significant difference might have been achieved. The running costs for APD treatment were US $75 per day and for CAPD treatment US $61 per day.

Conclusion

If APD treatment can help to keep selected patients vocationally or socially active, paying the extra cost seems reasonable.
Fluoroscopically-Guided Manipulation of Malfunctioning Peritoneal Dialysis Catheters
Authors: Simons Martin E. , Pron Gaylene , Voros Mario , Vanderburgh Leslie C. , Rao Panduranga S. , Oreopoulos Dimitrios G.
Published: February 2020

Objective

To review our experience with fluoroscopic evaluation and manipulation of malpositioned, malfunctioning, peritoneal dialysis (PD) catheters.

Materials and Methods

Thirty-one patients, over a 5-year period (1 May 1992 to 30 April 1997) with malfunctioning PD catheters, who had fluoroscopically-guided manipulation were reviewed. Catheters were manipulated using a malleable aluminum bar and, if necessary, guide wires or other stiffeners. Technical success was assessed on the basis of adequate, fluoroscopically verified, catheter placement at the time of the procedure and improved flows. A functional PD catheter at 30 days post manipulation was considered to be a clinically successful manipulation.

Results

There were 41 manipulations [33 initial (IM) and 8 remanipulations (RM)] for malpositioned or kinked catheters. In 31 (19 male, 12 female) patients ranging in age from 31 to 76 years (mean age 60 years), the initial technical success rate was 85% for IM ( n = 28/33) and 63% ( n = 5/8) for RM. The overall clinical success rate, or 30-day primary patency, was 55% for IM ( n = 18/33) and 63% for RM. Catheter function (combined IM and RM) continued for a median 869 days (95% CI: 118, 1620). No early complications were noted.

Conclusions

Fluoroscopic manipulation, including attempts at remanipulation, of PD catheters is a safe procedure. The technique is a simple, inexpensive, and effective way of prolonging PD catheter life, thereby reducing the number of surgical interventions.
A Multinational Clinical Validation Study of Pd Adequest 2.0
Authors:   for The PD ADEQUEST International Study Group, Vonesh Edward F. , Story Kenneth O. , O'Neill William T.
Published: February 2020

Objective

To clinically validate the use of the newly released kinetic modeling program, PD ADEQUEST 2.0 for Windows (Baxter Healthcare Corporation, Deerfield, IL, U.S.A.), by assessing the level of agreement between measured and modeled values of urea and creatinine clearances (CCr), glucose absorption, total drain volumes, and net ultrafiltration for all forms of peritoneal dialysis.

Design

A nonrandomized, multinational, prospective longitudinal study.

Patients

The study involved 104 adult patients [41 on continuous ambulatory peritoneal dialysis (CAPD), 63 on automated peritoneal dialysis (APD)] from 16 centers in 7 countries. All patients underwent a 4-hour peritoneal equilibration test (PET) but with varying percentage dextrose concentrations (1.5% or 2.5% dextrose) and varying fill volumes (range 1.5 – 2.5 L). Patients with a residual renal function greater than 10 mL/min were excluded, as were patients who had peritonitis within 6 weeks prior to baseline.

Main Outcome Measures

Correlation coefficients and Bland–Altman limits of agreement were used to assess the level of agreement between measured and modeled values of weekly peritoneal urea Kt/V (pKt/V) and total Kt/V, weekly peritoneal creatinine clearance (pCCr, L/week/ 1.73 m2) and total CCr (L/week/1.73 m2), daily drain volume (L/day), net ultrafiltration (UF, L/day), daily peritoneal urea and creatinine mass removal (g/day), and daily peritoneal glucose absorption (g/day). Measured values were obtained from three repeat 24-hour urine and dialysate collections per patient, while modeled values were calculated using the Baxter PD ADEQUEST 2.0 program in conjunction with kinetic parameters estimated from a 4-hour PET and long-dwell exchange independent of the 24-hour collections.

Results

The results show there is excellent agreement between measured and modeled urea Kt/V and CCr with concordance correlation coefficients ranging from 0.83 to 0.97 among CAPD and APD patients. There was also excellent agreement between measured and modeled values of glucose absorption and total drain volumes (concordance correlations of 0.90 and 0.98, respectively). This level of agreement was further supported by a Bland– Altman analysis of individual differences, including differences between measured and modeled net UF (coefficient of clinical agreement ranged from 0.66 to 0.92).

Conclusions

Data from a carefully performed PET and overnight exchange can, in combination with a scientifically and clinically validated kinetic model, provide clinicians with a powerful mathematical tool for use in CAPD and APD prescription management. Although not intended to replace actual measurements, kinetic modeling can prove useful as a means for quickly estimating approximate levels of clearance for a wide variety of alternative prescriptions. This, in turn, should speed up the process by which a physician can optimize the dose of dialysis suitable for a given patient and his/her lifestyle.
Carbonyl Stress: Increased Carbonyl Modification of Tissue and Cellular Proteins in Uremia
Authors: Miyata Toshio , Izuhara Yuko , Sakai Hideto , Kurokawa Kiyoshi
Published: February 2020

Advanced glycation end-products (AGEs) are formed during non enzymatic glycation and oxidation (glycoxidation) reactions. This process is accelerated in diabetics owing to hyperglycemia, and it has been implicated in the pathogenesis of diabetic complications. Surprisingly, AGEs increase in normoglycemic uremic patients to a much greater extent than in diabetics. AGE accumulation in uremia cannot be attributed to hyperglycemia nor simply to a decreased removal by glomerular filtration. Recently gathered evidence has suggested that, in uremia, the increased carbonyl compounds derived from carbohydrates and lipids modify proteins not only by glycoxidation reaction but also by lipoxidation reaction (“carbonyl stress”).

Carbonyl stress has been implicated in the pathogenesis of long-term uremic complications such as dialysisrelated amyloidosis. With regard to continuous ambulatory peritoneal dialysis (CAPD), the peritoneal cavity appears to be in a state of severe overload of carbonyl compounds derived from CAPD solution containing high glucose, from heat sterilization of the solution, and from uremic circulation. Carbonyl stress might modify not only peritoneal matrix proteins and alter their structures, but also react with mesothelial and endothelial cell surface proteins and initiate a range of inflammatory responses. Carbonyl stress might therefore contribute to the development of peritoneal sclerosis in patients with long-term CAPD.
Analysis of Non Enzymatic Glycosylation In Vivo: Impact of Different Dialysis Solutions
Authors: Ho-Dac-Pannekeet Marja M. , Weiss Miriam F. , De Waart Dirk R. , Erhard P. , Hiralall Johan K. , Krediet Raymond T.
Published: February 2020

Background

Glucose-containing dialysis solutions in peritoneal dialysis (PC) patients induce non enzymatic glycosylation (NEG) within the peritoneal cavity. The subsequent formation of advanced glycosylation endproducts (AGEs) may be implicated in the functional deterioration of the peritoneal membrane in long-term PC patients.

Aim of the Study and Parameters

Measurement of NEG by the determination of percent glycation of albumin and IgG (GP), and of AGEs by measuring pentosidine content of protein in 4-hour effluents (Peff) and serum.

Subjects

In 5 patients each, a comparison was made between 3.86% glucose and 1.36% glucose (GP and Peff), and between 3.86% glucose and 7.5% icodextrin (Peff). Nine patients with clinically severe ultrafiltration failure (UFF) were compared to nine patients treated with PC for 1 month. Six of the patients with UFF were treated with non glucose dialysis solutions and Peff was studied again after 6 weeks.

Results

No difference was found between Peff comparing 3.86% glucose to either 1.36% glucose or icodextrin. GP were higher in 3.86% glucose than in 1.36%. Glycatedlnon glycated (G/NG) protein clearance ratios were 1.29 for albumin and 1.12 for IgG (p = 0.003). In contrast to GP, both Peff and serum pentosidine were higher in the UFF patients than in the recently started patients. Peff, but not GP, correlated with duration of PC (r = 0.67, p = 0.04). In 5 of 6 patients treated with non glucose dialysate, Peff decreased while serum pentosidine was stable. .Discussion: These data show that 4-hour Peff contents are not influenced by glucose concentration or osmolality, in contrast to GP. The relation between Peff and duration of PC, and the effect of non glucose dialysate on Peff, suggest that long-term glucose exposure is an important determinant of membrane glycosylation. Thus Peff probably reflects the long-term effects of intraperitoneal glycosylation of peritoneal membrane proteins. Treatment with non glucose dialysis solutions may result in “washout” of glycosylated proteins from the peritoneal membrane.
Hydrostatic and Osmotic Pressures Modulate Partitioning of Tissue Water in Abdominal Muscle during Dialysis
Authors: Zakaria El Rasheid , Lofthouse Joanne , Flessner Michael F.
Published: February 2020

Objectives

To investigate the effect of simultaneous exposure of anterior abdominal muscle (AAM) to changes in intraperitoneal hydrostatic pressure (Pip) and to osmolality of peritoneal fluid on total tissue water (TTW) and on the pattern of distribution of TTW in the AAM.

Design

A pilot study of single 60-min dwells in anesthetized Sprague-Oawley (SO) rats, dialyzed with either isotonic (290 mOsm/kg) or hypertonic (510 mOsm/kg) dialysis solutions at nominal Pi of 0 mmHg or 6 mmHg.

Measurements

TTW (from dry-weight-to-wet -weight ratios) can be divided into the extracellular volume [0ec’ from quantitative autoradiography (QAR) with 14C-mannitol] and intracellular volume (0ic = TTW -0ec). 0ec = 0if + 0iv’ where 0if = interstitial volume and 0iv = vascular volume [from QAR with 1311-immunoglobulin G (lgG)]. All measured parameters are standardized to tissue dry weight and expressed as mean ± standard error.

Results

Regardless of the osmolality of the dialysis solution, elevation of PiP to 6 mmHg results in tissue expansion, primarily in 0if’ which is doubled to 1.71 ± 0.11 mUg dry weight and 1.60 ± 0.17 mUg dry weight with isotonic and hypertonic dialysis, respectively, as compared to controls (0.64 ± 0.04 mUg dry weight). The local 0iv was not affected by Pip or osmolality of the bathing solution. The overall 0iv is 0.046 ± 0.006 mUg dry weight. A two-way analysis of variance (ANOVA) to access the effect of osmolality and Pip on 0ic demonstrated no significant change in 0ic (F = 1.2, p > 0.1) as calculated for controls (3.13 ± 0.19 mUg dry weight), after isotonic dialysis (3.13 ± 0.20 mUg dry weight), or after hypertonic dialysis (2.77 ± 0.30 mUg dry weight).

Conclusion

Elevation of Pip to 6 mmHg significantly increased TTW and expanded the tissue. Tissue expansion is primarily in interstitium (0if, which is doubled from control value regardless of dialysis fluid osmolality.
Effect of N-Acetylglucosamine on Function of Peritoneal Leukocytes
Authors: Kuzlan-Pawlaczyk Malgorzata , Pawlaczyk Krzysztof , Tobis Katarzyna Wieczorowska , Polubinska Alicja , Wisniewska Justyna , Wu George , Tam Paul , Breborowicz Andrzej
Published: February 2020

Objective

To compare effects of N-acetylglucosamine (NAG) -based and glucose-based dialysis fluids on the function of peritoneal leukocytes in conditions of peritoneal dialysis.

Design

In vitro experiments on ex vivo isolated rat peritonealleukocytes.

Materials

Peritoneal leukocytes were isolated from rats on chronic peritoneal dialysis. On alternate days, fluid exchanges were performed with NAG-based or glucosebased dialysis solutions. After a 4-hour dwell, dialysate was drained and peritoneal leukocytes were incubated in vitro :I= lipopolysaccharide (LPS). Production of nitrites (index of NO synthesis), tumor necrosis factor α (TNFα), interleukin-1 β (IL -1 β), and interferon gamma (IFN-y) by unstimulated or stimulated peritoneal leukocytes originating from NAG-based or glucose-based fluid was measured.

Results

Dialysate cell count was lower during exchanges with NAG-based fluid (2113 :I= 615 cells/μL) as compared to glucose-based fluid (3643 :I= 1108 cells/μL; p < 0.01). Differential cell count was similar in both studied groups. Unstimulated peritoneal leukocytes from NAGbased dialysate produced more NO (nitrites) (0.65 ± 0.07 μmol per 106 cells) than did cells from glucose-based dialysate (0.26 :I= 0.09 μmol per 106 cells, p < 0.01). Stimulated peritoneal leukocytes from NAG-based dialysate produced more cytokines than did cells from glucose-based dialysate: TNFα, 135.2 ± 37.0 pg versus 70.2 :I= 21.8 pg per 106 cells respectively, p < 0.01; IL -1 β, 143.2 :I= 60.9 pg versus 99.1 :I= 22.4 pg per 106 cells respectively, p < 0.05; IFN-y, 16.2:1= 12.5 pg versus 6.0:1= 1.8 pg per 106 cells respectively, p <0.01.

Conclusions

We demonstrated that rat peritonealleukocytes exposed in vivoto NAG-based dialysis fluid have better ability to produce inflammatory mediators than do peritoneal leukocytes from the same donor, but exposed in vivo to glucose-based dialysis solution.
The Optimal Approach to Peritoneal Dialysis Prescription in Children
Authors: Fischbach Michel , Terzic Joëlle , Bergère Valerie , Gaugler Christophe , Provot Emmanuel
Published: February 2020

Objective

To describe the optimal approach to peritoneal dialysis (PO) prescription in children. .Design: Review of the available literature.

Results

Unlike the situation in adults, the main method used for PO in children is automated peritoneal dialysis (APO). The prone position, while resting, permits the dialysis prescription to use a higher fill volume (IPV), as in continuous ambulatory peritoneal dialysis (CAPO), and is also probably more effective than PO in an upright position. However, because APO is limited to 10 hours, the dialytic effectiveness of nocturnal APO should avoid two potential risks: (1) use of too high an IPV per exchange, inducing lymphatic reabsorption, a factor in unsuitable water and sodium balance [Fischbach M. Peritoneal dialysis prescription for neonates. Perit Diallnt. 1996; 16(Suppl): S52–4]; and (2) use of too short a dwell time per exchange, limiting the purification of creatinine and phosphate despite an apparently adequate urea purification (Malhotra C, Murota GH, Tzamaloukas AH. Creatinine clearance and urea clearance in PO: What to do in case of discrepancy. Perit Diallnt. 1997; 17:532–5).
Malnutrition: Detection and Intervention
Authors: McCann Linda M.
Published: February 2020

Malnutrition is common in patients with renal failure. Causes of malnutrition in this population are varied and sometimes specific to the method of renal replacement therapy. No single marker absolutely identifies malnutrition or tracks changes in status. Renal dietitians use a variety of parameters and techniques to identify malnutrition because many of the traditional markers can be skewed by renal disease and its comorbidities. Once malnutrition is identified, treatment is also complex and not well defined. Treatment is usually progressive in nature, ranging from intense nutritional counseling to total parenteral nutrition. Further research is needed to define optimal nutrition status, to refine techniques to maintain optimal nutrition status, to simplify the identification of malnutrition, and to improve the treatment for malnutrition.
Hybrid modeling and analysis of multidirectional variable stiffness of the linear rolling guideway under combined loads
Authors: Yang Lei , Wang Lei , Zhao Wanhua
Published: February 2020

In the working process of high-speed multiaxis machine tools, inertial loads due to high feed acceleration and time-varying gravity loads due to changing configuration of multiaxis structure result in time-varying complex loads applied to linear rolling guideway. Existing models cannot efficiently represent the effect of complex loads on multidirectional stiffness variation of linear rolling guideway. In this paper, a hybrid model of multidirectional stiffness of linear rolling guideway and the solving algorithm are proposed. The complex loading conditions of linear rolling guideway in high-speed multiaxis machine tool structure are considered. And contact flexibilities between rolling balls and grooves are modeled with the effect of elastic deformations of runner block and rail. The proposed model can calculate the multidirectional stiffness with high accuracy. Meanwhile the differences between the stiffness characteristics in different directions are represented correctly. The variations of multidirectional stiffness of linear rolling guideway under time-varying combined loads are analyzed. This study provides an effective way to comprehensively evaluate the stiffness characteristics of linear rolling guideway which can contribute to the dynamic analysis and active design of high-speed machine tool structure.
Continuum of HIV care of newly diagnosed individuals in Israel, 2011–2015: a population-based cohort study
Authors: Chowers M , Chemtob D , Mor O , Levy I , Elbirt D , Elinav H , Rizenberg K , Lorber M , Istomin V , Nemet S , Shahak G , Turner D
Published: February 2020

Our aim was to assess the linkage to care (LTC) and treatment for people newly diagnosed with HIV in Israel during 2011–2015. The Ministry of Health estimated the annual prevalence of undiagnosed HIV; new diagnoses were identified by the Central Virology Laboratory. Only adult Israeli citizens were included. LTC at HIV centers within 90 days of diagnosis was assessed. Demographic and clinical data were collected from patient files. A total of 1538 individuals were diagnosed in 2011–2015. A moderate improvement over time was observed in the calculated proportions of undiagnosed individuals (23.1–17.3%) but no change occurred in LTC rates (82.6–81%). The proportion of diagnosed patients initiating treatment within six months increased from 54.7% in 2011 to 89.7% in 2015, with a parallel increase in the viral suppression rate from 30.5% in 2011 to 59.9% in 2015. Of 1159 patients with detailed records, 79.4% were men, median age 36 years (16–92), median CD4 cell count 342 cells/µl. Younger age, intravenous drug use, and imprisonment were independent risk factors for loss to follow-up. HIV is diagnosed late in Israel and LTC rates remain stagnated; higher awareness is still needed. Once in care, however, treatment and outcomes were in line with international standards.
Collective Emotions
Authors: Goldenberg Amit , Garcia David , Halperin Eran , Gross James J.
Published: February 2020

When analyzing situations in which multiple people are experiencing emotions together—whether the emotions are positive or negative and whether the situations are online or offline—we are intuitively drawn to the emotions of each individual in the situation. However, this type of analysis often seems incomplete. In many of the cases in which people experience emotions together, there appear to be emergent macrolevel affective processes that cannot be readily captured at the individual level. In this article, we examine these macrolevel affective phenomena, which are termed collective emotions. We open with a general review of research on collective psychological processes. We then define collective emotions and discuss their key features. Next, we focus our attention on the emergent properties of collective emotions and map them using three dimensions: quality, magnitude, and time course. Finally, we discuss pressing open questions and future directions for research on collective emotions.
Studying the Intergenerational Transmission of Risk for Depression: Current Status and Future Directions
Authors: Gotlib Ian H. , Goodman Sherryl H. , Humphreys Kathryn L.
Published: February 2020

Studying offspring of depressed mothers is a promising strategy for elucidating factors that contribute to depression onset, given that these offspring are 3 to 6 times more likely to develop depression than are their low-risk peers. In this article, we briefly describe representative findings from studies of younger and older offspring of depressed mothers and identify factors that have garnered the most consistent empirical support across development. We discuss what these studies can and cannot tell us about mechanisms that might underlie the intergenerational transmission of risk for depression regardless of the age of offspring being studied. Finally, in light of limitations of this literature, we offer recommendations for future research.
Metaphors, Communication and Effectiveness in Indian Politics
Authors: Antil Anjuman , Verma Harsh V.
Published: February 2020

The aim of this article is to give insights on the role and usage of metaphors in political communication. The article studies the use of conceptual metaphors by politicians in two different scenarios, namely election campaign and addresses of a prime minister to a global audience. Both these settings are important from political image building perspective. For studying political communication during election campaigns, we have examined the text of newspaper articles and social media handles of politicians. For analysing metaphors used while addressing an international audience, select speeches delivered abroad by Indian Prime Minister Modi have been studied. The analysis is carried out on the basis of Lakoff and Johnson’s Conceptual Metaphor Theory. For this, important metaphors are culled out and analysed, including POLITICS IS WAR, A POLITICIAN IS A WATCHMAN, WORLD IS COMMUNITY, WORLD IS FAMILY AND NATION IS PERSON.
Korea’s ‘New Southern Policy’ Towards India: An Analysis
Authors: Dhawan Ranjit Kumar
Published: February 2020

The Moon Jae-in administration in South Korea (hereafter Korea) initiated the ‘New Southern Policy’ in 2017 to foster closer relations with ASEAN and India and bring them at par with the four major powers—the United States of America (USA), China, Russia and Japan, which have traditionally played a dominant role in Korea’s foreign affairs. Korea’s strategy through this new policy has been to diversify its foreign relations and lessen dependence on these four major powers of the Northeast Asian region. In this policy shift India is projected as one of the key partners for Korea. However, there has not been much progress in Korea’s relations with India in the last 2 years. The New Southern Policy is also not compatible with US-led ‘Indo-Pacific strategy’ in which India is an integral component. This article argues that Seoul’s New Southern Policy toward New Delhi shall remain limited and would largely focus on developing economic relations rather than building security cooperation between the two countries.
A Literature Review of Racial Disparities in Overall Survival of Black Children With Acute Lymphoblastic Leukemia Compared With White Children With Acute Lymphoblastic Leukemia
Authors: Eche Ijeoma Julie , Aronowitz Teri
Published: February 2020

Despite major advances in acute lymphoblastic leukemia [ALL] treatment, poorer overall survival (OS) persists for Black children with ALL compared with White children with ALL. The purpose of this literature review was to examine the racial disparities on OS in Black versus White children with ALL. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, PubMed, and Academic Search Complete databases were searched using the Medical Subject Heading (MeSH) terms: survival or mortality or outcome AND black or African-American or AA or minority AND racial disparities or race or racial/ethnic disparities AND cancer in children or pediatric cancer or children with leukemia or children with ALL for articles published in English between January 2009 and July 2019. Exclusion criteria were non-research articles, systematic reviews, conference abstracts, editorials, commentaries, correspondence, and case reports. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data were extracted, appraised, and synthesized. Sixteen articles met the inclusion criteria. Sample sizes across studies ranged from 184 to 31,866 participants. The factors most associated with disparities in OS included: age at diagnosis (e.g., <1 year and/or >10 years old), differences in clinical prognosticators (e.g., white blood cell count at diagnosis, T-cell vs. precursor B-cell immunophenotype, central nervous system disease status, cytogenetic profile) and lower socioeconomic status. Future prospective studies are needed to elucidate the role of these factors in OS of Black children with ALL.
Artificial Turf Infill: A Comparative Assessment of Chemical Contents
Authors: Massey Rachel , Pollard Lindsey , Jacobs Molly , Onasch Joy , Harari Homero
Published: February 2020

Concerns have been raised regarding toxic chemicals found in tire crumb used as infill in artificial turf and other play surfaces. A hazard-based analysis was conducted, comparing tire crumb with other materials marketed as alternative infills. These include other synthetic polymers as well as plant- and mineral-based materials. The comparison focused on the presence, absence, number, and concentration of chemicals of concern. No infill material was clearly free of concerns, but several are likely to be somewhat safer than tire crumb. Some alternative materials contain some of the same chemicals of concern as those found in tire crumb; however, they may contain a smaller number of these chemicals, and the chemicals may be present in lower quantities. Communities making choices about playing surfaces are encouraged to examine the full range of options, including the option of organically managed natural grass.