bluuebunny/crossref_metadata_2025_split huggingface dataset:
Studies on the Resistance of the Peritoneal Mesothelium to Solute Transport
Authors: Breborowicz Andrzej , Knapowski Jan 
Published: February 2020

Permeability of the mesothelium for rubidium and albumin was evaluated in vitro. There were pores through which free diffusion of rubidium occurs in 0.03% of the mesothelium area. On the other hand, albumin seems to be transported through transport system by some mechanism other than simple diffusion. The role of the mesothelium as a barrier to the transport of solutes during peritoneal dialysis is not cleared finally (I). Most of the data characterising the transport characteristics of the peritoneal membrane were obtained from in vitro studies (2–4). From their in vitro studies Gosselin and Berndt calculated that, on the aggregate, water-filled pores, through which small molecules may diffuse, occupy 0.6% of the area of the mesentery (5). However we showed, recently, that the values of the transport rate of various substances across the mesentery in vitra are overestimated because of damage to the membrane edges (6). All the membranes studied in vitro are damaged as a result of compression between the edges of the chambers used for study. This damage creates an additional (shunt) pathway through which solutes can be transported at the same time as they cross the undamaged membrane. We decided to re-evaluate the calculations of Gosselin and Berndt, based on our studies of the bidirectional, transmesothelial transfer of rubidium (m. w. 86) and albumin, (m. w.X 68000) and correcting for the existence of the edge damage.
CAPD in Canada in 1982
Authors: Pose” Gerald , Lam Eric , Rappaport Anita 
Published: February 2020

This study examined the role of CAPD in the treatment of end stage renal failure in Canada in 1982, using data obtained from the Canadian Renal Failure Registry. In comparison to 1981, there was an increase in the number of patients on peritoneal dialysis. As of December 31, 1982, equal proportions of patients had started on hemodialysis and peritoneal dialysis. The average patient age was slightly lower for the hemodialysis. The most common reason for discontinuing CAPD was transplantation, followed by peritonitis and other abdominal complications. Over one-half of CAPD patients had no peritonitis; most of the episodes occurred in a minority of patients. In the initial treatment of children, CAPD and hemodialysis were used with equal frequency. At two years the survival of non-diabetic patients on CAPD was similar to that of hemodialysis patients. The Canadian Renal Failure Registry, which was established in 1981, receives data from all 68 dialysis units in Canada (1–2). The Registry has two parts: the first receives data from each centre, and the second concerns data only on patients who were started on treatment after the Registry came into existence, that is, 1981. This report examines the place of CAPD in the overall management of all patients in Canada with end-stage renal failure, and the use and complications of CAPD in patients who started therapy in 1981 and 1982.
Anti-Hypertensive Drug Requirements in Continuous Ambulatory Peritoneal Dialysis
Authors: Young Michael A. , Nolph Karl D. , Dutton Sue , Prowant Barbara 
Published: February 2020

This retrospective analysis documents changes in antihypertensive drug requirements with time on CAPD. In 59 patients who were hypertensive at initiation of CAPD, antihypertensive drug use decreased from almost 1.2 to less than 0.3 drugs per patient during the first month. In this group, the proportion in whom blood pressure was controlled without drugs went from 0% to nearly 60% after 12 months. These results, which most likely reflect control of body -fluid volumes and sodium balance, are similar to those reported with hemodialysis. It has been noted that patients receiving antihypertensive medications to control blood pressure at the initiation of continuous ambulatory peritoneal dialysis (CAPD) frequently require fewer or no anti-hypertensive medications with time on CAPD (1–2). The purpose of this retrospective analysis was to quantitate the extent and the timing of this trend in a CAPD population at a single center.
An in VITRO Test of the Efficacy of the Perioexr CAPD Filterset
Authors: Poole-Warren Laura A. , Spencer Peter C. , Farrell Peter C. 
Published: February 2020

In an attempt to reduce the incidence of peritonitis caused by contamination during CAPD bag change procedures, Millipore (Bedford, Mass) developed the Peridex R CAPD filterset. Using the bacterium Serratia marcescens as the challenge organism, this filterset has been evaluated in vitro during 30 days of mock CAPD conducted in our laboratory. S. marcescens was chosen because it has been shown to remain viable in peritoneal dialysis (PD) fluid for more than 30 days. During the test period, the membrane filter and bypass lines were separated to allow identification of the route of bacterial invasion; in essence, two artificial peritoneal cavities were created. The membrane filter, composed of 0.22 [IJ.]m cellulose ester, maintained sterility of the filtered dialysate (n = 5) during the test period. However, the one-way bypass valve had a 60% failure rate by day 18, allowing the test organism to enter the other peritoneal cavity. Under the conditions of this study, the CAPD filterset was shown to be bacteriologically safe for up to 17 days, since contamination was detected following the 18th overnight dwell. Therefore we recommend that filtersets be changed twice monthly to prevent peritonitis due to touch contamination, resulting from failure of the one-way bypass valve on the dialysate outflow line.
Response to Graded Exercise Testing in Patients Treated with CAPD
Authors: Painter P.L. , Messer D. , Widener C. , Zimmerman S.W. 
Published: February 2020

Exercise tolerance in patients treated with CAPD is low compared to normals, however comparable to most studies of patients treated with hemodialysis. Blood pressure responses to graded exercise in the CAPD patients are abnormal, with dramatic yet non-symptomatic decreases in systolic pressure. In three patients tested with and without dialysate present in the abdomen, blood pressure responses were more appropriate (no fall in systolic pressure) in the empty condition. Recommendations at this time for exercise training for these patients is walking a minimum of three days per week at an intensity of 65–80% of maximal oxygen consumption (or below which any fall in systolic blood pressure occurs), working up to 30 minutes per exercise session. Patients exhibiting abnormal blood pressure responses to graded exercise should exercise with no fluid in the abdomen. Exercise tolerance in renal patients treated with hemodialysis has been reported to be low (1–4). A goal of CAPD is to allow the patient to be more active, however, little is known about the effect of CAPD on exercise tolerance and hemodynamics during dynamic exercise. The present study was designed to quantitate exercise tolerance in patients treated with CAPD and evaluate heart rate, electrocardiogram, and blood pressure responses to graded dynamic exercise.
Use of Amino Acid Containing Solution in CAPD Patients
Authors: Khanna Ramesh , Wu George , Rodella Helen , Oreopoulos Dimitrios G. 
Published: February 2020

A number of CAPD patients may develop malnutrition due to multiple causes. Average daily amino acid loss during CAPD was 2 gm per day. Serum concentrations of almost all essential and non essential amino acids were significantly lower than controls. Amino acid containing solution is an effective osmotic agent and at the same time is suitable for nutritional supplementation. Use of this solution up to 4 weeks did not lead to any abnormal accumulation of amino acids and patient appeared to tolerate it well. A number of CAPD patients may develop malnutrition which appears to be brought about by a combination of decreased appetite, and increased nutrient loss in the dialysate. In a group of 13 patients whose daily protein and caloric intakes at the beginning of CAPD were 1.5 9 per kg, and 35 Kcal/kg respectively, intakes decreased spontaneously after one year on CAPD even though they were being advised during their clinic visits to maintain initial protein and caloric intakes (1). Reduced intakes appear to result from decreased appetite and a feeling of fullness, although these factors are difficult to evaluate quantitatively. To gain information as to the etiology of appetite suppression during CAPD, we performed CAPD in nonuremic rabbits.
Convective Characteristics of Pediatric Peritoneal Dialysis
Authors: Morgenstern Bruce Z. , Pyle W. Keith , Gruskin Alan B. , Kaiser Bruce A. , Perlman Sharon A. , Polinsky Martin S. , Baluarte H. Jorge 
Published: February 2020

The convective aspects of pediatric peritoneal dialysis (PD) -fluid transfer with its attendant solvent drag -were evaluated in vivo in 8 children on maintenance PD. The evaluation was performed according to the mass transport model of pyle. Reflection coefficients were calculated for urea, creatinine, uric acid, glucose and idealized total protein. These values were compared to adult means. There were no differences in reflection coefficients, except for total protein, which had a lower value. Maximum ultrafiltration rates were also calculated for the three commercially avail able dialysate glucose concentrations (1.5%, 2.5%, 4.25%). These values were scaled for body surface area to allow comparison with adult means. All values were lower than the adult means, but were not outside two standard deviations. Convective transport in PD in children over 1 Vl years of age, does not appear to be significantly different than that in adults. There are two components to solute removal in peritoneal dialysis: diffusion and convection. Convective transport, the passive movement of solute in a solvent stream across a semipernleable membrane, is directly related to the rate of ultrafiltration. The convective component of solute removal in peritoneal dialysis may be responsible for a significant per cent of transport of larger molecular weight solutes (I). Little infornlation is currently available concerning this aspect of pediatric peritoneal dialysis. Kohaut and Alexander have reported that it is more difficult to achieve ultrafiltration in infants than in older children, adolescents, and adults (2). The convective component of peritoneal dialysis in infants may therefore contribute less to overall solute removal than in older children and adults.
Effects of Continuous Ambulatory Peritoneal Dialysis (CAPD) on Renal Osteodystrophy
Authors: Loschiavo Carmelo , Fabris Antonia , Adami Silvano , Tomelleri Luciana , Tessitore Nicola , Valvo Enrico , Lupo Antonio , Oldrizzi Lamberto , Rugiu Carlo , Gammaro Linda , Maschio Giuseppe 
Published: February 2020

The authors performed a metabolic and morphologic investigation of calcium metabolism in 22 patients on continuous ambulatory peritoneal dialysis (CAPD), selected as the first procedure. The patients were kept on a diet containing about 30 Kcal/ kg, 1 g/kg of protein, 950 mg of phosphate and 1500 mg of calcium per day. They showed normal mean values of serum calcium, phosphate, alkaline phosphatase, total protein and albumin at the start and after six, 12 and 21 months of CAPD. Serum PTH levels showed a progressive decrease over 21 months. Serum 25-OH-D3 were low at start and showed a further decrease after 12 months of CAPD. Before and during CAPD, serum 1,25 (OH)2D3 levels were undetectable. The bone mineral content was within normal range at start and showed a slight decrease after 12 months of CAPD. In 64% of the patients, bone biopsies, obtained from the iliac crest at the start showed osteomalacia, either isolated or associated with hyperparathyroidism. After 12 months, osteomalacia was still evident in 71% of this group. The authors concluded that dietary restriction of phosphate is important in preventing secondary hyperparathyroidism in patients on CAPD. However, prevalence of osteomalacia is due to defective vitamin D metabolism and its management requires administration of vitamin D metabolites. In its morphological aspects and clinical features, renal osteodystrophy (RO) may differ significantly between patients on CAPD and those on hemodialysis (1–3). In addition, workers have reported conflicting opinions concerning the incidence and severity of bone lesions in CAPD patients (4–6). We undertook this investigation in order to evaluate the evolution and clinical, biochemical and morphologic aspects of RO in 22 ESRD patients treated with CAPD after long-term restriction of dietary protein and phosphate.
Peritoneal Catheter Survival and Complications in end Stage Renal Disease
Authors: Bierman Martin H. , Kasperbauer Jan , Kusek Anthony , Hammeke Michael D. , Fitzgibbons Robert J. , Egan John D. 
Published: February 2020

Peritoneal catheter survival and complications were determined retrospectively over an eight-year period. Two hundred and twenty-two peritoneal catheters were placed in 124 patients; the 107 failures, which required catheter replacement, were due to dislodgment (38), one-way obstruction (31), peritonitis (28), leakage (7), and tunnel infection (3). Forty per cent of all catheter failures occurred within the first week due mainly to dislodgment and obstruction. Females had significantly more leakage-related catheter failures. Diabetic patients had fewer total catheter failures and fewer failures due to peritonitis. Over a 24-month period no difference was seen in the number or types of failures between straight and curled Tenckhoff catheters. By life-table analysis cumulative per cent catheter survival was 45% at 52 weeks; this was not affected by sex, type of catheter, or use of radiography during placement. In patients with multiple peritoneal catheter placements, subsequent catheters did not have a lower survival.
Complete Dialysate Drainage: An Unnecessary Step in Intermittent Peritoneal Dialysis
Authors: Indraprasit Suchati , Taramas Wandee , Panpakde Orasa 
Published: February 2020

Peritoneal dialysis was performed in 16 renal-failure patients to study the necessity of complete drainage during the outflow period. Comparison between complete drainage (CD) and the accelerated inflow and limited outflow (AILO) showed no difference of drainage volume despite the accelerated outflow during the AILO period. It is postulated that the higher level of dialysate in the fluid line during the AILO period resulted in a relative increase availability of the outflow through the catheter perforations. In the CD period the peritoneal clearances of urea, creatinine and inulin were lower because of inefficient transport of these solutes during the outflow phase. The authors concluded that complete drainage is not necessary in intermittent peritoneal dialysis. During intermittent peritoneal dialysis, dialysate drainage volume usually is a major concern among medical and nursing staffs. Particularly during the initial exchange, dialysate frequently is retained because of a pocket of fluid in an inaccessible area of the peritoneal cavity (1). Thus, in subsequent exchanges considerable effort is made to stimulate drainage so as to avoid further accumulation. This prolongs outflow time and takes up the time and attention of paramedical personnel. The present study was done to evaluate the necessity of complete dialysate drainage in term of mechanics and efficiency of dialysis.
Chronic Peritoneal Dialysis is Associated with Progressive Thrombocytosis
Authors: Zimmerman Stephen W. 
Published: February 2020

The mean platelet count of chronic peritoneal dialysis (cpD) patients (371.000 ± 15.500/mm3) was significantly greater than the mean of hemodialysis (HD) patients (224.000 ± 11.000/mm3. P <. 001). Thrombocvtosis (platelet count > 400.000/ mm3) was noted in 23 of 57 CPD patients hut in only two of 50 chronic HO patients (P < .001). Platelet counts increased with time on CPD. Of CPO patients on dialysis for two years or more .62 % h3d thrombocytosis, in contrast to 6% of HD patients. Platelet counts of CPD patients correlated positivelv with time on PD and serum creatinine. and negatively with age. While there is a progressive increase in platelet counts with peritoneal dialysis. we do not know the underlying mechanisms of thrombocvtosis. the relationship to a possible hypercoagulable state and potential risk for thromboembolic events. The urem1c bleeding tendency 1S associated with abnormal platelet function but platelet counts usually are normal III both uremic patients and those on hemodialysis (1. 2). The bleeding tendency in uremia is corrected by peritoneal dialysis (PD) (3–5), and several have suggested that hypercoagulability may exist in continuous ambulatory peritoneal dialysis (CAPD) (5). However. except tor a rare patient with thrombocytosis (4,6) platelet counts of most PD patients are normal (3–5), although these counts may increase after starting peritoneal dialysis (4). This study was done to assess platelet counts in chronic PD patients and compare them to those on hemodialysis (HD). Platelet counts were elevated in PD when compared to HD and we performed further correlations with clinical and laboratory parameters in PD patients.
Defective Opsonic Activity of Peritoneal Effluent during Continuous Ambulatory Peritoneal Dialysis (CAPD): Importance and Prevention
Authors: Lamperi Silvano , Carozzi Silvia 
Published: February 2020

To evaluate peritoneal immunological defenses and to find a way to prevent peritonitis we have studied the capacity of peritoneal dialysis effluent (PDE) to opsonize bacteria, and the phagocytic activity of peritoneal macrophages (PM). The subjects were 40 uremic patients followed for a mean period of 36 months and 40 normal women who underwent laparoscopy (controls). Opsonic capacity for Staphylococcus epidermidis of undiluted PDE from CAPD patients with low peritonitis incidence (LPI) proved to be similar to that of 10% control serum. However, the capacity of effluent from patients with a high peritonitis incidence (HPI) was noticeably inferior. In these cases, IgG concentration in PDE was lower than in LPI patients. There was a significant correlation between opsonization capacity for bacteria and IgG concentration values in PDE. We found inverse correlations between opsonic capacity of PDE and number of episodes of peritonitis. Phagocytic capacity of PM from CAPD patients was similar to that of control PM when micro-organisms were preopsonized by control serum. Treatment with intraperitoneal intmunoglobulin raised PDE opsonization capacity and lowered the incidence in those with previous HPI, thus demonstrating the importance of abnormal opsonization in CAPD peritonitis and the possibility of preventing infection by prophylaxis with intraperitoneal immunoglobulin. Intravenous immunoglobulin does not reduce the incidence of infection.
Survival Comparison of Adult Non-Diabetic Patients Treated with Either Hemodialysis Or CAPD for End-Stage Renal Failure
Authors: Posen Gerald , Arbus Gerald , Hutchinson Tom , Jeffery John 
Published: February 2020

The authors studied all adult patients (15 years and over), other than those with primary diagnosis of diabetes mellitus, who were registered in the Canadian Renal Failure Register, and who had begun treatment with either hemodialysis or peritoneal dialysis. Survival was calculated only for those on hemodialysis or for those on peritoneal dialysis who changed to or continued on CAPD. The calculations were done for life and technique survival in three age groups. The age groups were: 15–44, 45–64, and 65 and over. In all age groups the survival until death was similar. The technique survival rates were higher in hemodialysis in the 15–44 group, similar in the 45–64 group, and initially lower in CAPD in the 65 and over group. Previous studies and comparison (I, 2) of patient and technique survival in hemodialysis and CAPD have shown a poor technique survival in CAPD. Age-group analysis in the Australian Registry (2) demonstrated no difference in technique survival in different age groups, but patients over 64 were not studied separately either in Canada or other countries. This group represents 25% of our new patient population (3), and with an aging population their numbers can be expected to increase. Therefore we decided to study this group separately and to compare their technique and life survival results with the different treatment and different age groups.
Sexual and Marital Relationships and Dialysis the Patient's Viewpoint
Authors: Juliet Janis P. Stout , Kincey Auer John , Hillier Valerie F. , Gokal Ram , Gail Simon L. , Oliver Desmond 
Published: February 2020

This study of 133 patients of both sexes on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) focusses on the patient's viewpoint of their satisfaction with their sexual relationships, and asks whether this had changed since commencement of treatment. Patients also were asked about their marital satisfaction and their partner's feelings in relation to their sexual relationship. This study shows that about half the patients reported a significant deterioration in their satisfaction with sexual relationships since starting dialysis. This deterioration was significant regardless of age, sex or mode of treatment. Patients ex pressed concern about this deterioration and felt that their partners were similarly concerned. Patients aged less than 60 years and all patients on hemodialysis expressed significantly more concern than those over 60 and those on CAPD. Satisfaction with marriage was reported as good on dialysis and this response was not related to the reported sexual dysfunction on treatment. All members of the multidisciplinary renal team, especially the social worker, should ensure that dialysis patients and their partners have access to appropriate psychosexual counselling by a trained sex counsellor as part of the overall treatment and counselling of dialysis patients.
Limulus Lysate Study of Effluents from CAPD Patients
Authors: Cartmill T.D.I. , Tapson J.S. , Freeman R. 
Published: February 2020

A micro method, Limulus lysate assay, has been used to determine the presence, or otherwise, of endotoxin in the emuents of various groups of CAPD patients. Endotoxin, a freely diffusable product of most gramnegative organisms was not detected in emuents of 11 asymptomatic trainers. Only 1/33 proven gram positive episodes of peritonitis and 1/21 patients with illnesses other than peritonitis were positive for endotoxin. However only 7/10 proven cases of gram-negative peritonitis were positive for endotoxin. Thus, in its present state, the test is neither sensitive nor specific enough to be a reliable, rapid method of diagnosing gram-negative peritonitis. Only 1/24 cases of “culture-negative” peritonitis yielded a positive Limulus lysate test.