bluuebunny/crossref_metadata_2025_split huggingface dataset:
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).
Prognostic role of intrathecal IgM synthesis in multiple sclerosis: Results from a clinical series
Authors: Fonderico Mattia , Biagioli Tiziana , Lanzilao Luisa , Bellinvia Angelo , Fratangelo Roberto , Pastò Luisa , Prestipino Elio , Razzolini Lorenzo , Tudisco Laura , Ginestroni Andrea , Vuolo Luisa , Fainardi Enrico , Ballerini Clara , Portaccio Emilio , Amato Maria Pia 
Published: February 2020

Background: There is emerging evidence that intrathecal IgM synthesis (ITMS) is a risk factor for conversion to clinically defined multiple sclerosis (CDMS) in clinically isolated syndrome (CIS) patients. Objectives: The objective of this study is to verify the prognostic role of ITMS as a risk factor for the second clinical attack in patients after the first demyelinating event. Methods: Monocentric observational study performed on prospectively acquired clinical data and retrospective evaluation of magnetic resonance imaging (MRI) data. ITMS was assessed according to Reiber’s non-linear function. We compared time to the second attack by using Kaplan–Meier curves and performed adjustment by Cox regression analysis. Results: Demographics and clinical data were collected prospectively in a cohort of 68 patients. ITMS occurred in 40% (27/68) of patients who had a higher T1-hypointense lesion load at brain MRI ( p = 0.041). In multivariate Cox regression analysis (adjusted for age, sex, baseline Expanded Disability Status Scale, IgG oligoclonal bands and disease-modifying treatment exposure), relapsing-remitting multiple sclerosis (MS) patients with ITMS were at higher risk to experience a second clinical attack (adjusted hazard ratio (aHR) = 6.3, 95% confidence interval (CI) = 2.1–18.4, p = 0.001). Conclusion: Together with previous studies, our findings support the role of ITMS as a prognostic biomarker in MS.