bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technical Aspects in Studying Peritoneal Morphology in Animal Models of Peritoneal Dialysis
Authors: Duman Soner , Şen Sait 
Published: February 2020

Objective Peritoneal biopsies are considered useful for gaining a better understanding of the pathophysiology of the peritoneum during experimental peritoneal dialysis (PD). Different peritoneal tissue samples (i.e., abdominal wall, liver, diaphragm, intestine, and omentum) may be used, but there can be artifacts due to peritoneal tissue processing. Aim To investigate differences in peritoneal membranes from different parts of the peritoneum, and also 2 different fixatives, in experimental PD and a peritonitis model in rats. Methods Peritoneal tissues from the anterior abdominal wall, liver, omentum, and intestine were taken from each of 3 groups of animals: sham, experimental PD, and peritonitis model. Tissue samples were immediately fixed with 4% formaldehyde and routinely processed for histological examination. Two parietal peritoneal tissue samples according to longitudinal and horizontal sections of anterior wall inner abdominal muscle were also taken. All samples were immediately fixed with 4% formaldehyde and B5 fixative (B5), and then routinely processed for histological examination. Results In all groups, histopathological findings were more commonly seen in the abdominal wall samples. There were no changes observed in peritoneal membranes other than those of anterior abdominal wall samples from both sham and PD model rats. However, there was a significant difference between anterior and posterior facets of liver in the peritonitis model. Furthermore, the antimesenteric site of intestinal peritoneum was less affected than the mesenteric site. There were no significant histopathological differences between B5 and 4% formaldehyde fixation ( p > 0.05). Conclusion Our results suggest that peritoneum obtained from the anterior abdominal wall is the most affected area and therefore the most suitable site to investigate peritoneal changes in the experimental rat PD model. There were no significant differences between fixation with 4% formaldehyde and B5 solution. Abdominal wall samples should be of the same direction of inner abdominal muscle, that is, horizontal sectioning should be used for measurements of the submesothelial area.
Is Subjective Global Assessment a Good Index of Nutrition in Peritoneal Dialysis Patients with Gastrointestinal Symptoms?
Authors: Li Yanjun , Dong Jie , Zuo Li 
Published: February 2020

Objective We investigated whether patients with gastrointestinal (GI) symptoms were prone to be diagnosed as malnourished by subjective global assessment (SGA) by simultaneously evaluating SGA and other indices of nutrition in a cross-sectional survey of peritoneal dialysis (PD) patients. Patients and Method From June 2006 to June 2007, 214 PD patients were involved in the study. We recorded results of a GI symptoms questionnaire (GSQ) and SGA. Other indices of nutrition included dietary intake, chemistry examination, anthropometry, handgrip strength, and lean body mass measured by creatinine kinetics. Results Mean age of the 214 PD patients enrolled in the study was 60.22 ± 14.02 years, and mean dialysis duration was 60.22 ± 14.02 months. Of the 214 patients, 56 (27.16%) were diagnosed as malnourished by SGA. The mean GSQ scores were 9.37 ± 1.71 (range: 8 – 17). There were 90 patients with GSQ scores of 8 (group 1), 80 patients with scores of 9 or 10 (group 2), 44 patients with scores of 11 or more (group 3). The prevalence of malnutrition diagnosed by SGA was significantly different in the three groups: 15.56% in group 1, 27.5% in group 2, and 45.45% in group 3 ( p = 0.02). However, we observed no difference between the three groups in mid-arm circumference, skinfold thickness (biceps, triceps, subscapular, and suprailiac), daily protein and energy intake, handgrip strength, lean body mass, and serum albumin and prealbumin levels ( p > 0.05). Conclusions Our results showed that the reliability of SGA in PD patients with GI symptoms remains worth exploring. These patients are possibly diagnosed as malnourished by SGA, although many other indices of nutrition are not necessarily bad.
Carotid Intimal Thickness and Flow-Mediated Dilatation in Diabetic and Nondiabetic Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Prasad Narayan , Kumar Sudeep , Singh Anurag , Sinha Archana , Chawla Kamal , Gupta Amit , Sharma R.K. , Sinha Nakul , Kapoor Aditya 
Published: February 2020

Objectives We compared carotid intima media thickness (CIMT) and flow-mediated dilatation (FMD) between cases [end-stage renal disease patients (diabetic and nondiabetic) on peritoneal dialysis (PD)] and controls (diabetic and hypertensive patients with normal renal function) with the objective of identifying risk factors predicting atherosclerosis. Methods This cross-sectional study involved 124 subjects (62 cases, 62 controls). In both the case and control populations, we used B-mode ultrasonography to study CIMT and endothelium-dependent FMD, according to American College of Cardiology guidelines on brachial artery measurement. Pearson correlation was used to evaluate the correlation between CIMT and other variables. Results Compared with controls, cases had significantly higher systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglycerides, serum uric acid, inorganic phosphate, C-reactive protein, and parathyroid hormone, and significantly lower hemoglobin, calcium, and high-density lipoprotein. Compared with controls, cases showed significantly greater CIMT (0.60 ± 0.08 mm vs 0.54 ± 0.03 mm, p < 0.001) and significantly lower FMD (0.15 ± 0.08 cm vs 0.21 ± 0.04 cm, p = 0.02). Among cases, patients with diabetes had significantly greater CIMT (0.62 ± 0.08 mm vs 0.58 ± 0.07 mm, p = 0.05) than did patients without diabetes; FMD was similar in diabetic and nondiabetic patients on continuous ambulatory PD (0.16 ± 0.03 cm vs 0.18 ± 0.03 cm, p = 0.20). Conclusions Compared with controls, cases had significantly higher CIMT and lower FMD. Cases with diabetes had significantly higher CIMT than did cases without diabetes, but FMD was similar in diabetic and nondiabetic cases. Serum inorganic phosphate is an independent risk factor for atherosclerosis and was significantly correlated with CIMT. The noninvasive CIMT and FMD tests can be used to monitor atherosclerosis and endothelial dysfunction.
Effect of Pre-Transplant Dialysis Modality on Kidney Transplantation Outcome
Authors: Caliskan Yasar , Yazici Halil , Gorgulu Numan , Yelken Berna , Emre Turker , Turkmen Aydin , Yildiz Alaattin , Aysuna Nilgun , Bozfakioglu Semra , Sever Mehmet Sukru 
Published: February 2020

Background The effect of pre-transplant dialysis modality on early graft function is a matter of debate. Although some authors deny the existence of a significant influence, others suggest that peritoneal dialysis (PD) affects early graft function favorably, possibly by contributing to a more physiologic water balance. In the present study, we evaluated the influence of pre-transplant dialysis modality on early and late graft function. Patients and Methods We studied 745 patients who underwent a first renal transplantation during 1983 – 2006, comparing the records of 44 PD patients [26 male; mean age: 26 ± 9 years (range: 8 – 56 years)] who received 36 living related and 8 cadaveric renal transplantations with those of a control group of 44 consecutive hemodialysis (HD) patients [26 male; mean age: 27 ± 11 years (range: 7 – 49 years)] for the index cases. Results The groups showed no significant differences in donor type, human leukocyte antigen matching, immunosuppressive protocols, and duration of dialysis. Also, neither group differed significantly with regard to incidence of delayed graft function, acute tubular necrosis, wound infection, systemic viral and bacterial infections, or acute rejection in the early post-transplant period. In the late post-transplant period, incidences of chronic rejection, graft failure, and malignancies were also similar. During the follow-up period, 3 patients in the PD group experienced acute rejection, 2 developed cytomegalovirus (CMV) disease, and 5 developed various other infections. In the HD group, 4 patients experienced acute rejection, 1 developed CMV disease, and 8 experienced other infections. Five patients in the PD group and one in the HD group died with functioning grafts ( p = 0.09). No differences were noted between the groups in the incidences of post-transplant cardiovascular complications, malignancies, and diabetes mellitus. In the PD group, 33 patients with functioning grafts are still being followed, 6 have returned to dialysis, and 5 have died. In the HD group, 38 patients with functioning grafts are still being followed, 5 have returned to dialysis, and 1 has died. Conclusions As a pre-transplant dialysis modality, neither HD nor PD affects the outcome of renal transplantation.
Experience with Continuous Ambulatory Peritoneal Dialysis in Belgium
Authors: Lameire Norbert H. , De Paepe Marc , Vanholder Raymond , Verbanck Johan , Ringoir Severin 
Published: February 2020

This paper has reviewed experience in Belgium with 99 patients on CAPD. They represent 6-7% of all dialysis patients in this country. The principle reasons for selecting CAPD were old age, problems with vascular access and major cardiovas cular complications. Hemoglobin and hematrocrit values increased in all patients but preliminary measurements of red cell volume in some of them showed no change. Most patients showed moderate increases in serum triglycerides. In three non-diabetic patients with marked elevation in triglyceride levels, insulin, given intraperitoneally, prevented further increases. The frequency of peritonitis was still high; the average rate was one episode every 7.6 patient months. Other major complications included hypotension, which improved after the substitution of dialysate with a higher sodium concentration, severe respiratory disease and gangrene of the legs. After a mean follow-up of seven months, the death rate was 18% and the rate of technical success was 70%. The fact that most of our patients were in the high-risk category should be kept in mind when comparing these results with those obtained with other modes of treatment. At the end of 1978, a total of 1195 patients with end-stage renal disease (ESRD) were treated on either home or hospital dialysis in Belgium. There were 50 dialysis centers for a total population of 9.8 million. Of these 1195 patients, only seven were treated with either continuous ambulatory peritoneal dialysis (2-4) or intermittent peritoneal dialysis. Since then and until July 1, 1980 the number of patients treated with CAPD in Belgium has increased to 99 and this paper describes our experience with these patients.
Stephen Rosenak M.D. (1900): The Father of the Peritoneal Catheter
Authors: McBride Pat , Rosenak Stephen 
Published: February 2020

In this new section of the Bulletin, Pat McBride will describe the life and work of some of those pioneers who have been instrumental in the development of peritoneal dialysis. Mr. McBride, an experienced historian who is Director of Sales and Technical Education, Artificial Organs Division of Travenol Laboratories, Inc. has already written a successful history of hemodialysis (Genesis of the Artificial Kidney). The Editor and the Editorial Board of the Bulletin feel fortunate that Mr. McBride has agreed to undertake this new section of the Bulletin and thank him for his efforts in preserving the history of peritoneal dialysis. The readers of the Bulletin are encouraged to participate in this undertaking by passing on suitable information concerning the history of peritoneal dialysis and are invited, if they wish, to suggest individuals who, or events that, deserve recognition. In this first issue, Mr. McBride describes the contributions of Dr. Stephen Rosenak one of the fathers of peritoneal dialysis.
Cardiovascular Deaths among CAPD Patients
Authors: Wu George 
Published: February 2020

Forty-four of the 508 CAPD patients in Toronto died of cardiovascular complications during the period september 1977 -October 1982. More than 80% of these patients had evidence of ischemic or hypertensive heart disease before commencement of CAPD. The survival of CAPD patients, who were free of cardiac problems before starting CAPD, was significantly better than those who had angina pectoris, myocardial infarction or cardiomegaly at the onset of CAPD. The de novo incidence of ischemic heart disease in patients between ages 40 and 59 (n = 70) was 8.8% at the end of the first year, and 15%() at the end of the second year. These figures were comparable to those reported for hemodialysis patients but worse than those in nonuremic patients with similar risk factors. After starting CAPD, 68.2% of the initially hypertensive patients became normotensive without taking any medication, and 25.8%() became normotensive with a reduced dose of antihypertensive medications. There was no statistically significant difference between the mean fasting plasma cholesterol and triglyceride levels of patients with and those without coronary artery disease.
Changes in Left Ventricular Anatomy and Function on CAPD
Authors: Leenen Frans H.H. , Smith Donna L. , Khanna Ramesh , Oreopoulos Dimitrios G. 
Published: February 2020

In 17 patients with end-stage renal disease, we evaluated the effects of treatment with CAPD on L V anatomy and function by M -mode echocardiography. All patients had a history of hypertension and had echocardiographic evidence of increased LV mass related to both concentric and eccentric hypertrophy. On CAPD, blood pressure returned to normal in a consistent manner. L V mass decreased in most (14/17) patients as a result of a decrease in both L V wall thickness and LV dimension. Initially four of the 17 patients had diminished LV function. On CAPD, LV function improved in three of these four and no patient showed deterioration. These results indicate that CAPD improves L V hypertrophy and L V function by normalizing both pressure and volume overload.
Pathogenesis and Treatment of Back Pain in Peritoneal Dialysis Patients
Authors: Hamodraka-Mailis Angela 
Published: February 2020

Back pain made a major contribution to dialysis failure in eight CAPD patients during a five-year period, We were able to collect history, physical examination and radiological data in five of them. Common factors associated with back pain were: 1) long-standing back problem (4 of 5), 2) presence of bone or degenerative disease involving the spine or extraspinal disease affecting the posture and, 3) abnormal spinal mechanics on physical examination. It is recommended that the training program of patients on CAPD, who show these high-risk factors, incorporate a “custom-made” back exercise program and possibly these patients should wear lumbosacral supports.
Increased use of Hypertonic Dialysate by CAPD Patients following Repeated Episodes of Peritonitis
Authors: Cole Craig H. , Prichard Sarah , Waddell Robert W. 
Published: February 2020

Many investigators are concerned that in patients receiving long-term CAPD, repeated episodes of peritonitis may reduce the ultrafiltration capacity of the peritoneum. In our CAPD program, patients who had had no previous episodes of peritonitis used an average of 0.68 hypertonic exchanges per day, compared to 2.13 hypertonic exchanges required by patients who had had two or more episodes of peritonitis. When this phenomenon was examined in more detail, we found that the increase in the number of hypertonic exchanges could be explained by two factors. Daily urine output fell from an average of 585 ml in the peritonitis-free group to 284 ml in the group with recurrent peritonitis. The latter group needed more hypertonic exchanges to stay in fluid balance. Apparent fluid intake during a 64hour period was calculated in 13 CAPD patients. This increased from 3909 ml in those with no peritonitis to 6267 ml in those with two or more episodes of peritonitis. In a separate study, we measured drainage volume with a hypertonic exchange in 19 CAPD patients. There was no apparent relationship between drainage volume and the number of previous episodes of peritonitis or between drainage volume and the length of time on CAPD. We conclude that there is increased use of hypertonic exchanges in CAPD patients with a history of frequent peritonitis but this can be explained by factors other than a decrease in the ultrafiltration capacity of the peritoneum.
Recurrent Hepatic Coma in a Chronic Hemooialysis Patient: Successful Treatment by CAPO
Authors: Segaert Marc F. , Carlier Bernard , Verbanck Johan 
Published: February 2020

A hemodialysis patient developed hepatic cirrhosis with subsequent portal-systemic encephalopathy. Switching from hemodialysis to CAPD prevented the recurrent episodes of hepatic coma. This observation suggests that, in combined chronic renal and hepatic failure with portal-systemic encephalo pathy, CAPD may be the treatment of choice. This paper presents evidence to support this assumption. Chronic hemodialysis patients frequently develop hepatitis B, which sometimes results in hepatic cirrhosis. Portal-systemic encephalopathy (PSE) may ensue. We describe a patient in whom mild PSE repeatedly progressed to full hepatic coma during hemodialysis sessions. Switching the patient from hemodialysis (HD) to continuous ambulatory peritoneal dialysis (CAPD) prevented the recurrent hepatic coma.
Fungal Peritonitis in Peritoneal Dialysis: Our Experience and Review of Treatments
Authors: Fabris Aldo , Biasioli Stefano , Borin Donata , Brendolan Alessandra , Chiaramonte Stefano , Feriani Mariano , Pisani Edmondo , Ronco Claudio , La Greca Giuseppe 
Published: February 2020

From January 1975 to April 1982, 10 of our patients undergoing chronic peritoneal dialysis developed fungal peritonitis. Of six treated without removing the catheter two survived after intraperitoneal (IP) administration of imidazole derivatives, and four died despite combined IP and intravenous (IV) therapy. Of four patients treated by catheter removal, all survived, two without any additional therapy and two after IV antifungal treatment. Three of the deaths followed cardiac or cerebral accidents, while one was related to Candida sepsis. Bacterial peritonitis is a frequent complication of peritoneal dialysis (FD). In addition fungal peritonitis has been reported with increasing frequency with the growing diffusion of FD, the subsequent increase in infectious episodes, the antibiotic treatment, which such complications require and the improvement in technique for mycological diagnosis. This paper describes our experience with the clinical manifestations of fungal peritonitis and its treatment in 10 patients undergoing intennittent peritoneal dialysis (IFD) or continuous ambulatory peritoneal dialysis (CAFD).
Continuous Ambulatory Peritoneal Dialysis in South Africa -A Four-Year Experience
Authors: Parsoo I. , Seedat Y.K. , Naicker S. , Kallmeyer J.C. 
Published: February 2020

This study describes our experience with continuous ambulatory peritoneal dialysis (CAPD) over a four year period, during which 88 patients were offered CAPD. It compares and contrasts the response to CAPD among four racial groups in Natal viz asiatics, blacks, coloureds and whites. Peritonitis -the major complication, occurred with an overall incidence of one episode every 4.41 patient months. CAPD remains a useful alternative therapy in developing countries where a high percentage of patients with chronic renal failure would be denied a chronic renal failure program because of lack of expertise in hemodialysis and/or renal transplantation, or limited financial resources. Continuous ambulatory peritoneal dialysis (CAPD) was first described by Moncrief and Popovich (1) and, since its modification by Oreopoulos and his group (2), this technique has gained world wide usage. South Africa, like many developing countries has a high incidence of end-stage renal disease (ESRD) but because of lack of resources and economical problems, few patients with ESRD can be treated by dialysis or renal transplantation. CAPD affords a relatively simple and inexpensive form of therapy for these patients. At the present time about 200 patients are on CAPD in South Africa. Natal, the smallest of four provinces in South Africa, has a population of about five million, the majority being blacks. The minority groups include whites, asiatics and coloureds. There is only one chronic dialysis centre in Natal; situated in Durban, it serves the entire province including parts of the Transkei. This paper describes a four-year experience with CAPD in this mixed population and discusses problems unique to this situation.
The Durability of the Peritoneal Membrane
Authors: Diaz-Buxo Jose A. 
Published: February 2020

Severe membrane functional limitations with time on peritoneal dialysis are infrequently reported. Occasional reports where most patients were affected by peritoneal functional loss are in conflict with the good preservation of function reported by others. Such endemic distribution of structural and functional deterioration of the peritoneum should facilitate the search for etiologic factors. In the present state of ignorance it seems wise to treat infectious peritonitis promptly and aggressively, to support research in the area of membrane solution interaction and to carefully monitor the effects of chronic peritoneal dialysis on the peritoneal membrane. The most important determinant of the success of peritoneal dialysis in providing adequate therapy for chronic renal failure is the durability of the peritoneal membrane. Dobbie et al (I) have clearly stated the magnitude and severity of the problem in the following passage: “In view of the fact that most renal dialysis centres throughout the world are now embarking on a relatively new form of treatment for chronic renal failure -continuous ambulatory peritoneal dialysis, it is perhaps ironic that so little is known structurally of the tissue on which depends a life maintaining procedure and on which so many aspirations are now based.” Our ignorance of the peritoneal architecture is surpassed only by our poor understanding of the relationships between functional and structural changes. From the functional point of view, the peritoneal membrane includes the mesothelium which covers its free surface, the peritoneal interstitium, probably composed of an aqueous network bathing gels of mucosaccharides and collagen, and the microcirculation. Extensive research has been recently initiated to study the role of each of these components in transperitoneal transport and ultrafiltration and the effect of chemical and mechanical injury on the peritoneal membrane (1,2). The interest in investigating the factors responsible for altered states of solute and water transport during peritoneal dialysis has been stimulated by alanning reports suggesting functional deterioration of the peritoneal membrane system during chronic dialysis (3,4).