bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized Prospective Comparison of Oral Levofloxacin plus Intraperitoneal (IP) Vancomycin and IP Netromycin plus IP Vancomycin as Primary Treatment of Peritonitis Complicating Capd
Authors: Cheng Ignatius K.P. , Fang Guo Xing , Chau PakYin , Chan Tak Mou , Tong Kwok Lung , Wong Andrew K.M. , Li Chun Sang , Lo Wai Kei , Cheung King On , Kumana Cyrus R. 
Published: February 2020

Objective To compare the therapeutic efficacy of daily oral levofloxacin plus intermittent intraperitoneal (IP) vancomycin (group 1) versus daily IP netromycin and intermittent IP vancomycin (group 2) in the primary treatment of peritonitis complicating continuous ambulatory peritoneal dialysis (CAPD). Design A randomized multicenter prospective openlabel comparative clinical study. Setting University and Hospital Authority hospitals in Hong Kong. Patients All CAPD patients who developed bacterial or culture-negative peritonitis beyond 28 days of a previous episode and without evidence of septicemia, associated tunnel infection, or known sensitivity to trial medications were accepted into the clinical trial. Results A total of 101 patients entered the trial. The primary cure rate was 74.5% for group 1 and 73.6% for group 2. Baseline culture results appeared to influence the clinical outcome: the primary cure rate for culture negative, gram-positive, and gram-negative episodes was 83.3%, 78.6%, and 42.9% for group 1 and 69.1 %, 76.9%, and 71.3% for group 2, respectively. The primary cure rate also varied considerably among individual centers and was particularly noticeable in group 1. In the latter group, it correlated closely with in vitro levofloxacin resistance which in turn correlated closely with previous exposure to fiuoroquinolones. Conclusion Oral levofloxacin in combination with intermittent IP vancomycin has comparable efficacy to IP netromycin combined with intermittent IP vancomycin as primary treatment in CAPD peritonitis, but is simpler and more cost-effective to administer. It may be recommended as primary therapy in centers with relatively low exposure and, therefore, low background resistance to fiuoroquinolones.
Serum C-Reactive Protein: A Predictor of Mortality in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Noh Hyunjin , Lee Seoung Woo , Kang Shin Wook , Shin Sug Kyun , Choi Kyu Hun , Lee Ho Yung , Han Dae Suk 
Published: February 2020

Objective To evaluate the predictive value of a single baseline serum C-reactive protein (sCRP) as a marker of mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. Design A review of prospectively collected data in a 2-year follow-up study. Setting Tertiary medical center. Patients The study included 106 patients who were stable and had been on CAPD for a minimum of 3 months. Main Outcome Measures Patient survival rate was the main outcome measure of this study. Other outcome measures were technique survival rate, peritonitis rate, and hospitalized days. Covariables used in the survival analysis were age, sex, the presence of cardiovascular disease or diabetes mellitus, sCRP, serum albumin, hematocrit, cholesterol, HDL-cholesterol, malnutrition by subjective global assessment (SGA), weekly Kt/V urea, and weekly standardized creatinine clearance (SCCr). Results The 2-year patient survival rate was significantly lower in the increased sCRP group than in the normal sCRP group (66.7% vs 94.1%, p = 0.001), although there was no significant difference in technique failure, peritonitis rate, and hospitalized days between the two groups. By Cox proportional hazards analysis, independent predictors of mortality were: cardiovascular disease (relative risk, RR = 8.96, p < 0.005); increased sCRP level (RR = 1.19, p < 0.05); and high hematocrit (RR = 1.18, p < 0.05). ← Conclusion Serum CRP at enrollment is an independent predictor of 2-year patient survival in CAPD patients.
Comparison of Growth during Continuous Ambulatory Peritoneal Dialysis and Renal Transplantation using Conventional Immunosuppressive Drugs in Children
Authors: Litaka Kikuo , Hojo Midori , Moriya Shunsuke , Sakai Tadasu , Endo Tadao 
Published: February 2020

Objective Growth during continuous ambulatory peritoneal dialysis (CAPD) and after renal transplantation (Tx) was assessed in children under the age of 12 years. Design Growth was assessed by calculating the standard deviation score for height of normal children of the same age and gender. Patients Twenty-one patients undergoing CAPD and 13 patients who had received renal Tx at Kitasato University Hospital. Results Overall growth in those children undergoing CAPD and after renal Tx was not good, but growth during CAPD seemed to be slightly better than after renal Tx using conventional immunosuppressive drugs. Only young children who had started CAPD or received renal Tx before the age of 5 years with functioning graft showed catch-up growth, but the final height of these children may still be smaller than normal. Conclusion Growth in children with end-stage renal disease is poor but growth during CAPD seems to be slightly better than after renal Tx using conventional immunosuppressive drugs.
The Effects of Ouabain and Potassium on Peritoneal Fluid and Solute Transport Characteristics
Authors: Park Min Sun , Lee Eun Young , Lee Nam Soo , Waniewski Jacek , Lindholm Bengt , Lee Hi Bahl 
Published: February 2020

Background We reported anomalous transport characteristics of potassium during experimental peritoneal dialysis in rats and suggested that mechanisms of peritoneal potassium transport could be other than simple passive transport. Intracellular transport of potassium in cultured human mesothelial cells was reported to be regulated by three different pathways, such as channels blocked by ouabain, channels blocked by furosemide, and other. Objective To investigate the effect of ouabain on peritoneal potassium and water transport characteristics. Methods A single 4-hour peritoneal dwell was performed in 28 5prague-Dawley rats. To minimize the diffusive transport of potassium, 4.5 mmol/L of KCI was added into conventional dialysis solution with 3.86% glucose [acidic peritoneal dialysis solution (APD)]. To evaluate the effect of the pH of dialysis solution on the transport of potassium and water, 4 mmol/L of NaOH was added into the potassium -containing study solutions [neutral peritoneal dialysis solution (NPD)]. To evaluate the effect of a potassium channel blocker on peritoneal potassium transport ATPase sensitive Na+-K+-transport inhibitor, ouabain (10–5 mmol/L) was added to dialysis solutions immediately before the dwell study in eight rats with APD (APD-O) and six rats with NPD (NPD-O). Ouabain was not added in eight and six rats with APD and NPD (APD-C and NPD-C, respectively). They were used as control. Infusion volume was 30 mL. The intraperitoneal volume (V D) was estimated by using a volume marker dilution method with corrections for the elimination of volume marker, radioiodinated human serum albumin (RI5A), from the peritoneal cavity (KE). The diffusive mass transport coefficient (KBD) and sieving coefficient (5) were estimated using the modified Babb-Randerson-Farrell model. Results VD was significantly higher (p < 0.05 from 90 min to 240 min) and KE (0.027 ± 0.018 mL/min for APD-O, 0.026 ± 0.017 mL/min for NPD-O, and 0.030 ± 0.022 mL/min for NPD-C, vs 0.058 ± 0.030 mL/min for APD-C, p < 0.05 for each) significantly lower during dialysis with APD -O, NPD -O, and NPD-C than with APD-C. The intraperitoneal glucose expressed as a percentage of the initial amount was significantly higher with APD-O, NPD-C, and NPD-Q than with APD-C (p < 0.05 from 90 min to 240 min). KBD for sodium was higher during dialysis with ouabain than without ouabain, while KBD for urea, glucose, and potassium, and 5 for urea, glucose, sodium, and potassium did not differ between the four groups. Conclusions The physiologic potassium concentration in neutral dialysis solutions and the use of ouabain decreased the intraperitoneal fluid absorption. The diffusive transport coefficient and sieving coefficient for potassium did not differ, while the diffusive transport coefficient for sodium increased during use of ouabain.
Comparing Mortality Rates on Capd/Ccpd and Hemodialysis the Canadian Experience: Fact or Fiction?
Authors: Schaubel Douglas E. , Morrison Howard I. , Fenton Stanley S.A. 
Published: February 2020

← Objective To compare mortality rates on hemodialysis (HD) to rates on continuous ambulatory/cyclic peritoneal dialysis (CAPD/CCPD), to contrast our results with those of other recent investigations, and to discuss reasons for discrepancies. ← Data Sources Patient -specific data obtained from the Canadian Organ Replacement Register on patients initiating renal replacement therapy (RRT) between 1 January 1990 and 31 December 1995 (n = 14483). Recent mortality comparisons of CAPD and HD. ← Main Outcome Measures Mortality rate ratio (RR) based on “as-treated” (AT) analysis incorporating treatment modality switches and adjusting for age, primary renal diagnosis, and comorbid conditions using Poisson regression. Hazard ratios (HR) were estimated using Cox regression and based on an “intent-to-treat” (ITT) analysis wherein patients were classified based on dialytic modality received on follow-up day 90. ← Results Adjusted mortality rates were significantly decreased on CAPD/CCPD relative to HD [RR = 0.73, 95% confidence interval (CI) = (0.69, 0.77)] based on the AT analysis. Most of the protective effect of CAPD/CCPD was concentrated in the first 2 years of follow-up post-RRT initiation. Based on the ITT analysis, the estimated CAPD/ CCPD effect was greatly reduced, with HR = 0.93 (0.87, 0.99). ← Conclusions We provide further evidence that CAPD/ CCPD is not an inferior dialytic modality to HD, particularly in the short term. Comparing mortality rates on CAPD/ CCPD and HD is inherently difficult due to the potential for bias. Discrepancies between our results and those of previous investigations, and variability in findings among previous studies, relate to differences in clinical and demographic setting, patient populations, study design, statistical methods, and interaction between the dialytic modality effect and various other covariables.
Clearance of Tracer Albumin from Peritoneal Cavity to Plasma at Low Intraperitoneal Volumes and Hydrostatic Pressures
Authors: Zhu Qing , Carlsson Ola , Rippe Bengt 
Published: February 2020

Objective To assess the clearance of radiolabeled tracer albumin (RISA) from peritoneal cavity to plasma (CI → P) in rats under essentially “normal” conditions, that is, when intraperitoneal hydrostatic pressure (IPP) is subatmospheric and the intraperitoneal (IP) “free” fluid volume (IPV) is low. Methods A volume of 0.3 mL of RISA was injected IP into anesthetized Wistar rats (wt = 300 g) when the IPV was approximately 2 mL (normal) or the IPV was approximately 10 mL, and IPP was either -1.8 mmHg (normal) or +1.5 mmHg (produced by an external cuff). Plasma samples (25 μL) were obtained repeatedly during the dwell, which lasted 30 300 min, after which the peritoneal cavity was opened to recover the IPV and residuallP RISA activity. The CI → P was assessed as the mass transfer of RISA into plasma, occurring per unit time,-divided by the calculated mean IP RISA concentration (CD). The interstitial RISA space was measured as the mass of RISA accumulated, per unit tissue weight, in peritoneal tissue samples divided by the CD. Results A markedly lower CI → P (2.47 ± 0.67 μL/min), as well as total RISA clearance out of the peritoneal cavity (CI), was found under “normal” conditions (an IPV of approximately 2 mL and an IPP of approximately -1.8 mmHg) compared to the situation during peritoneal dialysis (an IPV of approximately 20 mL and an IPP of +1 mmHg). Furthermore, the interstitial RISA space increased linearly over time even at negative IPPs and at an unchanging peritoneal interstitial fluid volume. At a low (normal) IPV the CI → P did not increase significantly with elevating IPP, and increased only marginally when tracer distribution was improved by artificial vibration of the rats. However the CI → P increased when larger volumes were infused to increase the totallPV. Conclusions It is concluded that the CI → P and CI at low IPPs and IPVs are not as high as during peritoneal dialysis. Increases in CI → P were, however, coupled to increases in IPV. This highlights the importance of the IPV per se and of a sufficient IP tracer distribution for direct lymphatic absorption to be efficient. This study was presented in part at the XVIth Annual Conference on Peritoneal Dialysis, Denver, Colorado, U.S.A., 1997 (33).
Effects of Oral Glucose on Intermediary Metabolism in Continuous Ambulatory Peritoneal Dialysis Patients versus Healthy Subjects
Authors: Delarue Jacques , Maingourd Claude , Couet Charles , Vidal Sophie , Bagros Philippe , Lamisse Fernand 
Published: February 2020

Objective To explore the mechanisms and metabolic consequences of the insulin resistance of patients treated by continuous ambulatory peritoneal dialysis (CAPD). Design CAPD patients and healthy subjects ingested a similar mean oral glucose load per kilogram of fat-free mass (FFM) [1.20 ± 0.03 g/(kg FFM) vs 1.20 ± 0.06 g/(kg FFM); CAPD vs healthy subjects]. Substrate oxidation was monitored over 6 hours using indirect calorimetry. Setting Peritoneal dialysis unit of a tertiary-care institutional center. Outcome Measures Glycemia, insulinemia, substrate oxidation. Patients Six CAPD patients (68 ± 5 yr) and 6 healthy subjects (24 ± 1 yr). The CAPD patients had similar body mass index (21.4 ± 1.3 vs 22.9 ± 1.1 kg/m2), a higher percent fat (25.8% ± 3.7% vs 16% ± 2.2%; p < 0.05), and a lower FFM (42.2 ± 2.2 kg vs 56.5 ± 2.6 kg; p < 0.01) than healthy subjects. Results The CAPD patients displayed a higher glycemic and insulinemic responses to glucose than did healthy subjects (p < 0.05), but similar glucose oxidation and storage. Lipid oxidation and plasma nonesterified fatty acids were not increased in CAPD patients versus healthy subjects, in spite of a higher adiposity. Fat oxidation was related to fat mass in CAPD patients (r2 = 0.77, p < 0.05) but not in healthy subjects (r2 = 0.05). Conclusion CAPD patients display an insulin -resistance not explained by an increased lipid oxidation. The maintenance of intracellular glucose utilization at the expense of higher glycemic and insulinemic responses suggests a defective glucose transport.
Plasma Iohexol Clearance in Automated Peritoneal Dialysis -its Role in Adequacy Determination
Authors: Marx Michael A. , Shuler Cathryn L. , Golper Thomas A. 
Published: February 2020

Objective To compare the relationship of plasma iohexol clearance to standard adequacy measures in an automated peritoneal dialysis (APD) population. Design Prospective, nonrandomized, open label, simultaneous clearance studies of novel (iohexol) and traditional (urea and creatinine) markers of dialysis quantitation. Setting Outpatient peritoneal dialysis units associated with tertiary care university hospitals. Patients Eighteen stable patients, 13 undergoing continuous cycling peritoneal dialysis (CCPD) and 5 receiving intermittent dialysis, who underwent 24-hour clearance studies were enrolled in and completed the study. Interventions Each subject received 15 mL of iohexol intravenously the morning of a scheduled dialysis night. Blood was obtained for determination of serum concentrations of urea nitrogen and creatinine, and plasma iohexol concentration. Dialysate and urine were collected over 24 hours. Main Outcome Measures Urea and creatinine data from the total pooled dialysate and from the 24-hour urine collection were used to calculate daily Kt/V urea and normalized total daily creatinine clearance (CrCI). Total plasma iohexol clearance was calculated using a one-compartment model with the Bröchner-Mortensen correction. Results Normalized [to 1.73 m2 body surface area (BSA)] iohexol clearance correlated very well with normalized CrCI (r2 = 0.777; p < 0.001). A weaker correlation was observed between Kt/V urea and normalized iohexol clearance (r2 = 0.213; 0.05 < p < 0.1). When data are not normalized using BSA or urea distribution volume, the regressions are improved for both creatinine (r2 = 0.820) and urea (r2 = 0.533). These results were comparable between those on CCPD and those on intermittent therapy. Conclusion Total plasma iohexol clearance provides a simple assessment for APD adequacy by eliminating collection problems inherent to the methodologies currently employed. Such simplicity allows for more frequent assessments of delivered dialysis dose and efficacy of prescription changes.
Thyroid Dysfunction and Nodular Goiter in Hemodialysis and Peritoneal Dialysis Patients
Authors: Lin Chih Ching , Chen Tzen Wen , Ng Yee Yung , Chou Yi Hong , Yang Wu Chang 
Published: February 2020

Objective To investigate the prevalence of nodular goiter and thyroid dysfunction in uremic patients undergoing hemodialysis (HD) and peritoneal dialysis. Design Cross-sectional study. Setting Single dialysis unit and outpatient clinic. Patients The study included 221 patients [143 HD and 78 continuous ambulatory peritoneal dialysis (CAPD) patients] along with 135 consecutively selected outpatients as controls. Main Outcome Measures Ultrasonography was used to detect patients’ thyroid function and nodular goiter. Results Nodular goiter was detected in 54.8% of the uremic patients and in 21.5% of the controls. Uremic patients had higher prevalence of thyroid dysfunction, which included reduced serum concentration of total T3, total T4, and free T4, and increased serum level of TSH. Hypothyroidism was also observed more frequently in uremic patients than in the control group (5.4% vs 0.7%, p < 0.05). Nodular goiter was more frequently found in females than in males (63.5% vs 48%, p < 0.05). Moreover, the prevalence of nodular goiter increased with age (p < 0.02) in uremic patients. Hemodialysis patients had a higher frequency of reduced total T3 level (46.9% vs 29.5%, p < 0.02). However, CAPD patients had lower T4 levels (6.23 ± 1.82μg/dL vs 7.15± 1.99μg/dL, p < 0.05). Conclusion Because of the high incidence of hypothyroidism and nodular goiter in uremic patients, screening of thyroid function and goiter detection with ultrasound should be considered in evaluation of end-stage renal disease patients.
Biocompatibility of a Peritoneal Dialysis Solution with Amino Acids: Histological Evaluation in the Rabbit
Authors: Garosi Guido , Gaggiotti Enzo , Monaci Giulio , Brardi Simone , Di Paolo Nicola 
Published: February 2020

Objective To determine the biocompatibility of a peritoneal dialysis (PD) solution containing amino acids compared to PD solutions containing glucose. Design The biocompatibility of three dialysis solutions containing 1.1% amino acids, 1.36% glucose, and 3.86% glucose, respectively, was evaluated in vivo in rabbits. Methods After 60 days of PD, peritoneal histological changes in rabbits were investigated by light and transmission electron microscopy. The parameters investigated were: (1) mesothelial damage; (2) submesothelial edema; (3) submesothelial cell infiltration; (4) submesothelial fibrosis; and (5) vascular alterations. Semiquantitative evaluations were performed for all the above alterations; quantitative morphometric evaluation was performed for mesothelial damage (cubic transformation of the mesothelium, areas devoid of mesothelium, submesothelial edema) and thickness of peritoneal arteriole walls. Results (1) Mesothelial damage was practically nonexistent in rabbits dialyzed with the solution containing amino acids, and intermediate and severe with low glucose and high-glucose solutions, respectively. Both controls and rabbits dialyzed with amino acid solution showed flat continuous mesothelium; rabbits dialyzed with low-glucose solution showed cubic continuous mesothelium; and rabbits dialyzed with high-glucose solution showed cubic discontinuous mesothelium. Cytopathic mesothelial effects were slight with the solution containing amino acids and severe with both the low and high-glucose solutions. Duplication and thickening of mesothelial basement membrane were never observed. (2) Submesothelial edema showed a worsening trend from controls to rabbits dialyzed with solution containing amino acids, low glucose, and high glucose. (3) No difference in submesothelial infiltration was found between groups. (4) Submesothelial fibrosis was never observed. (5) Vascular alterations were never observed. Conclusion These results are evidence that PD solution with amino acids is more biocompatible than high and also low-glucose solutions.
Plasticizers and Inhibition of Leukocyte Function in Vitro
Authors: Fischer Frank-Peter , Machleidt Christoph , Rettenmeier Albert W. , Kuhlmann Ulrich , Mettang Thomas 
Published: February 2020

Objectives To evaluate the influence of the plasticizer metabolites of di(2-ethylhexyl)phthalate (DEHP), mono(2-ethylhexyl)phthalate (ME HP), 2-ethylhexanol (2-EH), and phthalic acid (PA) on various immune functions of poly-morphonuclear blood leukocytes (PMNL) and monocytes (MN). ME HP, 2-EH, and PA are the main hydrolysis products of DE HP. Since DE HP is leached out of the plastic matrix, patients on hemodialysis and continuous ambulatory peritoneal dialysis are exposed to considerable amounts of DE HP and its metabolites. Setting Teaching hospital, Department of Nephrology. Participants Ten healthy volunteers. Measurements After incubation of leukocytes in solutions with different plasticizer concentrations, oxidative respiratory metabolism was determined by luminolenhanced chemiluminescence (CL) after stimulation with phorbol myristate acetate (PMA). Furthermore, superoxide (02) generation was measured by cytochrome c reduction. Results At pH 5.4, a dose-dependent decrease of luminol-enhanced CL response was found in all assays. For ME HP and PA the level of significance was reached at 10 mg/L and 1 mg/L, respectively. Superoxide generation by PMNL and MN at pH 5.4 was also suppressed by ME HP and PA. At pH 7.4, only a slight suppression of oxidative metabolism at higher concentrations was observed. After incubation of the cells in a solution containing all DE HP metabolites (ME HP, PA, and 2-EH), a significant suppressive effect of CL at pH 5.4 could be observed at final plasticizer concentrations of 0.5 mg/L. Conclusions A dose-dependent impairment of leukocyte oxidative metabolism at a low pH could be demonstrated. The suppressive effect was particularly marked after incubation of the cells in solutions containing a mixture of the main plasticizers. At pH 5.4, we observed a slight alteration even at concentrations very close to those that could be found in commercially available peritoneal dialysis fluids. These results might point toward a possible synergistic detrimental effect of the different DE HP metabolites on leukocyte function, with possible clinical relevance.