bluuebunny/crossref_metadata_2025_split huggingface dataset:
Six Years’ Experience of CAPD at One Centre: A Survey of Major Findings
Authors: Tranæus Anders , Heimbürger Olof , Lindholm Bengt , Bergström Jonas 
Published: February 2020

This study summarizes the overall experience of the first six years of CAPD treatment at one centre, during which time all patients (n = 124) were selected, trained, and treated in a uniform way. Patient selection was largely influenced by a high transplantation activity. The patients had a high mean age, 54 years at start of CAPD, and there was a high proportion of diabetics, 26%. Patient survival was 81% after two years and 60% after four years for all patients, and 100% after four years for non-diabetic patients < 50 years of age. Patient and technique survival was significantly superior in younger non-diabetics than in diabetics and in non-diabetics ≥ 60 years. Thirty-nine percent of transfers to other forms of dialysis were due to peritonitis. The main reason for a high early discontinuation rate was transplantation. The mean treatment time in hospital was 27.7 d per patient year, one-third of which was attributable to peritonitis. The risk of developing peritonitis within the first year on CAPD was 55%. During CAPD, serum urea remained unchanged, serum potassium, creatinine, and uric acid levels increased, and serum albumin levels decreased. These findings suggest that patients being treated with four 2 L exchanges Id, may not be sufficiently dialyzed as the residual renal function deteriorates, thereby increasing the risk of anorexia and subsequent malnutrition.
Beta-2 Microglobulin in Peritoneal Dialysis Patients: Serum Levels and Peritoneal Clearances
Authors: DiRaimondo Carol R. , McCarley Patricia , Stone William J. 
Published: February 2020

Beta-2 microglobulin (B2M) is amyloidogenic in long-term hemodialysis patients, with amyloid deposition manifesting as lytic bone lesions, carpal tunnel syndrome, destructive arthropathies, tenosynovitis, and pathologic fractures. To study the behavior of this protein in the peritoneal dialysis population, serum levels of B2M from 14 chronic peritoneal dialysis (CPD) patients (4IPD, 10 CAPD) were compared to those of 15 chronic hemodialysis patients, and peritoneal clearances were measured in 9 CAPD patients. Standard cuprophan dialyzers were used for hemodialysis. Serum B2M levels were significantly lower in the peritoneal dialysis group (mean ± SD 73.2 ± 20.9 mg/L) than in the hemodialysis group (100.3 ± 24.7 mg/L, p < .004). When CAPD patients alone were compared to the hemodialysis patients, lower serum B2M levels were again apparent, with mean 68.7 ± 16.4 mg/L (p ≤ .002). Mean serum B2M in IPD patients (84.6 ± 28.9 mg/L) did not differ statistically from either the CAPD or the hemodialysis group. Peritoneal clearance of B2M, urea nitrogen, and creatinine over a 6 h exchange were obtained in 9 CAPD patients without peritonitis. Mean clearance (±SD) of B2M was 0.9 ± 0.4 ml/min/1.73 m2, urea nitrogen 5.3 ± 0.3 ml/min/1.73 m2, and creatinine 4.2 ± 0.8 ml/min/1.73 m2. Mean loss of B2M via the peritoneal cavity was 19.9 ± 6.6 mg/2 L-exchange/1.73 m2 (range 7.7 to 26.2 mg/2 L-exchange/1.73 m2). Decreased serum B2M in peritoneal dialysis patients is consistent with increased clearance by the peritoneal membrane versus standard cellulosic hemodialysis membranes. Whether use of CPD rather than hemodialysis can prevent or even treat dialysis-associated amyloidosis (AB2M) remains speculative.
Can the Risk of Peritonitis be Predicted for New Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients?
Authors: Coles Gerald A. , Minors Susan J. , Horton Jeffrey K. , Fifield Richard , Davies Malcolm 
Published: February 2020

Serum and overnight dialysate samples were obtained from 36 adult uraemic patients at the end of their continuous ambulatory peritoneal dialysis (CAPD) training. The samples were analysed for albumin, IgG, C3, and antistaphylococcal peptidoglycan antibody. None of the dialysate measurements correlated with the risk of peritonitis during up to one year's CAPD treatment. Nineteen of the 36 patients were retested 6 to 20 months after starting CAPD. There were significant rises in serum C3 ( p < 0.02) and albumin ( p < 0.001) and a significant fall in dialysate IgG ( p < 0.02). Eight further patients were sampled at the end of training and three weeks later. They had a significant fall in dialysate IgG ( p < 0.05). During CAPD training peritoneal permeability appears to be transiently increased. Analysis of overnight dialysate samples during training does not allow prediction of those at risk of subsequent peritonitis.
Recovery of HIV Antigen in Peritoneal Dialysis Fluid
Authors: Correa-Rotter Ricardo , Saldivar Sergio , Soto Luis E. , De Leon Samuel Ponce , Ojeda Francisco , Ruiz-Palacios Guillermo , Pena Jose Carlos 
Published: February 2020

We investigated the presence of HIV antigen in dialysis fluid of patients with end-stage renal disease (ESRD) undergoing continuous ambulatory peritoneal dialysis (CAPD), previously known to be infected with this virus. Sixteen adult patients and 6 adult volunteers were included in the study in 4 groups as follows: Group A: 3 patients on CAPD, previously known to be positive for serum HIV antibodies; Group B: 7 patients on CAPD, serum HIV negative; Group C: 6 AIDS patients without renal disease; and Group D: 6 healthy volunteers. Of the 3 patients of Group A, the HIV-1 Ag was positive in dialysis fluid in only 2. In 1, serum Ab and Ag were present, while in the others only serum Ab was detected. The samples from Group B were all negative for the viral antigen in dialysis fluid. We conclude that dialysis fluid of HIV-infected patients may contain the Ag and is therefore potentially infective. The presence of the HIV antigen was not constant, and was not related to antigenemia. It is possible that the presence of the Ag depends on local factors that influence viral replication or to alterations in the permeability of the peritoneal membrane. We discuss other possible factors that could influence the presence of viral Ag in peritoneal dialysis fluid.
Peritoneal Solute Clearances in Diabetics
Authors: Lee Hi Bahl , Park Min Sun , Chung Sung Hee , Lee Young Bae , Kim Kyung Soo , Hwang Seung Duk , Moon Chul 
Published: February 2020

In order to examine solute transport across the peritoneal membrane and responsiveness of the peritoneal microcirculation to a vasodilator in diabetics on continuous ambulatory peritoneal dialysis (CAPD), we obtained peritoneal clearances of urea (Curea) and creatinine (Ccr), protein concentrations in the drained dialysate (D PC), and percentage of peritoneal glucose absorption (% PGA) before and after nitroprusside (NP) addition to the dialysate in 13 diabetics (DM) and 13 nondiabetics (non-DM) matched for age, sex, body weight, and duration of CAPD. Control (before NP) Curea, Ccr, D PC, and %PGA were not different between DM and non-DM. NP significantly enhanced Curea, Ccr, and D PC in both DM and non-DM. Curea, Ccr, D PC, and %PGA after NP were again not different between DM and non-DM. The findings suggest that peritoneal solute clearances and responsiveness of the peritoneal microcirculation to NP in diabetics are not different from nondiabetics at the beginning of CAPD despite evidence for widespread vascular diseases in diabetic ESRD patients.
Single -Dose Pefloxacin Pharmacokinetics and Metabolism in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD)
Authors: Nikolaidis Paul , Walker Scott E. , Dombros Nicholas , Tourkantonis Achilleas , Paton Tom W. , Oreopoulos Dimitrios G. 
Published: February 2020

Seven adult patients on continuous ambulatory peritoneal dialysis (CAPD) received one dose of pefloxacin, a novel quinolone antibiotic, orally and intravenously on two separate occasions to characterize the pharmacokinetics and metabolism of the drug. Concentrations of both pefloxacin and its active metabolite N-desmethylpefloxacin (norfloxacin) were measured in serum and dialysate by HPLC. Half-life, total body clearance and peritoneal clearance were determined. The overall elimination half-life was 19.9h. Relative to the IV dose the bioavailability following oral administration of pefloxacin was 76%. The mean serum and dialysate concentrations were similar up to 24 h after the oral or IV dose. After a 6 h dwell time the dialysate concentration of pefloxacin was 2.24 mg/L which is above the MICgo for most bacteria responsible for peritonitis in CAPD patients. The peritoneal clearance of pefloxacin averaged 2.5 mL/min. Serum concentrations of the metabolite norfloxacin were less than 0.5 mg/L during the 24 h study period. We conclude that pefloxacin might be equally effective in the treatment of peritonitis of CAPD after oral or IV administration. Since the peritoneal clearance contributes insignificantly to the elimination of pefloxacin during CAPD, the proposed maintenance regimen of an oral or IV 400 mg dose/day seems to be a reasonable therapy for infections in CAPD patients.
Prevalence of Hepatitis c Antibodies (HCV) in a Dialysis Population at One Center
Authors: Selgas Rafael , Martinez-Zapico Rosa , Bajo M. Auxiliadora , Romero Jose Ramon , Munoz Jesus , Rinon Carmen , Miranda Blanca , Miguel Jose Luis 
Published: February 2020

Hepatitis C (HC) has been recently diagnosed by determination of specific antibodies that represent the former so-called non-A, non-B hepatitis. We studied the prevalence of plasma HCV antibodies among 61 unselected patients on hemodialysis (HD) and 43 on continuous ambulatory peritoneal dialysis (CAPD). Plasma C-antibodies were determined through the ELISA test system. Transfusion policy was the same in both groups. The prevalence of hepatitis C virus antibodies was significantly higher in hemodialysis patients than among those on CAPD. Time on dialysis, previous blood transfusions, and renal transplantation seem to increase the prevalence of C hepatitis antibodies among hemodialy sis patients. The effect of these parameters on CAPD was smaller. Understanding the reasons for these differences may help prevent this disease among dialysis patients.
Prevalence of Hepatitis C Antibodies (HCV) in a Dialysis Population at One Center
Authors: Selgas Rafael , Martinez-Zapico Rosa , Bajo M. Auxiliadora , Romero Jose Ramon , Munoz Jesus , Rinon Carmen , Miranda Blanca , Miguel Jose Luis 
Published: February 2020

Hepatitis C (HC) has been recently diagnosed by determination of specific antibodies that represent the former so-called non-A, non-B hepatitis. We studied the prevalence of plasma HCV antibodies among 61 unselected patients on hemodialysis (HD) and 43 on continuous ambulatory peritoneal dialysis (CAPD). Plasma C-antibodies were determined through the ELISA test system. Transfusion policy was the same in both groups. The prevalence of hepatitis C virus antibodies was significantly higher in hemodialysis patients than among those on CAPD. Time on dialysis, previous blood transfusions, and renal transplantation seem to increase the prevalence of C hepatitis antibodies among hemodialy sis patients. The effect of these parameters on CAPD was smaller. Understanding the reasons for these differences may help prevent this disease among dialysis patients.
Sleep Related Respiratory Disorders in End-Stage Renal Disease Patients on Peritoneal Dialysis
Authors: Wadhwa Nand K. , Seliger M. , Greenberg Harly E. , Bergofsky Edward , Mendelson Wallace B. 
Published: February 2020

Study Objective To assess the possible effects of peritoneal dialysis (PD) on sleep-related respiration, which might result from dialysate bulk load in the abdomen and/or alterations in metabolic control of respiration during sleep. Design Subjective and objective measures of sleep were prospectively compared on randomly assigned nights with PD fluid (2.0 L) and without PD fluid in the peritoneal cavity in 11 end-stage renal disease (ESRD) patients on PD. Setting Tertiary-referral university hospital. Patients and Methods Fifteen consecutive patients on peritoneal dialysis who complained of chronic sleep disturbance and requested sedative were selected. Four patients declined polysomnographic studies. Consequently, 11 ESRD patients (8 males and 3 females) with a mean age of 63±4 (SEM) years were studied. Results Eight of the 11 patients reported multiple types of sleep difficulties. Polysomnographic recordings revealed significant primarily obstructive sleep apnea in 6 of 11 patients on at least 1 of 2 nights. Arterial blood pH, paO2, and paC02 did not differ between nights with and without PD fluid in the peritoneal cavity in the group as a whole. In the 6 patients with sleep apnea, Pa02 was significantly lower (p<0.05) during the night with (Pa02=78±7 mmHg) than during the night without PD fluid (Pa02=92±4 mmHg). In the apneic patients, the amount of dialysate drained in the morning was negatively correlated with the minimum arterial oxygen saturation during the night (r=-0.94; p<0.005). Conclusions This study indicates a significant relationship between PD patients with chronic sleep disturbance and sleep apnea syndrome. These data suggest that apneic patients may be susceptible to complications of dialysate bulk effect on oxygen desaturation.
Comparison of Exit -Site Infections in Disconnect versus Nondisconnect Systems for Peritoneal Dialysis
Authors: Burkart John M. , Jordan Jean R. , Durnel Theresa A. , Case L. Douglas 
Published: February 2020

Objective To determine if disconnect systems reduce the incidence of exit-site infections when compared to nondisconnect systems. Design We prospectively monitored exit-site infections and peritonitis rates in 96 disconnect patients (Yset, automated peritoneal dialysis (APD)) and 60 nondisconnect patients (spike, ultraviolet connection device (UVXD)). Setting A freestanding chronic peritoneal dialysis unit staffed by physicians from both a medical school and a private setting. Patients All patients who began peritoneal dialysis at our unit were monitored, regardless of cause of endstage renal disease (ESRD) or age. Intervention Patients were dialyzed using the system (Y-set, spike, etc.) most appropriate for their life-style and their ability to administer self-care. Main Outcome We attempted to follow disconnect and nondisconnect patients for a similar median time on dialysis and compared differences in exit-site infections. Results Peritonitis rates (episodes/pt year) were reduced for disconnect (0.60) versus nondisconnect (0.99) systems (p=0.0006). Despite the marked reduction in peritonitis rates, there was no difference in exit-site infection rates (0.35 vs 0.38), the time to the first exit -site infection, or the time to the first catheter removal for disconnect versus nondisconnect groups. When individual systems were compared, differences in exit-site infection rates (episodes/pt years) were noted (0.62, spike; 0.26,UVXD; 0.32,Y-set; 0.41,APD). Conclusion We found no overall difference in exit site infection rates for disconnect versus nondisconnect systems, despite a reduction in peritonitis rates for disconnect systems.
The Effect of Peritoneal Dialysis Fluid on the Release of Il-113 and Tnfa by Macrophages/Monocytes
Authors: Douvdevani Amos , Rapoport Jayson , Konforti Aviva , Zlotnik Moshe , Chaimovitz Cidio 
Published: February 2020

Objective To study the effect of dialysis fluid on the release of interleukin-1β (IL-1β) and tumor necrosis factor (TNFα) by peritoneal macrophages (PM) and peripheral blood mononuclear cells (MNC), and the time course and factors involved in this effect Design PM and MNC were incubated for various periods with Dianeal itself, or Dianeal of varying pH and composition.IL-1 β was measured by radioimmunoassay and TNFα by cytotoxicity assay. Patients PM were obtained by centrifugation of dialysis effluent from 3 continuous ambulatory peritoneal dialysis (CAPD) patients. MNC were obtained from healthy volunteers. Results Dialysis fluid inhibited the release of both cytokines. Indomethacin had no effect on the inhibition of TNFα release caused by dialysis fluid. Thus prostaglandins are not involved in this inhibition. Solutions of pH 5.2 and high lactate concentration caused an identical inhibition to that caused by dialysate, whereas the presence or absence of glucose had no effect. Thus it seems that pH and lactate are the important inhibitory factors. Time course studies showed that the inhibition of TNFα release was substantial after only 15 minutes of incubation with dialysate, whereas the inhibition of IL-1 β became significant only after 60 minutes of incubation. Conclusions Even though dialysate pH rises within 15–30 minutes after instillation into the abdomen, the initial low pH present for only a short time could have a significant effect on TNFα release by peritoneal macrophages, and thus on their ability to mount a normal inflammatory response. Lactate also has a significant inhibitory role. It is suggested that commercial dialysis solutions should have a pH of 7. Oandthata physiological buffer other than lactate be used.
Cross Sectional Assessment of Weekly Urea and Creatinine Clearances and Indices of Nutrition in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Nolph Karl D. , Moore Harold L. , Prowant Barbara , Meyer Marianne , Twardowski Zbylut J. , Khanna Ramesh , Ponferrada Leonor , Keshaviah Prakash 
Published: February 2020

Objective To perform a cross sectional analysis in 71 patients on continuous ambulatory peritoneal dialysis (CAPD) to identify significant correlations of weekly small solute clearances and indices of nutritional status with each other and with patient demographics and other commonly monitored clinical and laboratory parameters. Design This was a retrospective, cross sectional analysis in 71 patients on CAPD from less than 1 to 105 patient-months (average, 20 months). Setting An outpatient CAPD program. Patients All patients on CAPD in our program at the time of the study willing to undergo the clearance and nutritional status measurements. Interventions No interventions other than the monitoring of their status. Main Outcome Measures Weekly small solute clearances, dietary protein intake, serum albumin, lean body mass, net protein catabolic rate, and urinary and dialysate nitrogen. Results Weekly K/V urea (weekly urea clearance normalized to total body water) of at least 1.7 and weekly total creatinine clearances (liter/week/1.7 m2) of at least 50 are associated with net protein catabolic rates (PCR) greater than 0.9 g/kg of normalized body weight in average CAPD patients. K/V urea and net PCR correlate significantly with serum albumin. High transporters identified by the peritoneal equilibration test have greater albumin losses and lower serum albumin concentrations. Estimates of lean body mass correlate significantly with serum albumin and net PCR; lean body mass correlates significantly and inversely with age. Conclusions Greater small solute clearances are associated with better nutritional status.
Chronic Tunnel Infections in Children: Removal and Replacement of the Continuous Ambulatory Peritoneal Dialysis Catheter in a Single Operation
Authors: Schröder Cornelis H. , Severijnen René S.V.M. , De Jong Maria C.J.W. , Monnens Leo A.H. 
Published: February 2020

Objective Chronic tunnel infections often necessitate the removal of the continuous ambulatory peritoneal dialysis (CAPD) catheter. Most published studies advocate postponing the insertion of a new catheter for several weeks. For young children it will be particularly difficult to wait this length of time, since vascular access may be cumbersome, and hemodialysis may not be well tolerated. The present study describes the results of the simultaneous removal and replacement of the CAPD catheter. .Design: Twenty-three Toronto Western Hospital II catheters were inserted in 17 children because of infectious complications (21 chronic tunnel infections; 2 recurrent peritonitis) in a single operation under appropriate antibiotic prophylaxis. The new catheter was inserted at the contralateral side of the abdomen with the deep cuff in the midline, using the same entrance to the peritoneal cavity. Dialysis was resumed immediately after the operation. Setting A university pediatric dialysis unit. Patients Seventeen children (mean age 3.7 years; range 1.0–8.5 years) were studied. In this group 23 catheters were replaced. Results In four cases a relapse of the tunnel infection was observed within 3 months. All other cases remained free of infection for a period of at least 6 months. The main causative microorganism was Staphylococcus aureus (15 occurrences). Conclusion It is not necessary to interrupt peritoneal dialysis for the replacement of a CAPD catheter because of infectious complications.
Survival of 138 Surgically Placed Straight Double-Cuff Tenckhoff Catheters in Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Weber Jochen , Mettang Thomas , Hübel Eugen , Kiefer Thomas , Kuhlmann Ulrich 
Published: February 2020

Objective To determine the natural history of a surgically placed Tenckhoff catheter in patients on continuous ambulatory peritoneal dialysis (CAPD). Design Prospective 7–year study analyzing catheter survival of all catheters using the Kaplan-Meier life table methodology. Setting Teaching hospital, department of nephrology. Patients One hundred and fifteen unselected patients beginning CAPD. Interventions Removal of the catheter required for the following complications: exit-site or tunnel infections or relapsing peritonitis, outflow obstruction, pericatheter leak, and development of hernias. Main Outcome Measures Period between insertion and removal of the catheter. Results The cumulative survival of all catheters after 1,2, and 3 years of CAPD was 87%, 69% and 65%. Catheter survival of the first versus the second catheter after 1 year was significantly longer (p=0.03). The difference was not significant in relation to diabetes, age, and sex. Infectious complications caused 61% (n=19) of all 31 catheter failures, mainly due to tunnel infections caused by Staphylococcus aureus (n=12). “Mechanical” complications accounted for 49% (n=12) of catheter failures. Eight of 12 mechanical complications were outflow failures. Seven patients had to be transferred to hemodialysis. Conclusions The straight Tenckhoff catheter is a reliable peritoneal access device for CAPD in an unselected patient population.