bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1185LUNG COMETS AND EVALUATION OF HYDRATION STATUS IN PERITONEAL DIALYSIS PATIENTS
Authors: Ekart Robert , Lucic Srajer Lucijan , Marko Katharina , Hojs Nina , Bevc Sebastjan , Hojs Radovan 
Published: June 2020

Abstract

Background and Aims
Assessment of optimal hydration status in patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) is a challenge. Multiple diagnostic options to determine hydration status in PD patients are available. Multifrequency bioimpedance spectroscopy (MBIS) is a cheap, simple and non-invasive method of estimating body composition, including estimates of total body water (TBW), extracellular water (ECW), intracellular water (ICW) and the ratio between both spaces (ECW/ICW). Lung ultrasonography (LUS) and lung B-lines (lung comets) can be used for the evaluation of extravascular lung water. Ultrasound evaluation of inferior vena cava (UIVC) provides rapid, non-invasive assessment of a patient's hemodynamic and volume status. N-terminal pro-brain natriuretic peptide (NT-proBNP) is related to fluid status and fluid distribution. The aim of our study was to assess fluid status in PD patients comparing four different methods: MBIS, LUS, UIVC and NT-proBNP.

Method
We performed a single-centre cohort study in 19 PD patients. The body composition was measured using the portable whole-body MBIS device, Body Composition Monitor-BCM(®) (Fresenius Medical Care, Bad Homburg, Germany), LUS with portable US device (VScan, General Electrics Corporate), UIVC index with SonoSite US device. NT-proBNP was measured in a one-step sandwich chemiluminescent immunoassay (Dimension Vista® System 1500, Siemens Healthcare Diagnostics Inc., Newark, NJ, USA).

Results
The mean age of patients was 54 ± 10 years, mean dialysis vintage 53 (10-194) months, 63% were men. Thirteen (68.4%) patients had fluid overload (FO) &gt; 1.1 L. Data of patients are presented in table 1. We found a statistically significant correlation between the number of lung comets and ECW/ICW ratio (r = 0.496, P = 0.031) and NT-proBNP (r = 0.759, P &lt; 0.0001). In contrast, there was no significant correlation between the number of lung comets and UIVC (r = 0.221, P &lt; 0.364).

Conclusion
According to our results, LUS with lung comets, MBIS with ECW/ICW ratio and NT-proBNP are useful and complementary methods for evaluation of fluid status in PD patients.
P1189OFFICE AND AMBULATORY RECORDING OF CENTRAL AORTIC PRESSURES, WAVE REFLECTION AND ARTERIAL STIFFNESS INDICES IN PERITONEAL DIALYSIS PATIENTS
Authors: Vaios Vasilios , Georgianos Panagiotis , Vareta Georgia , Geropoulou Evaggelia , Ntounousi Evangelia , Papagianni Aikaterini , Zebekakis Pantelis , Liakopoulos Vassilios 
Published: June 2020

Abstract

Background and Aims
Among peritoneal dialysis (PD) patients, aortic blood pressure (BP) and arterial stiffness indices are independent predictors of cardiovascular morbidity and mortality. Previous studies in PD patients recorded these parameters only in the office. The present study provides comparisons between office and ambulatory recordings of these parameters and explores the association of demographic, clinical and hemodynamic variables with high arterial stiffness.

Method
In 81 stable PD patients (mean age: 61.3±16.3 years; male gender: 64.2%), brachial and aortic BP, heart rate-adjusted augmentation index (AIx75) and pulse wave velocity (PWV) were recorded after a 5-minute seated rest in the office using the oscillometric device Mobil-O-Graph (IEM, Stolberg, Germany). Subsequently, all patients underwent ambulatory recording of these parameters with the same device for 24 hours. Logistic regression analysis was performed to identify factors independently associated with high ambulatory PWV.

Results
As expected, office brachial systolic BP (SBP) was higher than 24-hour brachial SBP (134.2±22.7 vs. 129.0±18.0 mmHg, P&lt;0.01). Similarly, office aortic SBP was higher than 24-hour aortic SBP (122.5±20.1 vs. 117.1±16.1 mmHg, P=0.001). By contrast, office AIx75 did not differ from 24-hour AIx75 (23.4%±11.7% vs. 23.9%±9.3%, P=0.602), whereas office PWV was only slightly higher than 24-hour PWV (9.2±2.3 vs. 9.0±2.2m/sec, P=0.001). Participants stratified in the high PWV tertile were older, had higher 24-hour mean BP (MBP) and had more commonly history of diabetes, dyslipidemia and coronary heart disease. In multivariate analysis, older age (OR: 4.23; 95% CI: 1.59-11.24) and higher 24-hour MBP (OR: 1.31; 95% CI: 1.03-1.67) were the only independent determinants of high PWV.

Conclusion
Among patients on PD, brachial and central aortic pressures recorded in the office were higher than 24-hour ambulatory pressures, whereas this variation between office and ambulatory recordings was diminished for AIx75 and PWV. Future studies are warranted to explore the prognostic significance of these parameters in the PD population.
P1192METABOLIC SYNDROME IN PATIENTS UNDERGOING PERITONEAL DIALYSIS (PD): A SINGLE CENTER EXPERIENCE
Authors: Di Gruttola Oto , Paribello Giuseppe , Paduano Immacolata Gaia , Migliaccio Silvia , Argentino Gennaro , Sannino Giuseppina , Russo Domenico 
Published: June 2020

Abstract

Background and Aims
Metabolic syndrome (MS) is a set of alterations represents a cluster of risk factors that increase the probability of causing cardiovascular (CV) events by three times. The aim of our study was to analyze the prevalence of MS in patients with Chronic Renal Failure undergoing replacement treatment by peritoneal dialysis afferent to our center.

Method
We retrospectively studied 117 patients in PD (2015-2019 census period). The characteristics are reassumed in tab1. We assessed the prevalence and impact of MS considering hard outcome: death for IMA and cerebral death. Patients with at least 3 of the following diagnostic criteria (CD) were considered affected by MS: waist circumference&gt; 102 cm in men or &gt; 88 cm in women, high blood pressure (PA&gt; 130/85 mmHg or under pharmacological treatment), HDL levels &lt;40 mg/dl in men or &lt;50 mg/dl in women, triglycerides&gt; 150 mg/dl and fasting glucose&gt; 100 mg/dl or under pharmacological treatment.

Results
The prevalence of MS in our cohort is 46% (54 patients), the patients who have 2 CD are 29% (34 patients), those with only 1 CD 25% (29 patients), no patient had 0 CD. Arterial hypertension represents the most represented risk factor (RF) (91.1%) in agreement with the literature and with the Framingham Offspring Study (non-dialysis patients). The others RF are distributed in this way: reduced HDL (55.8%), hypertriglyceridemia (40.2%), high waist circumference (38.2%), fasting hyperglycaemia (24.5%) (graph 1). Among the 54 patients with MS, 12 CV events occurred during the observation period, while among the 34 patients with two CD, 8 CV events occurred. Among the 29 patients with only 1 CD there was 1 death attributable to CV causes (graph 2). From these data it is clear that MS is a risk factor for CV events according to the literature. It is interesting to observe that comparing the group of patients with 2 CD and with 1 CD, it shows that the presence of 2 CD is a sufficient risk factor to increase the probability of CV events (OR = 8.6 & p &lt;0.05 ).

Conclusion
The prevalence of MS in patients receiving peritoneal dialysis is elevated with a negative impact on the risk of CV events. At the same time, our data shows the importance of assessing each individual risk factor regardless of the presence of full-blown MS. In particular, we observed that the presence of 2 CD is sufficient to predispose CV events. This shows that timely treatment of RF, even in the absence of full-blown MS, could favor the reduction of the risk of CV events in patients in DP
P1197ASSISTED APD IN ITALY: TRENTO EXPERIENCE
Authors: Devoti Elisabetta , Venturelli Chiara , Laudon Alessandro , Brunori Giuliano 
Published: June 2020

Abstract

Background and Aims
End-stage renal disease (ESRD) is common in elderly and fragile patients with several comorbidities. Dialysis (Hemodialysis-HD or Peritoneal Dialysis-PD) is often required. The choice between HD or PD is sometimes not easy. PD prevalence is significantly lower than HD prevalence in old and fragile patients because they are less likely to complete PD assessment, and due to stress over performing self-therapy. In the last years, in order to overcome these problems, assisted PD programs have spread out in several countries.

Method
Since 2008 in Trento Province (area of 541.399 people in the North East of Italy) we developed a program for elderly non-self sufficient patients requiring dialysis in nursing home. Admission criteria in nursing home were: age&gt;65 years, living in the province, PD therapy, non-self patient, no acute complications, no home caregivers. This patient had a priority access to nursing home. We selected HomeChoice Baxter APD as PD technique. Our nurses gave specific training of 6 hours to nursing home nurses. The patients were on APD during the night. Every 45 days patients had a clinical visit by nephrologists and hospital PD nurses, with a particular emphasis on clinical data and dialysis performances.

Results
From 1.1.2008 to 12.31.2018 we enrolled 36 patients (16 male and 20 female) in a population of 226 PD incident patient, age (M±DS) at PD start was 78 ± 7.3 years (range 65-91); break-in was 27 ± 20.4 days and time in PD was 374 ± 347 days (range 15-1257). The cumulative incidence of peritonitis was 1/75-patient/month. During these eleven-year period we trained 19 nursing home nurses.

Conclusion
Assisted APD in nursing home could be an appropriate therapy choice for non-self sufficient elderly patients requiring renal replacement therapy. These option is safe for patients and could increase PD incidence.
P1198CATHETER-RELATED INFECTIONS DUE TO SERRATIA SPECIES IN PATIENTS RECEIVING PERITONEAL DIALYSIS
Authors: Au Christy , Chan Jasper , Yip Terence , Yap Desmond , Chan Daniel Tak Mao 
Published: June 2020

Abstract

Background and Aims
Serratia species can cause catheter-related infections in peritoneal dialysis (PD) patients but data on this clinical entity remains limited. This study aims to investigate the clinical characteristics, antibiotics susceptibility/resistance profiles and treatment outcomes of Serratia catheter-related infections in PD patients.

Method
We retrospectively reviewed all PD patients who were followed up at Queen Mary Hospital and Tung Wah Hospital, Hong Kong between 2004 to 2017. Patients with Serratia exit site infection (ESI) or peritonitis were included for analysis.

Results
One hundred and seventy-three patients with Serratia catheter-related infections were included. 161 patients had ESI, of which 10 (6.2%) progressed to tunnel tract involvement and 11 (6.8%) developed PD peritonitis. Skin abnormalities surrounding the exit site were present in 58 patients (36%), and 40 patients (24.8%) were hospitalized within 1 month prior to Serratia ESI. 142 patients (88.2%) with ESI responded to medical therapy alone, and repeat ESI occurred in 56 patients (34.7%) at a median of 12 months. Twenty-two patients had Serratia peritonitis, which accounted for 1% of peritonitis during the study period. Concomitant intra-abdominal pathologies were detected in 12 patients (54.5%). Ten patients (45.5%) responded to medical treatment while the remaining 12 (54.5%) required catheter removal. Nine patients (36.4%) failed PD resumption and switched to chronic haemodialysis. Repeat peritonitis occurred in two patients at 2 months and 3 years after the initial episode respectively. While Serratia species in PD patients are generally susceptible to aminoglycosides, carboxy-/ureido-penicillins and carbapenems, they exhibit substantial rates of resistance to ampicillin, and 1st- and 2nd-generation cephalosporins.

Conclusion
Serratia ESI responds favourably to medical therapy and seldom progresses to tunnel tract infection or peritonitis. Serratia peritonitis is associated with considerable risk of catheter loss and peritoneal failure.
P1202EPIDEMIOLOGICAL AND EVOLUTIONARY PROFILE OF MECHANICAL COMPLICATIONS IN PERITONEAL DIALYSIS
Authors: Fattoum Safa , Samia Barbouch , Mariem Hajji , Nessrine Braiek , Tasnim Mesbahi , Imen Gorsane , Amel Harzallah , Fathi Ben Hmida , Mondher Ounissi , Taieb Ben Abdallah 
Published: June 2020

Abstract

Background and Aims
The success of peritoneal dialysis (PD) depends on a functional and sustainable peritoneal access. The mechanical complications of PD (MCPD) are a major cause of technique failure. The aim of the study was to determine the different types of these complications and to define their prevalence.

Method
It’s a retrospective study conducted in our PD unit in December 2019. We collected all data concerning clinical characteristics of all patients currently in PD, as well as incidence, type, outcome of MCPD.

Results
There were 90 patients with an average age of 45 years (extremes: 20.5 years and 80.6 years). The sex ratio is 1.25. Fourteen were diabetic (15.5%). All patients were on Automated PD (APD) except one on Continuous Ambulatory PD (CAPD). The average duration of PD was 40.5 months. The average body mass index (BMI) was 23,8 kg/m? All patients had a Tenckhoff 2 cuff catheter placed by a mini laparotomy.
Twenty six episodes of MCPD were noted in 17 patients (18,8%).The complications noted were early dialysate leakage in 2 patients(2,2%) spontaneously resolving before the beginning of the training, catheter obstruction in 8 patients(3 patients presented 3 episodes of obstruction each) (8,8%), umbilical hernia in 3 patients (3,3%), 2 patients had displaced repositioned catheter (2,2%). Five patients (5,5%) presented continued inflammation in the exit-site of the catheter: the outermost of the two Dacron cuffs spontaneously extruded in 2 patients, and was surgically extracted in 3 patients. Cuff externalization resolved the inflammation in all patients.

Conclusion
Successful access for PD placed by a trained operator is crucial in purpose to avoid MCPD. These complications must be treated on time to avoid technique failure.
P1208TREATMENT OUTCOMES IN PERITONEAL DIALYSIS PERITONITIS ARE NOT AFFECTED BY DEGREE OF RESIDUAL RENAL FUNCTION
Authors: Gleeson Sarah , Navaratnarajah Arun , Hisole Nora , McGrory Jacqueline , Chelapurath Titus , Galima Froilan , Zanovello Valentina , Bartholomew Carol , Punzalan Sally , Brown Edwina , Corbett Richard 
Published: June 2020

Abstract

Background and Aims
Early studies in peritonitis showed no difference in outcomes between anuric and non-anuric patients, despite pharmacokinetic studies showing the effect of residual renal function (RRF) on antibiotic clearance. Recent work identified a relationship between preserved RRF and treatment failure in gram-positive and culture-negative peritonitis. Our centre uses empiric vancomycin and gentamicin dosed by weight (both drugs) and by RRF (gentamicin). We sought to examine whether RRF is associated with treatment failure in our population.

Method
We retrospectively identified all episodes of PD peritonitis between January 2014 and July 2019 including demographic and clinical information. The RRF measured closest to the peritonitis episode was used. Treatment failure was defined as death, catheter removal or relapse.

Results
189 peritonitis episodes occurred in 128 patients (43% female, mean age 61.3±17.9). 80 episodes were caused by gram-positive bacteria, 49 gram-negative, 51 culture-negative, 5 fungal and 4 polymicrobial. 21, 88 and 61 episodes occurred in patients with a creatinine clearance &lt;0.5, 0.5-5, and &gt;5ml/min respectively. Creatinine clearance data was unavailable in 21 patients.
Treatment failure occurred in 72 cases (38%) (19 relapses, 52 catheter removals, 7 deaths). Treatment failure for all bacterial peritonitis episodes was not affected by RRF as compared to anuric patients: 0.5-5 (OR 0.41, 95% CI 0.12-1.35, p 0.14) or &gt;5 (OR 0.90, 95% CI 0.22-3.67, p 0.88). There was no difference in outcome in sub-group analysis by type of organism. Antibiotic concentrations did not differ between the RRF groups.

Conclusion
Although limited by small numbers we found no association between the degree of RRF and outcome. We hypothesise this is because we monitor antibiotic concentrations and therefore dose antibiotics appropriate to the level of RRF. In PD peritonitis regimes that adjust for RRF there is no impact of RRF on treatment outcomes.
P1211IOT(INTERNET OF THINGS) FOLLOW-UP VS. CONVENTIONAL CARE IN PATIENTS WITH CONTINUOUS AMBULATORY PERITONEAL DIALYSIS: A RETROSPECTIVE, CASE-CONTROL STUDY
Authors: Li Aihua , Liang Mengjun , Jiang Zongpei 
Published: June 2020

Abstract

Background and Aims
Peritoneal dialysis (PD) has been accepted as a home-based, more cost-effective renal replacement therapy worldwide. Increasing evidence indicates that patients on PD have clinical outcomes that are not optimistic than those on hemodialysis. The reasons for these observations are multifactorial and include lack of experience on self health-care, limited modality of follow-up, belated prescription adjustments, and shortage of management of the various complications. Internet of things (IoT), a novel technology that would improve access to and compliance in PD patients, has been designed and deployed to PD patients in our center for the nursing follow-up.

Method
A retrospective, case-control study enrolled 30 patients on continuous ambulatory peritoneal dialysis (CAPD) in The Six Affiliated Hospital of Sun Yat-sen University from 2018.09 to 2018.10. The patients were categorized into IoT group (15 patients) and conventional group in which patients was selected by propensity score matching for the gender, age, dialysis age and basic nephropathy. All the patients had been followed up for 3 months to assess their quality and compliance of PD. IoT follow-up was defined as the framework of home-based sphygmomanometer, electronic scale, weighing scale and portable application description (PAD) via bluetooth and the nurses in PD group could review the data timely over the internet and provide care management advice. Conventional care was defined as telephone or outpatient follow-up monthly.

Results
There were no differences among gender, age, dialysis age, and basic nephropathy distribution between the two groups. After 3-month follow-up, the weight compliance rate in IoT group seemed better than that in conventional group, with rate of 100% and 80%, p=0.068; the blood pressure compliance rate in IoT group seemed higher than that in conventional group, with rate of 60% and 46.7%, p=0.464. Nine patients (the rate of 60%) in IoT group, while only 2 patients (13.3%) in conventional group, had got alterations of hypotensive drugs, p=0.008. Eight patients (53.3%) in IoT group had acquired adjustments of PD doses, while no patient in conventional group had any changes, p=0.001.

Conclusion
Our preliminary results had indicated that IoT technology could provide innovations and timeliness for basic nursing care in PD follow-up. IoT devices would help to improve the availability and effectiveness of peritoneal dialysis.
P1214RELATIONSHIP BETWEEN CHANGE IN DIALYSATE CONDUCTIVITY AND INTRAPERITONEAL VOLUME DURING PET
Authors: Rosales Merlo Laura , Zhu Fansan , Kotanko Peter 
Published: June 2020

Abstract

Background and Aims
Bioimpedance spectroscopy (BIS) has been widely applied to measure fluid volume in dialysis patients. A fundamentally important, yet unanswered question is how changes in fluid conductivity affects the accuracy of BIS measurements. The aim of this study was to investigate whether the change in intraperitoneal volume (IPV) is – as hypothesized - linearly correlated with the change in dialysate conductivity during a peritoneal equilibrium test (PET).

Method
Four PD patients (age 58±13 years, three males, weight 87.8±28 kg) were studied during a standard PET. Segmental BIS was continuously measured with eight electrodes placed between rib and buttock on both sides of the body using a Hydra 4200 (Xitron Technologies Inc ). IPV was calculated based on BIS recordings as recently published (Zhu, Kidney Blood Press Res 2019;44:1465–1475). Dialysate samples were collected hourly from baseline to the end of dwell. Dialysate conductivity was measured with a portable conductivity meter (CDH-280-KIT, Omega Engineering Inc, CT, USA).

Results
In all patients dialysate conductivity increased significantly (p&lt;0.0001) from baseline (11.14±0.15 mS/cm) to the end of dwell (12.5±0.58 mS/cm) (Fig a). In 2 patients (Fig b and c) IPV and conductivity were linearly correlated; in one patient (Fig d) the relationship was nonlinear and absent in another one (Fig e).

Conclusion
Although the number of patients in this study was small, the results clearly indicated that dialysate conductivity increased linearly over time during PET. The correlation between dialysate conductivity and IPV is not linear and may be driven by other factors, such as dialysate electrolyte levels. In future studies measurements of dialysate electrolytes are necessary to better understand the drivers of the IPV / conductivity relationship.
P1217VALUE OF MYCOBACTERIUM TUBERCULOSIS SPECIFY ELISOPT IN THE DIAGNOSIS OF PERITONEAL DIALYSIS-ASSOCIATED TUBERCULOUS PERITONITIS PATIENTS
Authors: Fan Qiuxia , Huang Xiaoyan , Xiong Zibo , Zhang Jieyun , He Yan 
Published: June 2020

Abstract

Background and Aims
Patients with ESRD undergoing chronic dialysis are 6 to 25 times more likely to develop tuberculosis (TB) than the general population. Tuberculous peritonitis is the most common form of tuberculosis infection in peritoneal dialysis patients. However, diagnosing active TB infection can be challenging, early and rapid diagnosis of tuberculous peritonitis has always been a challenge for nephrologists. M.tuberculosis antigen-specific IFN-γ production by peripheral blood mononuclear cells (PBMC) was determined by using an in-house ELISPOT assay by Institute of Hepatology of Shenzhen Third Hospital.In this study, we evaluated diagnostic performance of an M.tuberculosis antigen-specific gamma interferon enzyme-linked immunospot (ELISPOT) assay in continuous ambulatory peritoneal dialysis (CAPD) patients with tuberculous peritonitis.

Method
There were nine patients (1.29%) with tuberculous peritonitis among 700 CAPD patients. M. tuberculosis accounted for 2.84 % of all peritonitis.IFN-γ response in peripheral blood and peritoneal fluid were determined in 9 patients with tuberculous peritonitis(TBP),at the same time, 13 cases diagnosed with non-tuberculous peritonitis(NTBP) were enrolled.All patients were examined for tuberculosis-specific IFN-γ ELISPOT in peripheral blood and peritoneal dialysis fluid.

Results
22 patients were recruited into this study, 9 were classified with confirmed tuberculosis peritonitis, 13 patients with bacterial or fungal peritonitis were enrolled as controls during the same period, in this patients, 3 were caused by Gram positive bacteria, 3 were caused by Gram negative bacteria, 3 were caused by fungus, 4 patients were negative athogenic bacteria culture .The AUC of ROC curve was 0.927 (95%CI:0.816–1.000,P=0.001) for ELISPOT on PFMC, which was higher than that of ELISPOT on PBMC (0.825,95%CI: 0.6490–1.000,P=0.011).When the cutoff value for the diagnosis of TBP was 40.5 SFCs/2 × 105 for ELISPOT on PBMC, with a sensitivity of 55.6%, a specificity of 92.3%,a diagnostic efficiency of 77.3%,The positive predictive value was83.3%, with negative predictive value of 75%,positive likelihood ratio of 7.2, and negative likelihood ratio of 0.48.The sensitivity, specificity,diagnostic efficiency,PPV, NPV, LR+, and LR- of the ELISPOT assay for the diagnosis of active TBP when performed on the PFMC were 77.8%, 84.6%, 81.8%, 77.8%, 84.6%, 5.05 and 0.26, respectively.Receiver operating characteristic(ROC) curves were used to estimate the diagnostic values of Elispot on PFMC and PBMC in 22 patients with confirmed TBP or NTBP.

Conclusion
IFN-γ release test can be used for early diagnosis of CAPD-related TBP; compared with peripheral blood, peritoneal dialysate may be a more effective and accurate way to diagnose CAPD complicated with tuberculous peritonitis.