bluuebunny/crossref_metadata_2025_split huggingface dataset:
Residual Renal Function Affects Lipid Profile in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis
Authors: Kagan Alexander , Elimalech Eti , Lerner Zvi , Fink Aaron , Bar-Khayim Yaacov 
Published: February 2020

Objective To determine whether lipoprotein abnormalities associated with continuous ambulatory peritoneal dialysis (CAPD) are influenced by residual renal function (RRF). Design Open, non randomized prospective and com -parative study. Setting Single university teaching hospital dialysis unit and outpatient clinic. Patients Twenty adult patients on standard CAPD (1 -38 months) were divided into two groups: group A (RRF ≤ 0.8 mL/min, n = 10) and group B (RRF ≥ 1.1 mL/ min, n = 10). Patients in the two groups were matched for age, time on dialysis, body weight, body mass index, serum urea and albumin levels, peritoneal and urinary albumin losses, and peritoneal transport characteristics such as overnight 8hour peritoneal creatinine and β2-microglobulin clearances and overnight 8-hour effluent glucose concentrations. Results The degree of uremia in patients with preserved RRF (group B) was obviously lower than in patients with negligible RRF (group A), that is, patients in group B had significantly lower serum creatinine and β2-microglobulin levels and significantly higher weekly KTN than group A patients. Despite the prevalence of allele 4 of apolipoprotein E genotype in group A patients, their levels of serum total cholesterol, low-density lipoprotein cholesterol, lipoprotein (a) [Lp(a)], apolipoprotein B (ApoB), and apolipoprotein A1 (ApoA1) were significantly lower than those of patients with preserved RRF (group B). The two groups did not differ significantly in the serum levels of triglyceride or high-density lipoprotein cholesterol. Serum concentrations of Lp(a) and ApoA1, as well as ratios of ApoA1 to ApoB, were correlated significantly with RRF (r = 0.63, r = 0.51, and r = 0.61, respectively). Conclusions The findings suggest that RRF affects the lipid profile of CAPD patients, especially serum levels of cholesterol-rich lipoproteins.
Predialysis Glycemic Control is An Independent Predictor of Clinical Outcome in Type Ii Diabetics on Continuous Ambula Tory Peritoneal Dialysis
Authors: Yu Chun-Chen , Wu Mai-Szu , Wu Ching-Herng , Yang Chih-Wei , Huang Jeng-Yi , Hong Jenn-Jye , Chiang Chun-Yi Fan , Leu Mei-Ling , Huang Chiu-Ching 
Published: February 2020

Objective To evaluate the correlation between predialysis glycemic control and clinical outcomes for type II diabetic patients on continuous ambulatory peritoneal dialysis (CAPD). Design Sixty type II diabetic patients on CAPD were classified into 2 groups according to the status of glycemic control. In group G (good glycemic control), more than 50% of blood glucose determinations were within 3.3 11 mmol/L and the glycosylated hemoglobin (HbA 1 C) level was within 5 -10% at all times. In group P (poor glycemic control), fewer than 50% of blood glucose determinations were within 3.3 -11 mmol/L or HbA 1 C level was above 10% at least once during the follow-up duration. In addition to glycemic control status, predialysis serum albumin, cholesterol levels, residual renal function, peritoneal membrane function, and the modes of glycemic control were also recorded. Setting Dialysis Unit, Department of Nephrology of a single university hospital. Patients From February 1988 to October 1995, 60 type II diabetic patients receiving CAPD for at least 3 months were enrolled. Main Outcome Measures Morbidities before and during the dialysis period, patient survival, and causes of mortality. Results The patients with good glycemic control had significantly better survival than patients with poor glycemic control (p < 0.01). There was no significant difference in predialysis morbidity between the two groups. No significant differences were observed in patient survival between the patients with serum albumin greater than 30 g/L and those with less than 30 g/L (p = 0.77), with cholesterol levels greater or less than 5.18 mmol/L (p = 0.73), and with different peritoneal membrane solutetrans port characteristics evaluated by peritoneal equilibration test (p = 0.12). Furthermore, there was no significant difference in survival whether the patients controlled blood sugar by diet or with insulin (p = 0.33). Cardiovascular disease and infection were the major causes of death in both groups. Although good glycemic control predicts better survival, it does not change the pattern of mortality in diabetics maintained on CAPD. Conclusions Glycemic control before starting dialysis is a predictor of survival for type II diabetics on CAPD. Patients with poor glycemic control predialysis are associated with increased morbidity and shortened survival.
The Diagnostic Value of Gram Stain for Initial Identification of the Etiologic Agent of Peritonitis in Capd Patients
Authors: Bezerra Dinoráh A. , Silva Mario B. , Caramori Jaqueline S.T. , Sugizaki Maria F. , Sadatsune Teruê , Montelli Augusto C. , Barretti Pasqual 
Published: February 2020

Objective To evaluate the effectiveness of the Gram stain in the initial diagnosis of the etiologic agent of peritonitis in continuous ambulatory peritoneal dialysis (CAPD). Design Retrospective study analyzing the sensitivity (S), specificity (SS), positive predictive value (+PV), and negative predictive value (-PV) of the Gram stain relating to the results of cultures in 149 episodes of peritonitis in CAPD. The data were analyzed in two studies. In the first, only the cases with detection of a single agent by Gram stain were taken (Study 1). In the second, only the cases with two agents in Gram stain were evaluated (Study 2). Setting Dialysis Unit and Laboratory of Microbiology of a tertiary medical center. Patients Sixty-three patients on regular CAPD who presented one or more episodes of peritonitis from May 1992 to May 1995. Results The positivity of Gram stain was 93.2% and the sensitivity was 95.7%. The values of S, SS, +PV, and -PV were respectively: 94.9%, 53.5%, 68.3%, and 90.9% for gram -positive cocci and 83.3%, 98.8%, 95.2%, and 95.6% for gram-negative bacilli. The association of grampositive cocci plus gram -negative bacilli were predictive of growth of both in 6.8%, growth of gram -positive cocci in 13.7%, and growth of gram -negative bacilli in 72.5%. Conclusions The Gram stain is a method of great value in the initial diagnosis of the etiologic agent of peritonitis in CAPD, especially for gram-negative bacilli.
Measurement of Serum Ionized Magnesium in Capd Patients
Authors: Saha Heikki H.T. , Harmoinen Aimo P.T. , Pasternack Amos I. 
Published: February 2020

Objective To evaluate the magnesium status of continuous ambulatory peritoneal dialysis (CAPD) patients using a new method for assessing the level of the ionized fraction a serume magnesiumy. Design Serum ionized magnesium was measured in CAPD patients using the ion-selective electrode for Mg2+. Setting The Dialysis Unit of Tampere University Hospital. Patients Twenty -six patients on CAPD (age: 21 -81 years, mean 54 ± 16 years; duration of CAPD: 3 -52 months, mean 13 months), and 26 sex and age-matched healthy controls. Results Both serum ionized magnesium (0.73 ± 0.11 mmol/L vs 0.56 ± 0.07 mmol/L, p < 0.001) and total magnesium (1.11 ± 0.22 vs 0.81 ± 0.08 mmol/L, p < 0.01) were higher in CAPD patients than in sex and agematched controls. The ionized magnesium fraction of total magnesium was slightly lower in dialysis patients in spite of the fact that 16/26 patients had serum albumin less than 36 g/L. Hypermagnesemia (mean serum ionized magnesium 0.78± 0.10 mmol/L) was observed in the 13 of 26 patients with 0.75 mmol/L Mg2+ dialysate; those with lower magnesium dialysate (Mg2+ 0.50 mmol/L in 10/26 and Mg2+ 0.25 mmol/L in 3/26) had mean serum ionized magnesium at the upper normal margin (0.69 ± 0.10 mmol/L). Conclusion In CAPD patients with Mg2+ 0.5 0.75 mmol/L in their dialysis fluid, both serum ionized and total magnesium concentrations were higher but the ionized/total magnesium ratio was lower than in healthy control subjects. Use of ion-selective electrodes to measure ionized magnesium may be a more useful methodology than measuring total magnesium in the evaluation of magnesium status of CAPD patients, because it is not infuenced by hypoalbuminemia or increased complexed fraction of magnesium often present in dialysis patients.
Increase of the Bioavailabllity of Intraperitoneal Erythropoietin in Children on Peritoneal Dialysis by Administration in Small Dialysis Bags
Authors: Reddingius Roel E. , De Boer Alberdina W. , Schröder Cornelis H. , Willems Johannes L. , Monnens Leo A.H. 
Published: February 2020

Objective To establish the effectivity of administration of erythropoietin intraperitoneally in a small amount of fluid in children with renal anemia on continuous ambulatory peritoneal dialysis (CAPD). Design Prospective study in which children with renal anemia on CAPD were treated with erythropoietin intraperitoneally, administered in a specially designed bag containing 50 mL NaCl 0.9%. Setting University hospital. Patients The patient population consisted of 9 children treated with CAPD and 1 treated with nightly intermittent peritoneal dialysis. The median age was 7.8 years (range 4.1 -15.2). Four of these children had not been treated with erythropoietin before (group A), and 6 had been treated with erythropoietin administered intraperitoneally in 250 mL of dialysis fluid (group B). Interventions Patients in group A started on a dose of approximately 300 units/kg per week (group A). Patients in group B received their previous dose. Do sage was adjusted to achieve a target hemoglobin level of 6.5 7.0 mmol/L (104 -112 g/L). Serum ferritin levels and transferrin saturation were monitored and iron supplementation was prescribed in the case of iron deficiency. Main outcome measures Weekly erythropoietin dose in relation to hemoglobin level. Results In group A, median hemoglobin level rose from 5.3 mmol/L (85 g/L) to 6.6 mmol/L (106 g/L) after 6 months of therapy, whereas the median erythropoietin dose decreased from 266 to 234 U/kg/week. In group B, hemoglobin levels remained stable and median erythropoietin dose decreased from 262 to 194 U/kg/week. One patient in this group, for unknown reasons, never responded to erythropoietin treatment. He was excluded from further analysis. In the remaining 5 patients the median cumulative erythropoietin dose was 3250 U/kg in the 3-month period prior to the start of the study and 2713 in the 3-month period starting 6 months after the beginning of the study. This difference of 17% was statistically significant using a Wilcoxon test (p < 0.05). Conclusion Intraperitoneal administration of erythropoietin in a small amount of dialysis fluid leads to a decrease in the required dose.
Staphylococcus Aureus Carriage in Adult Peritoneal Dialysis Patients and Their Spouses
Authors: Bistrup Claus , Jensen Kjeld Truberg , Kabel Bodil , Pedersen Robert Smith 
Published: February 2020

Objective We hypothesized that carriage of Staphylococcus aureus among continuous ambulatory peritoneal dialysis (CAPD) patients was influenced by their spouses. Furthermore, this carrier status was compared to previous Staph. aureus peritonitis episodes in order to identify the influence of Staph. aureuscarriage on peritonitis rate. Design A combined prospective surveillance study (Staph. aureus carriage) and retrospective chart review (Staph. aureus peritonitis). Setting A single peritoneal dialysis unit in a county hospital. Patients and methods Cultures from patients (n = 32) and spouses (n = 16) were obtained twice, with a 1-month interval, from the anterior nares, the umbilical, and one groin area. All positive cultures were phage typed. Retrospective chart review of all episodes of Staph. aureus peritonitis among the patients was carried out. Results Twelve of 32 patients (37.5%) and 5 of 16 spouses (31 %)evaluated were carriers. Half of the spouses of patients who were Staph. aureus carriers, were also carriers, as opposed to 20% of spouses of non carrier patients (p = 0.30). Patients and spouses always shared the same phage type. Among patients, Staph. aureus was found in the nose only (n = 9), in all three regions (n = 2), and extranasally only (n = 1). If only one nasal culture was used to establish carriage, the sensitivity and negative predictive value would be 92% and 95%, respectively. A trend toward a higher incidence (p = 0.062) of Staph. aureus peritonitis was found among carriers (patients), 0.37 versus 0.28 peritonitis episode/dialysis -year. Conclusions Only one positive nasal culture was necessary when carriage of Staph. aureus was to be established. Staph. aureuscarriage was found more often in patients who had previously suffered from Staph. aureus peritonitis. The phage types isolated remained fairly constant, and the patients and spouses often had the same carrier state and shared the same phage types, although transmission does not always take place.
The Role of Na, K-Atpase Inhibitors in Hypertension and End-Stage Renal Disease
Authors: Bargman Joanne M. 
Published: February 2020

Objective To review the role of Na, K-ATPase inhibitors in the pathogenesis of essential hypertension and hypertension associated with end-stage renal disease. Data Sources MEDLINE search, 1966 to 1997. Results There is a suggestive physiologic and epidemiologic relationship between Na, K-ATPase inhibition and hypertension. However, clearance data cannot support the hypothesis that differential metabolism of this family of compounds explains the improved hypertensive control seen in patients on peritoneal dialysis compared to those on hemodialysis. Conclusions As a result of the complex methodologies involved, it is unclear whether Na, K-ATPase inhibitors playa significant role in the hypertension of endstage renal disease in general and peritoneal dialysis in particular.
Symptomatic Ascites after Discontinuation of Continuous Peritoneal Dialysis
Authors: Haq Muhammad Z. , Tzamaloukas Antonios H. , Malhotra Deepak , Gibel Lawrence J. 
Published: February 2020

Objective To analyze pathogenetic associations, clinical features, management, and outcome of ascites following discontinuation of continuous peritoneal dialysis (CPD). Design Retrospective analysis of symptomatic ascites, defined as ascites requiring at least one therapeutic paracentesis, developing in patients who discontinued CPD. Setting Dialysis unit of one tertiary care center. Participants Twelve patients with 13 episodes of symptomatic ascites diagnosed soon after (a few days to 2 months) discontinuation of CPD. Interventions Diagnostic tests to characterize the pathogenesis of ascites; management of ascites by hemodialysis or CPD. Main Outcome Measures Evolution of clinical features and nutritional parameters, survival. Results Ascites was infectious in 3 episodes (nontuberculous mycobacterial peritonitis) and noninfectious in the remaining 10 episodes. Serum-to-ascites albumin concentration gradient (AG) was 6.3 ± 1.5 g/L in infectious ascites and 17.3 ± 2.7 g/L (>11 g/L in every episode) in noninfectious ascites. Infectious ascites was managed with hemodialysis, prolonged courses of antimicrobial agents, and repeated paracentesis. Paracentesis ceased after 3 9 months. The patients were alive after 52 ± 19 months. Seven episodes of noninfectious ascites were managed by hemodialysis and repeated paracentesis. Five patients died within 6 months from cardiac causes or sepsis. The remaining 2 patients died after 14 and 16 months from cardiac causes. Three episodes of noninfectious ascites in 2 patients were treated by restarting CPD within 2 -5 months. Patients were alive at 16.9 ± 13.2 months. They were asymptomatic and achieved fluid control. On the same CPD schedule, peritoneal clearances of urea and creatinine and normalized protein nitrogen appearance were unchanged between the initial and restarted CPD. Serum albumin was 33.3 ± 2.5 g/L at the end of the first CPD period, 23.6 ± 2.5 g/L soon after restarting CPD, and 31.3 ± 5.5 g/L 4 months after restarting CPD. Conclusions Noninfectious ascites after discontinuation of CPD is often characterized by an AG > 11 g/L, suggesting portal hypertension. Restarting CPD in noninfectious ascites may be associated with improvement in ascites symptomatology and nutritional parameters and with satisfactory survival.
Abdominal Catastrophe: Visceral Injury as a Cause of Peritonitis in Patients Treated by Peritoneal Dialysis
Authors: Harwell Carla M. , Newman Lynda N. , Cacho Carolyn P. , Mulligan David C. , Schulak James A. , Friedlander Miriam A. 
Published: February 2020

Objective Peritonitis is considered an acceptable and controllable risk in patients undergoing chronic peritoneal dialysis (PD). In contrast, peritonitis due to visceralleakage represents a true “abdominal catastrophe” because of striking morbidity and mortality. To delineate the incidence, causes, and outcomes of catastrophic peritonitis, we compared patients who developed peritonitis due to documented visceral leakage with patients who developed peritonitis due to enteric organisms without evidence of visceral leakage. Design Retrospective chart review. Setting PD Unit located in tertiary care referral center. Patients 230 patients treated by PD between January 1988 and June 1996. Main Outcome Measures All episodes of PD-related peritonitis occurring over an 8-year period. Hospital course of all patients with or without renal failure who were treated at University Hospitals of Cleveland for ischemic bowel disease, cholecystitis, viscus perforation, or diverticulitis. Results Anatomically documented visceral injury caused 32.5% of episodes of enteric bacterial peritonitis in 72 patients between January 1988 and June 1996. The overall incidence of this “abdominal catastrophe” was 11.3%, or 26 of a total of 230 patients treated by PD. Of the 26 patients, 50% died, 30.7% survived but switched permanently to hemodialysis, and only 19.2% remained on, or returned to, PD. Compared to renal failure patients treated by hemodialysis or transplantation and to nonrenal failure patients, the incidence of abdominal catastrophe was 20 -60 times greater in patients treated by PD. Conclusions Evidence for injury of an abdominal organ should be sought in all patients treated by PD who develop peritonitis with enteric organisms. Surgical intervention is definitive for diagnosis, and if performed early may reduce morbidity and mortality.
Inflammatory Demyelinating Neuropathy in Patients with End-Stage Renal Disease Receiving Continuous Ambulatory Peritoneal Dialysis (Capd)
Authors: Toepfer Marcell , Schiffl Helmut , Fricke Harald , Lochmüller Hans , Held Eckhard , Pongratz Dieter , Müller-Felber Wolfgang 
Published: February 2020

Objective To report on 3 patients with inflammatory demyelinating peripheral neuropathy in strong temporal coincidence with the initiation of peritoneal dialysis (PD) therapy. Setting Nephrology and Neurology Department of the University Hospital, Munich, Germany. Patients Three patients with end-stage renal failure presented with the clinical picture of inflammatory demyelinating peripheral neuropathy within 4 to 10 weeks after start of continuous ambulatory peritoneal dialysis (CAPD). They had acute or subacute onset of lower extremity or generalized weakness, diminished reflexes, elevated spinal fluid protein levels, and signs of demyelinating neuropathy on electrophysiological testing. Measures Clinical follow-up, nerve conduction studies, cerebral spinal fluid (CSF). Results All patients did not improve under intensified PD therapy but took profit from immunomodulatory therapy. One bed-bound patient improved after change to hemodialysis and showed complete remission after renal transplantation. Conclusion Because of strong temporal coincidence, a causal relationship between CAPD and inflammatory demyelinating peripheral neuropathies can be suspected in these 3 patients.
Replacement of Amino Acid and Protein Losses with 1.1% Amino Acid Peritoneal Dialysis Solution
Authors: Jones Michael R. , Gehr Todd W. , Burkart John M. , Hamburger Richard J. , Kraus Alfred P. , Piraino Beth M. , Hagen Tricia , Ogrinc Francis G. , Son Marsha Wolf 
Published: February 2020

Objective Losses of nutrients into dialysate may contribute to malnutrition. Peritoneal dialysis (PD) patients are reported to lose 3 -4 g/day of amino acids (AAs) and 4 -15 g/day of proteins. The extent to which one exchange with a 1.1% AA dialysis solution (Nutrineal, Baxter, Deerfield, IL, U.s.A.) offsets these losses was investigated in a 3-day inpatient study in 20 PD patients. Design Simple, open-label, cross-over study on consecutive days in a clinical research unit. On day 1 all patients were given a peritoneal equilibration test (PET). On day 2 they received 1.5% dextrose Dianeal (Baxter) as the first exchange of the day and their usual regimen thereafter. On day 3, the first exchange of the day was the 1.1% AA solution in place of 1.5% Dianeal and the usual PD regimen thereafter. On days 2 and 3 all dialysate effluent was collected and analyzed for AAs and proteins. Patients were maintained on a constant diet. Results Losses of AAs and total proteins on day 2 were 3.4 ± 0.9 g and 5.8 ± 2.4 g, respectively, totaling 9.2 ± 2.7 g. The net uptake of AAs on day 3 was 17.6 ± 2.6 g (80 ± 12% of the 22 g infused). Mean gains of AAs on day 3 exceeded losses of proteins and AAs on day 2, p < 0.001. Losses of total proteins, but not losses of AAs, and the net absorption of AAs from the dialysis solution were correlated directly with peritoneal membrane transport characteristics, obtained from the PET. Conclusion Daily losses of AAs and proteins into dialysate are more than offset by gains of AAs absorbed from one exchange with 1.1% AA-based dialysis solution. Net gains of AAs exceeded losses of proteins and AAs in all patients studied. The difference was relatively constant across a wide range of membrane transport types. Net AA gains were approximately two times the total AA and protein losses.
N-Acetylglucosamine Changes Permeability of Peritoneum during Chronic Peritoneal Dialysis in Rats
Authors: Wu George , Tobis Katarzyna Wieczorowska , Polubinska Alicja , Korybalska Katarzyna , Filas Violetta , Tam Paul , French Ian , Breborowicz Andrzej 
Published: February 2020

Objective To evaluate the effect of supplementation of dialysis fluid with N-acetylglucosamine (NAG) on the permeability of peritoneum during chronic peritoneal dialysis in rats. Design Experiments were performed on rats with surgically implanted peritoneal catheters. Dialysis solution [DianeaI1.5% (Baxter, Deerfield, IL, U.S.A.) supplemented with either NAG 50 mmol/L or glucose 50 mmol/L (control)] was infused intraperitoneally twice, every day, for 8 weeks. Peritoneal equilibration tests (PET) were performed in all animals at the beginning of the study and after 8 weeks of dialysis. Additionally, at the end of each week, dialysis solution infused in the morning was drained after 4 hours of intraperitoneal dwell. White blood cell count, creatinine, and total protein concentrations were measured in the effluent dialysate. After 8 weeks of dialysis, the morphology of the peritoneum was studied. Results In rats exposed to dialysis fluid supplemented with NAG, peritoneal permeability to creatinine and proteins was reduced when compared to animals dialyzed with glucose solution. In NAG treated animals, staining with alcian blue for polyanions in the peritoneal interstitium was significantly stronger than in rats dialyzed with glucose solution. Conclusions Chronic peritoneal dialysis with dialysis solution supplemented with N-acetylglucosamine causes accumulation of glycosaminoglycans in the peritoneal interstitium, which results in a change of peritoneal permeability.