bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum Carnitine Levels, Lipid Profile, and Metabolic Status of Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Pliakogiannis Theodoros , Chatzidimitriou Christos , Evangeliou Athanasios , Söhles Hans Josef , Kalaitzidis Kleonikos 
Published: February 2020

The purpose of our study was to evaluate the influence of serum carnitine levels on the metabolic status and lipid profile of patients on continuous ambulatory peritoneal dialysis (CAPD). We studied the lipid profile, the metabolic status (triceps, skinfold thickness, midarm muscle circumference, relative body weight, serum total protein, albumin), and serum carnitine levels in 22 patients (11 male, 11 female) on CAPD. The results are summarized as follows: mean serum total camitine (TC) was normal, free carnitine (FC) was reduced, while acylcarnitine (AC) was elevated in our patients (p<0.001). A positive correlation was found between TC (p<0.02), FC (p<0.05), and serum total protein. A positive correlation was also found between TC (p<0.05), AC (p<0.02), ACIFC (p<0.02), and relative body weight, and TC (p<0.001), FC (p<0.02), AC (p<0.01), ACIFC (p<0.02), and triglycerides. No correlation was found between carnitine and midarm muscle circumference, triceps skinfold thickness, albumin, total cholesterol, and HDL. or LDL-cholesterol. Further studies are needed to confirm our results.
Low and High Turnover Bone Disease in Continuous Ambulatory Peritoneal Dialysis: Effects of Low-Ca + Peritoneal Dialysis Solution
Authors: Carozzi Silvia , Nasini Maria Grazia , Santoni Oscar , Pietrucci Angelo 
Published: February 2020

Calcium carbonate (CaCO3) is an effective phosphate (P04) binder in uremics, and its use reduces aluminum (AI) intake. By maintaining high serum Ca2+, it decreases serum parathyroid hormone (PTH) levels. Hypercalcemia, however, often limits the dosage. In order to evaluate the effects of a low-Ca peritoneal dialysis solution (PDS) (1.25 mmol/L) on Ca metabolism, we studied the following in 12 continuous ambulatory peritoneal dialysis (CAPD) patients with hypercalcemia (6 with low PTH levels, low-turnover bone disease, group 1, and 6 with high PTH levels, high-turnover bone disease, group 2, documented by bone biopsies): serum Ca2+; serum PTH; bone morphology. The follow-up was 12 months. Results show that in both groups within the third month there was a decrease in serum Ca2+. In group 1 serum PTH increased, reaching the norm, and In group 2 it further Increased exceeding the norm. Because In both groups serum Ca2+ was normal, It was possible to increase oral CaC03 (10.5±2.5 g/day) to control P04 levels and to stop AI gels. In group 2, In order to avoid the further rise of serum PTH, the low-Ca PDS was supplemented with 2 μg/day of 1,25(OH)2D3 (vitamin D3); this was followed by a reduction In serum PTH with no increase in Ca2+ and P04. The use of low-Ca PDS may be useful In preventing hypercalcemia In CAPD patients treated with high oral doses of CaC03 and in improving low-turnover bone disease, while low-Ca PDS supplemented with vitamin D3 improves high-turnover bone disease.
Effects of Intraperitoneal Infusion of Dextrose and Amino Acids on the Appetite of Rabbits
Authors: Balaskas Elias V. , Rodela Helen , Oreopoulos Dimitrios G. 
Published: February 2020

We studied the effect of Intraperitoneal Infusion of various volumes and concentrations of dextrose (D) and amino acid (AA) solutions, In a variety of peritoneal dialysis schedules on food Intake and biochemical profile in normal and uremic rabbits. Following omentectomy, a peritoneal catheter was implanted. Animals had free access to food, and consumption was measured daily by weight of the remaining food in the cage. We studied the effect of volume (30-50-100 mL/kg), dextrose concentration (0.5-1.5-2.5-4.25-6.6 g/dL) and AA (Travasol based) (2% in Dianeal or glucose-free solution). Dialysis schedules Included once/day, twice/day, or four-daily exchanges similar to CAPD. The durations of the exchanges were 4–6 weeks and in certain groups, amino acid exchanges for a week alternated with dextrose exchanges. Our results Indicate the following: omentectomy and catheter implantation significantly decrease food Intake. There is a significant decrease In food Intake after initiation of dialysis that returns to baseline after 2–4 weeks while dialysis continues. Higher volumes (100 mL/kg) decrease food Intake significantly, especially with hypertonic solution of either D or AA. There was no difference in food Intake between D and AA Infusion In any amount of infused volumes. Amino acids do not seem to have a suppressing effect on appetite. However, large volumes and hypertonicity reduce food Intake.
β2-Microglobulin Elimination in End-Stage Renal Disease Patients on Renal Replacement Therapy
Authors: Stefanovic' Vladisav , Kostic' Svetislav , Djordjevic' Vidojko , Mitic' Marina , Bogicevic' Momcilo 
Published: February 2020

β2-microglobulin (β2M) is a small molecular mass protein associated with dialysis amyloidosis. We have studied β2M elimination in end-stage renal disease (EsRD) patients treated by peritoneal dialysis. In 12 patients on continuous ambulatory peritoneal dialysis (CAPD) and 7 patients on intermittent peritoneal dialysis (IPD) 30.4±4.2 mg/day and 21.3± 1.8 mg/12 hour of β2M, respectively, were removed by dialysis fluid. Approximately the same amount of β2M was removed by each of four 2-L exchanges in CAPD; however, the most efficient removal of β2M was in the first IPD exchange. Serum β2M levels in these patients were 25.7 ±4.4 and 31.4±5.2 mg/L, respectively. In 24 patients on hemodialysis using cuprophan membrane the serum level of β2M was 55.1±4.1 mg/L. After a 3-month dialysis on polyacrylonitrile (PAN) membrane, the serum β2M level decreased to 45.0±2.3 mg/L. A substantial amount of β2M was removed by urine, 14.6.:1:2.3 mg/L, and saliva, 2.3±0.4 mg/L. This study has shown markedly increased β2M levels in patients on conventional hemodialysis treatment, predisposing to β2M-related amyloidosis. A significant amount of β2M was removed during both CAPD and IPD treatment.
Pruritus in Continuous Ambulatory Peritoneal Dialysis and Hemodialysis Patients
Authors: Balaskas Elias V. , Chu Maggie , Uldall Robert P. , Gupta Amit , Oreopoulos Dimitrios G. 
Published: February 2020

To study the prevalence and pathogenesis of uremic pruritus, CAPD and HD patients were asked to complete a questionnaire. The replies were quantitated based on numerical scales, and the results were compared with various hematological and biochemical parameters, underlying disease, and duration of dialysis. There were 113 CAPD patients (63 males and 50 females), mean age 60 (range 20–84) years, average time on CAPD 20 (range 1–163) months and 76 HD patients (44 males and 32 females) mean age 57 (range 23–81) years, mean time on HD 44 (range 2–242) months. Replies to questions were evaluated and graded by the same Investigator who did not know the patients. Pruritus was present in 70 (62%) CAPD patients (64% in females and 600/0 in males p=NS) and in 41 (54%) HD patients (69% in females and 43% in males, p=0.025). Before starting dialysis pruritus was present in 30% CAPD patients and 28% HD patients. Pruritus was graded as mild, moderate and severe; the distribution was 58.6%, 34.3%, and 7.1% (CAPD) and 43.90/0, 41.5%, and 14.6% (HD), respectively. Dry skin was reported by 73% CAPD patients and 72% HD patients. This xerodermia was correlated with the severity of pruritus and was also present In 65% CAPD and 48.5% HD patients without pruritus. Patients with pruritus were older than those without pruritus both for CAPD (63 vs 54 years, p=0.004) and HD (61 vs 51 years, p=0.003). A significant correlation was observed only between pruritus score and age for CAPD patients. There were no other correlations between pruritus and the other parameters studied. We conclude that pruritus Is a frequent symptom In dialysis patients, but It Is severe only In a small proportion. Its prevalence, as also that of dry skin, Increases after start of dialysis and Is higher In females on HD. Patients with pruritus are older, and the severity of pruritus correlates with age in the CAPD patients. Presence of dry skin correlates with severity of pruritus, and Its prevalence Is high even among patients without pruritus.
Abbreviated Method for Urea Kinetic Modeling in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Dumler Francis , Schmidt Rebecca , Cruz Cosme 
Published: February 2020

Urea kinetic modeling (UKM) is an established method for quantitating hemodialysis, with target values clearly defined. Precise methods for measuring continuous ambulatory peritoneal dialysis (CAPD) prescriptions are less well-defined, and 24-hour collections of dialysate effluent are logistically impractical. UKM parameters derived from an abbreviated (4-hour) collection period were compared with simultaneously obtained 24hour collections of urine and dialysate effluent in 22 CAPD patients. Daily Kt/V was calculated from total (residual renal and peritoneal) urea clearance and an anthropometric-derived total body water volume. Results yielded from the 24-hour collection included a mean Kt/V of 0.29±0.09, and mean protein catabolic rate (PCR) of 0.84±0.24 g/kg/day. Daily Kt/V values were calculated from each individual dialysate cycle. The first morning cycle after an overnight dwell correlated best with results obtained using 24-hour collections (r=0.921; p<0.0001) with no significant differences in Kt/V found (p=0.454) between the short and 24-hour methods. Daily Kt/V values converted by exponential transformation to a thrice-weekly hemodialysis value yielded a Kt/V equivalent of 1.02±0.40. UKM using an abbreviated collection period is an accurate and practical tool for quantitating CAPD adequacy in a routine clinical setting.
Subcutaneous Recombinant Human Erythropoietin in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis
Authors: Pais Maria João , Gaspar Augusta , Santana Alice , Bruges Margarida , Simões Jacinto 
Published: February 2020

We compared the effect of twice weekly subcutaneous recombinant human erythropoietin (SC rHuEPO) In two groups of patients treated with a starting dose of 80 U/kg body weight/week: group I, 7 hemodialysis (HD) patients; group II, 8 continuous ambulatory peritoneal dialysis (CAPD) patients. In a third group (group III) of 4 patients transferred from HD to CAPD with anemia previously corrected with Intravenous (IV) rHuEPO, we studied the changes In the maintenance SC dose to maintain the same hemoglobin. In groups I and II the mean SC doses required to correct anemia and to maintain hemoglobin/hematocrit levels were similar; the mean time for the correction of anemia was significantly longer In HD patients (p=0.032). In group III the maintenance SC rHuEPO does was reduced to more than 50% at 12 weeks of CAPD. Subcutaneous rHuEPO Is effective In reversing anemia in HD and CAPD patients, but It takes longer to correct anemia In HD with the same initial SC rHuEPO low dose. CAPD patients need lower doses of SC rHuEPO than HD patients in IV therapy to maintain the same hemoglobin levels.
Influence of Erythropoietin on Blood Pressure in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Balaskas Elias V. , Melamed I. Rogers , Gupta Amit , Bargman Joanne , Oreopoulos Dimitrios G. 
Published: February 2020

To assess the effect of erythropoietin (EPO) treatment on blood pressure in continuous ambulatory peritoneal dialysis (CAPO) patients, we analyzed in a retrospective study the results of 6 months of EPO treatment in 17 CAPO patients. There were 10 females and 7 males, mean age 52 years, mean duration on CAPO 35 months. They received subcutaneously a mean initial EPO dose of 114±45 U/kg/week (range 59–209). This dose was adjusted throughout 6 months to achieve and maintain a target Hb of 100 g/L (Hct 30%). Seven of the patients were hypertensive before starting EPO treatment. Fifteen paients (88.2%) achieved the target hemoglobin. For all subjects (n=17) there was a significant increase in lying mean blood pressure (MBP) from 93.8± 10.0 to 1 05.2± 14.4 mmHg (p=0.0024). Four patients required an increase in their antihypertensive medication, and 4 were not treated before we started antihypertensive treatment (Group I). This group represents 46% (8/17) of the patints. There was no change in the antihypertensive medication status of the remaining 9 patients (Group II). The baseline lying MBP was not significantly different for the two groups (98.8±9.8 mmHg vs 96.1±7.2 mmHg). The mean weekly dose of EPO during the first 3 months was higher in Group I (126 vs 100 U/kg) and conversely was lower during the last 3 months (mean dose 108 vs 117 U/kg). Patients of Group I were younger (mean age 47 vs 56 years), had a lower body weight at the time of EPO start (55 vs 66 kg), a higher increase of Hb during the first 2 months (28.8 vs 20.8 g/L), and reached the target Hb sooner (2.25 vs 4.0 months). A comparison group of 17 patients (matched for age, sex, duration on CAPO, underlying disease and antihypertensive treatment) who did not receive EPO did not show an increase in MBP over time, and only 2 patients increased their antihypertensive medication. Our data suggest that higher Initial EPO doses may be accompanied by hypertension changes In CAPD patients. This may be prevented by a lower Initial dose and lower rates of increase of Hb and Hct. Our study shows that EPO treatment is effective in correcting anemia in uremic patients on CAPD. Increase of blood pressure during the treatment is frequent. It seems that higher initial EPO doses may be accompanied by increased hypertension in CAPD patients and that this may be prevented by a lower initial dose and lower rate of increase in hemoglobin and hematocrit.
The Cytotoxicity of Continuous Ambulatory Peritoneal Dialysis Solutions with Different Bicarbonate/Lactate Ratios
Authors: Schambye Hans Thalsgård , Pedersen Fritz Bangsgaard , Christensen Hanne Knoldsborg , Berthelsen Henrik , Wang Palle 
Published: February 2020

Five different bicarbonate-based continuous ambulatory peritoneal dialysis (CAPD) solutions (pH: 7.0-7.4; bicarbonate: 10-27 mM; lactate: 20.8–0.7 mM) were produced in order to examine the cytotoxic effects of the different compositions. The migratory capacity of normal human polymorphonuclear (PMN) granulocytes after exposure to the solutions was used as a cytotoxicity assay. All the tested solutions reduced cellular function compared to a standard cell culture medium, but considerable differences between the solutions were observed. The optimal Conditions for the PMN migration were at a pH of 7.0 and at bicarbonate and lactate concentrations of 20 mM and 12.5 mM, respectively. Bicarbonate concentrations of more than 25 mM were associated with reduced cellular function as were lactate concentrations of more than 15 mM. The most advantageous CAPD solution regarding cytotoxicity towards normal human PMN's is a combination of a lactate and bicarbonate-based solution, which has a bicarbonate concentration of approximately 20 mM, a lactate concentration of 12.5 mM, and a pH of approximately 7.2.
Gastroparesis: An Important Cause of Hospitalization in Continuous Ambulatory Peritoneal Dialysis Patients and the Role of Erythromycin
Authors: Gallar P. , Oliet A. , Vigil A. , Ortega O. , Guijo G. 
Published: February 2020

Gastroparesls Is a disabling complication In diabetic patients. It has been reported as the second most frequent cause of hospitalization In diabetic patients on continuous ambulatory peritoneal dialysis (CAPD). We analyzed Infectious and noninfectious complications In our CAPD patients. We Included 31 patients (12 diabetics and 19 nondiabetics) with an average time on CAPD of 14±7 months. The Incidence of peritonitis was 1.68 episodes/patient/year In diabetics and 0.84 tn nondiabetics. Nine (75%) diabetic patients had peritonitis, 5 (42%) had vomiting, and 4 (33%) had Ischemic heart disease. The hospitalization Index (days/year) was greater In diabetics: 11.83± 11.36 versus 4.16±8.84 In nondiabetics (p<0.05). Vomiting was the first cause of admission in diabetics. We were unable to control severe gastroparesls with cisapride and metoclopramide in 4 patients. Erythromycin, 100 mg/2-L bag of dialysate, improved symptoms In all of them. We concluded that gastroparesls Is an Important cause of morbidity In CAPD patients. Intraperitoneal erythromycin can Improve symptoms If other prokinetic drugs fail.
Computerized Management of Peritoneal Dialysis
Authors: Mandolfo Salvatore , Corradi Bruno , Malberti Fabio , Imbasciati Enrico 
Published: February 2020

The importance of the evaluation of dialytic adequacy is well known In peritoneal dialysis. It is necessary to be able to quantify and Individualize the substitution treatment. In 15 patients we compared five quantitative approaches by using original software: Teehan's dialysis index (D1); Dlaz-Buxo's liters/week (LW); Keshavlah's the quantity of dialysis prescribed (wKt/V); and Boen and Twardowskl's weekly creatinine clearance (WC). All patients were treated by continuous ambulatory peritoneal dialysis (CAPD) according to the peritoneal equilibration test (PET). Peritoneal solute clearances for urea, creatinine, uric acid, and phosphorus were adequate, but there was disagreement between adequacy indexes. According to the D1, 40% of our patients were underdialyzed, 33% were adequate, and 27% received excessive dialytic dose, while according to LW and wKt/V, about 50% were adequate, 100/0 underdialyzed, and 40% received excessive doses. According to WC, 74% were overdialyzed and 26% were adequate. In two patients only (13%) all the Indexes Indicated underdialysis. We think that the D1 is too severe an adequacy Index, probably because residual renal clearances have a great weight In the formula, while WC may lead to an overestimate of the actual dose of therapy in patients with significant residual renal clearance. Prospective, randomized and clinical studies are needed to better assess the optimal Index for Individualization of targeted peritoneal dialysis prescription.
Psychiatric and Psychosocial Status of Elderly Patients Undergoing Dialysis
Authors: Iordanidis Pantazis , Alivanis Polichronis , Lakovidis Apostolos , Dombros Nicholas , Tsagalidis Ioannis , Balaskas Elias , Derveniotis Vasilis , Lerodiakonou Charalambos , Tourkantonis Achilles 
Published: February 2020

We Investigated the psychiatric and psychosocial status of 31 elderly (age >65 years) end-stage renal disease patients undergoing hemodialysis (HO) (17 patients) and continuous ambulatory peritoneal dialysis (CAPO) (14 patients). There was no difference between the two groups In terms of age (67.3:1:.2.3 and 68.5:1:.4.3 In HO and CAPO groups, respectively), duration of dialysis treatment, and biochemical profile. The psychiatric and psychosocial status of the patients was assessed using the standardized psychiatric Interview (SPI), Hamilton's depression scale (HRS-O), and a questionnaire for the evaluation of the psychosocial Impact of the method of treatment. Sixteen of 31 patients presented with psychiatric morbidity (9 mild, 5 moderate, 2 severe). However, there was no significant relationship between psychiatric morbidity and method of dialysis (HO or CAPO). The mean values of SPI (21.47:1:.16.38 and 17.14:1:.13) and HRS-O (20.91:1:.17.33 and 15.41:1:.13.13) scores for the HO and CAPO groups, respectively, did not differ significantly. The analysis of the results of the questionnaire regarding the Impact of the method of treatment on psychosocial status Indicated that the HO patients felt that their lives were more dependent on factors that they could not Influence (I.e., the dialysis equipment, etc.). Our findings suggest that the psychiatric status of elderly patients undergoing chronic dialysis treatment Is not affected by the method of treatment, a factor that should be taken Into consideration when deciding the proper dialysis treatment for these patients.
Analysis of Complications in a Chronic Peritoneal Dialysis Pediatric Patient Population
Authors: Verrina Enrico , Bassi Sergio , Perfumo Francesco , Edefonti Alberto , Zacchello Graziella , Andreetta Barbara , Pela Ivana , Penza Rosa , Piaggio Giorgio , Picca Marina , Cantaluppi Alberto 
Published: February 2020

During the period 1986–1991, the Italian Registry of Pediatric Chronic Peritoneal Dialysis collected data from 140 patients younger than 15 years at the start of chronic peritoneal dialysis (CPD). In this study we review the Registry's complications and patient hospitalization data. A total of 395 complications directly related to CPD were registered during 2722 dialysis-months. There were 176 episodes of peritonitis (44.5%), 161 catheter-related complications (40.7%) (103 exit-site Infections, 17 leakages, 15 obstructions, 15 cuff extrusions, 5 hemoperitoneum, and 6 other complications), and 58 technique-related complications (14.8%) (39 abdominal hernias, 10 hydroceles, 5 with abdominal pain, 4 hydro. thorax complications). The patient hospitalization rate during the period 1989–1991 was evaluated; the analysis referred to 106 patients who underwent treatment for a total of 1520.5 dialysis-months. Patients starting CPD in the year and patients already on CAPD spent 5.8 and 2.1 days per patient-month in the hospital, respectively; the difference was not statistically significant. The evaluation of complications (both technical and systemic) causing patient hospitalization showed that peritonitis was responsible for 43.2% of patient admissions and 36.3% of days hospitalized, catheter-related complications for 22% and 19.80/0, technlque-related complications for 8.3% and 5.1%, and other clinical complications for 26.5% and 38.8%, respectively.
Reduction in Peritonitis Incidence in Continuous Ambulatory Peritoneal Dialysis with a New Catheter and Implantation Technique
Authors: Moncrief Jack W. , Popovich Robert P. , Dasgupta Mrinal , Costerton J. William , Simmons Everett , Moncrief Blain 
Published: February 2020

Recurrent episodes of peritonitis with the same organism cultured at the catheter exit site suggest that early tunnel colonization is associated with a transfer of these organisms through the catheter tunnel directly from the skin Into the peritoneal cavity. In this instance the catheter has failed In Its fundamentel design to establish and maintain a bacteriological berrier. A three-part study was conducted using the Moncrlef-Popovich catheter and Implantation technique. The first part of the study Included 59 patients who used standard spike exchange systems with this new catheter and implantation technique. A reduction in the incidence of peritonitis occurred in the continuous ambulatory peritoneal dialysis (CAPO) program at the Austin Olagnostic Clinic. The previous peritonitis incidence was 1 every 9 patient-months. This study had 1 every 29 patient-months with 530 patient months of experience. The second part of the study had 79 patients. All except 11 used disconnect exchange systems. There was a total of 482 patient-months of experience with 1 episode every 27 patient-months. Those using the disconnect systems (86%) had 1 episode every 32 petient-months. The third part of the study Included microscopic studies of 12 excised catheters. Three were known to be contaminated. The examiners identified those catheters that were free or nearly free of biofilm on the catheter segment between the two cuffs. It Is concluded that biofilm analysis and reduction In peritonitis Incidence supports the theory that the new catheter and implantation technique form an Improved becterlologlcal barrier In the access for peritoneal dialysis.