bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced Ultrafiltration in Rabbits with Bicarbonate Glycylglycine Peritoneal Dialysis Solution
Authors: Yatzidis Hippocrates 
Published: February 2020

Objective The aim of the study was to investigate net ultrafiltration (NUF) with a new bicarbonate glycylglycine (BiGG) peritoneal dialysis solution compared to the standard lactate (La) solution. Design In six groups of 12 normal rabbits each we measured NUF after a 2-,4-, and 6–hour peritoneal dialysis with a BiGG solution (pH 7.35) and a standard La solution (pH 5.5) of similar glucose, electrolyte, and osmolality formulation. Furthermore, we studied the phosphatidylcholine concentration in the effluent of the two solutions. Results NUF volume was significantly greater with the BiGG rather than with the La solution by approximately 15% (p<0.05), 30% (p<0.01), and 40% (p<0.005) at 2,4, and 6 hours, respectively. The glucose absorption rate was greater with the La solution than with the BiGG solution, but the difference was significant only at 2 hours (p<0.05). pH was increased in the La solution from its initial value of 5.5 to 7.18,7.32, and 7.40 at 2,4 and 6 hours, respectively, while it remained almost unchanged in the BiGG solution. Phosphatidylcholine (PC) in the peritoneal effluent was significantly higher in the BiGG solution in all instances (p<0.0001). Conclusion It is concluded that the BiGG solution, which has a stable pH, 7.35, due to the potent buffering capacity of bicarbonate and glycylglycine, enhances peritoneal NUF by maintaining a higher osmotic gradient and retarding lymphatic absorption through an increase in PC concentration in the peritoneal cavity.
Continuous Ambulatory Peritoneal Dialysis Connection Systems
Authors: Buoncristiani Umberto 
Published: February 2020

The history of the various connection systems proposed and tried during the first 15 years of clinlcal application of continuous ambulatory peritoneal dialysis (CAPD) is reviewed. In order to understand the reasons for their success or lack of success, the main technical and operating characteristics regarding their efficacy In preventing peritonitis are examined in detail, together with a range of other pros and cons (I.e., reliability, simplicity, ease of use, cost, aesthetlcal aspects). The result Is an updated state-of-the-art review In the field of CAPD connectology, with a look at future trends.
Prevalence of Symptomatic Arterial Disease and Risk Factors for its Development in Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Webb Alan T. , Brown Edwina A. 
Published: February 2020

The prevalence of coronary, cerebral, and peripheral arterial disease was assessed using a standard cardiovascular questionnaire in a cohort of 70 patients on continuous ambulatory peritoneal dialysis (CAPD). Symptomatic vascular disease was found in 47% of patients, 72% of whom were smokers and 30% diabetic. In 39% of these patients vascular disease was evident prior to the commencement of peritoneal dialysis. A case control study matching for age and sex revealed patients with vascular disease to have higher median systolic blood pressure (162 mmHg vs 150 mmHg, p=0.026), cholesterol (6.60 mmol/L vs 6.00 mmol/L, p=0.014), and LDL cholesterol (4.80 mmol/L vs 3.80 mmol/L, p=0.009). Vascular disease is common in patients on peritoneal dialysis, a considerable proportion of whom have the disease prior to the commencement of dialysis. Elevated systolic blood pressure and hypercholesterolemia, but not smoking, are most closely associated with vascular disease in these patients.
Does Continuous Ambulatory Peritoneal Dialysis Induce Hypercholesterolemia?
Authors: Panarello Giacomo , Calianno Giuseppina , De Baz Hamurabi , Signori Daniela , Cappelletti Piero , Tesio Franco 
Published: February 2020

Hypercholesterolemia has been recognized as a significant risk factor for atherosclerosis and coronary artery disease. The aim of this study was to evaluate the prevalence of hypercholesterolemia and the role, if any, of type of dialysis. In 19 hemodialysis (HD) and 20 continuous ambulatory peritoneal dialysis (CAPD) subjects, body weight, body mass index (BMI), arm muscle area (AMA), total choles terol (C), HDL and LDL fractions, triglycerldes, C/HDL ratio, glycosilated hemoglobin, and apolipoproteins AI, All, B, CII, CllI, and E were evaluated. Hypercholesterolemia was defined as cholesterol greater than 220 mg/dL and LDL greater than 150 mg/dL. Body weight, body mass index, and arm muscle area were higher (p<0.05) in CAPD as compared with HD; so were total cholesterol, LDL, C/HDL ratio, and glycosllated hemoglobin (Hbalc). Hypercholesterolemia prevalence was 3/19 in HD and 11/20 in CAPD (p<0.05). A relationship between Hbalc and C/HDL ratio was found in the CAPD group (r=0.48; p<0.05). We are greatly concerned about these metabolic effects of CAPD; therefore, we should carefully select patients to be treated by CAPD. Aggressive nutritional and pharmacological treatment for glucose Intolerance and hypercholesterolemia In CAPD patients must be performed in order to reduce the incidence of coronary artery disease (CAD).
Ca2+ Concentration in the Peritoneal Dialysis Solution Regulates Peritoneal Fibroblast Proliferation and Peritoneal Macrophage and Lymphocyte Cytokine Release
Authors: Carozzi Silvia , Nasini Maria Grazia 
Published: February 2020

Peritoneal fibrosis remains one of the major causes of dropout In continuous ambulatory peritoneal dialysis (CAPD), because it reduces ultrafiltration capacity. Since studies In vitro have demonstrated that cytoplasmic Ca2+ regulates the proliferation of most cell lines and the release of cytokines from immune cells, we evaluated In 8 uremic patients at the start of CAPD and in 4 control patients the effects in vitro of different peritoneal dialysis solution Ca concentrations (1, 1.25, 1.75, and 2 mmol/L) on peritoneal fibroblast (PF) proliferation, peritoneal macrophages (PMΦ), and peritoneal lymphocyte (Ply) release of interleukin-1 (11–1) and Interferon-gamma (IFN-gamma) (cytokines which are known to induce PF proliferation), and cytoplasmic Ca2+ concentration in PF, PMΦ, and Ply. Results showed that in both the uremic and control patients, increasing the dose of Ca2+ In the medium induced a dose-dependent increase in PF proliferation and the release of IL-1 and IFN-gamma from PMΦ and Ply. Meanwhile, the cytoplasmic parameters PF, PMΦ, and Ply Ca2+ in the uremic patients were below normal; they exceeded the norm with a Ca2+ concentration of 1.75 and 2 mmol/L and were normal with a Ca2+ concentration of 1.25 mmol/L. These data suggest that In CAPD patients the use of a physiological Ca peritoneal dialysis solution (1 and 1.25 mmol/L) may be useful in reducing the proliferation of PF and the production of IL-1 and IFN-gamma thus preventing peritoneal sclerosis.
Effect of Hypertriglyceridemia Correction by Omega-3 Fatty Acids on Peritoneal Transport in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Fracasso Agostino , Toffoletto Pierpaolo , Landini Silvano , Morachiello Paolo , Righetto Flavio , Scanferla Flavio , Genchi Rosangela , Roncali Oavide , Bazzato Giorgio 
Published: February 2020

Lipid abnormalities, both hypercholesterolemia and particularly hypertriglyceridemia (hyperTg), are common in long-term continuous ambulatory peritoneal dialysis (CAPO) patients. Hyperviscosity and rheological alterations have been proposed as major hemodynamic problems in hyperTg patients. The aim of this study was to evaluate whether a hyperTg correction by employing omega-3 fatty acids (ω-3) affects peritoneal transport. Six hyperTg (>700 mg/dL) CAPO patients were treated with 2–3 g/day of ω-3 until normal Tg values were achieved. The assessment of peritoneal dialysis efficacy was performed by evaluating the peritoneal equilibration test (PET) before ω-3 supplementation, when normal Tg levels were reached, and 3 weeks after stopping therapy when hyperTg returned. When normal Tg levels were reached, a small but significant Improvement of urea and creatinine O/P was noted: 0.85±0.05 versus 0.93±0.03 (p<0.05) and 0.78±0.03 versus 0.86±0.05 (p<0.05), respectively, with negative correlation between O/P of urea and Tg. These preliminary data demonstrate that a hyperTg correction with ω-3 may Induce an Increase In peritoneal transport of small molecules in CAPO.
Procollagen Type-I in the Serum and Dialysate of Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Digenis George E. , Dombros Nicholas v. , Christophoraki Mary , Grapsa Irene , Savidis Nicholas , Datseris John , Samuilidou Elisa , Zerefos Nicholas , Tourkaritonis Achilleas 
Published: February 2020

Procollagen-1 carboxylterminal extension peptide (PICP) was determined In the serum and dialysate of 26 continuous ambulatory peritoneal dialysis (CAPD) patients and in the serum of 11 healthy controls. PICP serum levels were significantly higher in CAPD patients than in healthy controls (p<0.001). There was no correlation between serum PICP levels and those of calcium, phosphorus, magnesium, alkaline phosphatase, osteocalcin, and intact parathyroid hormone (IPTH). Serum and dialysate levels of osteocalcin and lPTH showed a significant correlation (p<0.001). The dialysate-to-serum PICP ratio in 21 patients was lower than 1.0. In the remaining 5 patients, however, the above ratio was higher than 1.0. We conclude that In CAPD patients serum PICP levels do not correlate with biochemical parameters of renal osteodystrophy. A dialysate-to-serum PICP ratio above 1.0 could implicate an increased local peritoneal fibro blastic activity and could be a useful marker of peritoneal fibrosis In CAPD.
An Animal Model for the Study of Amino Acid Metabolism in Uremia and during Peritoneal Dialysis
Authors: Oreopoulos Antigone K. , Balaskas Elias V. , Rodela Helen , Anderson G. Harvey , Oreopoulos Dimitrios G. 
Published: February 2020

We tried to determine the suitability of the rabbit as an animal model to study amino acid (AA) metabolism in continuous ambulatory peritoneal dialysis. We also measured the effect of intraperitoneal (ip) infusion of AA on blood AA changes and food consumption. Plasma AA levels were measured in 10 normal rabbits after an overnight fasting and 30, 60, and 120 minutes after a meal. Following these baseline observations, rabbits were randomly divided into two groups. One group of five rabbits was made uremic after surgical partial nephrectomy, whereas the remaining (controls) underwent sham operations. Two weeks after the induction of uremia we measured the effect of chronic renal failure on fasting and postprandial (30,60,120 minutes) plasma AA levels. Upon the completion of the second experiment (4 weeks after the induction of uremia) we studied the effect of an ip AA on plasma AA profile 1, 2, 4, and 6 hours after the infusion in both uremic and control rabbits. We also measured the food intake in all experiments. The results of our experiments showed the following: 1. plasma AA in the rabbits decreased after induction of chronic renal failure and increased after food ingestion and ip infusion of AA solution; 2. neither induction of uremia nor ip AA infusion have an effect on food consumption; 3. the majority of the alterations in plasma AA levels we observed in the uremic rabbits were similar to those observed in humans, indicating that the rabbit may be a suitable model for the study of AA metabolism in chronic renal failure and during peritoneal dialysis.
Phosphatidvlcholine and Intraperitoneal Adhesions
Authors: Kappas Angelos Michael , Fatouros Michael , Siamopoulos Kostas , Mylonakis Manolis , Cassioumis Diamantis 
Published: February 2020

Phosphatidylcholine (PC), which has successfully been used in the past to increase ultrafiltration in continuous ambulatory peritoneal dialysis (CAPD) patients, has recently been found to prevent experimental adhesion formation after intraperitoneal irrigation with warm saline. The aim of this study was to determine the most effective route(s) of PC administration in the aforementioned model. Eighty Wistar rats underwent laparotomy and intraperitoneal irrigation with saline at 40°C, which in 20 rats was followed by closure of the abdomen (control group, Gc). In another 20 rats PC was given per os before and after irrigation (per os PC group, GoPc). In the third group PC was diluted in the irrigation fluid (intraperitoneal PC group, GIPC), and in the last group PC was given per os and intraperitoneally (combined PC group, Gcpc) Assessment of adhesions was performed 2 weeks after the irrigation. Adhesions were found in 12 rats in the Gc, 5 rats in the Gopc (p=0.05, Fisher's test), 17 rats in the GIPC, and 3 rats in the Gcpc (p=0.007, Fisher's test). The difference between Gopc and Gcpc was not statistically significant. The decreased adhesion formation after PC administration combined with the increased ultrafiltration may be of considerable importance in CAPD patients.
Catheter Obstruction with Omental Wrap Stimulated by Dialysate Exposure
Authors: Moncrief Jack , Popovich Robert , Simmons Everett , He Zhengzhi 
Published: February 2020

A new Implantation technique and catheter design (Moncrlef-Popovlch Catheter) were tested in the continuous ambulatory peritoneal dialysis (CAPO) dog model. With this technique the catheter distal (external) segment was Implanted in a subcutaneous tunnel for 4–6 weeks. Therefore, no irrigation of exposure to dialysate was present. Secondary exteriorization and irrigation (CAPO exchanges) demonstrated no episodes of primary catheter obstruction. Fifteen mongrel female dogs had 30 catheters implanted; 2 catheters simultaneously in each dog. One catheter was implanted with the interabdominal segments in the pelvis and the second interabdominal segment directed upward In direct contact with the omentum. Following initial irrigation, all catheters were patent, but within 24–48 hours all upwardly directed catheters were obstructed. Nine of the 15 downwardly directed catheters became obstructed by omentum wrapping around the catheter within 5 days. Preliminary studies have failed to demonstrate the cause of this “omental stimulation,” which occurs with peritoneal contact with fresh dialysate. Possible explanations include pH, osmolality, flow direction, volume, vasodilator effect of osmols or lactate, and glucose, among others. This effect needs study, and this model would allow evaluation of improvements in the biocompatibility of dialysis fluids.
In Vitro and in Vivo Efficacy of a New Connector Device for Continuous Ambulatory Peritoneal Dialysis
Authors: Viglino Giusto , Colombo Adolfo , Cantu Paolo , Camerini Corrado , Catizone Luigi , Bonello Franco , Lombardo Vincenzo , Balteau Patrick R. , Cavalli Pier Luigi , Renzetti Gian Antonio , Farfaglia Piera , Cancarini Giovanni , Zucchelli Pietro , Quarello Francesco , Acciarri Pier Marino , Peluso Franco 
Published: February 2020

The purpose of this study was to evaluate the In vltro and in vivo efficacy of a new connection system for continuous ambulatory peritoneal dialysis (CAPO), called the T-set. With this system the patient wears a 27–cm extension line filled with Amuchina during the dwell time; the bag is made of a fill container linked to a drainage tube with a Y-shaped set. For bag exchange, only one connection is needed and this is subsequently flushed with the entire drainage volume. The in vitro efficacy of the system was tested with 20 sets filled with 10 mL of Amuchina and inoculated in the distallumen with 2.1x103 colony-forming units (cfu) of S. aureus. After an Incubation of 4–6 hours at 35–37°C, three dialysate samples per set were collected, respectively, at the beginning of drainage and filling. Al1120 samples were negative, whereas two control sets, filled with a phosphate-buffered saline, had positive drainage samples, and at least one positive Infusion sample, Indicating the efficacy of Amuchina in sterilizing the system under conditions simulating touch contamination. To evaluate the in vivo efficacy, safety, and acceptability of the T-system, a prospective randomized controlled trial was performed In seven centers: a control group (CG) of 56 patients (follow-up: 952.3 months, mean±SO: 17.0±7.8) was treated with a long branch (21 patients) or short branch (35 patients) Y-set and a test group (TG) of 66 patients (follow-up: 898.1 months, mean±SO: 13.6±7.8) with the T-set. The two groups were comparable for patient and dialysis characteristics. The incidence of peritonitis was 1143.3 months in the CG and 1129.0 months In the TG (p=NS). The percentage of patients without peritonitis was 67.8% In the CG and 68.2% In the TG (p=NS); the probability of remaining free from peritonitis was, respectively, 76% and 75% In the CG and in the TG at 1 year, and 66% and 60% at 2 years (p=NS). In the CG 26 patients and In the TG 21 patients were already on CAPO before the trial; among these 21 patients, 10 of 10 with the long Y-set and 4 of 11 with the short Y-set who transferred to the T-set preferred the latter for better handling (52.4%) or for less encumbrance (14.3%).
Ten Years of Continuous Ambulatory Peritoneal Dialysis: Analysis of Patient and Technique Survival
Authors: Viglino Giusto , Cancarini Giovanni , Catizone Luigi , Cocchi Roberto , De Vecchi Amedeo , Lupo Antonio , Salomone Mario , Segoloni Giuseppe Paolo , Giangrande Alberto ,   Italian Cooperative Peritoneal Dialysis Study Group: Scientific Committee, 1 Registry Commit tee, 2 and Chairman,3 Italy
Published: February 2020

The patient survival (PS) and technique survival (TS) were evaluated in 1990 patients on continuous ambulatory peritoneal dialysis (CAPD) (males: 55.9%, mean age±SD: 58.4± 14.8 years), treated in 30 centers participating in the Italian PD Study Group, from 1980 to 1989 (follow-up: 3953 years; mean±SD: 2.02±1.86 years). The total PS was 50.7% at 4 years, compared to 73.3% of patients without clinical high -risk condition (HRC) at the beginning of CAPD. In this group (34.0%) PS was significantly higher (p<0.001) compared, respectively, to patients with cardiovascular disease (30.5%), diabetes (13.1%), and age ≥70 years (11.2%). The percentage of death reached the mean value of 11.3% per year without any statistically significant tendency to variation during the follow-up, despite the increased number of patients ≥65 years old and those with HRC (p<0.001). Cardiovascular diseases (47.3%) and cachexia (17.8%) were the most frequent causes of death, whereas the mortality due to peritonitis showed a progressive in crease in patients with peritonitis Incidence 1 ep/year (G4) compared to those with <0.5 ep/year (G2). Peritonitis (0.68 ep/year) was the most frequent cause of technique failure (30.0%), with clinical complications (18.2%) and peritoneal membrane failure (16.4%) as the second and third causes. The dropout percentage was 8.3% per year with a significant decrease over time (p=0.012) and a positive correlation with the reduction of peritonitis incidence (p=0.035). The total TS was 50.1% at 7 years, and it was significantly worse in G4 compared to G2. The TS was significantly better in patients 65 years of age than in younger ones, who had the same probability and risk of peritonitis, but a higher incidence of membrane failure. In those patients where CAPD was the second dialysis treatment TS was significantly worse (p<0.001), with a higher probability and risk of peritonitis. The TS was not affected by diabetes, and probability and relative risk of peritonitis were similar to that of non diabetic patients.
Patients’ Group Experiences
Authors: Cerruti Gabriella , Cotto Maria , Rivetti Margherita , Servetti Luciana , Baracco Maddalena , Ferrero Renata 
Published: February 2020

In 11 years of experience with dialysis, we have tried to supply a kind of treatment In our center that takes the patient's physical, psychological, and social needs Into account. We have been able to observe how Important It Is to share the common problems connected with a chronic illness in order to make them appear less dramatic. This led to the Idea of organizing a group holiday in which the patients and their families would be able to spend some time together. As a result of this positive experience, we decided to organize group encounters In which all the problems could be freely discussed. The group Is open to all the patients on dialysis or who have undergone transplants and their families. The group, which has been meeting once every 3 weeks for the last 2 years, Is coordinated by a psychologist. This has proved to be Important both for the operators, who have been able to expand their own knowledge, and for the patients and their families for whom these gatherings represent a way of helping themselves face up to and accept the limits imposed by chronic Illness.
Quantification of Adequacy of Peritoneal Dialysis
Authors: Arkouche Walid , Delawari Ehsan , My Horn , Laville Maurice , Abdullah Elias , Traeger Jules 
Published: February 2020

Nineteen patients treated by continuous ambulatory peritoneal dialysis (CAPD) were studied according to clinical outcome parameters: insomnia, asthenia, pruritus, arterial hypertension, anorexia, nausea and/or vomiting, anemia, and rate of hospitalization. Using clinical scores, three groups were defined: poor clinical outcome (P), intermediate (I), and good (G). The quantity of treatment by PD was evaluated monthly with urea kinetic tests (weekly Kt/V, weekly urea clearance/1.73 m2 of body surface area (BSA), index of dialysis by Teehan), and with the weekly creatinine clearance/1.73 m2 of BSA. The metabolic index was analyzed: normalized protein catabolic rate (NPCR), serum albumin (Alb) and prealbumin, and reabsorption of glucose. There was good correlation between clinical scores and quantity of dialysis. The Alb was lower in group P. Group G was differentiated from group I and from group P by quantification tests and NPCR, with lower levels as follows: weekly Kt/V=2.06, urea clearance 70 L/week/1.73 m2, index of dialysis = 0.87, and creatinine clearance = 60 L/week/1.73 m2. We conclude that the qualitative clinical approach is not sufficient to predict deleterious signs, and the quantitative approach is predictive of the good clinical outcome and good nutritional status. We think that levels proposed to now are insufficient, and we suggest the following: weekly urea clearance >70 L, weekly Kt/V >2, weekly creatinine clearance >60 L, and index of dialysis >0.85.
Bent Subcutaneous Peritoneal Catheter Shape for Regular Dialysis Treatment in Children
Authors: Bonzel Klaus-Eugen , Lettgen Bernhard , Bald Martin , Kleine Ludwig , Erhard Jochen 
Published: February 2020

A permanent bowing of the subcutaneous part of the Tenckhoff-type catheter (bent neck -Qulnton, and swan neck -Accurate Surgical Instruments) enables the catheter to turn from an upward direction of the subcutaneous tunnel to a downward direction by a smooth 160°-180° bend creating a downward skin exit° We have used this catheter shape In combination whh a colled Intra-abdominal edge. Two sizes are available for children° We use 2 cuffs and glue them ourselves according to the body size. In this study we compare the durability of the traditional subcutaneously straight catheter In 8 children aged 0.1-12.6 years (Group A) whh the bent shaped catheter In 8 children aged 3°7–15°8 years (Group B)° Median duration of function was 10°5 (2–34) and 8 (3–36) months, respectively; Frequency of complications was equal In both groups: peritonitis episodes 0°69/year in Group A and 0°53/year in Group B; tunnel Infection 0.16 vs 0°11/year; skin exit infection 0°54 vs 0.53/year; noninfectious complications 0°16 vs 0°32/year; mean number of catheters used was 1°0 vs 1°1/treatment years treatment had to be terminated in some patients: kidney transplantation 5, kidney recovery 1, severe peritonitis 1. The bent subcutaneous catheter shape did not show any medical or technical disadvantage compared with the straight type, but the downward directed catheter skin exit can be covered Invisibly under bikini or bermuda shorts which means aesthetic and social advantage. Whether the downward drainage of secretes and cell detritus Influences the rate of tunnel Infection positively cannot be answered to date.