bluuebunny/crossref_metadata_2025_split huggingface dataset:
Absence of Modulating Effects of Cytokines on Antioxidant Enzymes in Peritoneal Mesothelial Cells
Authors: Chen Jinn-Yang , Yang An-Hang , Lin Yao-Ping , Lin Jen-Kou , Yang Wu-Chang , Huang Tung-Po 
Published: February 2020

Objective To investigate the modulation of superoxide dismutase, glutathione peroxidase, and catalase by cytokines and endotoxin in human peritoneal mesothelial cells. Design Cultured human peritoneal mesothelial cells were treated with various concentrations of interleu kin-1 α, tumor necrosis factor-α(TNFα), interleukin-6, interleukin-8, transforming growth factor-β (TGFβ), and lipopolysaccharide. Cell morphology was observed and the activities of superoxide dismutase, catalase, and glutathione peroxidase were assayed. The antioxidant enzyme activities of human peritoneal mesothelial cells were also compared with those of human liver and kidney tissues. Results Interleukin-1α, TNFα, TGFβ, and lipopolysaccharide caused dose-dependent cytotoxicities in mesothelial cells. The activities of these three antioxidant enzymes did not change after treatment with cytokines and endotoxin. The total superoxide dismutase activity of confluent human peritoneal mesothelial cells was found to be greater than that of human liver and kidney tissues and was composed mostly of manganese superoxide dismutase activity. Furthermore, glutathione peroxidase and catalase activities of human peritoneal mesothelial cells were lower than those of human liver and kidney tissues. Conclusion In human peritoneal mesothelial cells, lack of induction of antioxidant enzymes by inflammatory cytokines, as well as high superoxide dismutase activity accompanied by insufficient glutathione peroxidase and catalase activities may both contribute to the susceptibility of these cells to oxidative damage. Therefore, appropriate management to decrease oxidative injury to the peritoneum should be taken into consideration when treating long-term continuous ambulatory peritoneal dialysis patients.
Toward Targets for Initiation of Chronic Dialysis
Authors: Mehrotra Rajnish , Saran Rajiv , Moore Harold L. , Prowant Barbara F. , Khanna Ramesh , Twardowski Zbylut J. , Nolph Karl D. 
Published: February 2020

Objectives To better defaine the targets for initiation of chronic dialysis, we compared the relationship between the normalized protein equivalent of nitrogen appearance (nPNA, g/kg standard weight/day) and weekly urea clearance (Kt) normalized to total body water (V) in predialysis chronic renal failure (CRF) patients and in patients on continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD). We also studied the relationships of other nutritional parameters to weekly Kt/Vurea in CRF patients. Design This cross-sectional study was a prospective observational design meant to study each patient once. Setting The University Hospital and Clinics and Harry S. Truman VA Medical Center, Columbia, Missouri. Patients Forty-five consecutive predialysis CRF patients were enrolled and the results compared with patients on CAPD and HD. Results In CRF, the nPNA calculated from urea appearance correlated with the weekly Kt/Vurea (r = 0.57, p < 0.0001) and, using exponential best-fit, nPNA = 1.217 x (1 - e-0.769Kt/v). This exponential relationship was similar to that for CAPD and both were different from that in patients on HD. Likewise, nPNAs, calculated from Kjeldahl nitrogen output, and weekly Kt/Vurea were correlated (r = 0.37, p = 0.014) and, using exponential best-fit, nPNA = 1.102(1 - e-0.867Kt/v), similar to the relationship in patients on CAPD. Evidence is presented that these relationships are not explained only by mathematical coupling. There was a significant correlation between the weekly Kt/Vurea and 24-hour urinary creatinine excretion. Conclusions The findings suggest that in CRF, as in CAPD, a weekly Kt/Vurea less than 2.0 is likely to be associated with a nPNA less than 0.9 g/kg standard weight. In CRF patients, initiation of chronic dialysis should be considered if weekly renal Kt/Vurea falls below 2.0 and a nPNA greater than 0.8 is desired.
Increase of Intra-Abdominal Fat in Patients Treated with Continuous Ambulatory Peritoneal Dialysis
Authors: Fernström Anders , Hylander Britta , Moritz Ake , Jacobsson Hans , Rössner Stephan 
Published: February 2020

Objective To evaluate changes in amount and distribution of body fat in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Design Prospective study. Computed tomography (CT) and dual energy x-ray absorptiometry (DEXA) were used for determination of body composition at commencement of CAPD, and after a mean of 7.2 months of dialysis treatment. Setting CAPD unit at an academic teaching hospital. Patients The study included 19 consecutive patients who started CAPD during a 15-month time frame. Of these 19 patients, 12 (8 males) with a mean initial age of 60 years completed the study. Main Outcome Measures Siemens Somatom HiQ (Erlangen, Germany) was used for CT of the abdomen and of the right thigh. Fat and muscle areas were expressed as square centimeters. The proportion of total fat mass was determined by body composition analysis using DEXA (DPX-L densitometer) (Lunar, Madison, WI, U.S.A.) and expressed as percentage of total body weight (FAT%). Results Body weight changed from 67.1 to 68.4 kg (p = 0.20), and the intra-abdominal fat area increased 22.8% (p = 0.02). This increase was predominantly seen in male patients (p = 0.007). The FAT% changed from 27.8% to 30.9% (p = 0.25), without difference between sexes. Conclusion The increase of intra-abdominal fat found in this study may suggest a mechanism by which the established risk for CAPD patients to develop cardiovascular morbidity and mortality may be at least partially explained.
The Effect of a Nitric Oxide Inhibitor (L-Name) on Peritoneal Transport during Dialysis in Rats
Authors: Breborowicz Andrzej , Tobis Katarzyna Wieczorowska , Korybalska Katarzyna , Polubinska Alicja , Radkowski Maciej , Oreopoulos Dimitrios G. 
Published: February 2020

Objective To assess the effect of an inhibitor of nitric oxide synthesis [NG-nitro-L-arginine methyl ester (L-NAME)] on peritoneal transport during peritoneal dialysis (PD) and peritonitis in rats. Methods The authors studied peritoneal transport of small and large solutes, and net ultrafiltration (UF) in rats during PD with Dianeal 3.86 (Baxter, McGaw Park, IL, U.S.A.). They evaluated the effect of L-NAME used as an additive to dialysis fluid in concentrations 0.5 -5 mg/m L on peritoneal transport of small and large molecules and on transperitoneal UF. In addition, they studied the effect of L-NAME (5 mg/mL) during acute peritonitis induced by lipopolysaccharides (5 μg/mL) given intraperitoneally. Results The addition of L-NAME to dialysis fluid increased the selectivity of the peritoneum and net UF during dialysis. Lipopolysaccharides used as an additive to the dialysis fluid, together with L-NAME, did not induce changes in transperitoneal transport of small and large solutes and did not cause a significant decline in net UF. L-NAME given intraperitoneally reduced both local and systemic production of nitric oxide, which might explain its effects on peritoneal transport. Conclusions Nitric oxide is an important mediator of changes in peritoneal transport and its effect is especially significant during peritonitis.
Calcium and Strontium Metabolic Studies in Patients on Capd
Authors: Apostolidis Nicholas , Paradellis Themis , Karydas Andreas , Manouras Andreas , Katirtzoglou Nicholas , Mayopoulou-Symvoulidou Dora 
Published: February 2020

Background Strontium is known to affect calcium metabolism both experimentally and in clinical studies on conditions other than end-stage renal failure (ESRF) and continuous ambulatory peritoneal dialysis (CAPD). Objective To investigate Sr metabolism in relation to that of Ca in ESRF patients undergoing CAPD, and the possible influence of the duration of treatment. Design Cross-sectional observational study. Setting University medical center and Institute of Nuclear Physics. Patients Twenty-four patients on CAPD; 14 chronic renal failure (CRF) patients not on dialysis, and 52 healthy controls. Measurements Calcium and Sr content of serum, urine or dialysate effluent, and selected dietary products. Results Calcium and Sr are absorbed by the intestinal tract of healthy subjects with equal efficiency. Serum Ca levels were considerably lower in CRF patients than in healthy subjects and patients on CAPD (p < 0.001). Serum Sr was significantly higher in both CAPD and CRF patients than in healthy controls (p < 0.001). The Sr/Ca ratio in the sera of the healthy subjects was defined by the preferential excretion of Sr over Ca by the kidney. This preferential excretion was lost during renal failure. During treatment there was a tendency for the uptake of both Ca and Sr to increase. Conclusions Strontium is accumulated in the body during renal failure and CAPD cannot restore normal levels. Considering the varying effects of different doses of Sr on bone metabolism experimentally, it would be interesting to determine by further studies the possible significance of the observed Sr accumulation for renal bone disease.
Tenckhoff Catheter Salvage by Closed Stiff-Wire Manipulation without Fluoroscopic Control
Authors: Jones Bryn , McLaughlin Kevin , Mactier Robert A. , Porteous Colin 
Published: February 2020

Objective To describe the results of Tenckhoff catheter salvage by a modified, closed, stiff-wire manipulation technique without the use of general anesthesia or fluoroscopy, and compare this with previously described techniques. Design Retrospective study in patients treated with continuous ambulatory peritoneal dialysis (CAPD) over a 41-month period. Setting Renal unit in an inner city hospital. Patients Eighteen patients using CAPD who had 22 episodes of outflow failure due to radiologically confirmed malposition of straight two-cuff Tenckhoff catheters. Interventions Closed stiff-wire manipulation of malpositioned Tenckhoff catheter without the use of general anesthesia or fluoroscopy. Main Outcome Measures Initial success rate of manipulation, catheter and technique (CAPD) survival, and procedure-related complications. Results Catheter manipulation was technically successful in 21 of 22 cases. An additional six episodes of malposition occurred ranging from 2 to 630 days after the primary manipulation (median 7 days). A second manipulation was carried out in four cases that resulted in long-term success in two. Three patients were forced to discontinue CAPD for reasons other than catheter malposition, and the overall success rate at 1 month (patient successfully performing CAPD) was 59.1% (±0.1 %). No major complications were experienced during the procedure and no episodes of peritonitis occurred. Conclusion The technique described is relatively straightforward, does not require fluoroscopy or general anesthetic, and its success is comparable to previously reported methods of Tenckhoff catheter salvage. We would recommend this technique of catheter salvage in patients with Tenckhoff catheter malposition in whom conservative treatment has failed.
Capd in Patients with Autosomal Dominant Polycystic Kidney Disease
Authors: Hadimeri Henrik , Johansson Ann-Cathrine , Haraldsson Börje , Nyberg Gudrun 
Published: February 2020

Objective To investigate whether there are specific complications to continuous ambulatory peritoneal dialysis (CAPD) in patients with autosomal dominant polycystic kidney disease (ADPKD) due to defects in various wall structures -causing hernia and diverticulitis -and to enlarged kidneys. Design The clinical experience of CAPD in 26 patients with ADPKD, treated for 11 ± 6 months, was studied in retrospect and compared with that of 26 contemporary controls. Medical records were reviewed with respect to survival in this treatment form and any complication. Peritoneal dialysis capacity (PDC), as measured in 21 ADPKD patients and 20 controls, was also evaluated. Setting University Hospital. Results Before initiation of CAPD, enlarged kidneys necessitated nephrectomy in 2 of 26 ADPKD patients; both cases were registered as preparation tor transplantation, not for CAPD. Survival in CAPD was similar in ADPKD patients and controls. Hernia was present in 4 ADPKD patients and 2 controls, and required transfer to hemodialysis in 1 patient from each group, temporarily. The incidence of peritonitis was 1 per 20 months in ADPKD patients versus 1 in 27 months in the controis, not significantly different. Peritonitis was caused by colonic bacteria in similar numbers. Residual renal function was 1.9 ± 2.1 mL/min per 1.73 m2 in ADPKD patients versus 1.9 ± 1.4 mL/min per 1.73 m2 in the controls. No difference was detected in any of the variables measured by PDC. Conclusion There were no specific problems related to ADPKD.
A Survey of Home Visits at Peritoneal Dialysis Centers in the United States
Authors: Bernardini Judith , Dacko Carol 
Published: February 2020

Objective To determine the frequency and characteristics of home visits in centers that provide training for peritoneal dialysis (PD). Design Mail survey sent to all dialysis centers in the United States providing home PD, using the Health Care Federal Administration (HCFA) Renal Provider list. Results Surveys were mailed to 1247 centers; 13 were undeliverable, resulting in 1234 surveys successfully delivered; 670 (54%) of those surveyed responded. Of those responding, 525 (78.4%) reported home visits were part of the care of home PD patients: 11% made a single home visit, 52% made an initial home visit with at least one followup visit, and 16% made visits only as needed. No home visits were made by 21% of responding centers. A registered nurse (RN) alone made the home visit in 61% of the centers, while a multidisciplinary team accompanied the RN in 35% of centers; 3% of visits were made by a licensed practical nurse, and 1% by the physician. Half of the visits required 0.5 -1 hour, while 41% required 1 -2 hours. Travel time was most often an hour or less one way. Staff were reimbursed for travel expenses by 90% of the centers. The 525 centers making home visits were not different than the 145 centers not making home visits in number of patients per center, number of RNs, rural or urban location, or affiliation with a university. Interpretation of the HCFA regulations concerning home visits was the most important factor influencing centers making home visits. Conclusions Home visits to continuous ambulatory PD and continuous cycling PD patients in the United States are common. Nearly 80% of centers responding to the survey include home visits in the care of their home peritoneal dialysis patients.
Influence of Age, Time, and Peritonitis on Peritoneal Transport Kinetics in Children
Authors: Hölttä Tuula M. , Rönnholm Kai A.R. , Holmberg Christer 
Published: February 2020

Objective To evaluate peritoneal transport kinetics and its changes over time in children with and without peritonitis, and to record possible differences between children under and over 5.0 years of age. Design A prospective study. The patients underwent a 4hour peritoneal equilibration test (PET) comprising 2.27% dextrose with a dialysate fill volume of 1000 mL/m2 of body surface area (BSA), at baseline and after a mean of 0.8: I: 0.4 years of uninterrupted dialysis. Patients We investigated 28 patients on maintenance peritoneal dialysis at baseline; 10 were under 5.0 years of age. The final PET was performed in 21 patients. Main Outcome Measures Peritoneal equilibration rates for urea (U), creatinine (C), glucose (G), sodium, potassium, phosphate, and albumin (A) were measured. Initial and final peritoneal equilibration rates were compared. Mass transfer area coefficients (MTAC) were calculated for urea, creatinine, glucose, and albumin. Residual dialysate volume was determined. Results Median age at first PET was 7.6 years (range 0.3 -16.6 yr). The mean (±1 SD) 4-hour dialysate-to-plasma (DIP) ratios for U, C, and A were 0.92:1: 0.05,0.70 ± 0.12, and 0.014: I: 0.007, respectively. The mean 4-hour DIDo ratio for G was 0.32: I: 0.10. DIP and DIDo results were similar in the two age groups, and peritoneal membrane function remained stable over the study period. Mean MTAC (:1:1 SD) values were: U, 22.3: I: 4.8; C, 10.9: I: 4.1; G, 11.1: I: 3.3; and A, 0.07: I: 0.03. MTAC data were similar in the two age groups and no significant changes occurred during the study period. Conclusions When the volume tested in children is proportional to BSA, the solute DIP ratios seem to be age-independent. Our data provide evidence that in pediatric patients MTAC is also age-independent.
Six-Year Experience with Swan Neck Presternal Peritoneal Dialysis Catheter
Authors: Twardowski Zbylut J. , Prowant Barbara F. , Nichols W. Kirt , Nolph Karl D. , Khanna Ramesh 
Published: February 2020

Background The presternal peritoneal catheter is composed of two silicone rubber tubes joined by a titanium connector at the time of implantation, and has an exit on the chest. Objective Comparison of survival and complication rates of Swan neck abdominal catheters with those of the presternal catheter. Design Nonrandomized study with prospective collection of data between August 1991 and October 1997. Setting Tertiary referral center. Patients In 57 patients, 58 presternal catheters and, in 81 patients, 86 abdominal catheters were implanted. Patients chose the type of catheter; however, obese individuals and those with ostomies and previous catheter problems were encouraged to opt for the presternal catheter. Others chose the presternal catheter in order to take tub baths or use a whirlpool. Main Outcome Measures Life-table analyses of catheter survival censored for transplant, transfer, and death; reasons for catheter removal due to complications; and patient satisfaction. Results Two-year survival probabilities were 0.95 and 0.75 for presternal and abdominal catheters, respectively. Nine abdominal catheters were removed due to exit/tunnel infections (including five with peritonitis), and four due to peritonitis. External cuff shaving in four presternal catheters has extended survival for more than 1 year. Four presternal catheters were removed due to peritonitis. No catheters in either group were lost due to leakage or obstruction. The peritonitis rate was 1 episode per 37.4 patient-months and 1/20.5 patient-months for presternal and abdominal catheters, respectively. These differences are not significant. Patient acceptance of the presternal catheters was excellent; in the latest period, from January to October 1997, presternal catheters were chosen by 15/24 patients. Conclusions The trend to improved outcomes in presternal catheters continues to validate the rationale for presternal catheter design. Decreased frequency of exit/ tunnel infection may be due to more effective immobilization on the chest, less trauma, and avoidance of submersion in stagnant water. No specific contraindications to use of the presternal catheter have been identified.
Effect of Hypertonic Stress on Amino Acid Levels and System a Activity in Rat Peritoneal Mesothelial Cells
Authors: Horio Masaru , Yamauchi Atsushi , Matsuoka Yasuko , Moriyama Toshiki , Fukunaga Megumu , Imai Enyu , Orita Yoshimasa 
Published: February 2020

Objective Peritoneal mesothelial cells (PMC) are exposed to a hypertonic environment during peritoneal dialysis. When exposed to a hypertonic medium, many types of cells accumulate small osmotically active organic solutes, which are called osmolytes, to match the higher external osmolality. However, no information has been available concerning the osmolytes in PMC. To investigate osmoregulation in rat PMC, the levels of amino acids in the cells and the activity of system A, a major neutral amino acid transport, were measured after switching to a medium made hypertonic by the addition of NaCl. System A was measured by Na+-dependent [14C]-2-methylamino-isobutyric acid (MeAIB) uptake. Results Total amount of 20 amino acids increased from 306 to 757 nmol/mg protein after 12 hours of hypertonicity. The amount of neutral amino acids accounted for 81% of the increase in total amino acids. Glutamine, alanine, glycine, threonine, and serine were the major neutral amino acids that accumulated in the hypertonic mesothelial cells. The amount of neutral amino acids increased 2.9-fold after 12 hr of hypertonicity, and decreased thereafter. MeAIB uptake increased 36-fold relative to the uptake in isotonic cells after 4 – 8 hr of hypertonicity. When the culture medium was made hypertonic by adding raffinose or glucose, the activity of system A was also stimulated (raffinose > glucose > NaCl). System A was located on both the apical and basal sides of isotonic PMC, and extracellular hypertonicity stimulated the MeAIB uptake on both sides. Conclusions These data indicate that neutral amino acids and system A transport play an important role in earlyphase osmoregulation in rat peritoneal mesothelial cells.
Suppression of Nε-(Carboxymethyl)Lysine Generation by the Antioxidant N-Acetylcysteine
Authors: Nakayama Masaaki , Izumi Giichi , Nemoto Yasushi , Shibata Koji , Hasegawa Toshio , Numata Miwako , Wang Kengmin , Kawaguchi Yoshindo , Hosoya Tatsuo 
Published: February 2020

Objective Accumulated evidence suggests that Nε-(carboxymethyl)lysine (CML), which is a dominant antigen of advanced glycation end-products (AGEs), is generated in the peritoneal cavity of patients undergoing continuous ambulatory peritoneal dialysis (CAPD), and that this process may be involved in the pathophysiology of the peritoneal injury found with CAPD treatment. Since CML is a sequential product of glycation and oxidation processes, CML generation could be suppressed by antioxidants. The aim of this in vitro study was to clarify the effect of N-acetylcysteine (NAC), an antioxidant, on CML generation from proteins under high glucose settings mimicking peritoneal dialysis solutions. Design Test proteins (bovine serum albumin/type I collagen) were incubated continuously for 16 weeks in glucose solutions (200 mmol/L) with or without NAC (2 mmol/L), and the generation time courses (8 and 16 weeks) of CML and furosine (the biomarker of the glycation products of the early Maillard reaction) were determined. Results In both proteins, furosine and CML were progressively generated in accordance with the duration of the incubation period. No apparent differences were found between solutions with and without NAC in furosine levels at the 8th and 16th weeks. However, the generation of CML was lower in the solution with NAC throughout the test periods. Conclusion The results showed that NAC could suppress the generation of CML. This indicates the therapeutic potential of antioxidants for the glycoxidative stress-related peritoneal injury occurring during CAPD.