bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antioxidant Status of Patients on Peritoneal Dialysis: Associations with Inflammation and Glycoxidative Stress
Authors: Sundl Isabella , Roob Johannes M. , Meinitzer Andreas , Tiran Beate , Khoschsorur Gholamali , Haditsch Bernd , Holzer Herwig , Winklhofer–Roob Brigitte M. 
Published: February 2020

Background Patients on peritoneal dialysis (PD) frequently exhibit oxidant–antioxidant imbalance, advanced glycation end-product overload, and subclinical inflammation but the interrelations between these pathophysiological changes have not been fully elucidated. Subjects and Methods To study possible associations, a cross-sectional study of antioxidant status, glycoxidative stress, and inflammation, using HPLC and ELISA methods, was undertaken in 37 PD patients and age- and sex-matched healthy controls. Results Plasma ascorbate concentrations were low in patients not taking at least low-dose vitamin C supplements. In patients taking vitamin C supplements, there was a positive relation between ascorbate and pentosidine concentrations. Vitamin E and carotenoid concentrations were comparable between patients and controls, while lycopene and lutein/zeaxanthin concentrations were lower. Interleukin-6, C-reactive protein (CRP), and pentosidine concentrations were elevated in PD patients. β–Cryptoxanthin, lycopene, and lutein/zeaxanthin concentrations were inversely related to interleukin-6 concentrations. β–Cryptoxanthin concentrations were also inversely related to CRP concentrations. Pentosidine showed a low dialysate-to-plasma ratio, indicating low peritoneal clearance. Pentosidine concentrations increased with duration of PD therapy, while α– and β–carotene concentrations decreased. Malondialdehyde concentrations were elevated compared to controls but remained within the normal range. Retinol concentrations decreased with PD therapy and were inversely related to interleukin-6 and CRP concentrations. Conclusions Low-dose vitamin C supplements and a carotenoid-rich diet should be recommended for PD patients to maintain normal antioxidant status and efficiently counteract the chronic inflammatory response, rather than high doses of vitamin C, which could play a role as a precursor of pentosidine.
Long-Term Modality-Related Mortality Analysis in Incident Dialysis Patients
Authors: Lee Chin-Chan , Sun Chiao-Yin , Wu Mai-Szu 
Published: February 2020

Background The effects of the various dialysis modalities on patient survival are different, especially for diabetic patients. Hemodialysis (HD) and peritoneal dialysis (PD) are the predominant renal replacement modalities. This study analyzes modality-related mortality in long-term dialysis patients. Methods This prospective cohort study was conducted between May 1991 and October 2005. Incident patients that had initiated dialysis and had been on dialysis for more than 3 months were enrolled. All cause, infection related, and cardiovascular disease-related mortalities were used as end points. Patient survival was analyzed by the Cox proportional hazards model after adjusting for age, sex, diabetes, comorbidity, and time-averaged values of laboratory data to control influential covariates. Results In total, 1347 patients (258 on PD and 1089 on HD) were enrolled. Adjusted all cause, infection related, and cardiovascular disease-related mortality did not differ significantly between HD and PD patients. In diabetic patients, adjusted all-cause [HD vs PD: hazard ratio (HR) 0.717, 95% confidence interval (CI) 0.400 – 1.282] and infection-related mortality (HD vs PD: HR 1.341, 95% CI 0.453 – 3.969) did not differ significantly between patients on HD and patients on PD. However, adjusted cardiovascular disease-related mortality increased significantly in diabetic PD patients (HD vs PD: HR 0.375, 95% CI 0.154 – 0.913). For nondiabetic patients, adjusted all cause, infection related, and cardiovascular disease-related mortality did not differ significantly between HD and PD patients. Conclusions Dialysis modality had no significant impact on all-cause or infection-related mortality. More studies are needed to clarify the putative difference in cardiovascular mortality risk between diabetic patients on PD and diabetic patients on HD.
Technique Failure and Center Size in a Large Cohort of Peritoneal Dialysis Patients in a Defined Geographic Area
Authors: Afolalu Bayode , Troidle Laura , Osayimwen Osasu , Bhargava Jaya , Kitsen Jenny , Finkelstein Fredric O. 
Published: February 2020

Background Hemodialysis (HD) and peritoneal dialysis (PD) are both viable options for renal replacement therapy. Technique failure has been shown to be a major problem in PD therapy. Objective To examine the relationship between center size and PD technique failure. Setting ESRD Network #1 (NW1). Design Retrospective review of NW1 database. Patients and Methods 5003 incident PD patients between 2001 and 2005 in 105 PD units were included. Patients were grouped into 2 based on center size: group A, patients in units with ≤25 patients, and group B, patients in units with >25 patients. Outcome measures were analyzed for the first and second years of PD therapy. Patients were censored at transplantation, transfer to HD, or death. Outcome Measures Technique failure and mortality reported as death in Standard Information Management Systems (SIMS) database (NW1 data system). Results Technique failure rates were significantly higher in group A for year 1 (odds ratio: 1.36, p = 0.005) and for year 2 (odds ratio: 1.35, p = 0.03). Mortality rates were not statistically different between the 2 groups. Conclusion Technique failure was higher in units with ≤25 patients than in units with >25 patients. There was no difference in mortality between the 2 groups. The majority of patients in NW1 receive care in small units.
Peritonitis Remains the Major Clinical Complication of Peritoneal Dialysis: The London, Uk, Peritonitis Audit 2002–2003
Authors: Davenport Andrew 
Published: February 2020

Background Over the past two decades, the rate of peritonitis in patients treated by peritoneal dialysis (PD) has been significantly reduced. However, peritonitis remains a major complication of PD, accounting for considerable mortality and hospitalization among PD patients. Objective To compare the outcome of peritonitis in a large unselected group of PD patients with that from singlecenter and selected groups. Method We audited the outcome of peritonitis in PD patients attending the 12 PD units in the Thames area in 2002 and 2003. There were 538 patients on continuous ambulatory PD (CAPD) and 325 patients on automated PD (APD) and/or continuous cycling PD (CCPD) at the end of 2002, and 635 CAPD and 445 APD/CCPD patients at the end of 2003. Results There were 1467 episodes of PD peritonitis during the 2-year period, including 129 recurrent episodes, with the average number of months between peritonitis episodes being 14.7 for CAPD and 18.1 for APD/CCPD, p < 0.05. However there was considerable variation between units. Coagulase-negative staphylococcus (CoNS) was the most common cause, accounting for around 30% of all peritonitis episodes, including recurrences, followed by non-pseudomonas gram negatives and Staphylococcus aureus. Cure rates were 77.2% for CoNS, 46.6% for S. aureus, and 7.7% for methicillin-resistant S. aureus. The cure rate for pseudomonas was 21.4%, and other gram negatives 56.7%. In total, there were 351 episodes of culture-negative peritonitis, with an average cure rate of 76.9%. Cure rates were higher for those centers that used a combination of intraperitoneal gentamicin and cephalosporins than those centers that used oral-based regimes. A total of 296 PD catheters were removed as a direct consequence of PD peritonitis: 121 due to gram-positive and 123 due to gram-negative organisms. Only 49 catheters were reinserted and the patients returned to PD. 52 patients died during or subsequent to their episode of PD peritonitis, with an overall mortality rate of 3.5%. Conclusion This audit showed that, in a large unselected population of PD patients, the incidence of peritonitis was significantly greater than that reported in single-center short-term studies, and varied from unit to unit. Similarly, the success of treating PD peritonitis varied not only with the cause of the infection but also from unit to unit. PD peritonitis remains a major cause of patients discontinuing PD and switching to hemodialysis.
Peritoneal Dialysis Access — Results from a UK Survey
Authors: Wilkie Martin , Wild Janet 
Published: February 2020

Objective To obtain information about peritoneal dialysis (PD) access practices in the United Kingdom. Methods During July of 2007, a PD access survey was circulated to 80 clinical directors of renal units in the UK. Results Returns were received from 43 units; annual catheter insertion numbers ranging from 5 to 100 (median 34, mean 38) were reported. The majority of responding centers (30/43) reported a waiting time for catheter insertion of 1 week to 1 month; primary patency rates were reported as >90% in 26 and 60%–90% in 16 centers. Day case catheter insertion was reported by 19 of the 43 respondents. Most centers (40) reported that catheters could be removed in 2 days or sooner when required. The majority of surgical problems (hernia, leaks, or catheter malfunction) were reported as being managed in 1 – 4 weeks. A variety of catheter insertion techniques were reported: 22 centers used surgical insertion alone; 13 used a combination of surgical and medical percutaneous techniques; 4 reported using a combination of surgical and peritoneoscopic insertion; 2 centers reported using combinations of all 3 techniques; 1 center used only a radiographic technique and another used only the peritoneoscopic technique. Catheters were most often inserted by consultant surgeons (71.7%), followed by consultant nephrologists (19.3%), trainee nephrologists (2.9%), trainee surgeons (2.4%), associate specialists (2.4%), or a nurse specialist (1.2%). Two thirds of respondents indicated that they would be interested in attending a medical catheter-insertion training program. Conclusion In the UK, reducing waiting times for PD catheter insertion may have an important role in increasing patient access to the technique.
Peritoneal Dialysis in Brazil: Twenty-Five Years of Experience in a Single Center
Authors: Moraes Thyago P. , Pecoits–Filho Roberto , Ribeiro Silvia C. , Rigo Mariane , Silva Margarete M. , Teixeira Patricia S. , Pasqual Daisy D. , Fuerbringer Roseana , Riella Miguel C. 
Published: February 2020

Objectives To evaluate patient and technique survival and to provide an analysis of peritoneal dialysis (PD)-related peritonitis in 25 years of experience in a single center. Study Design Retrospective study of incident patients on PD from July 1980 to July 2005. Setting Single, university based, Brazilian dialysis program. Patients 680 patients were analyzed in our study from July 1980 to July 2005, with a cumulative experience of 15303 patient-months. All patients over 15 years of age entering the dialysis program were included in the study. Patients with less than 30 days of follow-up were excluded. Biochemical and demographic variables, peritonitis episodes, and patient and technique survival were analyzed. Results Mean age at start of PD was 53 ± 16 years; diabetic nephropathy was the main cause of chronic kidney disease. Cardiovascular disease was the main cause of death (44%); peritonitis was responsible for 16% of fatal events. The predictors of death in our study were diabetes [relative risk (RR) 1.23, p < 0.01], advanced age (RR 1.58, p < 0.001), low serum albumin level (RR 1.25, p < 0.01), and low serum phosphate level (RR 1.39, p < 0.001) upon starting PD. There were 1048 cases of peritonitis over the 25-year period, with a significant reduction in incidence after the introduction of the double-bag system. The number of incident PD patients originating from hemodialysis increased threefold over the observation period ( p < 0.001), with a similar increase in comorbidities over time. Conclusion In the largest single-center report of PD experience in Latin America, we describe the overall rate and trends over time of peritonitis as well as patient and technique survival, which are similar to previous reports. Significant changes in peritonitis rates and causative organisms as well as a significant time-dependent increase in high-risk patients starting PD were observed.
Prolonged Peritoneal Gene Expression Using a Helper-Dependent Adenovirus
Authors: Liu Limin , Shi Chang-Xin , Ghayur Ayesha , Zhang Claire , Su Je Yen , Hoff Catherine M. , Margetts Peter J. 
Published: February 2020

Background Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis. The causes of EPS are not well defined and are likely multifactorial. A suitable animal model would facilitate research into the pathophysiology and treatment of EPS. Methods We developed a helper-dependent adenovirus that expresses both green fluorescent protein (GFP) and active transforming growth factor-beta (TGF-β1; HDAdTGF-β1). Mice were administered HDAdTGF-β1 via intraperitoneal injection and the response was compared with mice administered either first-generation adenovirus expressing TGF-β1 (AdTGF-β1) or control adenovirus (AdGFP). Results HDAdTGF-β1-treated mice continued to express the GFP reporter transgene to day 74, the end of the observation period. Transgene expression lasted less than 28 days in the animals treated with first-generation adenoviruses. Animals treated with first-generation AdTGF-β1 demonstrated submesothelial thickening and angiogenesis at day 7, with almost complete resolution by day 28. The HDAdTGF-β1-treated mice demonstrated progressive peritoneal fibrosis with adhesion formation and encapsulation of bowels. Weight gain was significantly reduced in animals treated with HDAdTGF-β1 compared to both the control-treated animals and the AdTGF-β1-treated animals. Inflammation was not a major component of the fibroproliferative response. Conclusions Peritoneal administration of a first-generation AdTGF-β1 leads to transient gene expression, resulting in a resolving fibrotic response and histology similar to that seen in simple peritoneal sclerosis. Prolonged TGF-β1 expression induced by the helper-dependent HDAdTGF-β1 led to changes in peritoneal morphology resembling EPS. This suggests that TGF-β1 may be a contributing factor in both simple peritoneal sclerosis and EPS. This model will be useful for elucidation of the mechanism of EPS and evaluation of potential treatment.
Quantification of Free Water Transport during the Peritoneal Equilibration Test
Authors: Cnossen Trijntje T. , Smit Watske , Konings Constantijn J.A.M. , Kooman Jeroen P. , Leunissen Karel M. , Krediet Raymond T. 
Published: February 2020

Objective Free water transport (FWT) can be calculated after a dwell of 1 hour with a 3.86% glucose solution using sodium kinetics (mini-PET, as developed by LaMilia et al.). This requires measurement of the intraperitoneal volume after drainage of the abdomen. Since valuable information of a 4-hour peritoneal equilibration test (PET) may be lost, the aim of the present study was to investigate whether temporary drainage of the peritoneal cavity after 1 hour and re-instillation thereafter would influence the results of the 4-hour PET. Methods and Patients Two PETs were performed in 10 stable peritoneal dialysis (PD) patients (mean age 59 ± 13 years, mean duration on PD 33 ± 15 months) within a mean period of 54 (range 13 – 104) days: one standardized 4-hour PET using 3.86% glucose (PET A) and one with drainage after 1 hour followed by re-instillation (PET B). Results Mean total ultrafiltration (UF) of PETs A and B was 667 ± 210 mL and 621 ± 206 mL (NS). Mean FWT at 60 minutes was 164 ± 74 mL and mean UF through the small pores was 204 ± 181 mL; FWT correlated well with total UF ( r = 0.720, p = 0.019). Classification of transport categories was identical for 9 of the 10 patients. Comparison of 1-hour and 4-hour results in test B showed a good correlation between dialysate-to-plasma ratios (D/P) of creatinine and urea and Dt/D0 ratios of glucose. Conclusion A 4-hour 3.86% glucose PET, including temporary drainage after 1 hour for assessment of free water transport, does not influence the results of D/P creatinine or Dt/D0 glucose and gives essential additional information on aquaporin function.
Calcium and Magnesium Flux in Automated Peritoneal Dialysis
Authors: Eddington Helen , Hurst Helen , Ramli Marlina T. , Speake Mary , Hutchison Alastair J. 
Published: February 2020

Background Calcium and magnesium balance in continuous ambulatory peritoneal dialysis (CAPD) has been extensively studied with several of the different formulations of fluid available. Calcium and magnesium balance in automated PD (APD) is less well studied and the effect on Ca and Mg flux is unknown. Data on glucose polymer solutions are also lacking. This prospective observational study was undertaken to examine mass transfer of Ca and Mg in APD patients. Methods 12 patients on APD were studied for two 24-hour periods using, alternately, 1.75 mmol/L and 1.25 mmol/L Ca (Dianeal PD1 and Dianeal PD4; Baxter Healthcare, Newbury, UK) 1.36% glucose-based dialysis fluid for the 9-hour overnight dialysis, followed by a 15-hour daytime dwell of glucose polymer-based fluid (icodextrin). Serum ionized Ca, serum Mg, and dialysate Ca and Mg concentrations were measured at the beginning and end of each period. Mass transfer was calculated as millimoles per exchange. Results During rapid overnight exchanges with Dianeal PD1 and PD4, mass transfer of Mg and Ca did not show significant correlations with serum levels when using PD1 fluid; however, mass transfer of Mg, but not Ca, was significantly correlated to serum levels when using PD4 fluid. During the long dwell with icodextrin, dialysate drain volume was the most significant factor determining the flux of both Ca and Mg. Conclusion Mass transfer of Ca and Mg in APD patients using conventional dialysis fluid was not related to drain volume in this study, which differs to studies in CAPD. Flux of Ca and Mg during icodextrin use was found to be dependent on ultrafiltration rate and not dialysate or serum concentration.
Pharmacokinetics of Moxifloxacin in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis
Authors: Skalioti Chrysanthi , Tsaganos Thomas , Stamatiadis Dimitrios , Giamarellos–Bourboulis Evangelos J. , Boletis John , Kanellakopoulou Kyriaki 
Published: February 2020

Objective To investigate the effect of continuous ambulatory peritoneal dialysis (CAPD) on plasma and peritoneal fluid concentration and pharmacokinetics of moxifloxacin after administration of one 400 mg dose orally to end-stage renal failure patients undergoing CAPD. Patients and Methods Blood and peritoneal samples were collected from 8 patients at standard time intervals and concentrations of moxifloxacin were estimated by HPLC analysis with fluorometric and ultraviolet detection. Pharmacokinetic parameters were estimated using standard noncompartmental methods. Results Median maximum plasma moxifloxacin concentration was 5.86 mg/L at a median time of 1.25 hours. In serum, median area under the concentration–time curve (AUC0→inf) was 157.95 ± 100.34 mg·hour/L, median t½ 25.00 hours, median clearance 2.54 L/hour, and median distribution volume 94.90 L. Median peritoneal fluid-to-plasma ratio of moxifloxacin ranged between 0.84 and 1.00, denoting adequate penetration and lack of considerable moxifloxacin removal during CAPD. Maximum moxifloxacin concentration/minimum inhibitory concentration (MIC) and AUC0→24/MIC ratios were above the cutoff points that indicate clinical success. Conclusion A single 400 mg oral dose of moxifloxacin is safe, presents rapid peritoneal fluid penetration, has similar plasma and peritoneal fluid pharmacokinetics, and should therefore be efficacious in the treatment of CAPD-induced peritonitis.
The Influence of Dialysate Calcium on Progression of Arterial Stiffness in Peritoneal Dialysis Patients
Authors: Demirci Meltem Sezis , Ozkahya Mehmet , Asci Gulay , Sevinc Ebru , Yilmaz Mumtaz , Demirci Cenk , Toz Huseyin , Basci Ali , Ok Ercan 
Published: February 2020

Background One of the origins of cardiovascular disease in dialysis patients is arterial stiffness. The aim of our study was to assess the relationship between the calcium content of peritoneal dialysis (PD) solution and arterial stiffness. Patients and Methods We enrolled into the study 49 PD patients who had been treated with the same PD solution for the preceding 6 months. The calcium content of the PD solution was 1.25 mmol/L in 34 patients (low-Ca group) and 1.75 mmol/L in 15 patients (high-Ca group). Study patients were followed for 6 months on the same PD prescription. Arterial stiffness was assessed by measurement of augmentation index (AI) and brachial pulse wave velocity (PWV) at baseline and at month 6 (SphygmoCor: Atcor Medical, West Ryde, NSW, Australia). Demographic data were recorded from patient charts. Results Mean age of the whole group was 51 ± 11 years, prevalence of diabetes was 14%, duration of PD was 43 ± 30 months, percentage of women was 45%, and percentage of patients using a cycler was 33%. We observed no differences between groups with regard to those variables or creatinine clearance, residual renal function, Ca, phosphorus, parathormone, C-reactive protein, lipid parameters, and use of phosphate binder with or without Ca content. Mean arterial pressure was higher in the high-Ca group, but the difference was not statistically significant (100 ± 22 mmHg vs 88 ± 18 mmHg, p = 0.06). At baseline, AI was significantly higher in the high-Ca group than in the low-Ca group (27% ± 10% vs 21% ± 9%, p < 0.05). Measurements of PWV were not different between the groups (8.4 ± 1.1 m/s vs 8.5 ± 1.7 m/s). Measurement of arterial stiffness parameters at month 6 revealed that PWV had increased in the high-Ca group (to 9.6 ± 2.3 m/s from 8.4 ± 1.1 m/s, p < 0.05), but had not changed in the low-Ca group (to 8.2 ± 1.9 m/s from 8.5 ± 1.7 m/s). The AI did not change in either group. Conclusions These data suggest that Ca exposure through PD solution plays a role in the progression of arterial stiffness, which may be related to increased vascular calcification.
3,4-Dideoxyglucosone-3-Ene in Peritoneal Dialysis Fluids Infused into the Peritoneal Cavity Cannot be Found in Plasma
Authors: Erixon Martin , Wieslander Anders , Lindén Torbjörn , Carlsson Ola , Jönsson Jan Åke , Simonsen Ole , Kjellstrand Per 
Published: February 2020

Objective Glucose degradation products (GDPs) are important for the outcome of peritoneal dialysis (PD) treatment. The most cytotoxic GDP found in conventionally manufactured fluids, 3,4-dideoxyglucosone-3-ene (3,4-DGE), may in addition be recruited from 3-deoxyglucosone (3-DG). What happens with the GDPs in the fluid infused into patients during PD is not known. We investigated whether 3,4-DGE and 3-DG in PD fluid can be found in plasma during treatment. Design Patients on PD were dialyzed with a conventional PD fluid containing 43 μmol/L 3,4-DGE and 281 μmol/L 3-DG. Parallel experiments were performed in rats and in vitro with human plasma. The rats were dialyzed with a PD fluid containing 100 μmol/L 3,4-DGE and 200 μmol/L 3-DG. Results The 3,4-DGE concentration in the peritoneum declined at a much higher rate during the dwell than did the 3-DG concentration. However, 3,4-DGE was not detected in the plasma of patients or of rats during dialysis. The 3-DG concentration in plasma peaked shortly after infusion of fluid into the peritoneal cavity. The 3,4-DGE concentration during experimental incubation in plasma declined rapidly; the 3-DG concentration declined only 10% as rapidly (or less). Conclusion During dialysis, 3,4-DGE could not be detected in plasma of either PD patients or rats, presumably because of its high reactivity. On the other hand, 3-DG may pass through the membrane and be detected in the blood.