bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma Vitamin-A Levels in Children on CAPD
Authors: Parrott Keith A. , Stockberger Roxy A. , Alexander Steven R. , Miller Lorraine T. , Leklem James E. , JenkinsJ Randall D. 
Published: February 2020

Accumulation of vitamin A in patients with renal failure was first described in the 1940's. This study reports dietary intake and plasma concentration of vitamin A in children undergoing CAPD. Dialysate loss of vitamin A was also evaluated. Eight children (mean age 12 years) were studied who had been on CAPD from nine months to five years. Vitamin supplements were discontinued for three weeks before the study and a three-day dietary record was obtained. Mean plasma vitamin A concentration was 617 μg/dl with a range of 342 to 1051 μg/dl. No vitamin A was detected in the dialysate. Mean dietary intake was 944 retinol equivalents per day, which is equivalent to a mean per cent RDA of 125. Dietary vitamin A ranged from 62 to 262% of the RDA. Not only should these patients avoid supplements containing vitamin A but the individual should monitor dietary intake of vitamin A and avoid intake in excess of the RDA.
Acquired Cystic Disease of the Kidney in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients
Authors: Rodriguez-Perez1 Jose Carlos , Vega Nicanor , Camaño Tomas , Fernandez Ana , Plaza Celia , Palop Leocadia , Gragera Francisco 
Published: February 2020

Acquired Cystic Disease of the Kidney (ACDK) has been increasingly noted in patients with long-standing renal failure and in those treated with dialysis. We assessed the prevalence of different patterns of cysts in 48 randomly selected patients treated with CAPD (23.1 ± 16.0 months). Only 3 patients had been previously treated with hemodialysis. All patients underwent renal ultrasonography (US) and nine underwent computerized tomography (CT). In 22 patients no cysts were found. The other 24 patients were Included In three different groups. Group 1: Cysts that predominate In the renal cortex from 0.3 to 3.0 cm In diameter: 14 patients. Group 2: Cysts less than 0.3 cm in diameter (granular-microcystic pattern): 4 patients. Group 3: SolItary cysts 1 to 3: 6 patients. US and CT are relIable and sensitive enough to detect cysts even smaller than 0.3 cm in diameter. The incidence of patients with renal cysts increases with the duration of CAPD. Cysts less than 0.3 cm In diameter (Group 2) could correspond to an initial stage of Group 1 cysts or to a new aspect of ACDK. Group 1 and Group 2 cysts were predominant In male patients, while Isolated renal cysts were more frequent in females.
Effect of Various Factors on Peritoneal Lymphatic Flow in Rabbits
Authors: Breborowicz Andrzej , Rodela Helen , Oreopoulos D.G. 
Published: February 2020

Peritoneallymphatic flow in normal and uremic rabbits was measured by estimation of the disappearance of the radiolabelled 1311–albumin from the peritoneal cavity. The results show that lymph flow rate from the peritoneal cavity is not steady and depends on dialysate volume, its tonicity, and protein content. During peritoneal dialysis, peritoneal lymphatic flow is lower at the beginning of an exchange. Peritoneal lymphatic drainage is higher in uremic rabbits compared to normal controls.
Continuous Ambulatory Peritoneal Dialysis (CAPD) in a Patient with Glucose-6-Phosphatase Deficiency
Authors: Vandepitte K. , Lins R.L. , Daelemans R. , Zachée P. , Kuyken Ch. , De Broe M.E. 
Published: February 2020

The metabolic disturbances in glucose-6-phosphatase deficiency (von Gierke's disease) are the consequence of hypoglycemia, occurring mostly during the night. Continuous provision of glucose is the aim of every recently introduced treatment procedure. We studied the influence of continuous ambulatory peritoneal dialysis (CAPD) on the metabolic disturbances in a 42-year-old female patient with von Gierke's disease and end-stage renal disease. During six months of CAPD, there were no dialysis-related complications. The metabolic acidosis didn't worsen: arterial bicarbonate and lactate were not changed. Mean glycemia was 118.6 ± 14.4 mg %. Total lipemia, cholesterol and triglycerides were not different from those before CAPD, despite the fact that all hypolipidaemic drugs were stopped. Three different exchange procedures were compared during the night: no dialysis, one exchange with a 2 L solution without buffer containing glucose 15 g/L and containing glucose 42.5 g/L. The results show that the 4.25% glucose solution prevents hypoglycaemia, and diminishes the increase in lactate and pyruvate concentration. Intraperitoneal glucose normalizes the plasma free fatty acid concentration. A very important result is the disappearance of hypo-insulinism. We conclude that, from a clinical point of view, CAPD is a well-tolerated treatment in von Gierke's disease. The limited results provide some evidence that the use of a 4.25% glucose solution as an overnight exchange, instead of the usual 1.5% solution, can prevent at least partly the glycogenolysis and consequently the metabolic disturbances of von Gierke's disease.
Peritonitis in Continuous Ambulatory Peritoneal Dialysis {CAPD): A Multi-Centre Randomized Clinical Trial Comparing the Y Connector Disinfectant System to Standard Systems
Authors:   Canadian CAPO Clinical Trials Group, Churchil O.N. , Taylor O.W. , Vas S.I. , Oreopoulos O.G. , Bettcher K.B. , Fenton S.S.A. , Fine A. , Lavoie S. , Page O. , Wu G. , Beecroft M.L. , Pemberton R. , Wilczynski N.L. , Deveber G.A. , Williams W. 
Published: February 2020

sixty-one new continuous ambulatory peritoneal dialysis (CAPD) patients were allocated to a Y connector disinfectant (Amuchina, Italy) and 63 to standard systems (Baxter Systems II & III) in a randomized clinical trial addressing peritonitis rates in 8 CAPD programs in 6 Canadian cities. In the Y connector-disinfectant group, 15 patients experienced 21 episodes of peritonitis in 452 patient-months or 1 per 21.53 patient-months. In the standard systems group, 30 patients experienced 47 episodes of peritonitis in 467 patient-months or 1 per 9.93 patient-months ( p = 0.009). The peritonitis risk reduction was 61% (95% confidence limits 27–79%). Exit-site infections occurred in 36% of each group. Prior to the development of exit -site infection, the monthly risk for peritonitis was 3.12% for the Y connector disinfectant system and 7.37% for the standard system. After an exit -site infection, these probabilities increased to 6.15% and 15.47%, respectively. Skin organisms were responsible for peritonitis in 8/21 (38%) in the Y connector-disinfectant group and 30/47 (64%) in the standard group. There were 75 days hospitalized for peritonitis in the Y connector-disinfectant group compared to 257 days for the standard group. The Y connector disinfectant system decreases the peritonitis rate through its effect on skin organisms. Exit -site infections are a major source of organisms responsible for peritonitis.
Comparison of Large Volume Culture to Other Methods for Isolation of Microorganisms from Dialysate
Authors: Sewell David L. , Golper Thomas A. , Hulman Peter B. , Thomas Catharine M. , West Linda M. , Kubey Winnie Y. , Holmes Clifford J. 
Published: February 2020

Patients on continuous ambulatory peritoneal dialysis (CAPD) who reside long distances from a CAPD center often use community medical laboratories to document and manage episodes of peritonitis. We examined the feasibility of using large volume cultures as an alternative to more costly and labor intensive methods and to enhance earlier recovery of microorganisms from these patients. Three methods of processing dialysate from patients on CAPD were compared: (a) inoculation of 400 mL dialysate into a transfer bag (Baxter Healthcare, Inc., Round Lake, IL) containing 100 mL of 5-fold concentrate of trypticase-soy broth: (b) inoculation of 5 mL into each of two Bactec bottles (Johnston Laboratories, Towson, MD): and (c) centrifugation of 50 mL and culture of the sediment without white cell lysis on plated media and two Bactec bottles. Of the 58 specimens cultured, 34 (59%) were positive by one or more methods. Antimicrobial activity was detected in 20158 (34%) dialysates, which represent 54% of all no-growth cultures. Of the 34 culture-positive specimens, microorganisms were recovered on plated media in 22 (65%); by the centrifugation system in 32 (94%); by the routine Bactec system in 28 (82%); and by large volume culture in 30 (88%). The large volume culture system is an acceptable alternative to the more costly Bactec System and the labor intensive centrifugation method but does not significantly improve recovery of microorganisms.
Initial Treatment of Dialysis Associated Peritonitis: A Controlled Trial of Vancomycin versus Cefazolin
Authors: Flanigan Michael J. , Lim Victoria s. 
Published: February 2020

Objective To determine if intraperitoneal administration of vancomycin (a slowly absorbed antibiotic) im proves the management of dialysis-associated peritonitis over that obtained by using cefazolin, an equally potent, rapidly absorbed antibiotic. Setting A university operated teaching hospital, with patient treatment initiated at home. Patients One hundred thirty-one patients trained to perform peritoneal dialysis (CAPD and CCPD) and followed at the University of Iowa Hospitals and Clinics Home Dialysis Treatment Center. Design Patients were prospectively allocated into groups adding either vancomycin 25 mgm/L, orcefazolin 50 mgm/L to their dialysate when signs or symptoms of peritonitis developed. Treatment results were analysed using chi-square testing. Findings Compared to cefazolin, initial peritonitis therapy with vancomycin improved the peritonitis resolution rate [67% vs 81 %; p=0.008], reduced the incidence of hospital admissions [68% vs 48%; p=0.001], and decreased the risk of superinfection [4% vs 0%; p=0.039]. Conclusion Vancomycin appeared to be superior to cefazolin in the treatment of peritoneal dialysis associated peritonitis.
CAPD Peritonitis and Fluoroquinolones: A Review
Authors: Janknegt Robert 
Published: February 2020

Fluoroquinolones are potentially useful agents in the treatment of CAPD peritonitis, due to their wide spectrum of antimicrobial activity, favourable pharmacokinetics, oral availability and their relatively low toxicity. The microbiological, pharmacokinetic, and clinical aspects of these drugs in CAPD are reviewed. Ciprofloxacin showed superior in-vitro activity in comparison with various beta lactam agents; gentamicin and vancomycin against staphylococci and particularly against Gram-negative bacteria. Its activity against streptococci is low. The in vitro activity of fiuoroquinolones is reduced in peritoneal dialysis fluid. A limited rise in serum levels is observed with daily administration of fiuoroquinolones in CAPD patients during 5–15 days. Effective dialysate levels are reached in most patients after oral dosing, but these levels are highly variable and low levels are often observed during the first day, an d with short dwell times. Concurrent administration with phosphate binding antacids should be avoided. Initial clinical experience shows that ciprofloxacin and ofloxacin may be effective agents to treat CAPD peritonitis via the oral route. They are usually well tolerated, although convulsions have been observed. The relative efficacy in comparison with “standard therapies” will have to be shown in comparative studies.
Dialysis at Home in the West of Scotland: A Comparison of Hemodialysis and Continuous Ambulatory Peritoneal Dialysis in Age and Sex-Matched Controls
Authors: Grant Alexander C. , Rodger R. Stuart C. , Howie Catherine A. , Junor Brian J.R. , Briggs J. Douglas , Macdougal1 Alisdair I. 
Published: February 2020

Objective To audit the outcome of patients treated at home by hemodialysis and continuous ambulatory peritoneal dialysis (CAPD). Design Retrospective comparison of nondiabetic hemodialysis patients with age and sex-matched nondiabetic patients treated by CAPD. Setting Renal Units, Stobhill General Hospital and Western Infirmary, Glasgow, providing the home dialysis service for the West of Scotland. Patients Between 1982 and 1988, 139 hemodialysis patients starting treatment at home, compared with 139 matched patients starting CAPD over the same time period. Main Outcome Measures Patient characteristics and cardiovascular risk factors at the start of home treatment. Patient and technique survival with both forms of dialysis. Results Patients selected for home hemodialysis were less likely to be smokers (p<0.02) and to have electrocardiographic evidence of ischemia or left ventricular hypertrophy (p<0.05) than patients treated by CAPD. Patient survival and technique survival (excluding death and renal transplantation) at 3 years were 93.8% versus 86.2% (p<0.05) and 94.2% versus 80.8% (p<0.04) for hemodialysis and CAPD, respectively. Cardiovascular events were responsible for the majority of deaths in both groups, but there was a greater proportion of deaths from other causes in patients treated by CAPD. There was no significant difference in the transplantation rate between the two treatment groups. Conclusions Home dialysis is an effective method of renal replacement treatment for patients with end-stage renal disease. The results of hemodialysis are superior to CAPD, but this may be partly due to selection bias.
Effect of Erythropoietin in Continuous Ambulatory Peritoneal Dialysis Patients: Comparison between Intravenous and Intraperitoneal Administration
Authors: Nasu Takahito , Mitui Hiroshi , Shinohara Yoichi , Hayashida Shigeaki , Ohtuka Hiroyuki 
Published: February 2020

The administration of recombinant human erythropoietin (rHuEPO) in CAPD patients is usually done subcutaneously. Only a few authors have reported on its intraperitoneal (IP) administration. We compared the effect of IP administration of rHuEPO in CAPD patients to that of intravenous (IV) administration. Ten anemic CAPD patients injected rHuEPO into their dialysis bag once a day, 3 times a week, for 18 weeks. The initial dose was 12000 U. The dwell time of the exchanges with rHuEPO was about 6 hours. Nineotheranemic CAPD patients were treated with IV rHuEPO once a week for 18 weeks. The initial dose was 6000 U. In the IP group the hematocrit rose from 24.04±2.7% to 33.3±3.8% (mean±SD). In the IV group 2 patients were excluded from the efficiency evaluation. In 7 of the 9 patients in the IV group, the hematocrit rose from 23.27±2.6% to 32±5.5% (mean±SD). The intraperitoneal administration of rHuEPO in CAPD patients is sufficient in improving anemia, although it requires a much larger dosage to yield the same level of improvement as the one obtained with the intravenous administration. However, in patients on continuous cycling peritoneal dialysis or IP dialysis, a smaller dosage during the prolonged dwell time may be effective.
The Need for Second-Generation Antihepatitis C Virus Testing in Uremic Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Ng Yee-Yung , Lee Shou-Dong , Wu Shiao-Chi , Liu Wu Tse , Chia Wei-Lian , Huang Tung-Po 
Published: February 2020

Objective To assess the prevalence and clinical relevance of a hepatitis C virus (HCV) infection in continuous ambulatory peritoneal dialysis (CAPD) patients by first (Ortho) and second-generation (Abbott and UBI) HCV antibody enzyme immunoassays. Design Thirty-two serum samples tested by first generation HCV antibody enzyme immunoassays (EIA's) were reevaluated using two second-generation HCV antibody EIA's. Basic demographic data, history of blood transfusions, and duration of hemodialysis and CAPD were reviewed. Results were analyzed by chi square analysis, Wilcoxon rank sum, and the paired t-test. Setting The medical college's affiliated teaching hospital. Results The prevalence of the antibody anti-HCV increases with the duration of previous hemodialysis, but not with the duration of CAPD. The positive detection of anti-HCV by second-generation HCV antibody EIA's was higher than first-generation EIA's (25% and 34.4% vs 12.5%). Conclusion The prevalence and clinical relevance of HCV infection can be more accurately studied using the second-generation assays in uremic patients.
Heat Sterilization of Fluids for Peritoneal Dialysis Gives Rise to Aldehydes
Authors: Thorell Carin B. Nilsson , Muscalu Natalia , Andrén Anders H.G. , Kjellstrand Per T.T. , Wieslander Anders P. 
Published: February 2020

Objective To chemically identify and quantify glucose degradation products in heat sterilized fluids for peritoneal dialysis. Design Three different brands of commercial PD-fluids and one laboratory made fluid, sterilized either by heat or filtration, were investigated for the presence of aldehydes. Measurements Aldehydes were identified and quantified using high performance liquid chromatography and gas chromatography. Results The tested brands of heat sterilized PD-fluids were found to contain several different aldehydes while the sterile filtered PD-fluid contained none. The highest concentrations in commercial PD-fluids of these aldehydes were: acetaldehyde (420 μm), glyoxal (14 μm), methylglyoxal (12 μm) and formaldehyde (11 μm). Valeraldehyde was also identified but not quantified. The presence of 5–HMF (15 μm) and 2-furaldehyde (2 μm), which has been identified by others, was confirmed. Conclusions The heat sterilization of commercial PD fluids gives rise to several aldehydes which may contribute to adverse effects of PD-fluids on patients.
A Three-Pore Model of Peritoneal Transport
Authors: Rippe Bengt 
Published: February 2020

The three-pore model of peritoneal transport treats the capillary membrane as a primary barrier determining the amount of solute that transports to the interstitium and the peritoneal cavity. According to the three-pore model, the principal peritoneal exchange route for water and water-soluble substances is a protein-restrictive pore pathway of radius 40–55 A, accounting for approximately 99% of the total exchange (pore) area and approximately 90% of the total peritoneal ultrafiltration (UF) coefficient (LpS). For their passage through the peritoneal membrane proteins are confined to so-called “large pores” of radius approximately 250 Å, which are extremely few in number (0.01% of the total pore population) and more or less nonrestrictive with respect to protein transport. The third pathway of the three-pore model accounts for only about 2% of the total LpS and is permeable to water but impermeable to solutes, a so-called “water-only” (transcellular?) pathway. In contrast to the classical Pyle-Popovich (P&P) model, the three-pore model can predict with reasonable accuracy not only the transport of water and “small solutes” (molecular radius 2.3–15 Å) and “intermediatesize” solutes (radius 15–36 Å), but also the transport of albumin (radius 36 Å) and larger molecules across the peritoneal membrane. The model operates with reflection coefficientsa (a's) for small solutes <0.1. These are approximately one order of magnitude lower than the & sigma's In the P&P model. Furthermore, the peritoneal LPS is one order of magnitude higher than In the P&P model. As a consequence, the major portion of the “fluid loss” from the peritoneal cavity In continuous ambulatory peritoneal dialysis (CAPD) can be explained by the operation of the so-called Starling forces (the transcapillary hydrostatic pressure gradient opposed by the plasma colloid osmotic pressure as multiplled by the LpS), and to a much lesser extent by lymphatic absorption (L). Furthermore, In contrast to the P&P model, the three-pore model can with reasonable accuracy predict the UF profiles produced when glucose Is substituted by high molecular weight solutes as osmotic agents In CAPO.
Risk Factors of Ischemic Cardiac Disease in Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Cavagna Romano , Schiavon Renzo , Tessarin Cristina , Papa Nunzio , Scorrano Dante , Casol Daniela , De Silvestro Linda 
Published: February 2020

Elevated plasma levels of fibrinogen, factor VII coagulant activity (F VIIc), and plasminogen activator inhibitor (PAI-1) have been reported to be strictly associated with thrombotic events and are considered to be important risk markers of atherothrombotic caridovascular disease. Therefore, we evaluated in 15 patients on continuous ambulatory peritoneal dialysis (CAPD) the plasma levels of these coagulation factors, basal insulin values, and the lipid pattern in comparison with 33 hemodialysis (HD) patients and 59 healthy subjects. In CAPD the total cholesterol and triglyceride results were significantly increased, but no difference was found in HDL cholesterol. Fibrinogen and F VIIc results were significantly higher In CAPD and HD than In the control group, probably due to an increased hepatic synthesis as a nonspecific response to the peritoneal protein loss. Elevated F VIIc activity may be caused by the presence of large negatively charged lipoproteins, in viva thrombin formation, or reduced hepatic clearance. Both PAl 1 and t-PA results were higher in CAPD, probably due to an increased synthesis by endothelial cells activated by glucose peritoneal absorption and hypertonic dialysis solutions. The contemporary elevation of fibrinogen, F VIIc, PAI-1, and t-PA suggests that CAPD patients present a hypercoagulability and hypofibrinolysis condition, which may promote the development of atherothrombotic events.
Dislipemia in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis: Pharmacological Therapy (Simvastatin) versus Hemodialysis
Authors: Marangoni Roberto , Civardi Fernando , Masi Franceso , Cimino Roberto , Maltagliati Luca , Longhena Giorgio Romei 
Published: February 2020

Peritoneal dialysis can worsen disllpemia, which is frequent in chronically uremic patients. In order to verify the therapeutic possibilities, we retrospectively studied 20 chronically uremic patients who had been previously treated with continuous ambulatory peritoneal dialysis (CAPO) and who had developed an IV-type dislipemia. Twelve have continued CAPO treatment and have been simultaneously treated with simvastatin; 8 have withdrawn from CAPO and have begun HO, without any antidislipemic pharmacological support. The results, after 3, 6, 12, and 18 months of treatment, showed the following: In patients treated with CAPO and simvastatin, highly significant decreases were noted in total cholesterol (T-cho) and triglycerides (TG) (p<0.001), and highly significant increases were noted in HOL-cholesterol (HOL-cho) (p<0.005) and apolipoprotein-A 1 (Apo-A 1) (p<0.01). In patients treated with HO, only slightly significant decreases were noted in T-cho (p<0.01) and TG (p<0.02), a slightly significant increase in Apo-A1 (p<0.05), and no significant change in HOL-cho. Apollpoprotein-B showed no change in the two groups. Therefore, patients undergoing CAPO, with dislipemia only, can continue the treatment, because simvastatin is capable of correcting dislipemia, while those patients who have displemia as well as other complications strictly due to CAPO must abandon treatment and must be transferred to extracorporeal methods.
The Effect of Simvastatin on Dyslipemia in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Dimitriadis Athanassios , Antoniou Staveos , Hatzisavvas Nikolaos , Pastore Franca , Kaldi Loanna , Stangou Maria 
Published: February 2020

The efficacy of simvastatin, an inhibitor of HMG-CoA reductase, was evaluated in 14 nondiabetic hypercholesterolemic continuous ambulatory peritoneal dialysis (CAPD) patients with or without hypertriglyceridemia. Following a hypolipemic diet for 6 weeks, simvastatin was administered at a dose of 10 mg/day for 6 months. After 6 weeks on simvastatin, cholesterol was reduced by 22% (p<0.001), triglycerides by 24% (p<0.001), lowdensity lipoprotein (LDL) by 27% (p<0.001), while high density lipoprotein (HDL) increased by 18% (p<0.005). These changes remained steady for 6 months. Apolipoprotein-B (Apo-B) was reduced by 17.8% (p<0.0001), while Apo-A was stable. There were no liver function abnormalities observed. In 3 patients serum creatinine kinase (CK) was increased, and in 2 treatment was stopped. No new lens opacities or other side effects were detected. Simvastatin seems to be an effective and relatively well-tolerated drug for dyslipemias in CAPD.