bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Carnitine Levels According to the Peritoneal Equilibration Test in Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Chatzidimitriou Christos , Pliakogiannis Theodoros , Evangeliou Athanasios , Tsalkidou Theodora , Böhles Hans Josef , Kalaitzidis Kleonikos 
Published: February 2020

The evidence of carnitine abnormal metabolism in patients on continuous ambulatory peritoneal dialysis (CAPO) is unclear, and previous studies have reported conflicting results. The total (TC), free (FC), and acylated (AC) carnitines were estimated in blood and dialysate, as well as the AC/FC ratio, in 29 patients on CAPO, grouped into high (H-Abs) and low (L-Abs) absorbers, according to the results of the peritoneal equilibration test (fast PE-test). Ourdata demonstrated that patients with higher peritoneal transport rates, which was the H-Abs group, males and females, showed a better carnitine metabolic status compared to the L-Abs group. Although the H-Abs group lost significantly more free carnitine than the L-Abs group, the AC/FC ratio of the H-Abs group remained within normal range. All the patients in our study showed abnormally high triglyceride (TAG) levels and an abnormally high total cholesterol/HOL cholesterol ratio. In particular, the patients In the L-Abs group showed significantly higher TAG levels and total cholesterol/HOL cholesterol ratios than the H-Abs group. Those patients who have been on CAPO for more than 2 years showed significantly abnormally higher AC/FC ratios than those with shorter periods on CAPO treatment. In patients with AC/FC ratio greater than 0.4, the supplementation of L-carnitine may have a beneficial effect on their carnitine and lipid metabolism.
Peritoneal Sclerosis: Role of Plasticizers in Stimulating Interleukin-1 Production
Authors: Fracasso Agostino , Calo Lorenzo , Landini Silvano , Morachiello Paolo , Righetto Flavio , Scanferla Flavio , Toffoletto Pierpaolo , Genchi Rosangela , Roncali Davide , Cantaro Salvatore , De Silverstro Giustina , Cavatton Gianni , Masiero Mauro , Plebani Mario , Borsatti Arturo , Bazzato Giorgio 
Published: February 2020

The role of plasticizers (PLS) in inducing water flow inhibition and peritoneal sclerosis has been demonstrated in both In vivo and In vitro studies. Interleukin-1 (IL-1) has been shown to be a regulator of fibroblast proliferation as well as collagenase production. The aim of this study was to evaluate the role of PLS in stimulating mononuclear ce1l1L-1 secretion. Two cultures containing 103 cells/mL were obtained from 14 healthy subjects. One was used as the control, and the other was mixed with diethylhexylphthalate (DEHP) to reach a final concentration of 2.8x10” M. After 4 hours the samples were centrifuged, and the supernatants were tested by radioimmunoassay for IL-1α and IL-1β. The results showed a significant increase In both IL-1α and IL-1 β production In DEHP-stimulated cells in comparIson to the controls: 42.6±15.4 versus 29.3±10 ng/L (p<0.015) for IL-1α. and 153.6±55 versus 113.6±32 ng/L (p<0.03) for IL-1β In conclusion, PLS added to mononuclear cells were able to Induce IL-1 secretion. This mechanism could be responsible, at least in part, for the development of peritoneal sclerosis. Thus the employment of plasticlzer-free bags should be elective in peritoneal dialysis.
Effect of Erythropoietin Treatment on Nutritional Status of Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Balaskas Elias V. , Melamed I. Rogers , Gupta Amit , Bargman Joanne , Oreopoulos Dimitrios G. 
Published: February 2020

Seventeen patients -10 females, 7 males -mean age 52 years (range: 21–77 years), on CAPD for an average of 35 months (range 10–160 months) were studied. Mean initial dose of EPO was 114±45 U/kg/week subcutaneously (range: 59–209). The dose was adjusted to achieve and maintain a target Hb of 100 g/L and Hct 30%. Fifteen of the patients (88.2%) achieved this target within 6 months [baseline to month 6 changes: Hb 72±10 g/L to 107±12 g/L (p=0.0001); Hct 22±3% to 33±4% (p=0.0001)]. Serum total protein also increased significantly over the time of EPO use (p=0.0133); changes from baseline were significant by the fourth month [68±9 g/L to 72±9 g/L (p=0.0115)]. Serum albumin also increased significantly over time (p=0.0157). The change from the baseline result (37±4 g/L) was statistically significant by month 2 (p=0.0060) and was maintained over the following 4 months [month 6 result: 40±3 g/L (p=0.0180)]. The increase was greater for 8 patients with initial serum albumin <35 g/L (mean change 5.75 g/L) than for the 9 subjects with levels >35 g/L (mean change 0.11 g/L). In a comparison group of 17 patients (matched for age, sex, duration of CAPD, underlying disease and antihypertensive treatment), who did not receive EPO treatment, albumin and protein did not appear to increase over time. Mean body weight increased from 60.9± 14.0 kg at the start to 62.1± 13.9 kg at month 6 (p=0.281) and the absolute lymphocyte count from 1.6±0.8 x 109/L to 1.8±1.0 x 109/L (p=0.0472). Serum potassium, urea, creatinine, phosphorus, cholesterol, tri. glycerides, WBC and platelets did not show significant changes over time. Serum phosphorus increased at the end of the second and third months (from 1.6±0.5 mmol/L to 1.9±0.4 and 1.8±0.4 mmol/L and then decreased at the sixth month (1.7±0.5 mmol/L); this is probably due to an increase in phosphate binders in 9 of 17 patients. An improvement in appetite, sleep and well-being, by patients’ self-assessment, was noted during the treatment. We conclude that the treatment with EPO is associated with improvement of the nutritional status of patients on CAPD.
Hematocrit Influence on Peritoneal Dialysis Effectiveness during Recombinant Human Erythropoietin Treatment in Patients with Chronic Renal Failure
Authors: Ksiazek Andrzej , Baranowska-Daca Elzbieta 
Published: February 2020

Seven intermittent peritoneal dialysis (IPD) patients were investigated before and after correction of anemia with recombinant human erythropoietin (r-HuEPO). When hematocrit exceeded 300/0, the peritoneal equilibration test was performed at 1, 2, 4, 8 hours. Correction of anemia was associated with a mean value Increment In creatinine and phosphate clearance In 1 and 2-hour dwells. Differences In clearance of sodium, potassium, and urea In protein loss and glucose absorption before and after r-HuEPO therapy were not statistically significant. Increased creatinine and phosphate clearance during short dwells can be effected in IPD patients.
Paramedian Insertion of Tenckhoff Catheters with Three Purse-String Sutures Reduces the Risk of Leakage
Authors: Stegmayr Bernd G. 
Published: February 2020

Starting peritoneal dialysis (PD) Immediately after insertion of a peritoneal dialysis catheter is essential in some patients. However, due to a poor insertion technique, leakage may occur in up to 20% of patients after insertion of a peritoneal dialysis catheter, for example, in the midline. PD was started in 50 consecutive patients (age range 7–81 years). Under local anesthesia the Tenckhoff catheter was inserted about 3 cm lateral to the linea alba (mostly to the right) near the navel. The ventral and dorsal fasciae of the rectus muscle were split sagitally before entering the peritoneal membrane by a small incision. One pursestring suture fixed the peritoneal membrane around the Inner cuff, while the second suture fixed the dorsal fascia of the rectus muscle around the outer side of the cuff. A third suture was placed around the catheter in the ventral fascia. Dialysis in all our patients was started peroperatively, Initially by the use of 1 L of peritoneal dialysis fluid (Dlaneal, Baxter Medical AB, Sweden). Bed rest for 2 or 3 days was requested of and performed by most patients. Only one early and no late leakages occurred. At reoperation of the patient with the leak, the second suture was found to have been loosened. The technique is easy to handle and enables immediate dialysis. The risk for leakage Is very low.
Swan Neck Presternal Peritoneal Dialysis Catheter
Authors: Twardowski Zbylut J. , Nichols W. Kirt , Nolph Karl D. , Khanna Ramesh 
Published: February 2020

We hypothesized that a swan neck catheter for peritoneal dialysis with the exit in the presternal area will be less likely to develop an exit-site infection than currently used peritoneal dialysis catheters with the exit located on the abdomen. The chest is a sturdy structure with minimal wall motions; the catheter exit located on the chest wall is subjected to minimal movements decreasing the chances for trauma and contamination. Also, in patients with abdominal ostomies and in children with diapers, a chest exit location will decrease chances of contamination. The presternal peritoneal dialysis catheter is composed of two flexible (silicone rubber) tubes joined through a titanium connector at the time of implantation. Four such catheters were implanted in four patients: two in extremely obese patients, one in a patient with a suprapubic catheter, and one in a patient with a chronic exit infection with a previous catheter. Tensile strength tests showed that the two parts of the catheter practically cannot separate spontaneously in the tunnel. Flow rates were adequate in the supine and sitting positions. All catheters functioned and healed well, and the exits have not become infected during the whole observation period up to 11 months. These preliminary experiences support the rationale of catheter design.
Blood Glucose and Cholesterol Control Improved by Continuous Ambulatory Peritoneal Dialysis in Patients with End-Stage Renal Disease and Diabetes Mellitus
Authors: Wikdahl Ann-Marie , Granbom Lena , Sörensen Jens G. , Stegmayr Bernd G. 
Published: February 2020

This longitudinal study was performed to evaluate the change of total cholestererol, triglycerides, and glucose control in patients with insulin-dependent diabetes mellitus (IDDM) and end-stage renal disease (ESRD) during predialysis (PreD), on continuous ambulatory peritoneal dialysis (CAPD) and after kidney graft. A total of 20 consecutive patients (7 women, 13 men, mean age 42 years) with IDDM and ESRD were studied retrospectively in 1991 during PreD and during CAPD. Twelve were also investigated after obtaining a kidney graft. Insulin was administered Intraperitoneally (CAPD period) and subcutaneously (PreD and transplant). The mean values of weight, serum albumin, glycosylated hemoglobin (HbA1c), total cholesterol, and triglycerldes were calculated during each period. Patients were age and sex-matched with a group of healthy controls (Group 1) and with a group of patients with IDDM without nephropathy (Group 2). T-test statistics were used. During CAPD, there were significant decreases in HbA1c (mean 8.1 mmol/L vs 12.1, p=0.003) and cholesterol (mean 6.1 mmol/L vs 7.1, p=0.025) compared to PreD. No differences were found between PreD and CAPD stages with regard to weight, serum albumin, or triglycerides. After transplantation an improvement was found In serum albumin compared to PreD and CAPD (mean value 40 g/L.vsvs 34 and 35, p<0.03), and HbA1c compared to PreD (9.6 mmol/L vs 12.1, p=0.014), if the pancreas transplanted were included. Patients compared to Group 1 or 2 showed no differences in total cholesterol or triglycerldes. HbA1c was higher in patients during PreD than in Group 2. Peritoneal dialysis may not be a poor alternative for glucose and total cholesterol control in diabetic patients with ESRD. Transplantation further Improves serum albumin.
Variability of Peritoneal Protein Loss in Diabetic and Nondiabetic Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Spaia Sophia , Christidou Fotini , Pangidis Panayotis , Tsoulkas Thomas , Pazarloglou Michalis , Pappa Anna , Vayonas George 
Published: February 2020

In order to evaluate the Influence of diabetes mellitus on peritoneal membrane permeability, we studied the peritoneal protein loss In two groups of patients. Group A consisted of 16 patients (9 nondlabetics and 7 diabetics) who were In the first month of treatment on continuous ambulatory peritoneal dialysis (CAPO). Group B consisted of 13 patients (7 nondlabetics and 6 diabetics) who had been on CAPO for approximately 15 months. In both groups we measured the body weight, serum total protein, albumin, and total protein, urea, and glucose In the peritoneal fluid. We did not find any difference In groups A and B between diabetics and nondlabetics as far as the estimated parameters were concerned. Age, body weight, serum biochemistry, and protein and urea content In peritoneal fluid were similar, when group A was compared to group B. Patients of group B hed on average higher protein losses than those who had been on the method for a short period (mean 7.9 g/dL, vs 6.09 g/dL). Six patients were followed for over 15 months and were found to have significantly Increased protein losses (p=0.02). Glucose levels In peritoneal fluid were significantly lower In patients In group B, p<0.05 (mean 51.8 g/dL vs 37.1 g/dL). Peritoneal protein loss does not seem to differ between diabetic and nondiabetic patients with end-stage renal disease treated with CAPO, at any given time of the treatment. We observed an Increase In protein loss In some patients and a tendency to Increase the protein loss In others. This, along with the fall In glucose levels, might reflect progressive alterations In structure and permeability of the elements Involved In peritoneal transport, and It should receive further evaluation.
Exit. Site Care -is it Time for a Change?
Authors: Hasbargen Barbara J. , Rodgers Darlene J. , Hasbargen James A. , Quinn Margaret J. , James Mary K. 
Published: February 2020

Peritoneal catheter exit -site Infections (ESI's) continue to Impact significantly on morbidity and catheter longevity. The controversy concerning protocols for dally exit site care continues for frequency, methodology, cleansing agent, and dressing. Routine dally exit-site care prior to January 1991 consisted of dally showers using liquid soap, povidone scrub, rinsing the shower, and drying with a 4x4-in. gauze pad. Catheters have always been immobilized, either with tape or an Immobilizing device. Hydrogen peroxide was used only when needed to soften crust formation prior to showering. A lightdressing, usually 2x2 In., was optional. A recent survey revealed that povidone Iodine was the antiseptic of choice for catheter care In 75% of the respondents. However, povidone Iodine Irritates and dries the skin predisposing It to Infection. ESI's are prospectively monitored as part of our quality Improvement (01) program. An Incidence of 0.76 episodes/patient-year was noted between January 1989 and May 1991. Given the relative high frequency of ESI's, the protocol was modified and Introduced during the January-May 1991 time frame. Routine care now consists of dally showers using only CC-500, a gentle antibacterial cleanser (Care Tech Laboratories, Inc.), rinsing In the shower, and drying with a 4x4-in. gauze. Use of hydrogen peroxide and dressings has remained the same. Additionally, a protocol addressing the prophylaxis for traumatized exit sites was Initiated. The Incidence of ESI's has dropped significantly to 0.12 episodes/patient-year. Although our population size Is small (n≅18), this study does point out the utility of prospectively monitoring trends for appropriate Indicators within a 01 program. The problem was Identified and procedures were modified to achieve quality patient outcome.
The Impact of Peritonitis on Peritoneal and Systemic Acid-Base Status of Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Sennesael Jacques J. , De Smedt Godelieve C. , Van der Niepen Patricia , Verbeelen Dierik L. 
Published: February 2020

Objective To assess the possible effects of peritonitis on peritoneal and systemic acid-base status. Design pH, pCO2, lactate, and total leukocyte and differential count were simultaneously determined in the overnight dwell peritoneal dialysis effluent (PDE) and arterial blood in noninfected patients (controls) and on days 1, 3, and 5 from the onset of peritonitis. Setting University multidisciplinary dialysis program. Patients Prospective analysis of 63 peritonitis episodes occurring in 30 adult CAPD patients in a single center. Results In controls, mean (±SD) acid-base parameters were pH 7.41 ±0.05, pCO2 43.5±2.6 mm Hg, lactate 2.5±1.5 mmol/L in the PDE, and pH 7.43±0.04, PaCO2 36.8±3.8 mm Hg, lactate 1.4±0.7 mmol/L in the blood. In sterile (n=6), gram-positive (n=34), and Staphylococcus aureus (n=9) peritonitis PDE pH's on day 1 were, respectively, 7. 29±0.07, 7. 32±0.07, and 7.30±0.08 (p<0.05 vs control). In gram -negative peritonitis (n=14) PDE pH was 7.21 ±0.08 (p<0.05 vs all other groups). A two-to-threefold increase in PDE lactate was observed in all peritonitis groups, but a rise in pCO2 was only seen in gram -negative peritonitis. Acid-base profile of PDE had returned to control values by day 3 in sterile, gram -positive and Staphylococcus aureus peritonitis and by day 5 in gramnegative peritonitis. Despite a slight increase in plasma lactate on the first day of peritonitis, arterial blood pH was not affected by peritonitis. Conclusion PDE pH is decreased in continuous ambulatory peritoneal dialysis (CAPD) peritonitis, even in the absence of bacterial growth. In gram-negative peritonitis, PDE acidosis is more pronounced and prolonged, and pCO2 is markedly increased. Arterial blood pH is not affected by peritonitis.
Prosthetic Mesh Repair of Multiple Recurrent and Large Abdominal Hernias in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Imvrios George , Tsakiris Dimitrios , Gakis Dimitrios , Takoudas Dimitrios , Koukoudis Paraschos , Papadimitriou Menelaos , Antoniadis Antonios A. 
Published: February 2020

Objective The aim of this study was to find out whether prosthetic mesh repair of recurrent and large abdominal hernias in continuous ambulatory peritoneal dialysis (CAPD) patients is effective in maintaining them on CAPD. Design Retrospective analysis of case notes over a period of 5 years. Setting Single renal unit of a university hospital. Patients Forty-six of 217 CAPD patients (16%) had their hernias repaired. Among them, 5 women in whom hemodialysis was not possible had multiple or large hernias repaired with polypropylene (PP) mesh. Results Radical repair was achieved by a modified operation consisting of a conventional hernioplasty complemented by a supporting prosthetic overlay mesh, without discontinuation of CAPD. The patients continued CAPD for a mean period of 17.6 months without hernia recurrence. Two patients died in the twelfth and fifteenth postoperative month due to cardiac arrest and hepatic failure, respectively, and the remaining 3 are alive and have been doing well on CAPD for 13, 14, and 21 months. Conclusions Prosthetic mesh repair of large recurrent hernias in CAPD patients with vascular access problems seems to be a valuable method to maintain them on this renal replacement therapy.
Biocompatibility Studies on Peritoneal Cells
Authors: Topley Nicholas , Goles Gerald A. , Williams John D. 
Published: February 2020

This review outlines the problems involved in assessing the biocompatibility of PD fluids. It has summarized the data available from conventional in vitro studies and highlights many of the inadequacies of this approach. In viva data are lacking both on host defense and on the clinical effect of changing conven tional PD fluids for a more “ideal” formulation. The best parameters for assessing biocompatibility need to be defined. Alternative formulation of fluids must be aimed towards (1) a system that interferes minimally with host defense, and (2) a system that maintains the integrity of the peritoneal membrane for ultrafiltration and clearance. Cell culture studies should be designed to model the in viva situation. Ex viva studies (cells exposed within the peritoneal cavity) should be used to support in viva findings. Finally, in vitra results must be related to clinical significance, and changes in fluid composition should be followed by improvements in clinical outcome.
Adequacy of Fluid/Sodium Balance and Blood Pressure Control
Authors: De Vecchi Amedeo F. 
Published: February 2020

Hypotension and orthostatic hypotension are frequently observed in CAPD patients. In the present paper the possible causes of these complications were reviewed, and the roles of sodium and water were pointed out. In addition, we reported our experience using different sodium concentrations in CAPD dialysis fluid. In 38 CAPD patients sodium concentration in the dialysate was changed from 132 to 137 mEq/L. At first, arterial blood pressure increased in 4 patients (10%), and they were switched to 132 mEq/L sodium. Of the other 34 patients, 3 required larger doses of antihypertensive agents, while 9 reduced the number and/or dose of antihypertensive drugs. Thirst, body weight, residual renal function, 24-hour ultrafiltration, and biochemical examinations did not change using 137 mEq/L sodium concentrations for 6 months. In the 21 patients who did not change their antihypertensive treatment, upright blood pressure tended to increase, but the difference was not statistically significant. In 3 hypotensive patients sodium concentration was increased to 142 mEq/L. Thirst increased in 2 of the 3, one observed a transient increase in 24-hour ultrafiltration, and none showed changes in plasma sodium level. One patient developed reversible hypertension, one became normotensive, and the third had no changes in blood pressure.
Continuous Ambulatory Peritoneal Dialysis and the Heart
Authors: Alpert Martin A. , Hüting Jürgen , Twardowski Zbylut J. , Khanna Ramesh , Nolph Karl D. 
Published: February 2020

Objective To review clinical research pertaining to continuous ambulatory peritoneal dialysis (CAPD) and the heart. Data Sources A Medline computer search was employed to identify appropriate references from 1970 1994. Indexing terms were: continuous ambulatory peritoneal dialysis, hemodialysis, heart or cardiac, left ventricle, coronary artery disease, and survival. English and non-English language abstracts were scrutinized. Study Selection Forty-six studies were reviewed and utilized. Numerical data extracted are reported in this review as they were reported in the original article. Results This review provides a broad-based survey of studies pertaining to CAPD and the heart. Most of the studies relate to CAPD and left ventricular structure or function. Little information exists concerning CAPD and coronary artery disease, valvular disease, pericardial disease, and cardiac arrhythmias. Studies pertaining to patient survival on CAPD identify coronary artery disease and congestive heart failure as major risk factors, but in-depth quantification of these cardiovascular disorders is lacking in the literature. Conclusions CAPD is capable of decreasing left ventricular (LV) volume and improving LV systolic function in patients with L V enlargement and those with L V systolic dysfunction. The effect of CAPD on left ventricular hypertrophy (LVH) and LV diastolic function is variable. CAPD produces symptomatic improvement in patients with refractory congestive heart failure, but its effect on survival in such patients is uncertain. Atherogenic lipid abnormalities occur in CAPD patients. The clinical significance of these abnormalities is uncertain. Coronary artery bypass surgery can be performed safely and effectively on CAPD patients. CAPD is not arrhythmogenic. Survival of CAPD patients is similar to that of hemodialysis patients except in elderly diabetics for whom it is slightly lower.