bluuebunny/crossref_metadata_2025_split huggingface dataset:
Staphylococcus Aureus Peritoneal Catheter-Related Infections: A Cause of Catheter Loss and Peritonitis
Authors: Zimmerman Stephen W. , O'Brien Mark , Wiedenhoeft Frances A. , Johnson Curtis A. 
Published: February 2020

To determine the impact of Staphylococcus aureus catheter-related infections in a peritoneal dialysis program we reviewed all S. aureus catheter-related infections in our program over a six-year period. Twenty -five percent (51/204) of patients at risk developed S. aureus catheter exit-site or tunnel infections. S. aureus accounted for 61% of all positive exit-site cultures; of 320 catheters implemented, 65 were infected with S. aureus. Fifty-one S. aureus-infected patients were retrospectively matched with 51 noninfected patients from our peritoneal dialysis program. Patients with S. aureus catheter-related infections had significantly greater catheter loss from catheter infection and peritonitis. There was significantly more S. aureus peritonitis but less coagulase negative staphylococcus peritonitis in patients with S. aureus catheter-related infections. Significantly more noninfected control patients remained peritonitis free. During this period, 83% of all S. aureus peritonitis was associated with S. aureus catheter infections, and 28 of 57 replacement catheters were reinfected with S. aureus. These findings suggest S. aureus is a major catheter-related pathogen leading to catheter loss and peritonitis. The high recurrence rate suggests that host factors may predispose to S. aureus catheter-related infections.
Effect of Dietary Fish Oil on Lipid Abnormalities in Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Jones Richard G. , Dibble John B. , Gibson Jill , Tompkins Lesley , O'Kane Mary , Hobson Shirley M. , Young Gerald A. , Grant Andrew M. , Turney John H. , Brownjohn Aleck M. 
Published: February 2020

Fifteen patients receiving continuous ambulatory peritoneal dialysis (CAPD) were given 10 mL of a dietary fish oil rich in omega-3 fatty acids (MaxEPA) b.i.d. for eight weeks without other dietary manipulation. Fasting lipids, vitamins A and E, and glucose were measured at 0, 4, and 8 weeks, and again at 4 and 8 weeks after the cessation of treatment. Basal serum triglyceride concentrations were raised, and fell by 29% (p < 0.005) with treatment, returning to baseline values over the washout period. The fall in triglyceride during treatment correlated with the initial value (As = 0.57; p < 0.05). Total, HDL and LDL cholesterol, apolipoprotein A, vitamin A, glucose, lean body mass, and dietary fat/CHO intake were unchanged throughout. Apolipoprotein B concentrations tended to rise during the first half of treatment but fell thereafter. Vitamin E concentrations rose significantly during supplementation and fell after withdrawal (p < 0.001 for both). Supplementation with dietary fish oil significantly reduced hypertriglyceridemia. Its long-term use might be accompanied by beneficial effects on the excess cardiovascular morbidity seen in patients on CAPD.
Trimethoprim-Sulfamethoxazole Pharmacokinetics during Continuous Ambulatory Peritoneal Dialysis (CAPD)
Authors: Walker S.E. , Paton T.W. , Churchill D.N. , Ojo B. , Manuel M.A. , Wright N. 
Published: February 2020

Ten adult patients on continuous ambulatory peritoneal dialysis (CAPO) received one dose of trimethoprim320 mg (TMP) and sulfamethoxazole 1600 mg (SMX) orally (p.o.), intravenously (i.v.), and intraperitoneally (i.p.) on three separate occasions to characterize the pharmacokinetics of both drugs. Concentrations of both TMP and SMX were measured in serum and dialysate by HPLC to 48 h. Half-life, total body clearance (TBC), and peritoneal clearance (PCI) were determined. The mean half-life of TMP was 28 h, while for SMX it was 12.5 h. Relative to the i.v. dose, the bioavailability following oral administration for TMP was 98% and 87% for SMX. Intraperitoneal bioavailability was 73% for TMP and 65% for SMX after a 4-h dwell. After 24 h, regardless of the route of administration, less than 3% of TMP and less than 6% of SMX appeared in dialysate. We conclude that peritoneal losses contribute insignificantly to TMPISMX elimination during CAPO.
Comparison of Patient and Technique Survival in Continuous Ambulatory Peritoneal Dialysis (Capd) and Hemodialysis: A Multicenter Study
Authors: Serkes Kenneth D. , Blagg Christopher R. , Nolph Karl D. , Vonesh Edward F. , Shapiro Fred 
Published: February 2020

Patient and technique survival were compared in adult patients new to continuous ambulatory peritoneal dialysis (CAPD) or (primarily) center hemodialysis (HD) in the time period 1981 to 1983, and followed-up in March 1985. Risk factors were identified at entrance into the study, and results were analyzed using Cox's proportional hazards model. For nondiabetic patients, the difference in survival which favored CAPD (relative risk = 0.62) was not significant at the 5% level (p = 0.08). Age was a significant risk factor in both groups. The average number of hospital visits was the same; however, CAPD showed a small but significant increase in average annual hospital days per year (10.14 vs. 9.18). For diabetic patients, there was no significant difference in survival between CAPD and HD. The CAPD group showed a significant increase in hospital visits (relative risk 1.81 vs. 1.40) and average hospital days per year (19.43 vs. 13.41). Both CAPD groups showed significantly higher treatment changeover rates.
Amino-Acid-Based Continuous Ambulatory Peritoneal Dialysis (CAPD) Fluid over Twelve Weeks: Effects on Carbohydrate and Lipid Metabolism
Authors: Dibble John B. , Young Gerald A. , Hobson Shirley M. , Brownjohn Aleck M. 
Published: February 2020

Aspects of lipid and carbohydrate metabolism were studied in 8 patients established on continuous ambulatory peritoneal dialysis (CAPD) with plasma albumin < 35 g/L, before, during, and after substitution of 1 of the daily glucose exchanges by a commercial 1 % amino acid dialysis fluid for 12 weeks. The amount of glucose absorbed from the dialysis fluid was consequently reduced by about 25%, hence total energy intake decreased by about 100 Kcallday, but peritoneal glucose transfer kinetics were unaffected. Glucose was lost into amino acid dialysate as expected (2 g/day). Excluding 1 patient with a large rise in calorie intake, total and LDL cholesterol fell at 8 and 12 weeks (LDL cholesterol week 0, 5.26 ± 1.13; week 8, 4.32 ± 0.74; week 12,4.30 ± 1.22; mean ± SD, p < 0.01 for both), but returned to baseline 2 weeks after the restoration of glucose fluid (LDL 4.91 ± 1.22, p < 0.05 vs. week 12). Apolipoprotein B concentration also fell at 12 weeks (p < 0.01). No changes were seen in body weight, body fat, arm muscle circumference, fasting plasma glucose, insulin, growth hormone, triglyceride, non esterified fatty acids, or HDL cholesterol. The response of these biochemical indices to single 8-h glucose and amino acid morning exchanges at 0 and 12 weeks were studied. After 12 week's use of amino acid dialysis fluid, plasma cholesterol and apolipoprotein B were significantly lower throughout the exchange. The decrease in cholesterol and apolipoprotein B during the substitution of 1% amino acid dialysis fluid may be associated not only with the reduction in glucose intake, but also with a gradual change in lipid metabolism. The routine use of such solutions may lower cardiovascular morbidity and mortality in CAPD but further evaluation is indicated.
Six-Month Overnight Intraperitoneal Amino-Acid Infusion in Continuous Ambulatory Peritoneal Dialysis (CAPO) Patients-No Effect on Nutritional Status
Authors: Dombros Nicholas V. , Prutis Krystyne , Tong Mathew , Anderson G. Harvey , Harrison Joan , Sombolos Kostas , Digenis George , Tit Jean Pet , Oreopoulos Dimitrios G. 
Published: February 2020

The long-term effect of an AA solution based on Tra-vasol®, a solution for total parenteral nutrition, given in-traperitoneally over a 6-month period was studied in 5 patients 22 to 75 years old, having been on continuous ambulatory peritoneal dialysis (CAPD) for 3 to 57 months. A low oral protein intake (<0.8 g/kg bw /day) and/or a low serum albumin «35 g/L) were used as inclusion criteria. Two liters of 1% AA solution were infused overnight, while a glucose Dianeal® was used for the other exchanges. During the study, BUN increased from 22.04 mM/L to 28.06 mM/L the first month and remained at these levels, indicating the increased protein intake. However, average oral total energy and protein intake, body weight (bw), serum creatinine, cholesterol, triglycerides, total proteins, albumin, transferrin, skinfold thickness, total body potassium, and plasma AA levels remained basically unchanged. The average total body nitrogen decreased from 1.746 to 1.554 Kg, but this decrease did not reach statistical significance (p > 0.05). We conclude that intraperitoneal overnight administration of 2 L of 1% AA based on Travasol® over 6 months did not improve the nutritional status of CAPD patients. This ineffectiveness might be due to the AA composition of the solution, the timing of administration, or to a low caloric intake and/or that our patients were not severely malnourished.
The Need for Using An Enzymatic Colorimetric Assay in Creatinine Determination of Peritoneal Dialysis Solutions
Authors: Larpent Liliane , Verger Christian 
Published: February 2020

The fate of the peritoneal membrane on continuous ambulatory peritoneal dialysis (CAPD) is usually evaluated through the modification of its permeability to various solutes as glucose, creatinine, and urea. Therefore, the accuracy of the methods used for measurements of creatinine is of great importance. A particular problem does exist for creatinine determination as it may be influenced by the presence of glucose. We studied a new enzymatic colorimetric method for creatinine determination in peritoneal dialysis solutions which contain high dextrose concentrations. Creatinine was measured in plasma, urine, and dialysate from 18 patients on CAPD and in pure dextrose solutions, with an enzymatic test (Boehringer Mannheim) and with Jaffe's reaction on two different analyzers: Astra (Beckman) and Eris (Merck). Creatinine results were similar with both assays (Jaffe's reaction and enzymatic test) when measured in blood and urine. However the Jaffe's reaction gave higher creatinine results than the enzymatic test (p < 0.001), when assays were performed in peritoneal dialysis solutions and in pure glucose solutions. In addition, it appeared that other components of dialysis solutions, mainly calcium chloride, influenced unpredictably the results of creatinine with the Jaffe's reaction. We conclude that specific enzymatic test is a more accurate and reliable method to evaluate creatinine kinetics through the peritoneal membrane when determined in CAPD solutions.
Newer Quinolones in the Treatment of Continuous Ambulatory Peritoneal Dialysis (CAPD) Related Infections
Authors: Nikolaidis Paul 
Published: February 2020

Newer fluoroquinolones such as ciprofloxacin, pefloxacin, ofloxacin, enoxacin, and fleroxacin are potent antimicrobial agents against many gram-negative bacteria, including Pseudomonas aeruginosa species and staphylococci-sensitive or resistant to methicillin. They are almost completely absorbed when given orally, reaching therapeutic plasma and dialysate concentrations, and their long half lives permit infrequent dosing intervals. Clinical studies on fluoroquinolones efficacy in continuous ambulatory peritoneal dialysis (CAPD) infections, although not extensive, demonstrate good results. They are well tolerated and the adverse reactions, consisting mainly of gastrointestinal disturbance, were uncommon, mild, and reversible. The fluoroquinolones offer a promising alternative to standard parenteral treatments in CAPD patients, while their good oral bioavailability makes them attractive and convenient for both patients and hospital staff. However, they must be used with caution until we have more information and gain further experience.
Continuous Ambulatory Peritoneal Dialysis (CAPD) of Children with Amino Acid Solutions: Technical and Metabolic Aspects
Authors: Canepa Alberto , Perfumo Francesco , Carrea Alba , Piccardo Maria Teresa , Ciardi Maria Rosa , Cantaluppi Alberto , Gusmano Rosanna 
Published: February 2020

The changes in plasma and dialysate amino acids (AA) in 7 continuous ambulatory peritoneal dialysis (CAPD) children after dialysis with a 1% AA solution were compared with a glucose-containing solution. During the AA exchange, the plasma levels of individual AA reached their peaks after 1 h, with their percentage increments significantly correlated (p < 0.001) with the ratio of the amount of AA in the bag to the basal plasma concentration. The plasma concentration of methionine, valine, phenylalanine, and isoleucine remained higher than the basal value at 4 h. The amount of AA absorbed was 66% after 1 h, and 86% after 4 h and 6 h, corresponding to 2574 ± 253 μmollkg body wt. During glucose-dialysis (1.36%), levels of histidine, methionine, valine, phenilal-anine, and isoleucine were significantly decreased in plasma after 1 h, and stayed low throughout the dialysis period. The loss of AA with the peritoneal effluent was 116 ± 69 μmol/kg/body wt. From this study, it seems that using an AA dialysis solution, with 1 exchange per day, might limit the daily glucose load and compensate for AA losses by supplying an extra amount of AA and by reducing the loss of other AA not contained in dialysis solutions. The AA pattern in plasma following AA-dialysis resembles that observed after a protein meal, with no signs of persistently high, nonphysiological levels.
The Curled Catheter: Dependable Device for Percutaneous Peritoneal Access
Authors: Swartz Richard , Messana Joseph , Rocher Leslie , Reynolds Janice , Starmann Barbara , Lees Patricia 
Published: February 2020

The curled peritoneal dialysis catheter is theoretically less prone to catheter migration and drainage failure. It also allows percutaneous placement, rather than surgical placement exclusively, whenever desired or necessary. Review of 213 curled-catheter placements, 134 (63%) percutaneous and 79 (37%) surgical, over the last 4 years, shows that the probability of continuing catheter function by life-table analysis was 88% at one year, 71% at 2 years, and 61% at three years, with no difference comparing percutaneous to surgical placement. Among the 213 total cases, nearly 50% of all catheters were still functioning at last follow up, and 38 catheters (17.8%) have been lost in total, attributed to infectious complications in 24 cases (tunnel-exit infection alone in 5, peritonitis alone in 11, combined infection in 8), refractory drain failure in 9 cases (early drain failure in 4, late drain failure in 5), recurrent late subcutaneous dialysate leaking in 3 cases, and peri-catheter hernia in 2 cases. Among other complications, the incidence of early drain failure (7.0%), and late drain failure (4.2%), compare favorably to reports describing other devices or other placement methods having comparable size of reported experience. Analyzing our own percutaneous and surgical placements separately, there were no differences in the respective frequencies of early drain failure, late drain failure, late subcutaneous dialysate leaking, outer cuff extrusion, required hernia repair, peritonitis or tunnel-exit infection. Only early external dialysate leaking was more frequent using percutaneous placement methods (21.6% vs. 10.1%; p < 0.05), although no catheters were lost due to early external leaking. In conclusion, the present experience suggests that the curled catheter is both amenable to safe and convenient percutaneous placement methods in the majority of cases, as well as dependable for long-term peritoneal dialysis in a large university program.
Multiple-Dose-Kinetics of Ofloxacin after Intraperitoneal Application in CAPD Patients
Authors: Kampf Dieter , Borner Klaus , Hain Hannelore , Conrad Wolfgang 
Published: February 2020

Pharmacokinetics of ofloxacin in plasma and peritoneal fluid were studied in 11 patients on continuous ambulatory peritoneal dialysis (CAPD). Seven patients without peritonitis received 20 mg ofloxacin added to 2L dialysate i.p. every 6 h for one day only, while 4 patients with acute peritonitis were treated with this same dosage every 4 h for 3 days, then every 6 h for the next 7 days. Ofloxacin concentrations in plasma and dialysate were determined by HPLC. After i.p. drug application there was a rapid elimination of ofloxacin from dialysate, this being significantly faster in patients with peritonitis as compared to those without. Likewise, the total amount lost from the first bag after a 3 h dwell was higher in the peritonitis group (84.7±1.5%; mean±SEM) than in the non-peritonitis group (75.6±2.1 %). Twenty-four h after start of ofloxacin treatment, the mean peritoneal fluid concentrations at the end of each exchange studied were all above 3 mg/L. In patients with peritonitis, plasma concentrations of ofloxacin rose to 0.94±0.05 mg/L after 24 h reaching a Cmax of 1.8±0.2 mg/L after a tmax of 84±23 h.lntraperitoneal administration of ofloxacin was well tolerated, and no local or systemic adverse events were observed. Peritonitis episodes that were caused by Staphylococcus epidermidis (3) and by E. coli (1) were cured in all patients.
Pathogenesis of Peritoneal Fibrosing Syndromes (Sclerosing Peritonitis) in Peritoneal Dialysis
Authors: Dobbie James w. 
Published: February 2020

Drawing from diverse sources including epidemiological and clinical data, surgical observations, histopathology, serosal healing responses to fibrin and fibrinolysis, tissue reaction to chronic exposure, and to exo and endotoxins, new information on mesothelial stem cells, autocrine and paracrine influences on their proliferation and collagen synthesis, and the effect of glucose on fibroconnective tissue, we have begun to piece together the pathogenetic jigsaw of fibrosis in continuous ambulatory peritoneal dialysis (CAPD). The reaction of peritoneal mesothelium and stroma to the stress of continual dialysis results in a spectrum of alterations ranging from opacification through a tanned peritoneum syndrome to sclerosing encapsulating peritonitis (SEP). Any agent that causes irritation of the mesothelial layer and induces serositis, or single severe or multiple episodes of peritonitis resulting in mesothelial loss, predisposes the peritoneum to fibroneogenesis. An accurate definition of the histopathological changes of peritoneal thickening is a prerequisite for defining pathogenesis. This paper is the first attempt to create such a framework. It is evident from many areas of study that fibrin deposition and fibrinolysis, hyalinization of the superficial stromal collagen possibly tanned through nonenzymatic glycosylation by dialysate glucose and the proliferative potential of mesothelial stem cells play an important and possibly interdependent role in excessive fibroneogenesis in certain patients on CAPD. Many of the pieces of the jigsaw are obviously still missing, and the picture is most surely incomplete. Nevertheless, the outline of the pathologic and etiologic landscape should now be discernible.
The Effect of Recombinant Erythropoietin on the Early Hematocrit Rise after Capd Initiation
Authors: Golper Thomas A. 
Published: February 2020

Objective To determine if the simultaneous initiation of continuous ambulatory peritoneal dialysis (CAPD) and Erythropoietin therapy masks the hematocrit (Hct) rise that frequently follows the initiation of CAPD alone. Design Single-center retrospective analysis. Setting University multidisciplinary dialysis program. Patients All adult CAPD patients with a Hct ≤28% whose nephrologist felt they would benefit from Erythropoietin therapy and who did not have technical reasons for exclusion (N=25). Interventions Eight patients began CAPD and Erythropoietin alfa subcutaneously, at a dose of 128:1:9 (X:1:SEM) units/kg/week at the same time. Seventeen patients already on CAPD for 8.7:1:1.5 months received Erythropoietin alfa subcutaneously at a dose of 124:1:7 units/kg/ week. Pre-epoetin Hct's were similar. Main outcome measures Hematocrit changes, status of iron stores, incidence of peritonitis, and dosage of Erythropoietin. Results In 1 month, the group initiating both therapies simultaneously demonstrated a mean Hct rise of 7.6:1:0.5% while established CAPD patients receiving Erythropoietin increased their Hct by only 4.7:1:1.0% (p<.03). Iron status could not explain this difference. Peritonitis did not appear to dampen the Hct rise following Erythropoietin in either CAPD group. By 2 months after Erythropoietin, the differences were less apparent. Conclusion The early rapid increase in Hct is probably the combined effect of CAPD and Erythropoietin and should not be attributed to Erythropoietin alone. When comparing responses to Erythropoietin from patients on different therapies, the timing of dialysis initiation and Erythropoietin initiation must be considered.
Red Blood Cell Susceptibility to Lipid Peroxidation, Membrane Lipid Composition, and Antioxidant Enzymes in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Girelli Domenico , Lupo Antonio , Trevisan Maria Teresa , Olivieri Oliviero , Bernich Patrizia , Zorzan Paola , Bassi Antonella , Stanzial Anna Maria , Ferrari Silvana , Corrocher Roberto 
Published: February 2020

Objective To investigate the overall susceptibility of red blood cells (RBC) to lipid peroxidation from patients on continuous ambulatory peritoneal dialysis (CAPD). Methods The following parameters were measured: RBC malondialdehyde (MDA) production after oxidative stress with H2O2, RBC antioxidant enzymes glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD), and RBC membrane lipid composition. The levels of plasma vitamin E and serum selenium were also as sayed. Patients Eleven patients on continuous ambulatory peritoneal dialysis. Twenty-one healthy blood donors of similar age were used as normal controls. Results The MDA formation after H2O2 stimulation was normal in CAPD patients (0.79±0.1 μmol/gHb versus 0.78±0.1 in the control group). RBC from CAPD patients also showed a normal SOD activity, a more than adequate vitamin E status, and a peculiar pattern of membrane lipids, with reduced polyunsaturated fatty acids (p<0.001) and increased monounsaturated fatty acids (p<0.001). Both RBC GSH-Px activity, a selenium-dependent enzyme, and serum selenium levels were significantly lower in CAPD patients, and a significant positive correlation (r=0.68; p<0.02) between the two parameters was found. Conclusions This study found a normal sensitivity to oxidant stress in RBC from a group of CAPD patients, despite an impaired GSH-Px activity. The peculiar lipid pattern of RBC membrane, characterized by reduced PUFA and increased MUFA content, may contribute, in addition to adequate SOD activity and vitamin E status, to normal RBC lipid peroxidation.