bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreased Formation of Advanced Glycation End-Products in Peritoneal Fluid by Carnosine and Related Peptides
Authors: Alhamdani Mohamed-Saiel Saeed , Al-Azzawie Hasan Fayadh , Abbas Fawzi K.H. 
Published: February 2020

Background Formation of advanced glycation end-products (AGEs) is a major problem in uremic patients treated with peritoneal dialysis (PD). Application of additives with known anti-glycosylation properties to PD fluid may be beneficial in minimizing the formation of AGEs. This study aimed to evaluate the effect of carnosine and its related peptides homocarnosine and anserine against the formation of AGEs in PD fluid. Methods PD solutions (1.5% dextrose) were incubated with human serum albumin (HSA) or collagen (type IV) with or without 10 mmol/L of each of carnosine, anserine, homo-carnosine, histidine, and aminoguanidine. The formation of AGEs was followed by fluorescence spectrophotometry at weekly intervals for 7 weeks. For the determination of the acute effect of carnosine and related compounds, HSA and collagen were incubated with 4.25% dextrose PD solutions for 24 hours, followed by incubation with 20 mmol/L of carnosine and related compounds for another 24 hours. The rate of AGE formation was monitored by fluorescence spectrophotometry. Results Carnosine and related compounds showed effective regression in AGE formation in both types of proteins in both long- and short-term exposure to PD fluids at a rate of effectiveness of the order of carnosine > homocarnosine > anserine, aminoguanidine > histidine in long-term exposure, and homocarnosine > carnosine > aminoguanidine > anserine > histidine in short-term exposure. Conclusion Carnosine and related peptides could suppress the formation of AGEs initiated by PD fluid. This observation may provide a new therapeutic approach for the prevention and treatment of the AGE-related complications in PD patients.
Nonocclusive Mesenteric Ischemia: A Lethal Complication in Peritoneal Dialysis Patients
Authors: Archodovassilis Fotios , Lagoudiannakis Emmanuel E. , Tsekouras Dimitrios Konstantinos , Vlachos Konstantinos , Albanopoulos Konstantinos , Fillis Konstantinos , Manouras Andreas , Bramis John 
Published: February 2020

Nonocclusive mesenteric ischemia (NOMI) is a relatively uncommon disorder, seen primarily in elderly patients with cardiac disease, and is characterized by progressive intestinal ischemia leading to infarction, sepsis, and death. It is suspected of being the underlying cause in at least 20% – 30% of acute mesenteric ischemia patients. End-stage renal disease patients are among the highest risk populations for developing this lethal complication; however, NOMI is not unique to hemodialysis and can occur in peritoneal dialysis patients as well. Unfortunately, the presentation of NOMI is very similar to that of peritonitis. The key to correct diagnosis is a high index of suspicion in predisposed patients. The high mortality rate is a clear reflection of failure to recognize the syndrome at an earlier, treatable stage. We present our case experience and an extensive review of the literature regarding this dreadful complication that may be reversible if considered early as a possible etiology and the appropriate diagnostic maneuvers undertaken.
Anti-Inflammatory Effects of 3-Hydroxy-3-Methylglutaryl Coenzyme a Reductase Inhibitors (Statins) in Peritoneal Dialysis Patients
Authors: Kumar Sanjeev , Raftery Martin , Yaqoob Magdi , Fan Stanley L.-S. 
Published: February 2020

Objective Elevated C-reactive protein (CRP) level is an independent predictor of all-cause and cardiovascular mortality in peritoneal dialysis (PD) patients. Statins have been demonstrated to have anti-inflammatory properties by virtue of their CRP lowering effects in hemodialysis patients. However, whether statins have an anti-inflammatory effect in PD patients is unknown. Design All prevalent PD patients at our center were reviewed. Eligible (257) patients were categorized into 2 groups: those on statin therapy ( n = 137) and those not on statins ( n = 120). Data were abstracted for hemoglobin, albumin, phosphates, cholesterol, CRP, Kt/V, and erythropoietin dose, along with relevant clinical data. Results The two groups had similar concentrations of hemoglobin, albumin, and phosphates. They were also matched for dialysis adequacy and duration of dialysis but the statin group patients were older (57 ± 13 vs 52 ± 17 years, p = 0.01). Serum cholesterol was lower in the statin group (4.74 ± 1.05 vs 5.02 ± 1.17 mmol/L, p < 0.05). Single-point (14 ± 13 vs 19 ± 18 mg/L, p < 0.02) and serially measured CRP (9 ± 7.4 vs 12 ± 10 mg/L, p < 0.02) levels were significantly lower in the statin group despite increased comorbidity (0.84 vs 0.54, p < 0.02) and greater incidence of diabetes mellitus (52% vs 25%, p < 0.01). Conclusion Statin therapy is associated with low single-point and serially measured CRP levels in PD patients, thereby suggesting that their anti-inflammatory properties persist in PD. These data have implications for considering statin therapy in PD patients as an anti-inflammatory agent in addition to a cholesterol lowering drug.
Carbonyl Stress Reduction in Peritoneal Dialysis Fluid: Development of a Novel High-Affinity Adsorption Bead
Authors: Yamamoto Makoto , Izuhara Yuko , Kakuta Takatoshi , Takizawa Shunya , Fujita Akio , Higaki Tatsuhiko , van Ypersele de Strihou Charles , Miyata Toshio 
Published: February 2020

Objective Heat sterilization of glucose peritoneal dialysis (PD) fluid generates reactive carbonyl compounds (RCOs), which have been implicated in the formation of advanced glycation end products (AGEs) on peritoneal proteins, with an attendant deterioration of peritoneal permeability in PD patients. To reduce their levels in PD fluid, we had previously devised beads coupled with RCO-trapping agents. The hazards linked to the diffusion of RCO-trapping compounds in the systemic circulation are avoided. Hydrazine-epoxy beads proved the most effective. Still, the amount needed to trap all RCOs remained relatively large. Methods We developed a novel agent linking a powerful RCO-trapping AGE inhibitor, pyrazolinone-polyethyleneimine, with cellulose beads (PPCBs). We tested its effectiveness to lower RCOs and AGE formation. Results Mixed with glucose PD fluid, PPCBs markedly lowered RCOs (α–dicarbonyls and aldehydes) and inhibited the generation of pentosidine, an AGE, to levels similar to those of filter-sterilized PD fluid. Their effectiveness is more than one order of magnitude above those of previously developed beads. The PPCBs markedly improved PD fluid biocompatibility. Incubation of 1 L commercial glucose PD fluid at 25°C for 24 hours with 10 or 30 g of wet PPCBs reduced RCO content by 75% – 90% and 100% respectively, without altering the pH or glucose and electrolyte contents of the PD fluid. Conclusions We developed a high-affinity adsorption bead to reduce the toxic RCO content and AGE formation potential (carbonyl stress) of PD fluid.
Peritonitis in Latin America
Authors: Barretti Pasqual , Bastos Kleyton A. , Dominguez Jorge , Caramori Jacqueline C.T. 
Published: February 2020

Peritoneal dialysis has a high acceptance rate in Latin America, thus the knowledge concerning complication patterns is of great relevance. This work reviews Latin American data on peritonitis, the most serious complication of peritoneal dialysis. The incidence of peritonitis has been reduced over time, concomitantly with the incorporation of safer exchange systems and the use of prophylactic measurements. Today, rates lower than 1 episode per 24 patient-months are commonly reported. Furthermore, changes in causative organisms have been observed, with predominance of Staphylococcus aureus up through the mid-1990s, as well as increases in coagulase-negative staphylococcus and participation of gram negatives. However, the prevalence of S. aureus is still high, due possibly to climatic conditions and the elevated prevalence of carriers. Resolution rate varies from 55% to 78%, transfer to hemodialysis from 10.9% to 15.4%, and death in 3% to 9.9% of cases. Outcome is worse in S. aureus episodes compared to those with coagulase-negative staphylococcus, despite the higher percentage of oxacillin-resistant strains among the former. In general, despite socioeconomic or climatic conditions, our results are similar to those in developed countries, perhaps as a consequence of technological improvements and/or center expertise.
The Progression and Impact of Vascular Calcification in Peritoneal Dialysis Patients
Authors: Ammirati Adriano Luiz , Dalboni Maria Aparecida , Cendoroglo Miguel , Draibe Sérgio Antonio , Santos Raul D. , Miname Márcio , Canziani Maria Eugênia F. 
Published: February 2020

Background Progression of coronary artery calcification (CAC) has been described in hemodialysis patients, and severe CAC has been associated with the occurrence of cardiovascular events in this population. Little information is available regarding peritoneal patients. Aim To prospectively evaluate peritoneal dialysis patients in order to identify the variables associated with the rate of CAC progression, as well as to determine the impact that baseline CAC has on clinical outcomes over a 1-year follow-up period. Methods Using multislice coronary tomography, calcium scores were estimated at baseline and after 12 months in 49 peritoneal dialysis patients. Patients with and without CAC progression were compared with respect to clinical characteristics and biochemical variables, including lipid profile, parameters of mineral metabolism, and markers of inflammation. Cardiovascular events, hospitalizations, and all-cause mortality were recorded. Results At baseline, 29 patients (59%) presented CAC and a median calcium score of 234.7 (range 10.3 – 2351) Agatston units. Progression of CAC was observed in 13 patients (43%) who, in comparison with those presenting no CAC progression, were older, presented higher baseline calcium scores, and had higher mean glucose levels, lower mean high density lipoprotein cholesterol levels, and more months using low calcium peritoneal solution. We also observed a trend toward more often presenting with a history of hypertension, exhibiting more hyperphosphatemic and hyperglycemic events, and having lower albumin levels. In multiple logistic regression, only baseline calcium score was independently associated with progression of CAC. A shorter cardiovascular event-free time and a trend toward lower survival rates were observed in the group with CAC. Hospitalization event-free time did not differ between the groups. Conclusion Determining CAC provides important prognostic data in peritoneal dialysis patients. Baseline calcium score and disturbances in glucose, mineral, and lipid metabolism were indicative of higher risk of CAC progression in this population.
Peritoneal Transport in Peritoneal Dialysis Patients Using Glucose-Based and Amino Acid-Based Solutions
Authors: Olszowska Anna , Waniewski Jacek , Werynski Andrzej , Anderstam Björn , Lindholm Bengt , Wankowicz Zofia 
Published: February 2020

Objective To evaluate peritoneal transport of fluid and solutes in continuous ambulatory peritoneal dialysis (CAPD) patients using amino acid (AA)-based versus glucose-based dialysis solutions. Methods Using iodine-labeled human serum albumin (125I-HSA) as intraperitoneal volume marker, peritoneal transport was investigated in a group of 20 clinically stable patients (11 females and 9 men, age 53 ± 15 years) on CAPD for 15 – 101 months. Two paired 4-hour dwells, one with 1.36% glucose and one with 1.1% AA dialysis solution, were performed in each patient. Intraperitoneal dialysate volume, fluid absorption rate, and diffusive mass transport coefficients (KBD) and sieving coefficients (S) for glucose, creatinine, urea, potassium, and total protein were estimated for each dwell study. Dwell studies with AA solution were used to estimate KBD values for individual AAs. Results Intraperitoneal dialysate volume was higher for AA solution in comparison with glucose solution due to the higher osmolality of the AA solution. No statistically significant difference was found for KBD or S for creatinine, urea, potassium, or total protein in the dwell studies with either solution, whereas KBD for glucose was higher with AA than with glucose solution. Mean values of KBD of AA were similar but with high standard deviation, reflecting inter-individual variations in peritoneal transport rate. Conclusion Our results indicate that the AA peritoneal transport rate is strongly dependent on transport characteristics of the individual peritoneal membrane.
Effects of Peritoneal Resting on Peritoneal Fluid Transport Kinetics
Authors: Zhe Xing-wei , Tian Xin-kui , Cheng Lei , Wang Tao 
Published: February 2020

Background Peritoneal resting has been used to restore peritoneal ultrafiltration capacity in peritoneal dialysis patients. Therefore, in the present study, we made a detailed investigation on the effects of peritoneal resting on peritoneal fluid transport characteristics in patients on continuous ambulatory peritoneal dialysis (CAPD). Methods A temporary transfer to daytime ambulatory peritoneal dialysis with a nocturnal “empty belly” was applied to let the peritoneal membrane rest overnight in patients with poor ultrafiltration capacity. All included patients were asked to record appropriately their dialysis exchanges for the assessment of peritoneal fluid transport characteristics, which were evaluated before and after peritoneal resting. Results Seven CAPD patients were included in the present study. There was a significant improvement in peritoneal ultrafiltration capacity as assessed by ultrafiltration volume per gram of glucose load. Patients’ daily glucose exposure and dialysate-to-plasma ratio of creatinine were significantly decreased after peritoneal resting. The peritoneal fluid absorption rate was also significantly decreased after peritoneal resting: 1.011 ± 0.4484 versus 0.625 ± 0.3833 mL/minute. Conclusion The present study suggests that peritoneal resting can improve CAPD patients’ ultrafiltration capacity and decrease the use of hypertonic dialysis solution. The improved ultrafiltration capacity by peritoneal resting was due to decreased membrane solute transport rate and decreased peritoneal fluid absorption rate.
Effects of SMAD7 Overexpression on Peritoneal Inflammation in a Rat Peritoneal Dialysis Model
Authors: Nie Jing , Hao Wenke , Dou Xianrui , Wang Xin , Luo Ning , Lan Hui Y. , Yu Xueqing 
Published: February 2020

Objective Transforming growth factor-beta (TGF-β) has been shown to play a role in peritoneal complications due to long-term peritoneal dialysis (PD). In this study, we examined the effects of the TGF-β signaling pathway on peritoneal inflammation associated with PD in rats by over-expressing Smad7, an inhibitor of TGF-β/Smad signaling. Methods Peritoneal inflammation was induced in male Sprague-Dawley rats by intraperitoneal injections of 4.25% glucose dialysate (100 mg/kg body weight) daily for 4 weeks, with the addition of lipopolysaccharides (0.6 mg/kg body weight) on days 8, 10, 12, 22, 24, and 26. Peritoneal Smad7 gene transfer was achieved using an ultrasound microbubble mediated, doxycycline regulated, Smad7-expressing plasmid on day 0 and day 14 after initiation of PD. An empty vector was used as control. All rats were sacrificed after 4 weeks of PD. Peritoneal inflammatory response, including infiltration of total leukocytes (OX-1 positive) and macrophages (ED-1 positive) and expression of interleukin (IL)-1β) and tumor necrosis factor-alpha (TNF-α), was examined by immunofluorescence and RT-PCR. Results After PD, peritoneal inflammation developed in control animals, as demonstrated by an increase in the number of OX-1-positive and ED-1-positive cells and upregulation of IL-1β and TNF-α mRNA and protein expression. In contrast, in animals treated with Smad7 gene transfer, IL-1β and TNF-α expression and OX-1-positive and ED-1-positive cell infiltration were significantly inhibited. Furthermore, prevention of peritoneal inflammation by overexpression of Smad7 was associated with inhibition of phosphorylation of Smad2/3, a downstream of the TGF-β signaling pathway, as well as TGF-β1 expression. Conclusion Overexpression of Smad7 suppresses peritoneal inflammation induced by high glucose and lipopolysaccharides. The ability of Smad7 gene transfer to inhibit peritoneal inflammation indicates that targeting TGF-β/Smad signaling may represent a new therapeutic strategy for the treatment of peritoneal complications associated with PD.
The Expression Patterns of Peritoneal Defensins
Authors: Grupp Alexander , Kimmel Martin , Fritz Peter , Voggenreiter Bernd , Stöltzing Hartmut , Kuhlmann Ulrich , Stange Eduard F. , Mettang Thomas , Fellermann Klaus , Alscher Dominik M. 
Published: February 2020

Background Local defense mechanisms are important for the integrity of the peritoneum, but few details are known about the expression patterns of antimicrobial proteins such as human defensin in normal and damaged peritoneum. Methods Part A: The expression of different defensins in normal ( n = 12), inflamed ( n = 5), and metastatic peritoneum ( n = 4) and in cultured human peritoneal mesothelial cells was analyzed using mRNA and immunohistochemistry. Part B: Using immunohistochemistry the expression of different defensins was analyzed in different subgroups: healthy controls ( n = 25), patients with chronic appendicitis ( n = 25) or acute appendicitis ( n = 10), and end-stage renal disease patients ( n = 25, with 15 on peritoneal dialysis). Results Part A: Human neutrophil peptides (HNP) 1 and 3 and human β-defensins (HBD) 1 to 3 mRNA were detected in peritoneal specimens. In addition, HNP1,3, HBD1, HBD2, and HBD3 proteins were detected using immunohistochemistry. Part B: HBD1 showed a constitutive expression in mesothelium, while HBD2 and HNP1,3 were associated with inflammation. Decreased expressions of HNP1,3 were observed in end-stage renal disease patients and in patients on peritoneal dialysis. Conclusions For the first time, the expression patterns of defensins in normal and damaged peritoneum have been described. The reduced expression of some defensins in end-stage renal disease is of potential clinical interest against the background of the frequent infective complications seen in peritoneal dialysis.
The Use of Nocturnal Home Hemodialysis as Salvage Therapy for Patients Experiencing Peritoneal Dialysis Failure
Authors: Wong Joseph H.S. , Pierratos Andreas , Oreopoulos Dimitrios G. , Mohammad Reem , Benjamin–Wong Fatima , Chan Christopher T. 
Published: February 2020

Background Failure of peritoneal dialysis (PD) results in poor quality of life and worsening morbidity in patients with end-stage renal disease (ESRD). Traditionally, hospital-based conventional hemodialysis has been the only option for this patient population. We hypothesized that nocturnal home hemodialysis (NHD), 3 – 6 sessions per week, 6 – 8 hours per session, is a suitable alternative salvage therapy for this vulnerable patient group. Methods This is a descriptive cohort study of all consecutive ESRD patients failing PD that were converted to NHD at the University Health Network and Humber River Regional Hospital from 2003 to 2005. Our primary objective was to describe the changes in clinical and biochemical indices before and after conversion from PD to NHD. Results 69 patients required transfer from PD to another form of renal replacement therapy during the period of interest. Our pilot cohort included 8 ESRD patients (5 males, 3 females; age 53 ± 7 years). Mean duration on PD was 4.8 ± 4.6 years. NHD delivered a higher dose of dialysis, as reflected by lower plasma creatinine concentration 1 year after beginning NHD (from 1107 ± 312 μmol/L with PD to 649 ± 309 μmol/L, p = 0.01) and a rise in standardized Kt/V (from 2.21 ± 0.73 with PD to 4.49 ± 1.92 after 6 months of NHD, to 4.51 ± 1.77 after 1 year of NHD; p < 0.001). There was a progressive and sustained rise in plasma albumin after conversion to NHD (from 31 ± 4 g/L with PD to 36 ± 4 g/L after 6 months of NHD, to 39 ± 2 g/L after 1 year of NHD; p = 0.001). Hemoglobin concentrations increased (from 102 ± 13 to 125 ± 7 g/L, p = 0.03), while erythropoietin requirement tended to fall (from 17500 ± 8669 to 9197 ± 7573 U/week). Plasma phosphate fell (from 2.1 ± 0.6 to 1.1 ± 0.3 mmol/L, p = 0.01) despite a decrease in phosphate binder requirement. Blood pressure profile also tended to improve after conversion to NHD. Conclusion Nocturnal HD represents a promising, viable, alternative renal replacement therapy for patients experiencing PD failure. The clinical impact of transferring ESRD patients failing PD to NHD deserves further investigation.
Does the Biocompatibility of the Peritoneal Dialysis Solution Matter in Assessment of Peritoneal Function?
Authors: Parikova Alena , Struijk Dirk G. , Zweers Machteld M. , Langedijk Monique , Schouten Natalie , van den Berg Nicole , Duis Saskia , Krediet Raymond T. 
Published: February 2020

Background Peritoneal function tests are performed in peritoneal dialysis (PD) patients to characterize peritoneal membrane status. A low pH/high glucose degradation product (GDP) dialysis solution is used as the test solution. The objective of the present study was to compare a 3.86% glucose, low pH/high GDP dialysis solution (pH 5.5) with a 3.86% glucose, normal pH/low GDP dialysis solution (pH 7.4) in assessments of peritoneal membrane function. Methods Two standard peritoneal permeability analyses (SPA) were performed in 10 stable PD patients within 2 weeks. One SPA was done with the 3.86% low pH/high GDP solution, and the other with the 3.86% normal pH/low GDP solution. The sequence of the two tests was randomized. Results Fluid transport parameters and glucose absorption were not different between the two groups. No differences were found for the mass transfer area coefficients (MTACs) of low molecular weight solutes calculated over the whole dwell. However, MTAC urea in the first hour of the dwell was higher in the test done with low pH/high GDP dialysate, suggesting more peritoneal vasodilation. No difference was found in protein clearances. Sodium sieving at multiple time points during the dwell was similar with the two solutions. Conclusion The results obtained with the glucose-containing normal pH/low GDP dialysis solution were similar to those obtained with the glucose-containing low pH/high GDP dialysate in assessments of peritoneal membrane function.