bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastric Emptying and Electrogastrography in Patients on Capd
Authors: Fernström Anders , Hylander Britta , Grybäck Per , Jacobsson Hans , Hellström Per M. 
Published: February 2020

Objective To evaluate if impaired gastric emptying of digestible solids can explain the disturbed eating behavior in continuous ambulatory peritoneal dialysis (CAPD) patients, and if predialytic and dialytic (CAPD and hemodialysis) patients with impaired gastric emptying have a higher prevalence of electrogastrographic (EGG) abnormalities. Design Cross-sectional study. After ingestion of a 99mTc-labeled test meal, anterior and posterior 1-minute scintigraphic acquisitions were collected every 5 minutes during the first 50 minutes and thereafter every 10 minutes until 2 hours had elapsed. Simultaneously, cutaneous EGG recorded gastric myoelectric activity. Setting The Division of Nephrology and the Department of Nuclear Medicine at the same academic teaching hospital. Participants Thirty outpatients participated in both the gastric emptying and the EGG studies. Dialysis patients should have been on dialysis for more than 3 months. For comparison, 160 healthy control subjects participated in the gastric emptying study. Main Outcome Measures The following parameters were used to describe gastric emptying: lag phase 90%, half-emptying time ( T50), gastric retention at 90 and 120 minutes (Ret 90/120) and gastric emptying rate (GER, %/min). Electrogastrographic measurements were expressed as percentages of normal slow waves [2.4 – 3.6 cycles/min (cpm)], bradygastria (1.5 – 2.4 cpm), and tachygastria (3.6 – 10 cpm). Results T50 was prolonged, Ret 90 and Ret 120 were higher, and GER was slower in male CAPD patients compared to male controls. No significant differences were found in postprandial EGG. Conclusion Gastric emptying is impaired in male non-diabetic CAPD patients. However, abnormalities in postprandial EGG cannot explain this finding.
Peritoneal Transport of Glucose in Rat
Authors: Park Min Sun , Lee Eun Young , Suh Gyo Il , Waniewski Jacek , Werynski Andrzej , Lee Hi Bahl 
Published: February 2020

Objective To evaluate the convective transport characteristics of glucose and the effect of high glucose and insulin during experimental peritoneal dialysis in rat. Methods Male Sprague–Dawley rats weighing 300 – 400 g were used in this study. Mannitol (5%) was used as osmotic agent. Glucose was added to dialysis solution to yield a concentration of 100 mg/dL (group 1) or 300 mg/dL (group 2). Mannitol solution (5%) containing the same concentration of electrolytes and lactate but without glucose was used as control (group 3). In group 2, blood sugar was maintained at approximately 300 mg/dL by continuous intravenous infusion of 25% glucose solution and 0.9% NaCl solution. A 2-hour dwell study was performed with 30 mL of test solutions. Intraperitoneal volume was calculated by volume marker (18.5 kBq of 131I-human radioiodinated serum albumin, RISA) dilution with corrections made for the elimination of RISA from the peritoneal cavity (KE) and sample volume. The diffusive mass transport coefficient (KBD) and sieving coefficient (SBRF) were calculated by using the Babb–Randerson–Farrell model. S was also calculated directly by using isocratic methods (SI). The peritoneal fluid absorption rate (KE) was taken into account for the calculation of SI. Results Intraperitoneal volume was significantly higher in group 2 compared with groups 1 and 3. Peritoneal fluid absorption rate, KE, was similar in all three groups. SBRF and SI for glucose were significantly lower in group 2 compared with groups 1 and 3. SBRF for glucose in group 2 was below zero and SI near zero. KBD for glucose was significantly higher in group 2 than in groups 1 and 3. Plasma and dialysate concentrations of insulin increased during the initial hour and then decreased to the baseline value in groups 1 and 3, while in group 2 it continuously increased. Conclusion Significantly lower sieving coefficients for glucose in the high glucose and high insulin group suggest that transport mechanisms other than simple passive transport are involved in peritoneal glucose transport, and that high glucose per se and/or high insulin may be important factors that determine glucose transport characteristics.
Small and Middle Molecular Weight Solute Clearance in Nocturnal Intermittent Peritoneal Dialysis
Authors: Brophy Donald F. , Sowinski Kevin M. , Kraus Michael A. , Moe Sharon M. , Klaunig James E. , Mueller Bruce A. 
Published: February 2020

Objectives To determine the dialysate-to-plasma (D/P) concentration ratios and peritoneal dialytic clearance (ClD) of substances with a wide range of molecular weights in subjects receiving a simulated nocturnal intermittent peritoneal dialysis (NIPD) session. Design Open-label single-dose study. Subjects Six end-stage renal disease patients undergoing peritoneal dialysis (PD). Setting Clinical research center of a university-affiliated hospital. Interventions Subjects received intravenous gentamicin and vancomycin on the first day of the study. Subjects received no PD until their return on the following day, when subjects underwent a simulated NIPD session utilizing four 2- to 2.5-L peritoneal dialysate dwells of 2 hours. Blood and dialysate samples were collected immediately before the session and after each dialysate dwell for determination of urea, creatinine, gentamicin, vancomycin, and β2-microglobulin (β2M) concentrations. Each solute's D/P concentration ratio and peritoneal ClD were calculated. Measurements and Main Results The (mean ±SD) 2-hour D/P concentration ratios were 0.78 ± 0.05 (urea), 0.49 ± 0.11 (creatinine), 0.38 ± 0.08 (gentamicin), 0.11 ± 0.06 (vancomycin), and 0.07 ± 0.03 (β2M). Peritoneal ClD values (mL/min of dialysis) were 19.0 ± 2.8 (urea), 12.1 ± 3.5 (creatinine), 8.4 ± 2.8 (gentamicin), 2.7 ± 1.5 (vancomycin), and 1.7 ± 0.8 (β2M). The D/P concentration ratios and peritoneal ClD values for urea, creatinine, and gentamicin were significantly different from vancomycin and β2M (repeated measures ANOVA, p < 0.05). β2-Micro-globulin peritoneal ClD was strongly related to gentamicin peritoneal ClD ( r = 0.96, p < 0.05). Conclusion Small molecular weight solutes have significantly greater D/P and peritoneal ClD than middle molecular weight solutes in NIPD. In NIPD, daily peritoneal ClD of β2M is lower than that reported in continuous ambulatory PD. NIPD also results in lower drug ClD than that reported in continuous ambulatory PD studies.
The Self-Locating Catheter: Clinical Evaluation and Comparison with the Tenckhoff Catheter
Authors: Cavagna Romano , Tessarin Cristina , Tarroni Giovanni , Casol Daniela , De Silvestro Linda , Fabbian Fabio 
Published: February 2020

Background Peritoneal catheter displacement appears to be related to various causes including omental attachment, bowel contractions, peritoneal adhesions, and the catheter floating in the dialysis fluid. In order to prevent this complication, which can impair peritoneal dialysis efficacy, Di Paolo et al. designed a “self-locating catheter” (SLC) that is similar to the Tenckhoff catheter (TC) and includes a small tungsten cylinder (weight 12 g) at the distal end (Di Paolo N, et al. The self positioning catheter. Proceedings of the VII Italian Congress on Peritoneal Dialysis. Milan: Wichtig Editore, 1993:539–42). The weight of the tip prevents the catheter from floating and migrating by gravitation toward the Douglas cavity. Objective Starting in 1996, we implanted SLC in 15 continuous ambulatory peritoneal dialysis patients. The aim of our study was to compare the ratio of migration and other catheter-related complications between patients with SLC (196 patient-months) and 13 patients with conventional straight TC (295 patient-months). Results Peritonitis ratio, catheter complication rate, dialysate inflow and outflow, and weekly creatinine clearance were similar in the two groups of patients. The incidence of catheter displacement was significantly higher ( p = 0.0349) in the TC group than in the SLC group (4 vs 0). Conclusion In our experience, the SLC seems to be useful in preventing catheter migration by continuous gravitation of its extremity toward the pelvic cavity.
Alterations in Water and Solute Transport with Time on Peritoneal Dialysis
Authors: Heimbürger Olof , Wang Tao , Lindholm Bengt 
Published: February 2020

Peritoneal ultrafiltration capacity and small -solute transport characteristics seem to be relatively stable in most patients treated with PD for up to 3 years. However, in patients treated with PD for 4 years or more, there is a tendency towards increasing diffusive transport for small solutes as well as a tendency towards decreasing net UF, whereas the peritoneal protein clearances seem to be reduced or stable. Loss of UFC is a well-known complication during long-term PD treatment, and the risk for loss of UFC may be as high as 50% after 6 years on PD. Several different mechanisms of UFC loss have been reported. In particular, the most common mechanism for loss of UFC is increased diffusive transport resulting in rapid glucose absorption and thus rapid loss of the osmotic driving force. Also reported as causes of UFC loss have been: reduced efficiency of the osmotic agent (perhaps owing to decreased transcellular water transport); loss of peritoneal surface area with slow solute transport owing to fibrosis and the formation of adhesions (during the late stage of sclerosing peritonitis); and increased peritoneal fluid absorption. In individual patients, a combination of several mechanisms may be involved in the apparent UFC failure.
Intraperitoneal Addition of Hyaluronan Improves Peritoneal Dialysis Efficiency
Authors: Wang Tao , Cheng Hui-Hong , Heimbürger Olof , Chen Chi , Waniewski Jacek , Bergström Jonas , Lindholm Bengt 
Published: February 2020

Background It has been shown that hyaluronan (HA) can decrease peritoneal fluid absorption. It is not known, however, how various molecular weights and various concentrations of hyaluronan affect peritoneal fluid absorption rate. Methods A study of 4-hour dwells, with frequent dialysate and blood sampling, was performed in male SpragueCawley rats (6 7 rats in each group) with 1311 albumin as an intraperitoneal volume marker. Each rat was infused intraperitoneally with 25 mL of 1.5% glucose solution alone or 1.5% glucose solution containing hyaluronan at various molecular weights (MW -85 kC, 280 kC, 500 kC, and 4 MC) or containing hyaluronan of MW 500 kC at various concentrations (0.01%,0.05%,0.1%,0.5%). Two additional groups were infused with 40 mL of 1.36% glucose dialysate alone or 1.36% glucose dialysate with 0.01 % hyaluronan (MW 500 kC) to test the effect of hyaluronan when high dialysate fill volume was used. Results Addition of 0.01% hyaluronan significantly decreased peritoneal fluid absorption rate (KE) (by 22%, p < 0.01). The decrease was more marked with hyaluronan at high MW or high concentration, or with high dialysate fill volume. The net ultrafiltration tended to be higher in all hyaluronan groups compared to their control groups except in the 4 MC group; this difference was mainly due to a lower KE in all the hyaluronan groups. The direct lymphatic flow was significantly decreased in the 0.5% HA group. The transcapillary ultrafiltration rate (au) was significantly lower in the 4 MC group as compared to the control group. No difference in au was found between the other groups as compared to their control groups. Conclusions (1) Intraperitoneal addition of hyaluronan may increase net peritoneal fluid removal, mainly because hyaluronan decreases peritoneal fluid absorption rate. The decrease was more marked when high dialysate fill volume was used, indicating that intraperitoneal addition of hyaluronan can prevent the decreased net ultrafiltration caused by an increase in dialysate fill volume. (2) The decrease in peritoneal fluid absorption rate may be both MW-dependent and concentration-dependent: that is, a higher MW as well as a higher concentration of hyaluronan result in a more marked decrease in peritoneal fluid absorption rate. (3) Low concentrations of high MW hyaluronan may also decrease au. However, au did not decrease when high concentrations of hyaluronan were used despite a significant decrease in peritoneal fluid absorption rate.
Effects of Recombinant Human Erythropoietin on Functional and Injury Endothelial Markers in Peritoneal Dialysis Patients
Authors: Aguilera Abelardo , Selgas Rafael , Ruiz-Caravaca M. Luisa , Bajo M. Auxiliadora , Cuesta M. Vicenta , Plaza M. Angeles , Hernanz Angel 
Published: February 2020

Clinical effects of recombinant human erythropoietin (rHuEPO) such as thrombosis, convulsions, hyperviscosity, hypertension, and angiogenic effect in culture cells have been described. We studied the rHuEPO effect on endothelial damage markers and endothelial function markers: tissue-type plasminogen activator (t-PA), nitrate (NO3), thrombomodulin (TM), and von Willebrand factor (vWF). Twenty-six peritoneal dialysis patients treated with rHuEPO and 19 controls were included. The study design for rHuEPO patients consisted of four periods: long-term treatment (rHuEPO-1); 2 months of withdrawal (rHuEPO-2); and 4 months on 5000 IU/week rHuEPO subcutaneously, with markers being measured after 2 months (rHuEPO-3) and after 4 months (rHuEPO-4). After 2 months of rHuEPO withdrawal, a decrease in hemoglobin level appeared (11 ± 1.8 g/dL to 9.2 ± 1.5 g/dL, p < 0.01). After rHuEPO reintroduction, this value reached 10.6 ± 1.5 g/dL at two months, and 11.1 ± 1.4 g/dL at four months. A significant increase in t-PA ratio was observed from two months without rHuEPO to two months on rHuEPO, returning to previous values after four months. Similarly, TM increased for patients with creatinine clearances (CrC) < 5 mL/min. No changes in the higher-thannormal plasma vWF levels were found during the various periods. A statistically significant lower value was found in controls compared with rHuEPO-4 patients. A statistically significant increase in NO3 levels was observed in the pre-venous occlusion (VO) test immediately after the re-introduction of rHuEPO. This increment returned to prior values four months after rHuEPO was reintroduced. Our results show that rHuEPO treatment causes an increase in some endothelial damage markers (TM, t-PA) and modifies endothelial function markers (t-PA ratio, NO3). These changes might favor thrombosis and atherosclerosis.
The Effect of Continuous Ambulatory Peritoneal Dialysis on Change in Serum Leptin
Authors: Kim Dae Joong , Oh Dong Jin , Kim Bum , Lim Young Hee , Kang Woo-Heon , Lee Bang Hoon , Lee Sung Ku , Huh Wooseong , Kim Sang Eun , Lee Moon-Kyu , Kang Soon Ah , Oh Ha-Young 
Published: February 2020

Objective Elevated serum leptin can contribute to anorexia and poor nutrition in patients with chronic renal failure, because leptin is elevated in chronic renal failure patients with or without dialysis, especially in chronic ambulatory peritoneal dialysis (CAPO) patients. The aim of this study was to find whether leptin can be removed by peritoneal dialysis (PO) and to analyze factors that can affect serum leptin after start of CAPO by observing the change in serum leptin shortly after start of CAPO and its correlation with body mass index (BMI), with serum insulin, and with residual renal function. Design Twenty patients who started CAPO during the observation period were studied. Serum leptin was measured by radioimmunoassay before start of CAPO, 3 5 days after start of CAPO, and 1 month and 3 months after start of CAPO. Simultaneously, body weight, serum insulin, and residual renal function were measured. To compensate for the circardian rhythm of leptin, removal of leptin was assessed by measuring dialysate leptin divided by average serum leptin before and after a peritoneal equilibration test (PET). Results Leptin was eliminated by PO with a dialysateto-serum ratio of 0.16 ± 0.07, which was comparable to removal of β2-microglobulin (0.14 ± 0.06). The mean serum leptin concentrations did not decrease after 3 5 days of CAPO (8.4 ± 13.1 ng/mL → 11.9 ± 18.0 ng/mL) despite its removal by PO, and levels increased markedly to 189% of basal serum leptin 1 month after start of PO and to 260% of basal serum leptin 3 months after start of PO. Correlation coefficients (Spearman's p) between change of serum leptin and change of BMI, of serum insulin, of glomerular filtration rate (average of urine creatinine clearance and urine urea clearance) were 0.267 (p > 0.05, n = 20),0.441 (p > 0.05, n = 16),0.706 (p > 0.05, n = 8) respectively. Conclusion Leptin is removed by peritoneal dialysis. Serum leptin did not decrease in 5 days after the start of PO despite its removal by PO, but increased markedly thereafter, within 3 months after start of PO. We could not find a significant correlation between the change in leptin and the change in BMI. Factors other than fat-mass gain can stimulate leptin increase shortly after start of PO.
Mathematical Models for Peritoneal Transport Characteristics
Authors: Waniewski Jacek 
Published: February 2020

Four mathematical models and for the description of peritoneal transport of fluid solutes are reviewed. The membrane model is usually applied for (1) separation of transport components, (2) formulation of the relationship between flow components and their driving forces, and (3) estimation of transport parameters. The three-pore model provides correct relationships between various transport parameters and demonstrates that the peritoneal membrane should be considered heteroporous. The extended threepore model discriminates between heteroporous capillary wall and tissue layer, which are assumed to be arranged in series; the model improves and modifies the results of the three-pore model. The distributed model includes all parameters involved in peritoneal transport and takes into account the real structure of the tissue with capillaries distributed at various distances from the surface of the tissue. How the distributed model may be applied for the evaluation of the possible impact of perfusion rate on peritoneal transport, as recently discussed for clinical and experimental studies, is demonstrated. The distributed model should provide theoretical bases for the application of other models as approximate and simplified descriptions of peritoneal transport. However, an unsolved problem is the theoretical description of bi-directional fluid transport, which includes ultrafiltration to the peritoneal cavity owing to the osmotic pressure of dialysis fluid and absorption out of the peritoneal cavity owing to hydrostatic pressure.
A Simple and Fast Method to Estimate Peritoneal Membrane Transport Characteristics Using Dialysate Sodium Concentration
Authors: Wang Tao , Waniewski Jacek , Heimbürger Olof , Bergstrβm Jonas , Werynski Andrzej , Lindholm Bengt 
Published: February 2020

Background The peritoneal equilibration test (PET) is widely used to classify a patient's peritoneal transport characteristics. However, PET is laborious and the prediction of fluid removal based on PET is generally poor. It is believed that osmosis by glucose occurs partially through transcellular water channels, resulting in sieving of sodium and decrease of dialysate sodium concentration when using hypertonic glucose dialysate. Objective In this study, we investigated the possibility of using dialysate sodium concentration to classify the patient's peritoneal transport characteristics. Methods A 6-hour dwell study with frequent dialysate and plasma sampling was performed in 46 patients using 2 L of 3.86% glucose dialysate with 1311-albumin as an intraperitoneal volume (IPV) marker. The peritoneal transport of sodium, creatinine, glucose, and fluid was evaluated. Results The dialysate sodium concentration at 240 min (ONa240) significantly correlated with O/P creatinine (r = 0.76, p < 0.001) and O/O0 glucose (r = -0.83, p < 0.001) at 240 min of the dwell (better than dialysate sodium concentration at any other time of the dwell). ONa240 also significantly correlated with IPV at 240 min of the dwell (r = -0.61, p < 0.001) (better than O/P creatinine and O/O0 glucose). There were significant correlations between ONa240 and the sodium-sieving coefficient (r= 0.71, p < 0.001) and the diffusive mass transfer coefficient for sodium (r = 0.50, p < 0.001). When using ONa240 to divide the patients into four groups, as in the PET method, no significant difference was found between the two methods. Conclusion Using 3.86% glucose solution, ONa240 can be used instead of O/P creatinine to classify patients into different transport groups. ONa240 provides a better prediction of peritoneal fluid transport and reflects both the diffusive and convective transport properties of the membrane. As only one dialysate sample (and no blood sample) is needed, ONa240 may offer important clinical advantages compared with PET.
Taste Buds and Neuronal Markers in Patients with Chronic Renal Failure
Authors: Astbäck Johnny , FernstrÖm Anders , Hylander Britta , Arvidson Kristina , Johansson Olle 
Published: February 2020

Objective To study the number of taste buds and, with the use of specific markers for peripheral nervous tissue, to study the neuronal pattern in taste buds from 36 patients with chronic renal failure (CRF), 19 renal transplant recipients, and 40 healthy subjects. Of the patients with CRF, 17 patients had not started dialysis, 12 patients were on peritoneal dialysis, and 7 patients were on hemodialysis. Design From all subjects, two or three fungiform papillae were collected from the anterior part of the tongue. Cryostat sections were cut and inspected under light microscopy to determine the presence of taste buds. The sections were subsequently incubated with primary rabbit antibodies against protein gene product 9.5, substance P, and nerve growth factor receptor. Results Using these antibodies, no differences between the groups were observed. However, patients with CRF had fewer taste buds than control subjects. Conclusion No immunohistochemical differences were observed between patients with CRF and healthy controls. However, patients with CRF had significantly fewer fungiform taste buds, suggesting an important factor contributing to the well-known impairment of taste acuity in this patient group.
Renal Osteodystrophy in Pre-Dialysis Patients: Ethnic Difference?
Authors: Shin Sug Kyun , Kim Do Hun , Kim Heung Su , Shin Kyu Tae , Ma Kyung Ae , Kim Sung Jung , Kwak Youn Sik , Ha Seung Kyu , Sherrard Donald J. 
Published: February 2020

The purpose of the present study is to investigate whether an ethnic difference exists in the incidence of renal osteodystrophy between Asian and Western countries in end-stage renal disease (ESRD) patients. We evaluated bone histology in 58 pre-dialysis patients (28 male, 30 female; mean age: 47.7 years). All patients had bone biopsies with quantitative histomorphometry and sero-logical parameters such as intact PTH, osteocalcin, total alkaline phosphatase, and basal and deferoxamine-stimulated serum aluminum levels. We observed that 91.4% of all evaluated patients showed renal osteodystrophy before the start of dialytic therapy. Mild osteitis fibrosa were observed in 21 patients (36.2%), severe osteitis fibrosa in 5 patients (8.6%), mixed lesions in 7 patients (12.1 %), osteomalacia in 6 patients (10.3%), aplastic bone disease in 14 patients (24.1%), and normal bone in 5 patients (8.6%). Among the bone histomorphometric parameters, fibrosis area rate (%) showed the best correlation with intact PTH, and osteocalcin and osteoid area rate (%) with total alkaline phosphatase. Aluminum-related bone disease was not observed. Among patients with aplastic bone disease, only 14.3% showed aluminum deposition of any significance (5% < stainable bone surface aluminum < 25%). In the diabetic patients, aplastic bone disease was most common, but no case was related to aluminum intoxication. In conclusion, the distribution of renal osteodystrophy in our study was different from that of Western countries in pre-dialysis patients. Our patients tended to have more mild-form osteitis fibrosa and normal findings, and less severe-form osteitis fibrosa and aplastic bone disease. Aluminum-related bone disease was not observed.