2009 Japanese Society for Dialysis Therapy Guidelines for Peritoneal Dialysis

Nakayama, Masaaki

doi:10.1111/j.1744-9987.2010.00901.x

Cited by 59 publications

(18 citation statements)

References 113 publications

(120 reference statements)

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“…They were treated with dialysates containing dextrose (Dianeal-NPD-2, -NPD-4 1.5 or 2.5, Baxter Japan, Tokyo; Mid Peric or Mid Peric L 135 or 250, Terumo, Tokyo) and a dialysate with or without icodextrin (Extraneal, Baxter Japan, Tokyo). We adhered to the Japanese Society for Dialysis Therapy guidelines for treatment by PD [16]. Dyslipidemia was diagnosed on the basis of the criteria of the Japan Atherosclerosis Society [17].…”

Section: Methodsmentioning

confidence: 99%

The association of very-low-density lipoprotein with ankle-brachial index in peritoneal dialysis patients with controlled serum low-density lipoprotein cholesterol level

Kanda

Okazaki³

et al. 2013

BMC Nephrol

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BackgroundPeripheral artery disease (PAD) represents atherosclerotic disease and is a risk factor for death in peritoneal dialysis (PD) patients, who tend to show an atherogenic lipid profile. In this study, we investigated the relationship between lipid profile and ankle-brachial index (ABI) as an index of atherosclerosis in PD patients with controlled serum low-density lipoprotein (LDL) cholesterol level.MethodsThirty-five PD patients, whose serum LDL cholesterol level was controlled at less than 120mg/dl, were enrolled in this cross-sectional study in Japan. The proportions of cholesterol level to total cholesterol level (cholesterol proportion) in 20 lipoprotein fractions and the mean size of lipoprotein particles were measured using an improved method, namely, high-performance gel permeation chromatography. Multivariate linear regression analysis was adjusted for diabetes mellitus and cardiovascular and/or cerebrovascular diseases.ResultsThe mean (standard deviation) age was 61.6 (10.5) years; PD vintage, 38.5 (28.1) months; ABI, 1.07 (0.22). A low ABI (0.9 or lower) was observed in 7 patients (low-ABI group). The low-ABI group showed significantly higher cholesterol proportions in the chylomicron fraction and large very-low-density lipoproteins (VLDLs) (Fractions 3–5) than the high-ABI group (ABI>0.9). Adjusted multivariate linear regression analysis showed that ABI was negatively associated with serum VLDL cholesterol level (parameter estimate=-0.00566, p=0.0074); the cholesterol proportions in large VLDLs (Fraction 4, parameter estimate=-3.82, p=0.038; Fraction 5, parameter estimate=-3.62, p=0.0039) and medium VLDL (Fraction 6, parameter estimate=-3.25, p=0.014); and the size of VLDL particles (parameter estimate=-0.0352, p=0.032).ConclusionsThis study showed that the characteristics of VLDL particles were associated with ABI among PD patients. Lowering serum VLDL level may be an effective therapy against atherosclerosis in PD patients after the control of serum LDL cholesterol level.

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Section: Methodsmentioning

confidence: 99%

The association of very-low-density lipoprotein with ankle-brachial index in peritoneal dialysis patients with controlled serum low-density lipoprotein cholesterol level

Kanda

Okazaki³

et al. 2013

BMC Nephrol

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“…Additionally, changes in dialysate-to-plasma ratio of creatinine (D/P Cr), obtained from a peritoneal equilibration test (PET) were examined. The total Kt/V and total weekly creatinine clearance rate (Ccr) just before switching therapy were calculated using the guidelines from the Japanese Society for Dialysis Therapy [10]. …”

Section: Methodsmentioning

confidence: 99%

Combined Therapy with Peritoneal Dialysis and Hemodialysis: A Multicenter Retrospective Observational Cohort Study in Japan

Maruyama

Yokoyama

Nakayama³

et al. 2014

Blood Purif

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Background/Aims: Combining peritoneal dialysis (PD) and hemodialysis (HD) has been common treatment option in Japan. Methods: In this retrospective, multicenter, observational study, the clinical characteristics and outcomes of 104 patients (57 w 11 years, males 72%) who had switched from PD alone to combined therapy with PD and HD were studied. Clinical parameters were measured at baseline and after 3 months of combined therapy. Results: At baseline, urine volume, dialysate-to-plasma ratio of creatinine (D/P Cr), and total Kt/V were 150 ml/day (range: 0-2,000 ml/day), 0.67 w 0.11, and 1.8 w 0.4, respectively. During the first 3 months of combined therapy, body weight, urine volume, serum creatinine level, and D/P Cr decreased, whereas hemoglobin levels increased. Conclusions: In patients where PD does not result in acceptable outcomes, combined therapy with PD and HD may have potential benefits in terms of dialysis adequacy and hydration status. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=368389 i 2014 S. Karger AG, Basel

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“…For those patients receiving combined therapy who cannot maintain adequate solute removal and fluid removal, we have to consider discontinuation of combined therapy and switching to other mode of RRT, especially HD thrice weekly. We also proposed criteria for discontinuation of combined therapy PD and HD (Table 5), determined based on the criteria for conventional PD and consideration of the prevention of EPS development as well as impaired solute and fluid removal was an important issue [24]. It is to be noted that conventional solution was used in the most of previous studies.…”

Section: Criteria For Discontinuation Of Combined Therapy and Preventmentioning

confidence: 99%

“…Kawanishi et al [14,16,29] used equivalent renal clearance (EKR) of urea as proposed by Casino et al [37], and both total Kt/V and total weekly creatinine clearance (Ccr) were increased in patients after starting combined therapy. The JSDT guideline [24] recommends that the adequacy of dialysis should be determined using the concept of body fluid clear space in combined therapy [24,31].…”

Section: Assessment Of Efficiency Of Combined Therapymentioning

confidence: 99%

“…For the better management of PD, adequate solute and fluid removal are essential and targets have been defined in several guidelines, including the Kidney Disease Outcomes Quality Initiative (KDOQI) guideline [22], the International Society for Peritoneal Dialysis (ISPD) guideline [23], and the Japanese Society for Dialysis Therapy (JSDT) guideline [24]. Weekly Kt/V is widely used to assess solute removal, and is determined using the combined renal and peritoneal clearance of urea.…”

Section: Criteria For Initiation Of Combined Therapymentioning

confidence: 99%

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Clinical efficacy of combined therapy with peritoneal dialysis and hemodialysis

Maruyama

Yokoyama

2016

Ren Replace Ther

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Combined therapy with peritoneal dialysis (PD) and hemodialysis (HD) represents a treatment option for PD patients who cannot maintain adequate solute and fluid removal. It has rapidly gained popularity in Japan, and 15 years of accumulated experiences is available. Serum creatinine, serum β2 microglobulin (β2m), body weight, and blood pressure decreased, whereas hemoglobin increased after initiating combined therapy. These results indicated that both adequacy of dialysis and hydration status were significantly improved. In addition, dialysate-to-plasma ratio of creatinine (D/P Cr) as obtained from peritoneal equilibration test (PET) was decreased, probably due to the functional and histological improvements of the peritoneal membrane. Combined therapy may have a good impact on the prevention of cardiovascular disease through reduction of blood pressure, correction of fluid overload, and improvement of left ventricular hypertrophy. Quality of life may improve as a result of decreases in uremic symptomatology and freedom from bag exchanges. On the other hand, combined therapy with PD and HD has some concerns. A reduction in urine volume during combined therapy indicates a decline in residual renal function, and may have potential negative impacts on life expectancy. Furthermore, induction of combined therapy would increase the overall duration of PD treatment and susceptibility to peritonitis. We have to pay attention to the development of encapsulating peritoneal sclerosis, as the most serious complication of PD, because both prolonged PD duration and increased number of peritonitis episodes are independent risk factors. Here, we propose criteria for the indication and discontinuation of combined therapy. Under these criteria, Kt/V, serum β2m, and uremic symptoms including nutritional status, erythropoiesis-stimulating agent-hyporesponsive anemia, and restless legs syndrome were used as markers of dialysis adequacy. On the other hand, higher blood pressure, heart enlargement or pleural effusion on chest X-ray, and persistent peripheral edema were used as markers of hydration status. Further studies, particularly prospective cohort studies with a large group of cases, are needed to confirm the clinical efficacy of combined therapy with PD and HD.

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2009 Japanese Society for Dialysis Therapy Guidelines for Peritoneal Dialysis

Cited by 59 publications

References 113 publications

The association of very-low-density lipoprotein with ankle-brachial index in peritoneal dialysis patients with controlled serum low-density lipoprotein cholesterol level

The association of very-low-density lipoprotein with ankle-brachial index in peritoneal dialysis patients with controlled serum low-density lipoprotein cholesterol level

Combined Therapy with Peritoneal Dialysis and Hemodialysis: A Multicenter Retrospective Observational Cohort Study in Japan

Clinical efficacy of combined therapy with peritoneal dialysis and hemodialysis

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