Activation of chronic inflammation and comorbidity in end-stage renal disease patients treated with continuous ambulatory peritoneal dialysis.

Shifris, I.; Dudar, І.; Driianska, V.; Shymova, A.

doi:10.26641/2307-0404.2020.2.206381

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…За даними Національного реєстру хворих на хронічну хворобу нирок та пацієнтів з гострим пошкодженням нирок станом на 01.01.2021 року лікування ПД отримували 776 пацієнтів, що становило 8,5% від загальної кількості НЗТ хворих в Україні [6,17].…”

Section: хворі які лікуються методом перитонеального діалізуunclassified

“…Водночас, є доведеним, що в мирний час, розвиток коморбідних станів пов›язаний з ба-гатьма факторами та має негативний вплив на наслідки у хворих на ХХН VД ст. [14,17]. Саме тому досвід, що нажаль будуть мати нефрологи України після закінчення російського військового вторгнення на територію нашої суверенної країни, має бути всебічно проаналізований та дозволить розробити рекомендації спрямовані на покращення медичної допомоги в умовах воєнного стану.…”

Section: адаптація організації та надання медичної допомоги хворим на...unclassified

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Recommendations of the Ukrainian Renal Disaster Relief Committee of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists regarding medical care to kidney disease patients during the war

Kolesnyk

Dudar²,

Stepanova

et al. 2022

Ukr. J. Nephrol. and Dial.

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Abstract. The occurrence of an emergency situation (ES) forced international (ISN, EDTA/ERA) and national (Turkey) nephrological associations to establish the Renal Disaster Relief Task Force, which is primarily concerned with the treatment of patients with acute kidney injury and end-stage renal disease requiring dialysis. The war started by the RF is putting the Ukrainian state, Ukrainian society, and the healthcare system in the catastrophic ES. Under these circumstances, all nephrological patients became one of the most vulnerable categories of patients. To provide immediate support in solving problems within the Ukrainian Association of Nephrologists and Kidney Transplant Specialists (UAN&KTS), the Ukrainian Renal Disaster Relief Committee (URDRC) has been established. One of the most important tasks was to form a group of experts to develop recommendations for specialized medical care for kidney patients in wartime. According to the experts, the key person for this type of medical care is the leading nephrologist in the region or city. He/she establishes a local Renal Disaster Relief Committee (LRDRC) and decides through horizontal (with other LRDRC) or vertical (with UAN &KTS) collaboration, using available communication tools, on the problems that arise; the most appropriate tool is the Viber platform "Nephrology. Dialysis. Transplantation". In this way, a network without administrative subordination and a non-hierarchical functional system was created, which, on the one hand, functions according to similar working principles, but, on the other hand, may differ in terms of LRDRC composition, communication methods, and more. The LRDRC divides all patients into three groups and provides work preparation measures before, during and after the cancellation of ES.

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Section: хворі які лікуються методом перитонеального діалізуunclassified

Section: адаптація організації та надання медичної допомоги хворим на...unclassified

Recommendations of the Ukrainian Renal Disaster Relief Committee of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists regarding medical care to kidney disease patients during the war

Kolesnyk

Dudar²,

Stepanova

et al. 2022

Ukr. J. Nephrol. and Dial.

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“…Nevertheless, little evidence is available on oxalate balance in ESKD patients in general and peritoneal dialysis (PD) patients in particular; almost all scientific data on this issue were published during the 1980s and 1990s (6,(12)(13)(14).Worldwide, PD is a key element of kidney replacement therapy (15-17). Nonetheless, peritonitis remains one of the major challenges associated with severe clinical complications of PD despite technological advances (17,18). Detrimental effects of dialysis-related peritonitis on the characteristics of peritoneal transport and the alterations of the peritoneal membrane have been documented (19-21).…”

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confidence: 99%

“…Worldwide, PD is a key element of kidney replacement therapy (15-17). Nonetheless, peritonitis remains one of the major challenges associated with severe clinical complications of PD despite technological advances (17,18). Detrimental effects of dialysis-related peritonitis on the characteristics of peritoneal transport and the alterations of the peritoneal membrane have been documented (19-21).…”

mentioning

confidence: 99%

Oxalate Balance in Peritoneal Dialysis Patients: A Potential Role of Dialysis-related Peritonitis

Stepanova

Korol

Lebid

et al. 2022

In Vivo

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Background: Little evidence is available on oxalate balance in peritoneal dialysis (PD) patients. Patients and Methods: We performed a cross-sectional observational pilot study with 62 adult PD patients to document oxalate balance and explore its association with PD-related peritonitis. Plasma oxalate concentration, levels of oxalate excretion in 24-h urine, and peritoneal dialysis effluent were evaluated. The peritoneal oxalate transport status and renal and peritoneal oxalate clearances were calculated according to the PD-related peritonitis history. Results: PD patients with a history of peritonitis had a statistically significantly lower peritoneal oxalate clearance, daily peritoneal oxalate excretion, and overall oxalate removal rate compared with the peritonitis-free PD patients. They had a 4-fold risk of plasma oxalic acid increase, and even a single episode of dialysis-related peritonitis resulted in plasma oxalate elevation. Conclusion: Peritoneal oxalate clearance plays an important role in oxalate balance in PD patients and, therefore, dialysis-related peritonitis is a significant predictor for hyperoxalemia. Further well-designed clinical trials need to be undertaken before the association between peritonitis and oxalate balance in PD patients is more clearly understood.Oxalate is an ionized form of a potentially toxic oxalic acid formed from endogenously synthesized and exogenously ingested oxalates (1, 2). In physiological conditions, the bulk of circulating oxalate (90-95%) is excreted through the kidneys, whereas the remainder (5-10%) through the terminal parts of the small intestine and colon (1-4). A decline in kidney function leads to decreased oxalate clearance and, ultimately, hyperoxalemia in end-stage kidney disease (ESKD) (1, 5-7). The accumulation of oxalate is associated with oxidative stress and systemic inflammation (1, 8, 9), high cardiovascular risk (9-11), and increased mortality rate (1, 11) in patients with kidney stones and ESKD. Nevertheless, little evidence is available on oxalate balance in ESKD patients in general and peritoneal dialysis (PD) patients in particular; almost all scientific data on this issue were published during the 1980s and 1990s (6,(12)(13)(14).Worldwide, PD is a key element of kidney replacement therapy (15-17). Nonetheless, peritonitis remains one of the major challenges associated with severe clinical complications of PD despite technological advances (17,18). Detrimental effects of dialysis-related peritonitis on the characteristics of peritoneal transport and the alterations of the peritoneal membrane have been documented (19-21). However, the potential effect of dialysis-related peritonitis on oxalate balance in PD patients has never been evaluated before. We hypothesized that the alteration of the peritoneal membrane due to dialysis-related peritonitis could decrease the peritoneal clearance of oxalate and, consequently, its removal levels. To test this hypothesis, the present study aimed to define oxalate balance and explore its association with dia...

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“…За результатами дослідження, проведеного в діалізній популяції Австралії та Нової Зеландії, ССЗ стали причиною смерті 31% та 20% пацієнтів, які отримували лікування перитонеальним діалізом (ПД) та гемодіалізом (ГД), відповідно. При цьому, через 1 рік після початку НЗТ лікування ПД, порів- [7][8][9][10][11][12][13].…”

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Predictors of cardiovascular disease in peritoneal patients: A Prospective longitudinal cohort study

Shifris

Dudar

2022

Ukr. J. Nephrol. and Dial.

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The present study aimed to investigate the incidence rate and possible predictors of cardiovascular disease (CVD) in end-stage renal disease (ESRD) patients treated with continuous ambulatory peritoneal dialysis (CAPD). Methods. This prospective longitudinal cohort study included 133 ESRD patients treated with CAPD between 2012 and 2019. The study was conducted in two phases. In the first phase, key patient demographic, clinical, and laboratory data, including the incidence of cardiovascular disease, were collected at baseline. In the second phase, an assessment of potential predictors of CVD in PD patients was performed. Baseline patient characteristics were used as potential predictors in this study. The mean duration of the prospective study was 28.2 ± 7.1 months, corresponding to 249.2 patient-years. Univariate and multivariate Cox proportional hazard regression and ROC analysis were performed to estimate predictors of CVD events. The primary end-point (newly diagnosed cardiovascular disease) was determined at the end of the study. Statistical processing of the results obtained was performed with "MedCalc," version 19.3 (Ostend, Belgium). Results. One hundred and three PD patients were included in the final analysis. During the study period, a significant increase (by 82%) in the frequency of all CVDs was observed (р < 0.0001), more than twice as frequent in heart failure (HF) (р < 0.0001) and atrial fibrillation (AF) (р= 0.0156). The primary endpoint was observed in 49 events: newly diagnosed HF in 21 (20.4%) patients, coronary artery disease in 9 (8.7%) patients, AF in 7 (6.8%) patients, acute myocardial infarction in 5 (4.9%) patients, another coronary heart disease in 7 (6.8%) patients. The incidence rate of CVD and HF was 19.66 and 8.43 per 100 patient-years, respectively. Multivariate Cox regression analysis indicated that hyperhydration (HR=4.2; 95% CI: 2,.2 - 7.3), diabetes mellitus as the primary cause of ESRD (HR=2.5; 95% CI: 1.3 - 4.3), history of MRSA colonization (HR=1.4; 95% CI: 1.2 - 1.7) and age (HR=1.03; 95% CI: 1.004 - 1.05) are independent predictors of all new-onset cardiovascular events in ESRD patients, treated with CAPD. A total of 44 patients (42.7%) died during the study period. The incidence rates of all-cause mortality were 17.67 per 100 patient-years. The most common cause of mortality was CVD, accounting for 50.0% of all events (8.82 per 100 patient-years). Conclusions. This prospective longitudinal study demonstrates that treatment with PD is associated with an increased incidence of CVD. Hyperhydration, diabetes mellitus, history of MRSA colonization, and age over 55 years are independent predictors of new-onset CVD in PD patients.

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Activation of chronic inflammation and comorbidity in end-stage renal disease patients treated with continuous ambulatory peritoneal dialysis.

Cited by 5 publications

References 10 publications

Recommendations of the Ukrainian Renal Disaster Relief Committee of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists regarding medical care to kidney disease patients during the war

Recommendations of the Ukrainian Renal Disaster Relief Committee of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists regarding medical care to kidney disease patients during the war

Oxalate Balance in Peritoneal Dialysis Patients: A Potential Role of Dialysis-related Peritonitis

Predictors of cardiovascular disease in peritoneal patients: A Prospective longitudinal cohort study

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