Catheter-related infections in peritoneal dialysis: comparison of a single center results and the literature data

Manani, Sabrina Milan; Virzì, Grazia Maria; Giuliani, Anna; Crepaldi, Carlo; Ronco, Claudio

doi:10.1007/s40620-019-00604-3

Cited by 5 publications

(2 citation statements)

References 22 publications

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“…The reduction of exit-site infections could be easier related with forms of virtual caregiver-based telemedicine such as Videodialysis or with careful PD training, performed by specialized nurses [ 7 , 30 ]. Future larger and prospective studies will be useful to explain better the effect of RM-APD on exit site infections.…”

Section: Discussionmentioning

confidence: 99%

Remote monitoring in peritoneal dialysis: benefits on clinical outcomes and on quality of life

et al. 2020

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Background Automated peritoneal dialysis (APD) has been proved benefit from remote monitoring (RM), but evidences are limited. In this study, we compared clinical outcomes and quality of life (QoL) in two group of patients undergoing APD, with and without exposure of RM. Methods This is a retrospective cohort study, comparing outcomes in two groups of APD patients monitored during 6 months with RM (group A: n = 35) or standard care (group B: n = 38 patients). In our clinical practice, we assign the RM system to patients who live more distant from the PD center or difficulty in moving. We evaluated emergency visits, hospitalizations, peritonitis, overhydration, and dropout. QoL was assessed with the Kidney Disease Quality of life-Short Form (KDQOL-SF). We included four additional questions focused on patient's perception of monitoring, safety and timely problems solution (Do you think that home-therapy monitoring could interfere with your privacy? Do you think that your dialysis sessions are monitored frequently enough? Do you think that dialysis-related issues are solved timely? Do you feel comfortable carrying out your home-based therapy?). Results The case group presented a higher comorbidity score, according to Charlson Comorbidity Index (group A: 5.0; IQR 4.0-8.0 versus group B: 4.0; IQR 3.0-6.0) (p = 0.042). The results in group A showed a reduction in the urgent visits due to acute overhydration (group A: 0.17 ± 0.45 versus group B: 0.66 ± 1.36) (p: 0.042) and in the number of disease-specific hospitalization (group A n = 2.0; 18.2% versus group B n = 7.0; 77.8%) (p = 0.022). We did not find any difference between the two groups in terms of hospitalization because of all-cause, peritonitis, overhydration, and dropout. The analysis of KDQOL-SF subscales was similar in the two groups; on the contrary, the answers of our pointed questions have showed a significant difference between the two groups (group A: 100 IQR 87.5-100.0 versus group B 87.5; IQR 75.0-100.0) (p: 0.018). Conclusion RM improved clinical outcomes in PD patients, reducing the emergency visits and the hospitalizations, related to nephrological problems, especially in patients with higher comorbidity score. The acceptance and satisfaction of care were better in patients monitored with RM than with standard APD.

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Section: Discussionmentioning

confidence: 99%

Remote monitoring in peritoneal dialysis: benefits on clinical outcomes and on quality of life

et al. 2020

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“…Peritonitis and exit site infections are the main problems associated with peritoneal dialysis (PD) patients, characterizing 25% of all hospital admissions for the PD population [ 1 , 2 , 3 ]. Serious and recurrent PD-related peritonitis provokes long-term complications which may hypothetically result in peritoneal membrane damage [ 4 ] and the need to switch to hemodialysis.…”

Section: Introductionmentioning

confidence: 99%

Eryptosis in Peritoneal Dialysis-Related Peritonitis: The Potential Role of Inflammation in Mediating the Increase in Eryptosis in PD

Virzì

Manani

Marturano

et al. 2022

JCM

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Background: Peritonitis and exit site infections are the main complications of patients treated with peritoneal dialysis (PD). Erythrocytes (red blood cells—RBCs) are very sensitive cells, and they are characterized by eryptosis (programmed cell death). The purpose of this research was to assess eryptosis in PD patients with PD-related peritonitis and its connection to inflammatory markers in vivo and in vitro. Material and Methods: In this study, we included 65 PD patients: 34 PD patients without systemic inflammation nor PD-related peritonitis in the previous 3 months, and 31 PD patients with an acute episode of PD-related peritonitis. We measured C-reactive protein (CRP) and cytokine (IL-1β, IL-6, and IL-18) levels as systemic inflammatory markers. Eryptosis was evaluated by flow cytometric analyses in freshly isolated RBCs. The induction of eryptosis due to in vitro exposure to IL-1β, IL-6, and IL-18 was verified. Results: Eryptosis was significantly higher in PD patients with peritonitis (9.6%; IQR 4.2–16.7), compared to the those in the other group (2.7%; IQR 1.6–3.9) (p < 0.0001). Significant positive correlations were noticed between eryptosis and CRP, IL-1β, and IL-6. RBCs, incubated with greater concentrations of all cytokines in vitro, resulted in significantly higher occurrences of eryptosis in comparison with those incubated with lower concentration and with untreated cell (p < 0.05), and for those with extensive exposure (p < 0.05). Conclusion: In conclusion, we investigated a potential relationship between systemic eryptosis and the in vivo and in vitro inflammatory damage of the peritoneal membrane during peritonitis. Thus, the presented results revealed that upregulated inflammatory markers and immune system dysregulation could be the cause of high levels of systemic eryptosis during PD-related peritonitis.

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Changes in serum albumin concentrations during transition to dialysis and subsequent risk of peritonitis after peritoneal dialysis initiation: a retrospective cohort study

et al. 2020

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Catheter-related infections in peritoneal dialysis: comparison of a single center results and the literature data

Cited by 5 publications

References 22 publications

Remote monitoring in peritoneal dialysis: benefits on clinical outcomes and on quality of life

Remote monitoring in peritoneal dialysis: benefits on clinical outcomes and on quality of life

Eryptosis in Peritoneal Dialysis-Related Peritonitis: The Potential Role of Inflammation in Mediating the Increase in Eryptosis in PD

Changes in serum albumin concentrations during transition to dialysis and subsequent risk of peritonitis after peritoneal dialysis initiation: a retrospective cohort study

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