Current Status of Peritoneal Dialysis

Mehrotra, Rajnish; Boeschoten, E. W.

doi:10.1007/978-0-387-78940-8_2

Cited by 5 publications

(5 citation statements)

References 179 publications

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“… 21 PD patients undergo abdominal surgery and usually have dialysate in their peritoneal cavity. 21 , 22 This last tenet underlies the rationale behind discouraging PD patients from participating in physical activity that involves lifting weights as the increased intra-abdominal pressure may precipitate the development of hernias and leaks. 23 - 25 …”

Section: Introductionmentioning

confidence: 99%

Physical Activity in Patients Treated With Peritoneal Dialysis: A Systematic Review and Meta-analysis

Thangarasa

Imtiaz

Hiremath

et al. 2018

Can J Kidney Health Dis

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Background:Exercise has been shown to be of benefit in the general population and in patients with chronic diseases. Despite a lack of compelling evidence, patients with end-stage kidney disease (ESKD) treated with peritoneal dialysis (PD) are often discouraged from participating in exercise programs that include weight lifting due to concerns about the development of hernias and leaks. The actual effects of physical activity with or without structured exercise programs for patients on PD remain unclear.Objective:To determine the risks and benefits of physical activity in the ESKD population treated with PD.Design:Systematic review and meta-analysis.Setting:Included all studies that met our criteria regardless of country of origin.Patients:Adult patients with ESKD treated with PD.Measurements:Descriptive and quantitative analysis of our primary and secondary outcome variables.Methods:We searched MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials for observational and interventional studies examining the effects of physical activity in patients on PD. A systematic review and meta-analysis was conducted of the identified studies. The primary outcomes of interest included patient-centered outcomes of mental health, physical functioning, fatigue, quality of life, and adverse events. Secondary outcomes included nutritional measures, lipid profile, blood pressure changes, maximum heart rate, resting heart rate, maximal oxygen consumption, muscle development, cognitive function, and markers of inflammation.Results:Of 1828 studies identified by the literature search, 12 met the inclusion criteria including 6 interventional and 6 observational studies. There was limited information on the patient important outcomes. However, there is some evidence for improvements in burden of kidney disease, physical function, and some mental health measures with physical activity.Limitations:Lack of well-designed randomized controlled trials impaired our ability to determine the benefits and risks of increasing physical activity.Conclusions:There is limited evidence of benefit with increased levels of physical activity in PD patients. Further research is needed to define the exercise program that is likely to be of most benefit to patients treated with PD.

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Section: Introductionmentioning

confidence: 99%

Physical Activity in Patients Treated With Peritoneal Dialysis: A Systematic Review and Meta-analysis

Thangarasa

Imtiaz

Hiremath

et al. 2018

Can J Kidney Health Dis

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“…P eritoneal dialysis (PD) is one of the alternative renal replacement treatment methods in end-stage renal disease. This method was first used in 1923 by Ganter (1). Icodextrin is a starch-based glucose polymer with a high molecular weight.…”

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confidence: 99%

Effects of Twice-Daily Icodextrin Administration on Blood Pressure and Left Ventricular Mass in Patients on Continuous Ambulatory Peritoneal Dialysis

Sav¹,

Oymak

İnanç

et al. 2009

Perit Dial Int

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Background Hypervolemia is a risk factor for left ventricular hypertrophy and hypertension in peritoneal dialysis patients. Icodextrin improves volume control by increasing ultrafiltration in peritoneal dialysis patients. Aim To examine the effects of twice-daily icodextrin administration on blood pressure and left ventricular hypertrophy in peritoneal dialysis patients with hypervolemia and ultrafiltration failure. Method and Results Administration of icodextrin twice daily resulted in a significant reduction in the left ventricular mass index (LVMI) of patients by the end of the third month ( p < 0.05). The reduction in LVMI was also significant for the once-daily icodextrin group ( p < 0.05). Mean blood pressure of patients receiving icodextrin twice daily was significantly reduced ( p < 0.05). By the end of the third month no significant changes were observed in mean blood pressure of the patients using once-daily icodextrin ( p > 0.05). No statistically significant changes were observed in weekly total creatinine clearances or Kt/V of patients in either group at the end of 3 months (NS). Conclusion Twice-daily icodextrin administration was clinically beneficial as shown by reduced blood pressure and prevention of the progress of left ventricular hypertrophy without causing any decrease in dialysis adequacy or any side effects. The icodextrin metabolite results did not suggest any further increase in their values when comparing once- to twice-daily administration of icodextrin. Although prescription of icodextrin once daily may yield good clinical results in the long term, this study showed that it may be more efficient to use twice-daily icodextrin for at least a specific period for the purpose of obtaining quicker results in patients with ultrafiltration failure, serious hypervolemia, or hard-to-control blood pressure conditions.

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“… 18 Peritoneal dialysis patients have undergone abdominal surgery and usually have dialysate in their peritoneal cavity. 18 , 19 This last tenant underlies the rationale behind discouraging PD patients from participating in physical activity that involves lifting weight. 20 , 21 In 1986, Twardowski et al demonstrated that PD patients have increased intra-abdominal pressures during various activities, including coughing, straining, and weight lifting.…”

Section: Introductionmentioning

confidence: 99%

Physical Activity in Patients Treated With Peritoneal Dialysis

Thangarasa

Imtiaz

Hiremath

et al. 2017

Can J Kidney Health Dis

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Background:Patients with chronic diseases are known to benefit from exercise. Despite a lack of compelling evidence, patients with end-stage kidney disease treated with peritoneal dialysis are often discouraged from participating in exercise programs that include resistance training due to concerns about the development of hernias and leaks. The actual effects of physical activity with or without structured exercise programs for these patients remain unclear. The purpose of this study is to more completely define the risks and benefits of physical activity in the end-stage kidney disease population treated with peritoneal dialysis.Methods/design:We will conduct a systematic review examining the effects of physical activity on end-stage kidney disease patients treated with peritoneal dialysis. For the purposes of this review, exercise will be considered a purposive subcategory of physical activity. The primary objective is to determine if physical activity in this patient population is associated with improvements in mental health, physical functioning, fatigue and quality of life and if there is an increase in adverse outcomes. With the help of a skilled librarian, we will search MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials for randomized trials and observational studies. We will include adult end-stage kidney disease patients treated with peritoneal dialysis that have participated in an exercise training program or had their level of physical activity assessed directly or by self-report. The study must include an assessment of the association between physical activity and one of our primary or secondary outcomes measures. We will report study quality using the Cochrane Risk of Bias Assessment Tool for randomized controlled trials and the Newcastle–Ottawa Scale for observational studies. Quality across studies will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The results of this review may help to inform guideline development for exercise recommendations specific to this patient population.Systematic review registration:PROSPERO:CRD42016041695.

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Current Status of Peritoneal Dialysis

Cited by 5 publications

References 179 publications

Physical Activity in Patients Treated With Peritoneal Dialysis: A Systematic Review and Meta-analysis

Physical Activity in Patients Treated With Peritoneal Dialysis: A Systematic Review and Meta-analysis

Effects of Twice-Daily Icodextrin Administration on Blood Pressure and Left Ventricular Mass in Patients on Continuous Ambulatory Peritoneal Dialysis

Physical Activity in Patients Treated With Peritoneal Dialysis

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