Development of a framework for minimum and optimal safety and quality standards for hemodialysis and peritoneal dialysis

Solá, Laura; Levin, Nathan W.; Johnson, David W.; Pecoits‐Filho, Roberto; Aljubori, Harith; Chen, Yuqing; Claus, Stefaan; Collins, Allan J.; Cullis, Brett; Feehally, John; Harden, Paul; Hassan, Mohamed; Ibhais, Fuad M.; Kalantar-Zadeh, Kamyar; Levin, Adeera; Saleh, Abdulkarim; Schneditz, Daniel; Tchokhonelidze, Irma; Kazancıoğlu, Rümeyza; Twahir, Ahmed; Walker, Robert; Were, Anthony J.O.; Yu, Xueqing; Finkelstein, Fredric O.

doi:10.1016/j.kisu.2019.11.009

Cited by 35 publications

(26 citation statements)

References 71 publications

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“…World-wide, each country must have a specialized peritoneal dialysis nurse coordinator at each hospital and at regional areas of the country [31,32]. Having a nurse led program, utilizing a clinical pathway that runs in all clinics throughout the country is of utmost importance to improve the health related quality of life [33,34].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Glucose Load and Worse Metabolic Status Post Initiation of Peritoneal Dialysis

Al¹,

Al²,

Abdul³

et al. 2020

Int Arch Endocrinol Clin Res

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Background: End-Stage Kidney Disease (ESKD) has a major effect on global health, both as a direct cause of global morbidity and mortality. Peritoneal Dialysis (PD) utilization increases gradually due to increase of patient's awareness for different types of RRT. Glucose constitutes the main component of the PD fluid utilized by the patients.Objectives: In this study, we aim to evaluate the various demography and clinical and laboratory data before and a year after initiation of PD and determine the impact of glucose load and worse metabolic status.

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Section: Discussionmentioning

confidence: 99%

The Impact of Glucose Load and Worse Metabolic Status Post Initiation of Peritoneal Dialysis

Al¹,

Al²,

Abdul³

et al. 2020

Int Arch Endocrinol Clin Res

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“…These barriers are particularly troublesome because they have limited the growth of PD utilization in the United States at a time when globally PD treatment is being encouraged because of the reduced costs associated with PD and the potential health related quality of life benefits 3,7,9‐11 . The reduced cost of PD in high resource countries is well‐documented in studies from the United States and Canada 3,10,11 and is one of the reasons for the recent government drive to expand home therapies in the United States.…”

Section: Barriers To Pd Therapymentioning

confidence: 99%

Barriers to optimal peritoneal dialysis

Finkelstein

2020

Seminars in Dialysis

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Peritoneal dialysis in the United States is underutilized when compared to the experience in other developed countries. The reasons for this are multifactorial and include government regulatory issues, the priority of dialysis facilities, and education and training of nephrology trainees and patients. The challenges to expanding PD in the United States are discussed and strategies to overcome the barriers are outlined.

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“…1,3,5,26 On a global scale, implementing practical and cost-effective transport studies may help to solve the substantial heterogeneity observed in PD practice and performance across the world. 27,28…”

mentioning

confidence: 99%

Assessing transport across the peritoneal membrane: Precision medicine in dialysis

Devuyst

2021

Perit Dial Int

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The good physician treats the disease; the great physician treats the patient who has the disease.Sir William Osler (1903) Peritoneal dialysis (PD) is the leading form of home-based dialysis therapy for patients with kidney failure. 1 The efficiency of PD depends on its ability to remove excess of water and small uremic solutes from the organism, through fundamental mechanisms of osmosis and diffusive and convective transport across the peritoneal membrane. 2,3 According to Fick's laws of diffusion, the transport of small solutes across the peritoneal membrane (named the peritoneal solute transport rate, PSTR) is primarily determined by the effective peritoneal surface area (i.e. the number of perfused peritoneal capillaries in contact with the dialysate), the intrinsic permeability of the membrane, its thickness and the concentration gradient between blood and dialysate. The PSTR can readily be measured by the peritoneal equilibration test (PET), formalized by Twardowski, Nolph and colleagues in 1987. 4 Patients starting PD present a large variability in PSTR, conditioning the maintenance of the osmotic gradient, and thus the rate of ultrafiltration (UF) across the membrane. 5 Higher PSTR has been associated with a greater risk of technique failure and with an excessive risk of death among patients on PD. 6,7 It can be mitigated by PD prescription, that is, shortening dialysate dwell time or using alternate osmotic agents. 3,5 A proper assessment of membrane transport properties at baseline and during exposure to PD is thus of major importance for individualized prescription and for precision dialysis.The peritoneal membrane consists of three major components layered between the plasma and the dialysate: the capillary endothelium, the interstitial tissue and the mesothelium. The capillary endothelium represents the rate-limiting barrier for water and solute transport during PD, restricting the solute exchange to less than 0.1% of its total surface area. In the capillary endothelium, the major route for small solute and fluid exchange corresponds to the small pores, located to interendothelial clefts. The functional radius (approximately 40-50 Å ) of these small pores restricts the leak of albumin and other large molecules,

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Development of a framework for minimum and optimal safety and quality standards for hemodialysis and peritoneal dialysis

Cited by 35 publications

References 71 publications

The Impact of Glucose Load and Worse Metabolic Status Post Initiation of Peritoneal Dialysis

The Impact of Glucose Load and Worse Metabolic Status Post Initiation of Peritoneal Dialysis

Barriers to optimal peritoneal dialysis

Assessing transport across the peritoneal membrane: Precision medicine in dialysis

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