Peritoneal Membrane Failure in Peritoneal Dialysis Patients

Krediet, Raymond T.; Esch, Ssadie van; Smit, Watske; Michels, Wieneke M.; Zweers, Machteld M.; Ho-dac-Pannekeet, Marja M.; Struijk, Dirk G.

doi:10.1159/000065202

Cited by 20 publications

(14 citation statements)

References 45 publications

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“…Exposure to such dialysis fluids, which also contain high concentrations of glucose degradation products, is likely to induce morphologic and functional abnormalities of the peritoneum (24,25). Loss of peritoneal ultrafiltration capacity is the most common clinical manifestation of peritoneal membrane alterations (26). The resulting overhydration is likely to be partly responsible for the high cardiovascular mortality rates for PD patients.…”

Section: Discussionmentioning

confidence: 99%

Hemodialysis and Peritoneal Dialysis

Termorshuizen¹,

Korevaar²,

Dekker

et al. 2003

Journal of the American Society of Nephrology

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244

176

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Various studies indicate that fair comparisons of mortality rates between hemodialysis (HD) patients and peritoneal dialysis (PD) patients are difficult because of differences in patient characteristics, because of nonconstant relative risks of death (RR), and because the survival times of patients who switch treatment modalities can be censored in different ways. The differences in mortality rates between HD and PD patients were investigated in an analysis in which these potential sources of bias were taken into account. The Netherlands Cooperative Study on the Adequacy of Dialysis is a multicenter, prospective, observational, cohort study in which new patients with ESRD are monitored until transplantation or death. A multivariate Cox regression analysis was used to analyze the mortality data according to treatment modality (HD, n = 742; PD, n = 480). No statistically significant differences in adjusted mortality rates between HD and PD patients were observed during the first 2 yr of dialysis. In the years thereafter, increases in mortality rates for PD patients and resulting decreases in RR in favor of HD were observed (e.g., months 24 to 36, adjusted RR, 0.53; 95% confidence interval, 0.31 to 0.91). This tendency was observed especially among patients >/=60 yr of age and was not influenced by the censoring strategy. These results suggest that long-term use of PD, especially among elderly patients, is associated with increases in mortality rates. Further analyses are required to determine the potential role of dialysis adequacy in the observed long-term differences in mortality rates between HD and PD patients and to establish the possible survival benefits for PD patients who switch to HD in time.

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Section: Discussionmentioning

confidence: 99%

Hemodialysis and Peritoneal Dialysis

Termorshuizen¹,

Korevaar²,

Dekker

et al. 2003

Journal of the American Society of Nephrology

Self Cite

244

176

View full text Add to dashboard Cite

show abstract

“…They also established that the capillary endothelium, which expresses both the endothelial nitric oxide synthase (eNOS) and the water channel aquaporin-1 (AQP1) [4], constitutes the major barrier for solutes and water transport during PD [2,3]. The amount of perfused capillaries within the PM determines the so-called "effective peritoneal surface area" (EPSA), which is the functional area of exchange between blood and dialysate [5].…”

mentioning

confidence: 99%

Functional and molecular characterization of a peritoneal dialysis model in the C57BL/6J mouse

Cnops

Debaix

et al. 2005

Kidney International

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“…Nonetheless the procedure is still time consuming as it must be carried out four times daily each taking between 30 and 45 minutes [40]. Patients can utilize this form of dialysis for a maximum of 4-6 years due to the risk of peritoneum failure, and other potentially dangerous anatomic changes in the tissue [25].…”

Section: Peritoneal Dialysismentioning

confidence: 99%

Compensated Living Kidney Donation: A Plea for Pragmatism

2009

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Kidney transplantation is the most efficacious and cost-effective treatment for end-stage renal disease. However, the treatment's accessibility is limited by a chronic shortage of transplantable kidneys, resulting in the death of numerous patients worldwide as they wait for a kidney to become available. Despite the implementation of various measures the disparity between supply and needs continues to grow. This paper begins with a look at the current treatment options, including various sources of transplantable kidneys, for end-stage renal disease. We propose, in accordance with others, the introduction of compensated kidney donation as a means of addressing the current shortage. We briefly outline some of the advantages of this proposal, and then turn to examine several of the ethical arguments usually marshaled against it in a bid to demonstrate that this proposal indeed passes the ethics test. Using available data of public opinions on compensated donation, we illustrate that public support for such a program would be adequate enough that we can realistically eliminate the transplant waiting list if compensation is introduced. We urge a pragmatic approach going forward; altruism in living kidney donation is important, but altruism only is an unsuccessful doctrine.

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Peritoneal Membrane Failure in Peritoneal Dialysis Patients

Cited by 20 publications

References 45 publications

Hemodialysis and Peritoneal Dialysis

Hemodialysis and Peritoneal Dialysis

Functional and molecular characterization of a peritoneal dialysis model in the C57BL/6J mouse

Compensated Living Kidney Donation: A Plea for Pragmatism

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