Peritoneal Transport Characteristics at the Beginning and in Long Term Peritoneal Dialysis: a Single Center Experience

Uncanin, Snezana; Serdarevic, Nafija; Klapuh, Nermina; Hasković, Edhem

doi:10.5455/msm.2020.32.-104

Cited by 6 publications

(8 citation statements)

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“…PET is used to characterize the capacity for transportation of the patient's peritoneal membrane (Wang et al, 2020). Transport capacity assists in deciding on the dwell time and is also a central factor in determining the morbidity and mortality of PD patients (Uncanin et al, 2020). Generally, patients with a high peritoneal transport status will find it beneficial to receive APD treatment employing lower dwell time, whereas patients with low peritoneal transport status may find treatments with longer dwell times, e.g., CAPD, more beneficial (Roumeliotis et al, 2020).…”

Section: Test Resultsmentioning

confidence: 99%

Peritoneal Dialysis Failure and its Impact on Holistic Kidney Care: A Case Report

Yip

2021

SAGE Open Nursing

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Introduction Peritonitis remains the primary cause of treatment failure among patients with end-stage kidney disease on continuous ambulatory peritoneal dialysis. However, detailed case analyses illustrating the application of current research in clinical practice remain scant. This case report aimed to elucidate the roles of dialysis nurses in a hospital setting in the management of a 62-year-old male patient with a history of kidney failure secondary to amyloidosis. Case Presentation The patient was diagnosed with continuous ambulatory peritoneal dialysis-associated peritonitis. Management and Outcomes Dialysis nurses applied evidence-based practices in the management of the patient’s exit-site infection, imbalanced nutrition, and psychosocial concerns. The patient was discharged after 7 days, with a comprehensive treatment regimen, including an individualized peritoneal dialysis protocol adjusted to his daily schedules, education on self-care techniques, and continual nutritional management to prevent recurrence and improve his overall health. This case report shows that admissions for continuous ambulatory peritoneal dialysis-associated peritonitis require evidence-based nursing interventions specific to, and geared toward, each patient’s prioritized health problems. Discussion Peritonitis cases are preventable with appropriate nursing interventions that can lower the chance of treatment failure and long-term impact caused by an abrupt switch to hemodialysis. To successfully manage patients with continuous ambulatory peritoneal dialysis-associated peritonitis, dialysis nurses should appreciate the intricacies of the analyses underpinning their professional practices in promoting the patient’s self-care techniques.

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Section: Test Resultsmentioning

confidence: 99%

Peritoneal Dialysis Failure and its Impact on Holistic Kidney Care: A Case Report

Yip

2021

SAGE Open Nursing

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“…Normally, to evaluate the adequacy of PD, ultrafiltration volume, transport of small solutes, such as D/P creatinine and D/P glucose were the most commonly used parameters. In most studies, increased D/P creatinine and decreased ultrafiltration volume were observed under long-term PD [36,37], and these changes were highly associated with disease progression, prognosis, and patient survival rate [38]. Increased density of perfused capillaries on the peritoneum caused by angiogenesis and local production of inflammation cytokines, such as IL-6, TNF-α, IL-1 and IFN-γ were considered as two main causes of the increasing transport of small solutes [39][40][41][42]; besides, the rapid dissipation of glucose led to an ultimate decrease of ultrafiltration volume [43,44].…”

Section: Discussionmentioning

confidence: 99%

Oxidative Stress-Induced Alterations of Cellular Localization and Expression of Aquaporin 1 Lead to Defected Water Transport upon Peritoneal Fibrosis

Wei

Cheng

et al. 2022

Biomedicines

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Being one of the renal replacement therapies, peritoneal dialysis (PD) maintains around 15% of end-stage kidney disease patients’ lives; however, complications such as peritoneal fibrosis and ultrafiltration failure during long-term PD compromise its application. Previously, we established a sodium hypochlorite (NaClO)-induced peritoneal fibrosis porcine model, which helped to bridge the rodent model toward pre-clinical human peritoneal fibrosis research. In this study, the peritoneal equilibration test (PET) was established to evaluate instant functional changes in the peritoneum in the pig model. Similar to observations from long-term PD patients, increasing small solutes transport and loss of sodium sieving were observed. Mechanistic investigation from both in vivo and in vitro data suggested that disruption of cytoskeleton induced by excessive reactive oxygen species defected intracellular transport of aquaporin 1, this likely resulted in the disappearance of sodium sieving upon PET. Functional interference of aquaporin 1 on free water transport would result in PD failure in patients.

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“…Previous trials reported that the UF percentage ranged from − 3.50-16.50% with 1.5% dextrose [33][34][35][36] , 10.50-18.76% with 2.5% dextrose 31,34,35,[37][38][39] , 30.60-51.40% with 4.25% dextrose [33][34][35] , and 11.7-12.62% with mixed dextrose concentrations 40,41 , with the same FV (2 liters) and different DTs (ranging from 1.5 hours to 6 hours). The UF/FV/DT values ranged from 0.97 to 6.07 ‱/min with 1.5% dextrose 35,36 and 2.93 to 11.85 ‱/min with 2.5% dextrose 31,35,[37][38][39] .…”

Section: Discussionmentioning

confidence: 99%

Ultrafiltration in Patients on Automated Peritoneal Dialysis with Homechoice Claria connected to Sharesource: A Pilot Study

Hsiao¹,

Tian²,

Yen³

et al. 2021

Preprint

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Introduction: Fluid overload is an unavoidable problem in patients on peritoneal dialysis (PD) and is associated with poor outcomes. The aim of our study was to estimate ultrafiltration (UF) under different dextrose concentrations and clarify possible predictors of UF.Materials and methods: Seventy patients, with 1848 daily treatment records and 8266 single dwells on automated PD through Homechoice Claria with Sharesource were followed in October 2020 and categorized into 2 groups according to the dextrose concentration (group D1.5% and D2.5%). Baseline characteristics, peritoneal membrane characteristics, and daily PD treatment records from Sharesource were obtained. We compared UF under the different conditions.Results: Multivariate linear regression revealed that the mean fill volume (FV) per cycle (p=0.006) and dextrose concentration (p=0.000) were independent predictors of UF. The mean night UF per cycle, the mean night UF corrected by FV per cycle, and the mean night UF corrected by FV and dwelling time (DT) per cycle were 95.8 ml, 5.5%, and 5.0 ‱/minutes in group D1.5% and 220.3 ml, 12.0%, and 11.6 ‱/minutes in group D2.5%, respectively. After an approximately 120-minute DT, there was a trend toward higher UF in the low peritoneal permeability group and lower UF in the high peritoneal permeability group.Conclusion: This retrospective study presents precise UF measurements with two solutions at different dextrose concentrations and four peritoneal transport levels. UF is positively correlated with DT and FV of the dialysate within a reasonable range. High peritoneal permeability is associated with decreased UF, and low peritoneal permeability requires a longer DT to reach the maximal UF.

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Peritoneal Transport Characteristics at the Beginning and in Long Term Peritoneal Dialysis: a Single Center Experience

Cited by 6 publications

References 0 publications

Peritoneal Dialysis Failure and its Impact on Holistic Kidney Care: A Case Report

Peritoneal Dialysis Failure and its Impact on Holistic Kidney Care: A Case Report

Oxidative Stress-Induced Alterations of Cellular Localization and Expression of Aquaporin 1 Lead to Defected Water Transport upon Peritoneal Fibrosis

Ultrafiltration in Patients on Automated Peritoneal Dialysis with Homechoice Claria connected to Sharesource: A Pilot Study

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