Three Years' Experience of Continuous Ambulatory Peritoneal Dialysis

Chan, Michael C. W.; Chuah, Patricia; Raftery, MartinJ; Baillod, R. A.; Sweny, P.; Varghese, Z.; Moorheàd, J. F.

doi:10.1016/s0140-6736(81)92582-4

Cited by 73 publications

(20 citation statements)

References 4 publications

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“…In the third quarter, Gram-negative bacteria, principally E. coli were increasingly recognized (Freedman et al 1981) and more recently group B streptococci have assumed some importance (Editorial, 1981). Coagulase-negative staphylococci (CONS) have recently emerged as significant pathogens in leukaemics with in-dwelling intra-atrial catheters (Wade et al 1982), in patients with ventriculo-atrial or peritoneal shunts (Callaghan, Cohen & Stewart, 1961), in patients undergoing ambulatory peritoneal dialysis (Chan et al 1981), and those on long-term total parenteral nutrition (Goldman & Maki, 1973). Each of these groups of patients have in common the insertion of synthetic polymers into normally sterile body compartments most often traversing the skin.…”

Section: Discussionmentioning

confidence: 99%

Serious infection in a neonatal intensive care unit: A two-year survey

Hensey

Hart

Cooke

1985

J. Hyg.

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SUMMARYOver a two-year period 160 episodes of serious infection occurred in 139 infants admitted to a regional neonatal intensive-care unit. Eighty-seven (26 00) of very low birth weight (VLBW) neonates and 52 (80) of infants of birth weight > 1500 g were infected. The majority (840%) had bacteraemia alone. Though the clinical features of infection were not distinctive, in 940 of episodes the peripheral white blood cell or band counts were abnormal. Thirty-three (21 00) of the infections occurred in infants under 48 h old and 15 of these followed prolonged rupture of membranes (>48 h). All of the infections due to group B streptococci (5), Streptococcus viridans (2) and Haemophilus influenzae (3) occurred in this group.Coagulase-negative staphylococci (CONS) accounted for 490 of the infections and there was a marked increase in incidence of such infections during the survey. Infections with CONS were not necessarily associated with parenteral nutrition, the presence of intra-arterial catheters or mechanical ventilation but the rise in incidence was coincident with change in skin disinfectant usage and the general use of a third-generation cephalosporin to which the CONS were resistant.Although VLBW infants with meningitis were more likely to die than those of higher birthweight, the risk for those with bacteriaemia was the same in both groups. Infants with CONS sepsis were less likely to die than those with infections due to Gram-negative bacteria and the time from onset of infection to death was significantly longer for the former.

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Section: Discussionmentioning

confidence: 99%

Serious infection in a neonatal intensive care unit: A two-year survey

Hensey

Hart

Cooke

1985

J. Hyg.

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“…Since the introduction of CAPD many of these problems are minimised but not eliminated during long-term ther apy. Furthermore, hyperlipidaemia, which is frequently associated with chronic renal failure, is increased [3,4].…”

Section: Introductionmentioning

confidence: 99%

Nutrition and Delayed Hypersensitivity during Continuous Ambulatory Peritoneal Dialysis in Relation to Peritonitis

Young¹,

Young²,

Young³

et al. 1986

Nephron

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Anthropometric measurements, sixteen specific plasma proteins, triglycerides, cholesterol, urea and creatinine were measured at 4-monthly intervals for 1 year in 15 patients on CAPD. Delayed hypersensitivity skin tests were performed on 11 patients at the start and after 4 and 12 months. Body weight increased due mainly to a mean increase in ‘calculated’ body fat of 2.0 kg with increases in cholesterol, triglycerides and apolipoprotein B. Gain in fat correlated with the daily supply of dextrose in the dialysis fluid. Albumin, transferrin, prealbumin and retinol-binding protein decreased in 8 patients who intermittently ate less than 1.3 g protein/kg/day. A high concentration of dextrose in the dialysis fluid probably caused loss of appetite. Peritonitis resulted in increases in acute phase proteins although other plasma proteins decreased. Skin test responses indicated improvement in cell-mediated immunity during continuous ambulatory peritoneal dialysis (CAPD). The incidence of peritonitis and length of stay in hospital were greater in the patients who were hypoalbuminaemic probably due to impairment of the humoral mechanism. Dextrose in dialysis fluid may contribute to hyperlipidaemia and malnutrition with impairment of immunocompetence.

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“…We are unaware of any descriptions of this approach in the literature, although sup plementing conventional CAPD with occa sional HD to increase solute or fluid removal has been reported [4],…”

Section: Introductionmentioning

confidence: 99%

Mixed-Mode Therapy: Kinetic Analysis and Acute Clinical Evaluation

et al. 1989

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A mixed therapeutic modality was devised in which patients with chronic renal failure were treated with a combination of continuous ambulatory peritoneal dialysis (CAPD; two daily 4-hour exchanges per day; 16 h dry belly) and hemodialysis (1 session per week). Kinetic modeling analysis indicated that a time-averaged urea concentration equivalent to CAPD could be obtained with a Kt/V value of 1.2-1.6, depending on patient parameters, for the single-weekly hemodialysis. The therapy format was acutely evaluated in a 2-week clinical trial on 4 patients. Excursions in small-solute concentration were virtually equivalent to those predicted from theory. Adequate fluid removal was obtained in the 2 CAPD exchanges and blood pressure was well controlled. As a result of the success of the acute trials, and since this format may offer potential lifestyle advantages ot patients who possess dual access, a chronic trial of mixed-mode therapy seems advised.

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Three Years' Experience of Continuous Ambulatory Peritoneal Dialysis

Cited by 73 publications

References 4 publications

Serious infection in a neonatal intensive care unit: A two-year survey

Serious infection in a neonatal intensive care unit: A two-year survey

Nutrition and Delayed Hypersensitivity during Continuous Ambulatory Peritoneal Dialysis in Relation to Peritonitis

Mixed-Mode Therapy: Kinetic Analysis and Acute Clinical Evaluation

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