scholarly journals Transperitoneal Calcium Balance in Anuric Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Chieko Hamada ◽  
Yasuhiko Tomino
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Biochemical Parameters ◽  
Calcium Balance ◽  
Automated Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Intact Pth ◽  
Rapid Removal ◽  
The Difference ◽  
Short Time

Backgrounds. Calcium (Ca) and bone metabolism in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) patients show a remarkable difference depending on dialysis modalities. The levels of serum Ca and phosphate (P) in HD patients fluctuate contributing to the intermittent and rapid removal of plasma solute unlike in CAPD. Characteristics of plasma solute transport in automated peritoneal dialysis (APD) patients are resembled with that in HD. The purpose of the present study was to examine the difference of transperitoneal Ca removal between APD and CAPD anuric patients.Subjects and Methods. Twenty-three APD anuric patients were enrolled in this study. Biochemical parameters responsible for transperitoneal Ca removal in 24-hour and 4-hour peritoneal effluents were analyzed on CAPD and APD.Results. Transperitoneal Ca removal on APD was smaller compared with that on CAPD. The Ca removal was related to the ultrafiltration during short-time dwell. Decrease of the Ca removal during NPD induced by short-time dialysate dwell caused negative or small Ca removal in APD patients. The levels of intact PTH were increased at the end of PET.Conclusion. It appears that short-time dwell and frequent dialysate exchanging might suppress the transperitoneal Ca removal in anuric APD patients.

scholarly journals Comparison of sodium removal in peritoneal dialysis patients treated by continuous ambulatory and automated peritoneal dialysis

2019 ◽  
Vol 32 (6) ◽  
pp. 1011-1019 ◽  
Author(s):  
Sarju Raj Singh Maharjan ◽  
Andrew Davenport
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Fluid Balance ◽  
Automated Peritoneal Dialysis ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Membrane Function ◽  
Peritoneal Dialysate ◽  
Hypertonic Glucose ◽  
Sodium Removal

Abstract Background Optimal fluid balance for peritoneal dialysis (PD) patients requires both water and sodium removal. Previous studies have variously reported that continuous ambulatory peritoneal dialysis (CAPD) removes more or equivalent amounts of sodium than automated PD (APD) cyclers. We therefore wished to determine peritoneal dialysate losses with different PD treatments. Methods Peritoneal and urinary sodium losses were measured in 24-h collections of urine and PD effluent in patients attending for their first assessment of peritoneal membrane function. We adjusted fluid and sodium losses for CAPD patients for the flush before fill technique. Results We reviewed the results from 659 patients, mean age 57 ± 16 years, 56.3% male, 38.9% diabetic, 24.0% treated by CAPD, 22.5% by APD and 53.5% APD with a day-time exchange, with icodextrin prescribed to 72.8% and 22.7 g/L glucose to 31.7%. Ultrafiltration was greatest for CAPD 650 (300–1100) vs 337 (103–598) APD p < 0.001, vs 474 (171–830) mL/day for APD with a day exchange. CAPD removed most sodium 79 (33–132) vs 23 (− 2 to 51) APD p < 0.001, and 51 (9–91) for APD with a day exchange, and after adjustment for the CAPD flush before fill 57 (20–113), p < 0.001 vs APD. APD patients with a day exchanged used more hypertonic glucose dialysates [0 (0–5) vs CAPD 0 (0–1) L], p < 0.001. Conclusion CAPD provides greater ultrafiltration and sodium removal than APD cyclers, even after adjusting for the flush-before fill, despite greater hypertonic usage by APD cyclers. Ultrafiltration volume and sodium removal were similar between CAPD and APD with a day fill.

Differences in predicting glucose absorption from peritoneal dialysate compared to measured absorption in peritoneal dialysis patients treated by continuous ambulatory peritoneal dialysis and ambulatory peritoneal dialysis cyclers

2020 ◽  
Vol 43 (7) ◽  
pp. 461-467
Author(s):  
Theerasak Tangwonglert ◽  
Andrew Davenport
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Glucose Absorption ◽  
Osmotic Gradient ◽  
Systematic Bias ◽  
Automated Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Predictive Equations ◽  
Disease Outcomes

Background and aims: Glucose-containing peritoneal dialysates are used to generate an osmotic gradient for the convective removal of water and sodium. Predictive equations were developed to estimate glucose absorption without having to formally measure changes in dialysate glucose. In view of the changes in peritoneal dialysis prescriptions over time, we compared predicted and measured glucose absorption. Subjects/methods: We measured peritoneal glucose losses when peritoneal dialysis patients attended their first assessment of peritoneal membrane function, and compared this to glucose exposure and Kidney Disease Outcomes Quality Initiative, Grodstein and Bodnar predictive equations. Results: We studied 689 patients; 329 (56.9%) males, 53 (37.1%) diabetics, with mean age 57.1 ± 16.2 years, with 186 treated by automated peritoneal dialysis cyclers and 377 by automated peritoneal dialysis with a daytime icodextrin exchange and 126 by continuous ambulatory peritoneal dialysis. Using Bland -Altman analysis, all equations demonstrated systematic bias overestimating glucose absorption with increasing glucose absorption. For continuous ambulatory peritoneal dialysis patients, the Kidney Disease Outcomes Quality Initiative formula underestimated glucose absorption (bias 188 (−39 to 437) mmol/day, as did Grodstein (bias 37.9 (−105 to 29) mmol/day, whereas mean bias for Bodnar was −29 (−130 to 180)). There was systematic overestimation for all equations for both automated peritoneal dialysis with and without a daytime exchange, with increasing bias with greater glucose absorption. Conclusion: Although formally measuring peritoneal glucose absorption is time consuming and requires patient co-operation, current predictive equations overestimate glucose absorption and do not provide accurate estimations of glucose absorption particularly for automated peritoneal dialysis patients.

In Younger Dialysis Patients, Automated Peritoneal Dialysis is Associated with Better Long-Term Patient and Technique Survival than is Continuous Ambulatory Peritoneal Dialysis

2011 ◽  
Vol 31 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Chiao-Yin Sun ◽  
Chin-Chan Lee ◽  
Yu-Yin Lin ◽  
Mai-Szu Wu
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Age Groups ◽  
Nutrition Status ◽  
Automated Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Technique Survival ◽  
Adjusted Risk ◽  
Technique Failure ◽  
Overall Mortality

BackgroundIn the U.S. Renal Data System registry, technique and patient survival are similar with automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD). The clinical outcomes of APD and CAPD in various age groups have not been clarified.ObjectivesWe investigated whether patient and technique survival are different for incident dialysis patients treated with APD or CAPD in two age groups.MethodsOur retrospective study of prospectively collected data included 282 incident peritoneal dialysis (PD) patients (161 on APD, 121 on CAPD). Patients on PD for less than 3 months were excluded. The patients were divided into those less than 65 years of age and those 65 years of age or older. Overall mortality and technique failure were the primary endpoints of the study. Hazard ratios (HRs) for mortality and technique failure were calculated by the Cox proportional hazards model and were adjusted for age, sex, diabetes mellitus, initial peritoneal equilibration test (PET), weekly peritoneal and renal creatinine clearances, and PD caregiver (self or other).ResultsThe characteristics and clinical data were not significantly different between patients on APD and CAPD, except for age and sex. The adjusted risk for overall mortality was not different between patients on APD and CAPD (HR: 0.72; 95% CI: 0.44 to 1.20; p = 0.207). The adjusted risk for technique failure was lower in APD patients than in CAPD patients (HR: 0.58; 95% CI: 0.34 to 0.98; p = 0.041). In patients less than 65 years of age, those on APD had a significantly lower risk of mortality (HR: 0.35; 95% CI: 0.16 to 0.75; p = 0.007) and technique failure (HR: 0.52; 95% CI: 0.28 to 0.95; p = 0.034) than did those on CAPD. In patients 65 years of age and older, those on APD had risks for mortality (HR: 1.14; 95% CI: 0.53 to 2.46; p = 0.730) and technique failure (HR: 0.51; 95% CI: 0.17 to 1.50; p = 0.220) that were similar to those of patients on CAPD. Nutrition status, including serum albumin and protein catabolic rate, was not significantly different between patients on APD and on CAPD, in either younger or older patients.ConclusionsYounger Chinese patients on APD have better patient and technique survival than do those on CAPD. However, there is a strong possibility that this benefit may be confounded or accounted for by baseline differences between the APD and CAPD populations.

Adequacy of Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 16 (8) ◽  
pp. 567-572 ◽  
Author(s):  
A.H. Tzamaloukas ◽  
G.H. Murata
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Outcomes ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Biochemical Parameters ◽  
Retrospective Studies ◽  
Dialysis Patients ◽  
Small Molecular Weight ◽  
Multicenter Studies ◽  
Dialysis Adequacy ◽  
Clearance Studies

Adequacy of continuous ambulatory peritoneal dialysis (CAPD) and its variants is assessed by clinical outcomes, biochemical parameters and clearance parameters. Clinical outcomes lack specificity and probably sensitivity. Nevertheless, they constitute the “gold standard” to which any other method assessing dialysis adequacy must be compared. Biochemical parameters are both non-sensitive and non-specific and cannot be used to assess dialysis adequacy. Clearance of small molecular weight azotemic substances (urea, creatinine) presents considerable computational problems and interpretative difficulties. In preliminary studies, clearance studies have been able to differentiate between peritoneal dialysis patients having symptoms of inadequate dialysis and those clinically adequately dialyzed. Among population outcomes (morbidity, maintenance of peritoneal dialysis for long periods, hospitalization rate, mortality), only mortality sems to be associated with low clearances in retrospective studies. Prospective multicenter studies comparing clearance values to clinical outcomes are needed to evaluate clearance studies as methods of assessing peritoneal dialysis adequacy.

scholarly journals THE RISK FACTORS AND OUTCOME OF FUNGAL PERITONITIS IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS PATIENTS

2009 ◽  
Vol 27 (1) ◽  
pp. 59-61
Author(s):  
E Indhumathi ◽  
V Chandrasekaran ◽  
D Jagadeswaran ◽  
M Varadarajan ◽  
G Abraham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Fungal Peritonitis
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