MIA Syndrome in Peritoneal Dialysis: Prevention and Treatment

2006 ◽  
pp. 135-143 ◽  
Author(s):  
Irum Shahab ◽  
Karl D. Nolph
Keyword(s):  
Peritoneal Dialysis ◽  
Prevention And Treatment ◽  
Mia Syndrome

Diagnosis, Prevention and Treatment of Peritonitis

1984 ◽  
Vol 4 (2_suppl) ◽  
pp. 139-142 ◽  
Author(s):  
E. Dale Everett
Keyword(s):  
Peritoneal Dialysis ◽  
Ultraviolet Light ◽  
Chronic Peritoneal Dialysis ◽  
Prevention And Treatment ◽  
Dialysis Solutions

Recent reports related to the diagnosis, prevention and treatment of peritonitis in patients on chronic peritoneal dialysis are reviewed. The reports deal with modifications of earlier drug therapies, the use of ultraviolet light, the use of the inline filter, and the biocompatibility of antibiotics in dialysis solutions.

Prevention and Treatment of Catheter-Related Infections in Children

1987 ◽  
Vol 7 (1) ◽  
pp. 34-36 ◽  
Author(s):  
Bradley A. Warady ◽  
Mary Anne Jackson ◽  
Joan Millspaugh ◽  
Rose Marie Miller ◽  
Douglas M. Ford ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Povidone Iodine ◽  
Patient Treatment ◽  
Chronic Peritoneal Dialysis ◽  
Exit Site ◽  
Tunnel Infection ◽  
Significant Difference ◽  
Prevention And Treatment ◽  
Age Range

There is no standardized approach to exit site care and the treatment of catheter-related infections. In this study 32 children (age range 1 month -15 years) receiving chronic peritoneal dialysis received an exit-site care regimen using either soap or Povidone-iodine as the primary antiseptic. Therapy of exit-site and tunnel infections consisted of either intravenous Vancomycin (15 mg/kg initially, then 8.5 mg/kg every four days for three doses) or a combination of oral Dicloxacillin (50 mg/kg/day) and oral Rifampin (20 mg/kg/day) for 14 days. In all, there were 48 catheter related infections in 270 patienttreatment months (one case per 5.6 patient treatment months). There was no significant difference in the frequency of infection between the two antiseptic groups. Antibiotics eradicated the infection in all but one patient and in none of these patients did peritonitis complicate an exitsite/tunnel infection.

State of the Art on Autologous Mesothelial Transplant in Animals and Humans

2007 ◽  
Vol 30 (6) ◽  
pp. 456-476 ◽  
Author(s):  
N. Di Paolo ◽  
G. Sacchi ◽  
M.T. Del Vecchio ◽  
G. Nicolai ◽  
S. Brardi ◽  
...  
Keyword(s):  
Heart Disease ◽  
Peritoneal Dialysis ◽  
Progenitor Cells ◽  
State Of The Art ◽  
Mesothelial Cell ◽  
Mesothelial Cells ◽  
The Body ◽  
Review Of The Literature ◽  
Peritoneal Adhesions ◽  
Prevention And Treatment

Sixteen years ago rabbit and human mesothelial cells were successsfully cultured and autoimplanted. The aim of the study was merely to demostrate that mesothelial implant was possible and interesting not only in peritoneal dialysis, but also in the vaster field of medicine and surgery concerning all the mesothelial districts of the body. The aim of this paper is to recollect the steps which have led to autolougous mesothelial transplantation and verify if the tecnique has been validated and adopted by others. Review of the literature published in the last 15 years shows that intraperitoneal transplantation of mesothelial cells has been effective in reducing the formation of peritoneal adhesions, and in remodeling the area of mesothelial denudation. New studies on the mesothelial cell opened the way to costruction of transplantable tissue-engineered artificial peritoneum, to the utilization of mesothelial progenitor cells and to find simple metods to collect autologous mesothelial cells. Finally mesothelial trasnsplantation may represent a new neovascular therapy in the prevention and treatment of ischemic coronaric heart disease.

Biocompatibility of New Peritoneal Dialysis Solutions: What Can We Hope to Achieve?

2000 ◽  
Vol 20 (5_suppl) ◽  
pp. 57-67 ◽  
Author(s):  
Sung Hee Chung ◽  
Peter Stenvinkel ◽  
Jonas Bergström ◽  
Bengt Lindholm
Keyword(s):  
Peritoneal Dialysis ◽  
Patient Survival ◽  
Fluid Overload ◽  
Systemic Effects ◽  
Peritoneal Membrane ◽  
Local Effects ◽  
Positive Effects ◽  
Baxter Healthcare ◽  
And Function ◽  
Mia Syndrome

Despite the bioincompatibility of the “old”, standard, high glucose, lactate-buffered peritoneal dialysis (PD) solutions, PD is itself a highly successful dialysis modality with patient survival equivalent to that of hemodialysis (HD) during the initial 3 – 5 years of dialysis therapy. Nevertheless, PD technique survival is often limited by infectious complications and alterations in the structure and function of the peritoneal membrane. These local changes also have a negative impact on patient survival owing to systemic effects such as those often seen in patients with high peritoneal transport rate and loss of ultrafiltration (UF) capacity. Patient mortality remains unacceptably high in both HD and PD patients, with most premature deaths being associated with signs of malnutrition, inflammation, and atherosclerotic cardiovascular disease (MIA syndrome). These systemic signs are likely to be influenced by PD solutions both directly and indirectly (via changes in the peritoneal membrane). New, biocompatible PD solutions may have favorable local effects (viability and function of the peritoneal membrane) and systemic effects (for example, on MIA syndrome). Amino acid–based solution [Nutrineal (N): Baxter Healthcare Corporation, Deerfield, IL, U.S.A.] may improve nutritional status as well as peritoneal membrane viability. Bicarbonate/lactate–buffered solution [Physioneal (P): Baxter Healthcare Corporation] may ameliorate local and systemic effects of low pH, high lactate, and high glucose degradation products. Icodextrin-based solution [Extraneal (E): Baxter Healthcare SA, Castlebar, Ireland] may improve hypertension and cardiovascular problems associated with fluid overload and may extend time on therapy in patients with loss of UF capacity. The positive effects of each of these new, biocompatible solutions have been demonstrated in several studies. It is likely that the combined use of N, P, and E solutions will produce favorable synergies in regard to both local effects (peritoneal viability) and systemic effects (less malnutrition, inflammation, and fluid overload). Solution combination is an exciting area for clinical study in the coming years. Furthermore, dialysis fluid additives such as hyaluronan, which protects and improves the function of the peritoneal membrane, may further improve PD solutions. The new, biocompatible PD solutions represent an entirely new era in the evolution of the PD therapy; they are likely to have markedly positive effects on both PD technique and PD patient survival in coming years.

scholarly journals Diagnosis, Prevention, and Treatment of Protein-Energy Wasting in Peritoneal Dialysis

2018 ◽  
Author(s):  
Francisco Gerardo Yanowsky-Escatell ◽  
Leonardo Pazarín-Villaseñor ◽  
Jorge Andrade-Sierra ◽  
Christian Santana-Arciniega ◽  
Eduardo de Jesús Torres-Vázquez ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Protein Energy Wasting ◽  
Protein Energy ◽  
Prevention And Treatment

scholarly journals Regional variation in the treatment and prevention of peritoneal dialysis-related infections in the Peritoneal Dialysis Outcomes and Practice Patterns Study

2018 ◽  
Vol 34 (12) ◽  
pp. 2118-2126 ◽  
Author(s):  
Neil Boudville ◽  
David W Johnson ◽  
Junhui Zhao ◽  
Brian A Bieber ◽  
Ronald L Pisoni ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Infection Prevention ◽  
Practice Patterns ◽  
Antibiotic Administration ◽  
Exit Site ◽  
Prevention And Treatment ◽  
The Usa ◽  
Dialysis Outcomes ◽  
The Uk ◽  
The Impact

AbstractBackgroundPeritoneal dialysis (PD)-related infections lead to significant morbidity. The International Society for Peritoneal Dialysis (ISPD) guidelines for the prevention and treatment of PD-related infections are based on variable evidence. We describe practice patterns across facilities participating in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).MethodsPDOPPS, a prospective cohort study, enrolled nationally representative samples of PD patients in Australia/New Zealand (ANZ), Canada, Thailand, Japan, the UK and the USA. Data on PD-related infection prevention and treatment practices across facilities were obtained from a survey of medical directors’.ResultsA total of 170 centers, caring for >11 000 patients, were included. The proportion of facilities reporting antibiotic administration at the time of PD catheter insertion was lowest in the USA (63%) and highest in Canada and the UK (100%). Exit-site antimicrobial prophylaxis was variably used across countries, with Japan (4%) and Thailand (28%) having the lowest proportions. Exit-site mupirocin was the predominant exit-site prophylactic strategy in ANZ (56%), Canada (50%) and the UK (47%), while exit-site aminoglycosides were more common in the USA (72%). Empiric Gram-positive peritonitis treatment with vancomycin was most common in the UK (88%) and USA (83%) compared with 10–45% elsewhere. Empiric Gram-negative peritonitis treatment with aminoglycoside therapy was highest in ANZ (72%) and the UK (77%) compared with 10–45% elsewhere.ConclusionsVariation in PD-related infection prevention and treatment strategies exist across countries with limited uptake of ISPD guideline recommendations. Further work will aim to understand the impact these differences have on the wide variation in infection risk between facilities and other clinically relevant PD outcomes.

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