Dry Body Weight and Ultrafiltration Targets in Peritoneal Dialysis

2009 ◽  
pp. 90-95 ◽  
Author(s):  
Raymond T. Krediet ◽  
Watske Smit ◽  
Annemieke M. Coester ◽  
Dirk G. Struijk
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis

Nutritional Status of Patients Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD)

1983 ◽  
Vol 3 (3) ◽  
pp. 138-141 ◽  
Author(s):  
Brigitte Heide ◽  
Andreas Pierratos ◽  
Ramesh Khanna ◽  
Jean Pettit ◽  
Raymond Ogilvie ◽  
...  
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Protein Intake ◽  
Biochemical Parameters ◽  
Total Body Potassium ◽  
Total Body ◽  
Over Time

Nutritional follow-up of 20 CAPD patients for 18–24 months showed a decrease in total body nitrogen, increase in total body potassium and body weight, and a decrease in protein intake over time. There was no correlation between changes in TBN and the biochemical parameters measured. Serial dietetic assessments and measurements of total body nitrogen as well as adherence to an adequate protein intake will assist in the prevention of malnutrition in CAPD patients.

MO704THE PROGNOSTIC IMPACT OF WEIGHT GAIN AFTER PERITONEAL DIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Win Hlaing Than ◽  
Jack K C Ng ◽  
Gordon C K Chan ◽  
Winston Fung ◽  
Cheuk Chun Szeto
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Peritoneal Dialysis ◽  
Weight Gain ◽  
Clinical Outcomes ◽  
Patient Survival ◽  
Survival Rates ◽  
Overweight And Obesity ◽  
Technique Survival ◽  
Technique Failure

Abstract Background and Aims The prevalence of obesity has increased over the past decade in patients with End Stage Kidney Disease (ESKD). Obesity at the initiation of peritoneal dialysis (PD) was reported to adversely affect clinical outcomes. However, there are few studies on the prognostic relevance of weight gain after PD. Method We reviewed the change in body weight of 954 consecutive PD patients from the initiation of dialysis to 2 years after they remained on PD. Clinical outcomes including patient survival, technique survival, and peritonitis rate in the subsequent two years were reviewed. Results The mean age was 60.3 ± 12.2 years; 535 patients (56.1%) were men and 504 (52.8%) had diabetes. After the first 2 years on PD, the average change in body weight was 1.2± 5.1 kg; their body weight was 63.0 ± 13.3 kg; body mass index (BMI) 24.4 ± 4.4 kg/m2. The patient survival rates in the subsequent two years were 64.9%, 75.0%, and 78.9% (log rank test, p = 0.008) for patients with weight loss ≥3 kg during the first 2 years of PD weight change between -3 and +3 kg, and weight gain ≥3 kg, respectively. The corresponding technique survival rates in the subsequent two years were 93.1%, 90.1%, 91.3%, respectively (p = 0.110), and the peritonitis rates were 0.7±1.5, 0.6±1.7, and 0.6±1.1 episodes per patient-year, respectively (p = 0.3). When the actual BMI after the first 2 years of PD was categorized into underweight, normal weight, marginal overweight, overweight, and obesity groups, the patient survival rates in the subsequent two years were 77.3%, 75.2%, 73.3%, 74.3%, and 75.9%, respectively (p= 0.005), and technique survival 98.0%, 91.9%, 88.0%, 92.8%, and 81.0%, respectively (p= 0.001). After adjusting for confounding clinical factors by multivariate Cox regression models, weight gain ≥ 3kg during the first 2 years of PD was an independent protective factor for technique failure (adjusted hazard ratio [AHR] 0.049; 95% confidence interval [CI] 0.004-0.554, p = 0.015), but was an adverse predictor of patient survival (AHR 2.338, 95%CI 1.149-4.757, p = 0.019). In contrast, weight loss ≥ 3kg during the first 2 years of PD did not predict subsequent patient or technique survival. Conclusion Weight gain during the first 2 years of PD confers a significant risk of subsequent mortality but appears to be associated with a lower risk of technique failure. The mechanism of this discordant risk prediction deserves further study.

Variability of Peritoneal Protein Loss in Diabetic and Nondiabetic Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 242-244 ◽  
Author(s):  
Sophia Spaia ◽  
Fotini Christidou ◽  
Panayotis Pangidis ◽  
Thomas Tsoulkas ◽  
Michalis Pazarloglou ◽  
...  
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Total Protein ◽  
Peritoneal Fluid ◽  
Protein Loss ◽  
Glucose Levels ◽  
Short Period ◽  
Group A ◽  
Group B

In order to evaluate the Influence of diabetes mellitus on peritoneal membrane permeability, we studied the peritoneal protein loss In two groups of patients. Group A consisted of 16 patients (9 nondlabetics and 7 diabetics) who were In the first month of treatment on continuous ambulatory peritoneal dialysis (CAPO). Group B consisted of 13 patients (7 nondlabetics and 6 diabetics) who had been on CAPO for approximately 15 months. In both groups we measured the body weight, serum total protein, albumin, and total protein, urea, and glucose In the peritoneal fluid. We did not find any difference In groups A and B between diabetics and nondlabetics as far as the estimated parameters were concerned. Age, body weight, serum biochemistry, and protein and urea content In peritoneal fluid were similar, when group A was compared to group B. Patients of group B hed on average higher protein losses than those who had been on the method for a short period (mean 7.9 g/dL, vs 6.09 g/dL). Six patients were followed for over 15 months and were found to have significantly Increased protein losses (p=0.02). Glucose levels In peritoneal fluid were significantly lower In patients In group B, p<0.05 (mean 51.8 g/dL vs 37.1 g/dL). Peritoneal protein loss does not seem to differ between diabetic and nondiabetic patients with end-stage renal disease treated with CAPO, at any given time of the treatment. We observed an Increase In protein loss In some patients and a tendency to Increase the protein loss In others. This, along with the fall In glucose levels, might reflect progressive alterations In structure and permeability of the elements Involved In peritoneal transport, and It should receive further evaluation.

Peritoneal Absorption of Vancomycin during and after Resolution of Peritonitis in Continuous Ambulatory Peritoneal Dialysis (CAPO) Patients

1988 ◽  
Vol 8 (2) ◽  
pp. 135-136 ◽  
Author(s):  
B. Bastani ◽  
D. A. Spyker ◽  
F. B. Westervelt
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Half Life ◽  
Loading Dose

We studied the absorption of i.p. loading dose of vancomycin (30 mg/kg of body weight) in five continuous ambulatory peritoneal dialysis (CAPD) patients, both at the time of peritonitis and after its resolution. Mean vancomycin absorption after 6 h of i.p. dwell was 74% from inflamed and 51% from noninflamed peritoneum. Mean peritoneal absorption half-life of vancomycin was 3.2 and 7.2 h in the inflamed vs. non inflamed peritoneum, respectively.

Vancomycin Removal during High-Volume Peritoneal Dialysis in Acute Kidney Injury Patients

2019 ◽  
Vol 39 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Daniela Ponce ◽  
Welder Zamoner ◽  
Fernanda Moreira Freitas ◽  
André Balbi ◽  
Linda Awdishu
Keyword(s):  
Acute Kidney Injury ◽  
Body Weight ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
High Volume ◽  
Total Body Weight ◽  
Empirical Treatment ◽  
Total Body

Studies on vancomycin pharmacokinetics in acute kidney injury (AKI) patients on high-volume peritoneal dialysis (HVPD) are lacking. We studied the pharmacokinetics of intravenous (IV) vancomycin in AKI patients treated by HVPD who received a prescribed single IV dose of vancomycin (15 - 20 mg/kg total body weight) to determine the extent of vancomycin removal and to establish vancomycin dosing guidelines for the empirical treatment of AKI patients receiving HVPD. The application of 18 mg/kg vancomycin every 48 - 72 hours in AKI patients undergoing HVPD was required to maintain therapeutic concentrations.

Relationship of Demographic, Dietary, and Clinical Factors to the Hydration Status of Patients on Peritoneal Dialysis

2004 ◽  
Vol 24 (3) ◽  
pp. 231-239 ◽  
Author(s):  
Ramzana B. Asghar ◽  
Sandra Green ◽  
Barbara Engel ◽  
Simon J. Davies
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Extracellular Fluid ◽  
Fat Free Mass ◽  
Single Frequency ◽  
Hydration Status ◽  
Clinical Factors ◽  
Membrane Function ◽  
Fluid Removal

Objectives To establish which clinical factors are associated with an increased proportion of extracellular fluid (ECF) in peritoneal dialysis (PD) patients. Design A single-center, cross-sectional analysis of 68 stable PD patients. Method Bioelectrical impedance measurements (RJL, single frequency; RJL Systems, Clinton, Michigan, USA) of resistance and reactance were used to determine the proportion of ECF comprising total body water (TBW) in 68 stable PD patients attending for routine clearance and membrane studies. All patients underwent detailed dietetic, adequacy, and membrane function tests. Blood pressure and antihypertensive requirements were also documented. Results Significant gender differences in body composition were observed, such that women had lower absolute TBW and fat-free mass per kilogram body weight, but proportionately more ECF for a given TBW, mean ECF:TBW 0.5 ± 0.03 versus 0.44 ± 0.05, p < 0.005. In view of this, patients were split into two groups, defined as “over-” or “normally” hydrated, either by using the single discriminator (median ECF:TBW = 0.47) for the whole population, which resulted in groups distorted by gender, or by using different discriminators according to gender (women: 0.49, men 0.45). In both analyses, overhydrated patients were older, had significantly lower plasma albumin, less total fluid removal per kilogram body weight, and higher peritoneal solute transport. When split by a single discriminator, the overhydrated patients had lower sodium removal and significantly less intracellular fluid volume due to an excess of women in this group who also had less residual function and had been on dialysis longer. Using gender-specific discrimination, overhydrated patients were heavier due to expansion of the ECF volume: 20 ± 4.1 L versus 16 ± 3.3 L, p < 0.001. Stepwise multivariate analysis found age ( p = 0.001), albumin ( p = 0.009), and fluid losses per kilogram body weight ( p = 0.025) to be independent predictors of gender-adjusted hydration status. Sodium intake did not vary according to hydration status. Conclusion Gender influences the assessment of hydration status of PD patients when employing bioimpedance, such that women tend to have more ECF. Taking this into account, age, albumin, and achieved fluid removal appear to be independently associated with hydration status, whereas peritoneal solute transport is not. Advice on dietary sodium should take account of hydration status and achievable losses.

Pharmacokinetics of Intermittent Intraperitoneal Cefazolin in Continuous Ambulatory Peritoneal Dialysis Patients

1999 ◽  
Vol 19 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Harold J. Manley ◽  
George R. Bailie ◽  
Rupesh D. Asher ◽  
George Eisele ◽  
Reginald F. Frye
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Rate Constant ◽  
Half Life ◽  
Elimination Rate ◽  
Pharmacokinetic Parameters ◽  
Number Of Patients ◽  
The Mean ◽  
Concentration Levels

Objective To investigate the pharmacokinetic parameters of intermittent intraperitoneal (IP) cefazolin, and recommend a cefazolin dosing regimen in continuous ambulatory peritoneal dialysis (CAPD) patients. Design Prospective nonrandomized open study. Setting CAPD outpatient clinic in Albany, New York. Patients Seven volunteer CAPD patients without peritonitis. Three of the patients were nonanuric while 4 were anuric. Interventions Cefazolin (15 mg/kg total body weight) was given to each patient during the first peritoneal exchange. Blood and dialysate samples were collected at times 0, 0.5, 1, 2, 3, 6 (end of the first antibiotic-containing dwell), 24, and 48 hours after the administration of IP cefazolin. Urine samples were collected in nonanuric patients over the study period. Results The mean ± SD amount of cefazolin dose absorbed from the dialysate after the 6-hour dwell was 69.7% ± 8.0% of the administered dose. The cefazolin absorption rate constant from dialysate to serum was 0.21 ± 0.1 /hr (absorption half-life 3.5 ± 0.8 hr). The mean serum concentrations reached at 24 and 48 hours were 52.4 ± 3.7 mg/L and 30.3 ± 5.9 mg/L, respectively. The mean dialysate cefazolin concentrations reached at 24 and 48 hours were 15.1 ± 3.4 mg/L and 7.9 ± 1.4 mg/L, respectively. The cefazolin serum elimination rate constant was 0.02 ± 0.01 /hr (elimination half-life 31.5 ± 8.8 hr). The total cefazolin body clearance was 3.4 ± 0.6 mL/min. In the 3 nonanuric patients the mean renal clearance of cefazolin was 0.6 ± 0.4 mL/min. The peritoneal clearance of cefazolin was 1.0 ± 0.3 mL/min. The systemic volume of distribution of cefazolin was 0.2 ± 0.05 L/kg. No statistical difference was detected in pharmacokinetic parameters between anuric and nonanuric patients, although this may be due to the small number of patients in each group. Conclusion A single daily dose of cefazolin dosed at 15 mg/kg actual body weight in CAPD patients is effective in achieving serum concentration levels greater than the minimum inhibitory concentration for sensitive organisms over 48 hours, and dialysate concentration levels over 24 hours. Caution is warranted in extrapolation of dosing recommendations to patients who maintain a significant degree of residual renal function.

Prevalence and predictors of postoperative peritoneal dialysis in infants

2020 ◽  
Vol 28 (8) ◽  
pp. 476-481
Author(s):  
Michael Caesario ◽  
Dicky Fakhri ◽  
Pribadi Wiranda Busro ◽  
Salomo Purba ◽  
Liza Fitria ◽  
...  
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Cardiopulmonary Bypass ◽  
Risk Adjustment ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Lower Body ◽  
Cardiopulmonary Bypass Time ◽  
Lower Body Weight ◽  
Younger Age

Background Data regarding predictors of the eventual need for postoperative peritoneal dialysis in infants undergoing open heart surgery is still limited. We aimed to determine whether prolonged cardiopulmonary bypass time, surgical complexity classified according to Risk Adjustment for Congenital Heart Surgery category, younger age, and lower body weight increase the probability of requiring postoperative peritoneal dialysis. Methods We retrospectively analyzed data of 181 infants who underwent open heart surgery at our institution from January 1 to December 31, 2018. Cardiopulmonary bypass time, Risk Adjustment for Congenital Heart Surgery category, age, body weight, and the need for postoperative peritoneal dialysis were recorded and analyzed. Results Thirteen (7.2%) of the 181 patients required postoperative peritoneal dialysis. This group was found to have a longer cardiopulmonary bypass time, younger age, and lower body weight. Longer cardiopulmonary bypass time ( p = 0.001), higher Risk Adjustment for Congenital Heart Surgery category ( p = 0.018), younger age ( p < 0.001), and lower body weight ( p < 0.001) significantly increased the risk of postoperative peritoneal dialysis. Conclusion Longer cardiopulmonary bypass time, more complex surgery, younger age, and lower body weight increase the probability of requiring postoperative peritoneal dialysis in infants undergoing open heart surgery.

scholarly journals Long-term peritoneal dialysis is associated with a decrease in body weight

2019 ◽  
Author(s):  
Talha H Imam ◽  
Jiaxio M Shi ◽  
David K Yi ◽  
Su-Jau Yang
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis

A Long-Term Study of a Bicarbonate/Lactate-Based Peritoneal Dialysis Solution — Clinical Benefits

2000 ◽  
Vol 20 (5) ◽  
pp. 516-523 ◽  
Author(s):  
◽  
Anders Tranæus
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Treatment Period ◽  
Cell Function ◽  
Ex Vivo ◽  
Well Being ◽  
Dialysis Adequacy ◽  
Long Term Study ◽  
Dialysis Solution ◽  
Peritoneal Dialysis Solution

Objective A bicarbonate/lactate peritoneal dialysis solution (Bic/Lac) has been developed based on in vitro and ex vivo data showing better preservation of cell function and correction of pain on infusion. Design This was a randomized, prospective, controlled, open-label study comparing a new 25 mmol/L bicarbonate/15 mmol/L lactate with a standard 40 mmol/L lactate-buffered peritoneal dialysis solution (Lac) over a 12-month treatment period. Setting 17 European nephrology centers. Patients 106 (70 Bic/Lac and 36 Lac) well-dialyzed continuous ambulatory peritoneal dialysis (CAPD) patients. Interventions Dialysis adequacy and peritoneal equilibration test (PET, week –4, months 3, 6, and 12); 24-hour ultrafiltration (week –4, months 1, 3, and 6); blood biochemistry (week –2, day 0, months 1, 2, 3,6, 9, and 12); and a product acceptability questionnaire (months 1 and 6). Results 88 patients completed the first 6 months, and 44 the full year. The solutions were shown to be therapeutically equivalent with respect to plasma bicarbonate and peritoneal urea and creatinine clearances. Ultrafiltration in the Bic/Lac group increased significantly from baseline by about 150 mL/day for the whole of the 6-month treatment period ( p < 0.05). The biochemistry profile, adverse events, and physical examination (except body weight where there was a statistically significant increase in the Bic/Lac group) results did not differ significantly between the two groups. Reduced pain/discomfort on infusion or an increased sense of well-being was reported by 41% of patients on the Bic/Lac fluid. Conclusions The Bic/Lac solution is safe and effective in correcting uremic acidosis, provides relief of inflow pain/discomfort, and improves ultrafiltration and body weight.

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