scholarly journals Peritonitis following Endoscopy in a Patient on Peritoneal Dialysis with a Discussion of Current Recommendations on Antibiotic Prophylaxis

2015 ◽  
Vol 9 (3) ◽  
pp. 302-306 ◽  
Author(s):  
Amy L. Gould ◽  
Elie Chahla ◽  
Christine Hachem
Keyword(s):  
Peritoneal Dialysis ◽  
Gastrointestinal Endoscopy ◽  
Previous History ◽  
Invasive Procedures ◽  
Limited Evidence ◽  
Increased Risk ◽  
History Of ◽  
American Society ◽  
Stage Renal Disease ◽  
End Stage

Patients on peritoneal dialysis (PD) are at increased risk for peritonitis. We report a case of a patient with end-stage renal disease on continuous ambulatory PD (CAPD) who developed peritonitis within 24 h of upper endoscopy with biopsy and colonoscopy with polypectomy. He had a previous history of peritonitis unrelated to invasive procedures and eventually was transitioned to hemodialysis because of his recurrent peritonitis. The International Society for Peritoneal Dialysis (ISPD) and newly revised American Society for Gastrointestinal Endoscopy (ASGE) guidelines recommend prophylactic antibiotics for CAPD patients undergoing endoscopic procedures. Other guidelines do not address this issue, and there has been limited evidence to support recommendations.

Seizures in Dialysis Patients Treated with Recombinant Erythropoietin. Review of the Literature and Guidelines for Prevention

1994 ◽  
Vol 17 (1) ◽  
pp. 5-13 ◽  
Author(s):  
M. Beccari
Keyword(s):  
Previous History ◽  
Hypertensive Encephalopathy ◽  
Cerebral Hypoperfusion ◽  
Recombinant Erythropoietin ◽  
Human Erythropoietin ◽  
Treatment And Prevention ◽  
Increased Risk ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

Anemia is one of the major limitations to rehabilitation in patients with end-stage renal disease (ESRD). The efficacy of recombinant human erythropoietin (rHuEPO) in the treatment of renal anemia is well established. Nevertheless, rHuEPO therapy has been associated with serious untoward effects. There appears to be an increased risk of hypertension, not infrequently accompanied by hypertensive encephalopathy and seizures. The mechanism of hypertension remains uncertain. It is associated with an increase in blood viscosity, a reversal of hypoxic vasodilatation, and, possibly, a direct pressor effect of the hormone. Seizures, otherwise, may be the result of cerebral hypoperfusion and, finally, of a focal cerebral edema. The guidelines for rHuEPO treatment and prevention of associated convulsions are outlined. The possible convulsive risk induced by this treatment, even at low doses, particularly in patients with a previous history of seizures, is stressed.

Overview of Peritoneal Dialysis in Latin America

2007 ◽  
Vol 27 (3) ◽  
pp. 316-321 ◽  
Author(s):  
Roberto Pecoits-Filho ◽  
Hugo Abensur ◽  
Alfonso M. Cueto-Manzano ◽  
Jorge Dominguez ◽  
José Carolino ◽  
...  
Keyword(s):  
Latin America ◽  
Peritoneal Dialysis ◽  
Replacement Therapy ◽  
Latin American ◽  
Personal Communication ◽  
Term Outcome ◽  
Long Term Outcome ◽  
American Society ◽  
Stage Renal Disease ◽  
End Stage

Latin America is a heterogeneous region comprised of 20 countries, former colonies of European countries, in which Latin-derived languages are spoken. According to the Latin American Society of Nephrology and Hypertension/ Sociedad Latino Americana de Nefrologia e Hipertensión (SLANH), the acceptance rate for renal replacement therapy is 103 new patients per million population. In Latin America, hemodialysis is the predominant form of replacement therapy for end-stage renal disease; however, some countries employ peritoneal dialysis (PD) in 30% or more patients. In particular, Mexico is the country with the largest PD utilization in the world, and furthermore, it is estimated that approximately 25% of the world's PD population may be found Latin America. Data concerning clinical practice and long-term outcome of PD in Latin America are scarce, although regional registries are increasing in number and quality. In this review article, we present an overview of the situation of PD in several countries of Latin America, based on the registry of the SLAHN, national registries, and personal communication with PD experts from different countries.

The Effects of Previous Abdominal Operations and Intraperitoneal Adhesions on the Outcome of Peritoneal Dialysis Catheters

2010 ◽  
Vol 30 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Amir Keshvari ◽  
Mohammad Sadegh Fazeli ◽  
Alipasha Meysamie ◽  
Sepideh Seifi ◽  
Mohammad Kazem Nouri Taromloo
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Surgery ◽  
Previous History ◽  
Laparoscopic Approach ◽  
Surgical Revision ◽  
Intraperitoneal Adhesions ◽  
Previous Abdominal Surgery ◽  
Increased Risk ◽  
History Of ◽  
Abdominal Operations

BackgroundPatients with previous history of abdominal operations are sometimes excluded from consideration for peritoneal dialysis because of concerns for increased risk of complications during the implantation procedure and inadequate dialysis due to reduced peritoneal surface area. Employing a laparoscopic approach, we compared the outcome of peritoneal dialysis catheters in 2 groups of patients with and without intra-abdominal adhesions.MethodsAll data in this report were recorded prospectively. Revision-free and overall survival of catheters, the incidence of mechanical and infectious complication, and surgical revision rates were compared between the 2 groups.ResultsIn 217 successful catheter implantations, there was a history of previous abdominal surgery in 42.9% of procedures; only 26.9% of them had intraperitoneal adhesions; 2.8% of patients without history of previous abdominal surgery had intraperitoneal adhesions. There were no significant differences between the 2 groups for 1- and 2-year revision-free and overall catheter survival, mechanical dysfunction, infectious complications, or surgical revision rates.ConclusionHistory of previous abdominal surgery should not be used to judge the eligibility of patients for peritoneal dialysis. Laparoscopic placement is the best way to ensure optimal catheter outcomes equivalent to patients without previous abdominal surgery.

scholarly journals Peritoneal Dialysis Initiation to treat end stage kidney desease during pregnancy. A report of 2 cases.

2021 ◽  
Vol 4 (1) ◽  
pp. 45-52
Author(s):  
Lucas Jacobs ◽  
Saleh Kaysi ◽  
Maria Mesquita ◽  
Christelle Fosso ◽  
Andrew Carlin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Scientific Literature ◽  
Pregnant Patient ◽  
The Other ◽  
Peritoneal Catheter ◽  
History Of ◽  
Prospective Comparative Study ◽  
Stage Renal Disease ◽  
End Stage

Despite strong evidence suggesting that peritoneal dialysis (PD) is a comparable technique to long-hour hemodialysis (HD) for pregnant patients (11,12), few cases are described in the current literature. Moreover, initiating PD in a pregnant woman needing extrarenal epuration is rarely described if at all. In this article, we present two cases of patients who initiated PD while being already multiple month pregnant: the first one 14 years ago and the other today. Our two patients are in their thirties, are respectively 16 and 10 weeks pregnant and have a history of anti-phospholipids syndrome. It was decided to start a PD program with both of them. Our first patient gave birth to a healthy 2.5 kg and 45 cm daughter despite an episode of peritonitis and the freeing of the peritoneal catheter from adherences. Our second patient is currently on dialysis without complications and is now 28 weeks pregnant with a healthy monitored child. Initiating PD in a pregnant patient is a subject that has not yet been published in the current scientific literature. With higher pregnancy rates than ever in the end stage renal disease population (31), we suggest to assess the objective benefits of PD extrarenal epuration method by performing a prospective comparative study between PD and HD.

Abstract P477: Clinical Outcomes In Individuals With And Without Heart Failure Presenting With Acute Coronary Syndromes

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Stephen Clarkson ◽  
Todd Brown ◽  
Nita Limdi ◽  
Chrisly Dillon ◽  
Mark Beasley
Keyword(s):  
Heart Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Characteristics ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Increased Risk ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

Objective: To determine the risk for major adverse cardiovascular events (MACE) following acute coronary syndrome (ACS) in patients with and without heart failure (HF) and whether this risk varies by race and comorbidity. Methods: We studied adults with and without HF who underwent percutaneous coronary intervention (PCI) for the treatment of ACS in the Pharmacogenomic Resource to improve Medication Effectiveness Genotype Guided Antiplatelet Therapy study. ACS was defined by the presence of ≥2 of the following: ischemic symptoms, acutely elevated cardiac troponin, or ischemic electrocardiographic changes. HF was defined prior to PCI as a known history of HF, left ventricular ejection fraction <50%, or brain natriuretic peptide level >400 pg/mL. Demographic and clinical characteristics were collected prior to PCI. Race was self-reported. Participants were followed for up to 1 year for MACE. We constructed Cox proportional hazard models, adjusted for demographic and clinical characteristics, separately in those with and without HF to identify independent predictors of MACE. Results: Since 2014, 1,230 individuals have undergone PCI for ACS. Those with HF (n=419) were older and had more comorbidities than those without HF (n=811). The incidence of MACE per 100 person years was 40.4 in those with HF and 22.2 in those without HF (p<0.001). African American race was associated with increased risk for MACE following ACS in those without but not with a history of HF. Other clinical factors associated with MACE following ACS were older age and end stage renal disease in those with HF and diabetes, end stage renal disease, and peripheral arterial disease in those without HF (Table). Conclusions: Individuals with HF are at increased risk of MACE following ACS irrespective of race. However, in those without HF, African Americans have a higher risk of MACE following ACS relative to their white counterparts. Individuals with end stage renal disease are at high risk of MACE following ACS regardless of HF status.

Safety of Peritoneal Dialysis after Nonrenal Solid-Organ Transplantation

2018 ◽  
Vol 38 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Anne Buffet ◽  
Sonia Guillouët ◽  
Thierry Lobbedez ◽  
Maxence Ficheux ◽  
Antoine Lanot ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Replacement Therapy ◽  
Organ Transplantation ◽  
Previous History ◽  
Solid Organ Transplantation ◽  
Prior History ◽  
Solid Organ ◽  
Increased Risk ◽  
Significant Difference ◽  
History Of

Background End-stage renal disease is a well-known complication after solid-organ transplantation, mostly as a result of calcineurin-inhibitor therapy. Among recipients of solid-organ transplants other than kidneys, peritoneal dialysis (PD) has been considered an accessory technique as an increased risk of infectious complications has been reported. The aim of our study was to evaluate the outcome of patients with a liver, heart, or lung transplant who underwent PD for replacement therapy. Methods This was a retrospective, monocentric study. Every adult patient starting PD between January 1, 2001, and December 31, 2016, at our center was included. The history of previous solid-organ transplantation was determined. For the statistical analysis, we considered 2 groups of patients: 1 group having a history of transplantation of an organ other than the kidney (lung, heart, liver), and 1 group that was starting dialysis without any prior history of organ transplantation. Patients who had previously undergone kidney transplantation were excluded. The events of interest were the first peritonitis episode, death, and PD failure, defined as transfer to hemodialysis. Results A total of 383 patients started PD during this period, 13 of whom had a history of organ transplantation. We found no significant difference between the solid-organ transplantation patients and those without a history of transplantation in terms of the occurrence of peritonitis (HR [hazard ratio] 0.91 [0.37 – 2.22]), death (HR 0.83 [0.26 – 2.63]), and PD failure (HR 1.01 [0.32 – 3.22]). Conclusion Peritoneal dialysis appears to be an effective replacement therapy for patients with a previous history of solid-organ transplantation.

scholarly journals A case of suspected antibiotic-associated encephalopathy in a patient undergoing long-term peritoneal dialysis

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092450 ◽  
Author(s):  
Yibin Guo ◽  
Xiaojiao Shao ◽  
Liyuan Zhang ◽  
Jiayi Miao ◽  
Yiwen Zhang
Keyword(s):  
Peritoneal Dialysis ◽  
Pulmonary Infection ◽  
Auditory Hallucination ◽  
Computed Tomography Imaging ◽  
Mental Symptoms ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Slow Rhythm

A man undergoing long-term peritoneal dialysis who had no history of mental illness suffered psychosis and auditory hallucination 2 days after clindamycin was initiated at a single dose of 0.6 g per day for pulmonary infection. His mental symptoms disappeared after clindamycin was discontinued and peritoneal dialysis was strengthened. The patient’s body temperature was mildly elevated the day before he was admitted to the hospital, and no abnormalities were observed on head and chest computed tomography imaging at admission, except for a slow rhythm on electroencephalogram. Many factors were involved in this case; antibiotic-related encephalopathy caused by clindamycin may be one factor. Physicians should carefully consider the use of antibiotics, especially in patients with end-stage renal disease.

scholarly journals Pyelonephritis and Bacteremia Caused by Klebsiella variicola following Renal Transplantation

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Cody Lo ◽  
Shazia Masud ◽  
Gregory D. Deans
Keyword(s):  
Renal Transplantation ◽  
Graft Loss ◽  
First Year ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Increased Risk ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Oral Ciprofloxacin

Klebsiella variicola (K. variicola) is a Gram-negative organism genetically similar to Klebsiella pneumoniae (K. pneumoniae) that can cause a variety of diseases in humans. Bacteremia due to K. variicola is associated with a higher mortality rate than bacteremia with K. pneumoniae. Here, we describe a 65-year-old woman who developed pyelonephritis 2 months after receiving a renal transplantation following a longstanding history of end-stage renal disease secondary to polycystic kidney disease. Her creatinine on admission was unchanged from her posttransplant baseline, and an abdominal CT scan showed inflammatory changes around the transplanted kidney that were suggestive of an infection rather than allograft rejection. She was initially treated empirically with meropenem given a history of extended-spectrum beta-lactamase- (ESBL-) producing E. coli bacteriuria. After a day of therapy with meropenem, her therapy was streamlined based on culture results to ceftriaxone. She continued to improve, her kidney function remained stable, and she was prescribed oral ciprofloxacin to complete a 14-day total course of antibiotics. This case is the first reported instance of K. variicola bacteremia associated with pyelonephritis in a renal transplant recipient. Hospitalization with acute pyelonephritis within the first year following kidney transplant is common and is associated with increased risk of graft loss and mortality. However, K. variicola is not a commonly known organism to cause this infection. Despite the risk of allograft failure in this circumstance, this patient was successfully treated with a 14-day course of antibiotic therapy.

scholarly journals Vision Impairment After Iron Chelating Agent in a Patient Under Peritoneal Dialysis

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Chi-Feng Huang
Keyword(s):  
Peritoneal Dialysis ◽  
Vision Loss ◽  
Ferritin Level ◽  
Chelating Agent ◽  
Olmesartan Medoxomil ◽  
Vision Disorders ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

A 54-year-old female patient had a history of end-stage renal disease (ESRD) under continuous automatic peritoneal dialysis (CAPD) therapy for 6 years. She had underlying hypertension history under oral hypertensives (olmesartan medoxomil). She was admitted to the ward for iron chelating agent therapy due to high ferritin level (5480 ng/ml). Deferoxamine 1 gram was prescribed with intravenous drip for 24 hours for 5 days. On the fifth day, she complained about vision problems, i.e. central halo pattern vision loss. A deferoxamine-related macula edema was diagnosed. After discontinuing the medication, her vision gradually improved. After 3 months of follow up, her vision disorders recovered.Although we reduced the dose of iron chelating agent, vision side effects also occurred in this ESRD patient.This case taught us to perform a careful detection of vision problems before, during, and after deferoxamine therapy in order to prevent irreversible vision disorders.

scholarly journals P1181URGENT START OF PERITONEAL DIALYSIS: OUTCOMES AND EXPERIENCE FROM NORTHERN INDIA

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Priti Meena ◽  
Vinant Bhargava ◽  
A K Bhalla ◽  
Ashwani Gupta ◽  
Manish Malik ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Infectious Complications ◽  
Northern India ◽  
Increased Risk ◽  
Catheter Malfunction ◽  
Feasible Option ◽  
Dialysis Outcomes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background and Aims Peritoneal dialysis (PD) widely practiced as the first-line modality for renal replacement therapy in end-stage renal disease (ESRD) patients. Urgent-start PD (use of the PD catheter within 14 days of insertion) is an effective approach to prompt initiation of PD after catheter insertion. However, there is a paucity of data regarding complications of urgent-start PD. We investigated the outcomes of urgent-start PD in our subset (Indian population). Method All patients in whom PD was initiated between 01 January 2015 and 31 July 2019 (54 months) were included. Patients were grouped according to the initiation of PD (break-in period) as &lt;8 days (PD1), 8 to 14 days (PD2), and &gt;14 days (PD3). Results In 100 patients included in the study, 57.5% were males. Among them, 75%, 10%, and 15% patients were in the PD1, PD2, PD3 break-in groups respectively. The most common cause of ESRD was diabetes mellitus. Functional catheter malfunction was the most frequent complication in PD1. The incidence of mechanical complications during the first six months was similar in all three groups (p = 0.06). No significant differences with respect to the catheter dysfunction requiring surgical intervention (p &gt; 0.05) were observed. In PD1 group, catheter patency rate at the end of the 1-month and 1-year was 98.6% and 95.4% respectively. No significant differences were found in the rate of peritonitis among the three groups. Female sex, low haemoglobin, and low albumin levels were independent risk factors for peritonitis. Conclusion Early break-in period of less than seven days is a feasible option for patients requiring urgent dialysis with no increased risk of mechanical or infectious complications. It offers a safe and efficacious option for unplanned ESRD patients.

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