scholarly journals COVID-19 in Hospitalized Patients on Chronic Peritoneal Dialysis: A Case Series

2020 ◽  
Vol 51 (8) ◽  
pp. 669-674 ◽  
Author(s):  
Mala Sachdeva ◽  
Nupur N. Uppal ◽  
Jamie S. Hirsch ◽  
Jia H. Ng ◽  
Deepa Malieckal ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Course ◽  
Case Series ◽  
The United States ◽  
Hospitalized Patients ◽  
End Stage Kidney Disease ◽  
Entire Cohort ◽  
End Stage ◽  
Culture Negative ◽  
Descriptive Statistical Analysis

Background: The COVID-19 pandemic has affected the end-stage kidney disease (ESKD) population, with high mortality rates reported among patients on hemodialysis. However, the degree to which it has affected the peritoneal dialysis (PD) population in the United States has not yet been elucidated. In this report, we describe the clinical characteristics, presentations, clinical course, and outcomes of ESKD patients on PD hospitalized with COVID-19. Methods: We describe the characteristics, presentation, and outcomes of adult ESKD patients on chronic PD hospitalized with CO­VID-19 in our 13 major hospitals in the NY health system using descriptive statistical analysis. Results: Of 419 hospitalized patients with ESKD, 11 were on chronic PD therapy (2.6%). Among those 11, 3 patients required mechanical ventilation, 2 of whom died. Of the entire cohort, 9 of the 11 patients (82%) were discharged alive. While fever was a common presentation, more than half of our patients also presented with diarrhea. Interestingly, 3 patients were diagnosed with culture-negative peritonitis during their hospitalization. Seven patients reported positive SARS-CoV-2 exposure from a member of their household. Conclusion: Hospitalized patients on PD with COVID-19 had a relatively mild course, and majority of them were discharged home.

scholarly journals Chemical peritonitis associated with intraperitoneal vancomycin: A case series

2021 ◽  
Vol 35 (2) ◽  
Author(s):  
José Silvano ◽  
◽  
Luciano Pereira ◽  
Ana Oliveira ◽  
Ana Beco ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Peritoneal Dialysis ◽  
Drug Withdrawal ◽  
Clinical Course ◽  
Leukocyte Count ◽  
Case Series ◽  
Aseptic Technique ◽  
Drug Challenge ◽  
Chemical Peritonitis ◽  
Culture Negative

Peritonitis is a serious complication in peritoneal dialysis, usually secondary to an infectious cause. Chemical peritonitis is rarer. No case exclusively attributed to vancomycin has been reported in the last 20 years. Data from 4 consecutive patients diagnosed with culture -negative peritonitis following administration of intraperitoneal vancomycin between May and June 2019 were retrospectively recorded. All patients were treated with 2 grams of intraperitoneal vancomycin after a break in aseptic technique and developed a cloudy effluent. No patient was previously known to be allergic to vancomycin. All had a clear dialysate before vancomycin. All developed an elevated leukocyte count in the dialysate. All had sterile cultures. All resumed a clear effluent with less <100 cells/μL after vancomycin cessation, and in two there were no further administrations. In one, a new drug challenge led to recrudescence of abdominal pain and reappearance of a cloudy sterile effluent. In another, vancomycin from a different lot was administrated 3 days after, no symptoms developed and dialysate cell count remained normal. The pathogenic mechanisms underlying chemical peritonitis are not fully known. The clinical course is typically benign. Management seems to be limited to drug withdrawal. If unrecognized, chemical peritonitis may ultimately lead to unnecessary catheter removal.

scholarly journals Mycobacterium abscessus - an uncommon, but important cause of peritoneal dialysis-associated peritonitis – case report and literature review

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Anup Singh Jheeta ◽  
Jayakeerthi Rangaiah ◽  
John Clark ◽  
David Makanjuola ◽  
Subash Somalanka
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Improvement ◽  
Acid Fast Bacillus ◽  
Mycobacterium Abscessus ◽  
End Stage Kidney Disease ◽  
Case Presentation ◽  
Genome Wide ◽  
Intravenous Antibiotics ◽  
End Stage ◽  
Culture Negative

Abstract Background Peritoneal dialysis (PD) is a form of therapy for end-stage kidney disease (ESKD), and peritonitis is a known complication. Mycobacterium (M) species associated peritonitis in PD patients is uncommon. Our experience of managing PD associated peritonitis caused by M abscessus in a middle-aged man with ESKD due to focal segmental glomerulosclerosis is shared in this article with a review of the literature on this condition. Case presentation A 49-year old man presented to our unit with symptoms of peritonitis and cloudy PD effluent. Initial analysis of PD fluid showed Gram stain was negative, with no organism grown. Empirical PD peritonitis treatment with intra-peritoneal antibiotics did not improve his symptoms and he required intravenous antibiotics, PD catheter removal and a switch to haemodialysis. Cultures of the PD fluid later grew M abscessus, and the antibiotic regimen was changed appropriately, leading to clinical improvement. Conclusion M abscessus associated peritonitis in PD patients is rare. It needs to be borne in mind when clinical improvement is not seen with standard broad-spectrum antibiotics, especially in situations where the PD fluid is initially deemed to be culture negative. PD fluid samples should be sent for acid-fast bacillus and if detected, should be further analysed with genome-wide sequencing to confirm the species of the Mycobacterium. Prompt removal of the catheter with peritoneal washout is critical for clinical improvement.

Age dependence of brachial cuff-based ambulatory PWV in end-stage kidney disease patients undergoing long-term peritoneal dialysis

2021 ◽  
pp. 089686082199692
Author(s):  
Vasilios Vaios ◽  
Panagiotis I Georgianos ◽  
Georgia Vareta ◽  
Dimitrios Divanis ◽  
Evangelia Dounousi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Pulse Wave ◽  
Age Dependence ◽  
End Stage Kidney Disease ◽  
End Stage

Background: The newly introduced device Mobil-O-Graph (IEM, Stolberg, Germany) combines brachial cuff oscillometry and pulse wave analysis, enabling the determination of pulse wave velocity (PWV) via complex mathematic algorithms during 24-h ambulatory blood pressure monitoring (ABPM). However, the determinants of oscillometric PWV in the end-stage kidney disease (ESKD) population remain poorly understood. Methods: In this study, 81 ESKD patients undergoing long-term peritoneal dialysis underwent 24-h ABPM with the Mobil-O-Graph device. The association of 24-h oscillometric PWV with several demographic, clinical and haemodynamic parameters was explored using linear regression analysis. Results: In univariate analysis, among 21 risk factors, 24-h PWV exhibited a positive relationship with age, body mass index, overhydration assessed via bioimpedance spectroscopy, diabetic status, history of dyslipidaemia and coronary heart disease, and it had a negative relationship with female sex and 24-h heart rate. In stepwise multivariate analysis, age ( β: 0.883), 24-h systolic blood pressure (BP) ( β: 0.217) and 24-h heart rate ( β: −0.083) were the only three factors that remained as independent determinants of 24-h PWV (adjusted R 2 = 0.929). These associations were not modified when all 21 risk factors were analysed conjointly or when the model included only variables shown to be significant in univariate comparisons. Conclusion: The present study shows that age together with simultaneously assessed oscillometric BP and heart rate are the major determinants of Mobil-O-Graph-derived PWV, explaining >90% of the total variation of this marker. This age dependence of oscillometric PWV limits the validity of this marker to detect the premature vascular ageing, a unique characteristic of vascular remodelling in ESKD.

scholarly journals End-Stage Kidney Disease From Scleroderma in the United States, 1996 to 2012

2018 ◽  
Vol 3 (1) ◽  
pp. 148-154 ◽  
Author(s):  
Donal J. Sexton ◽  
Scott Reule ◽  
Robert N. Foley
Keyword(s):  
United States ◽  
Kidney Disease ◽  
The United States ◽  
End Stage Kidney Disease ◽  
End Stage

Dietary Intake, Nutritional Status, and Body Composition in Children With End-Stage Kidney Disease on Hemodialysis or Peritoneal Dialysis

2017 ◽  
Vol 27 (3) ◽  
pp. 207-215 ◽  
Author(s):  
Consuelo Pontón-Vázquez ◽  
Edgar Manuel Vásquez-Garibay ◽  
Erika Fabiola Hurtado-López ◽  
Adriana de la Torre Serrano ◽  
Germán Patiño García ◽  
...  
Keyword(s):  
Body Composition ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Nutritional Status ◽  
Dietary Intake ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals Outcomes Associated With Apixaban Use in Patients With End-Stage Kidney Disease and Atrial Fibrillation in the United States

Circulation ◽  
2018 ◽  
Vol 138 (15) ◽  
pp. 1519-1529 ◽  
Author(s):  
Konstantinos C. Siontis ◽  
Xiaosong Zhang ◽  
Ashley Eckard ◽  
Nicole Bhave ◽  
Douglas E. Schaubel ◽  
...  
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Kidney Disease ◽  
The United States ◽  
End Stage Kidney Disease ◽  
End Stage

Does peritoneal dialysis have a role in urgent-start end-stage kidney disease?

2018 ◽  
Vol 31 (4) ◽  
pp. 325-331 ◽  
Author(s):  
Rory F. McQuillan ◽  
Charmaine E. Lok
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
End Stage Kidney Disease ◽  
End Stage
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