scholarly journals Utility of Peritoneal Scintigraphy in Peritoneal Dialysis Patients: One Center Experience

Kidney360 ◽  
2020 ◽  
Vol 1 (5) ◽  
pp. 354-358
Author(s):  
R. Haridian Sosa Barrios ◽  
María Eugenia Rioja Martín ◽  
Víctor Burguera Vion ◽  
Astrid Lucía Santos Carreño ◽  
Milagros Fernández Lucas ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Membrane ◽  
Polycystic Kidney ◽  
Dialysis Patients ◽  
First Line ◽  
Peritoneal Dialysate ◽  
Other Substances ◽  
Line Imaging ◽  
Technique Failure ◽  
Peritoneal Scintigraphy

BackgroundPeritoneal dialysis (PD) is the RRT of choice in 15% of patients with CKD and has multiple advantages over hemodialysis. PD leaks can prompt technique failure and dropout. Use of peritoneal scintigraphy (PS) for diagnosis of PD leaks has declined in favor of more complex and expensive tests. We analyzed the utility of PS for PD leak diagnosis in our center.MethodsWe retrospectively analyzed all PS done in our center from January 2000 until December 2018, inclusive, in all patients on PD with a suspected dialysate leak.ResultsA total of 39 PS procedures were done in 36 patients on PD in the study period. Of those, 81% were male and 11% had CKD due to polycystic kidney disease. During this period, 23 leaks were diagnosed, showing an incidence of 6% (three episodes per patient per year). In all cases with negative PS, other tests did not confirm a peritoneal dialysate leak.ConclusionsPS is a safe, inexpensive, reproducible, and highly effective diagnostic tool for peritoneal dialysate leaks that allows nephrologists to tailor or stop PD therapy if required. In our opinion, it should be the first-line imaging test to diagnose PD leaks with minimum exposure to radiation, contrast, or other substances that could irritate the peritoneal membrane. We believe PS should be considered as the initial test of choice to diagnose this PD complication as soon as possible, minimizing technique failure and dropout due to leaks.

scholarly journals Increased peritoneal membrane transport is associated with decreased patient and technique survival for continuous peritoneal dialysis patients. The Canada-USA (CANUSA) Peritoneal Dialysis Study Group.

1998 ◽  
Vol 9 (7) ◽  
pp. 1285-1292 ◽  
Author(s):  
D N Churchill ◽  
K E Thorpe ◽  
K D Nolph ◽  
P R Keshaviah ◽  
D G Oreopoulos ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Membrane Transport ◽  
Patient Survival ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Technique Survival ◽  
Survival Probabilities ◽  
The Mean ◽  
Technique Failure

The objective of this study was to evaluate the association of peritoneal membrane transport with technique and patient survival. In the Canada-USA prospective cohort study of adequacy of continuous ambulatory peritoneal dialysis (CAPD), a peritoneal equilibrium test (PET) was performed approximately 1 mo after initiation of dialysis; patients were defined as high (H), high average (HA), low average (LA), and low (L) transporters. The Cox proportional hazards method evaluated the association of technique and patient survival with independent variables (demographic and clinical variables, nutrition, adequacy, and transport status). Among 606 patients evaluated by PET, there were 41 L, 192 LA, 280 HA, and 93 H. The 2-yr technique survival probabilities were 94, 76, 72, and 68% for L, LA, HA, and H, respectively (P = 0.04). The 2-yr patient survival probabilities were 91, 80, 72, and 71% for L, LA, HA, and H, respectively (P = 0.11). The 2-yr probabilities of both patient and technique survival were 86, 61, 52, and 48% for L, LA, HA, and H, respectively (P = 0.006). The relative risk of either technique failure or death, compared to L, was 2.54 for LA, 3.39 for HA, and 4.00 for H. The mean drain volumes (liters) in the PET were 2.53, 2.45, 2.33, and 2.16 for L, LA, HA, and H, respectively (P < 0.001). After 1 mo CAPD treatment, the mean 24-h drain volumes (liters) were 9.38, 8.93, 8.59, and 8.22 for L, LA, HA, and H, respectively (P < 0.001); the mean 24-h peritoneal albumin losses (g) were 3.1, 3.9, 4.3, and 5.6 for L, LA, HA, and H, respectively (P < 0.001). The mean serum albumin values (g/L) were 37.8, 36.2, 33.8, and 32.8 for L, LA, HA, and H, respectively (P < 0.001). Among CAPD patients, higher peritoneal transport is associated with increased risk of either technique failure or death. The decreased drain volume, increased albumin loss, and decreased serum albumin concentration suggest volume overload and malnutrition as mechanisms. Use of nocturnal cycling peritoneal dialysis should be considered in H and HA transporters.

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.

scholarly journals Cefoperazone and sulbactam-related eosinophilic peritonitis: a case report and literature review

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110253
Author(s):  
Zi Wang ◽  
Zhiying Li ◽  
Suping Luo ◽  
Zhikai Yang ◽  
Ying Xing ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Cells ◽  
White Blood Cells ◽  
Antibiotic Use ◽  
Absolute Count ◽  
Peritoneal Dialysate ◽  
Refractory Peritonitis ◽  
Technique Failure ◽  
Peritoneal Dialysis Effluent ◽  
Pathogenic Infection

Eosinophilic peritonitis (EP) is a well-described complication of peritoneal dialysis that occurs because of an overreaction to constituents that are related to the catheter or tubing, peritoneal dialysate, pathogenic infection, or intraperitoneal drug use. EP caused by antibiotic use is rare. We present the case of a patient with cefoperazone and sulbactam-related EP. A 59-year-old woman who was undergoing peritoneal dialysis presented with peritonitis with abdominal pain and turbid peritoneal dialysis. Empiric intraperitoneal cefazolin in combination with cefoperazone and sulbactam was started after peritoneal dialysis effluent cultures were performed. Her peritonitis achieved remission in 2 days with the help of cephalosporin, but she developed EP 1 week later, when her dialysate eosinophil count peaked at 49% of the total dialysate white blood cells (absolute count, 110/mm3). We excluded other possible causes and speculated that cefoperazone and sulbactam was the probable cause of EP. The patient continued treatment with cefoperazone and sulbactam for 14 days. EP resolved within 48 hours after stopping cefoperazone and sulbactam. Thus, EP can be caused by cefoperazone and sulbactam use. Physicians should be able to distinguish antibiotic-related EP from refractory peritonitis to avoid technique failure.

Mortality and Technique Failure in Peritoneal Dialysis Patients Using Advanced Peritoneal Dialysis Solutions

2009 ◽  
Vol 54 (4) ◽  
pp. 711-720 ◽  
Author(s):  
Seung Hyeok Han ◽  
Song Vogue Ahn ◽  
Jee Young Yun ◽  
Anders Tranaeus ◽  
Dae-Suk Han
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Technique Failure ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions

Six-minute walk test predicts all-cause mortality and technique failure in ambulatory peritoneal dialysis patients

Nephrology ◽  
2017 ◽  
Vol 22 (2) ◽  
pp. 118-124 ◽  
Author(s):  
Yuanyuan Shi ◽  
Dongxia Zheng ◽  
Lin Zhang ◽  
Zanzhe Yu ◽  
Hao Yan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Walk Test ◽  
Dialysis Patients ◽  
Six Minute Walk Test ◽  
All Cause Mortality ◽  
Technique Failure ◽  
Minute Walk

scholarly journals Systemic Endotoxin in Peritoneal Dialysis Patients

2018 ◽  
Vol 38 (5) ◽  
pp. 381-384 ◽  
Author(s):  
Ali M. Shendi ◽  
Nathan Davies ◽  
Andrew Davenport
Keyword(s):  
Peritoneal Dialysis ◽  
Extracellular Volume ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Fungal Cell ◽  
Membrane Function ◽  
Patient Demographics ◽  
Markers Of Inflammation ◽  
Systemic Endotoxemia

Previous reports linked systemic endotoxemia in dialysis patients to increased markers of inflammation, cardiovascular disease, and mortality. Many peritoneal dialysis (PD) patients use acidic, hypertonic dialysates, which could potentially increase gut permeability, resulting in systemic endotoxemia. However, the results from studies measuring endotoxin in PD patients are discordant. We therefore measured systemic endotoxin in 55 PD outpatients attending for routine assessment of peritoneal membrane function; mean age 58.7 ± 16.4 years, 32 (58.2%) male, 21 (38.2%) diabetic, median duration of PD treatment 19.5 (13 – 31) months, 32 (58.2%) using 22.7 g/L dextrose dialysates, and 47 (85.5%) icodextrin. The median systemic endotoxin concentration was 0.0485 (0.0043 – 0.103) Eu/mL. We found no association between endotoxin levels and patient demographics, markers of inflammation, serum albumin, N-terminal pro-brain natriuretic peptide, extracellular volume measured by bioimpedance, blood pressure, PD prescriptions or peritoneal membrane transporter status, or medications. The measurement of endotoxin can be lowered by failure to effectively release protein-bound endotoxin prior to analysis and increased by contamination when taking blood samples and processing and storing the samples. Additionally, contamination with β–glucan from fungal cell walls and the use of different assays to analyze endotoxin can also give differing results. These factors may help to explain the disparate results reported in different studies. Our study would suggest that exposure to standard peritoneal dialysates does not substantially increase systemic endotoxin. However, until endotoxin assays can measure free and bound endotoxin separately, the role of endotoxin causing inflammation in PD patients remains to be determined.

Higher Eosinophils Predict Death-Censored Technique Failure in Peritoneal Dialysis Patients

2020 ◽  
Vol 181 (10) ◽  
pp. 765-773
Author(s):  
Jiayi Yang ◽  
Jinjin Fan ◽  
Li Fan ◽  
Chunyan Yi ◽  
Jianxiong Lin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Technique Failure

scholarly journals Meta-Analysis: Peritoneal Membrane Transport, Mortality, and Technique Failure in Peritoneal Dialysis

2006 ◽  
Vol 17 (9) ◽  
pp. 2591-2598 ◽  
Author(s):  
K. Scott Brimble ◽  
Michelle Walker ◽  
Peter J. Margetts ◽  
Kiran K. Kundhal ◽  
Christian G. Rabbat
Keyword(s):  
Peritoneal Dialysis ◽  
Membrane Transport ◽  
Meta Analysis ◽  
Peritoneal Membrane ◽  
Technique Failure
Sign in / Sign up

Export Citation Format

Share Document