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Impact of peritoneal dialysis on weight gain in a patient with anorexia nervosa. 腹膜透析对神经性厌食症患者体重增加的影响。
IF 2.7 3区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-02 DOI: 10.1177/08968608241307825
Misa Iimori, Takashi Kitani, Yayoi Shiotsu, Yasuto Sunahara, Mari Morimoto, Kanako Asai, Noriko Urata, Junko Ono, Tetsuro Kusaba, Keiichi Tamagaki

Anorexia nervosa (AN) is an eating disorder characterized by restriction of energy intake leading to a significantly low body weight, and intense fear of gaining weight. Severe electrolyte changes such as hypokalemia and hypophosphatemia; and alterations in water metabolism such as hyponatremia and edema, can occur in patients with AN. Hypokalemia and chronic volume depletion may lead to acute kidney injury (AKI) and chronic kidney disease (CKD). There are few reports of patients with AN who require maintenance dialysis. Therefore, it is unclear whether hemodialysis (HD) or peritoneal dialysis (PD) is suitable for such patients. We report a case of kidney failure that developed in the patient with AN who received successful psychiatric treatment aimed at weight gain while performing PD. The safety of PD may be improved in patients who also undergo cognitive behavioral psychotherapeutic intervention.

神经性厌食症(AN)是一种饮食失调症,其特征是限制能量摄入,导致体重明显降低,并对体重增加有强烈的恐惧。严重的电解质改变,如低钾血症和低磷血症;水代谢的改变,如低钠血症和水肿,可发生在AN患者身上。低钾血症和慢性容量衰竭可导致急性肾损伤(AKI)和慢性肾脏疾病(CKD)。很少有AN患者需要维持性透析的报道。因此,血液透析(HD)或腹膜透析(PD)是否适合这类患者尚不清楚。我们报告一例肾衰竭,发展在AN患者谁接受成功的精神治疗,旨在体重增加,同时执行PD。在接受认知行为心理治疗干预的患者中,PD的安全性可能会提高。
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引用次数: 0
The Point-of-Care Peritoneal Dialysis System Early Evaluation Study (POC-PDEE): A pilot proof-of-principal study of the Ellen Medical Devices Point-of-Care affordable peritoneal dialysis system. 护理点腹膜透析系统早期评估研究(POC-PDEE):对艾伦医疗设备公司的护理点腹膜透析系统进行试验性原理验证研究。
IF 2.7 3区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 Epub Date: 2024-01-05 DOI: 10.1177/08968608231209850
Benjamin Talbot, Simon Davies, Jenny Burman, Angus Ritchie, Paul Snelling, Sue Lynch, Youn Park, Brian Jones, Vincent Garvey, Allison Jaure, Meg Jardine, Vlado Perkovic, Martin Gallagher, Arthur Brandwood, Navneet Kaur, John Knight

The global unmet need for kidney replacement therapy means that millions of people die every year as they cannot afford treatment. Peritoneal dialysis (PD) offers comparable survival to haemodialysis and is often more affordable, but one barrier to increasing access is that conventional manufacturing and distribution of PD fluid is costly. Here we report the results from a pilot proof-of-principal study demonstrating for the first time that the Ellen Medical Devices Point-of-Care system can be used by patients to produce sterile PD fluid at the point-of-care. With further development, this low-cost system could offer a solution to the many millions of people around the world who currently cannot afford treatment for kidney failure.

全球对肾脏替代疗法的需求尚未得到满足,这意味着每年有数百万人因负担不起治疗费用而死亡。腹膜透析(PD)可提供与血液透析相当的存活率,而且通常更经济实惠,但增加腹膜透析机会的一个障碍是腹膜透析液的传统制造和配送成本高昂。在此,我们报告了一项试验性原理验证研究的结果,该研究首次证明了患者可以使用 Ellen 医疗设备护理点系统在护理点生产无菌腹膜透析液。随着进一步的发展,这种低成本系统可以为全球数百万目前无力负担肾衰竭治疗费用的患者提供解决方案。
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引用次数: 0
Will Xylocore® be the magic ELIXIR for peritoneal dialysis? Xylocore®会成为腹膜透析的神奇灵丹妙药吗?
IF 2.7 3区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 DOI: 10.1177/08968608241297861
Johann Morelle, Carl M Öberg
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引用次数: 0
The Pretzel Sign - an indicator of pre-peritoneal catheter location. 脆饼标志--腹膜前导管位置的指示器。
IF 2.7 3区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 Epub Date: 2024-08-16 DOI: 10.1177/08968608241272244
Zoya Adam, Elaine Bowes, Jonathan Dick
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引用次数: 0
Patient screening and assessment for home dialysis therapies: A scoping review. 家庭透析疗法的患者筛查与评估:范围综述。
IF 2.7 3区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 Epub Date: 2024-08-01 DOI: 10.1177/08968608241266130
Ryan Ting, Megan Borkum, Lian Ting Ni, Adeera Levin

Background: Home dialysis therapies have limited uptake in most regions despite recognized benefits such as increasing patients' independence, and several domains of quality of life with cost savings in some systems.

Objective: To perform a scoping review of published literature to identify tools and guides used in systematically screening and assessing patient suitability for home dialysis. A secondary objective was to explore barriers and enablers associated with the home dialysis assessment process. It is important to identify gaps in current research to pose pertinent questions for future work in the field.

Design: Online databases Embase, Medline (Ovid), and CINAHL were used to identify articles published between January 2007 to May 2023. A total of 23 peer-reviewed primary and secondary studies that investigated screening or selection for patients > 18 years old with kidney failure for home dialysis met the study inclusion criteria.

Results: The studies consisted of secondary studies (n = 10), observational studies (n = 8), and survey-based studies (n = 5). The major themes identified that influence patient screening and assessment for home dialysis candidacy included: screening tools and guidelines (n = 8), relative contraindications (n = 4), patient or program education (n = 9), and socioeconomic factors (n = 2).

Limitations: Consistent with the scoping review methodology, the methodological quality of included studies was not assessed. The possible omission of evidence in languages other than English is a limitation.

Conclusion: This scoping review identified tools and factors that potentially guide the assessment process for home dialysis candidacy. Patient screening and assessment for home dialysis requires a comprehensive evaluation of clinical, psychosocial, and logistical factors. Further research is required to validate and refine existing tools to establish standardized patient screening criteria and evaluation processes. Up-to-date training and education for healthcare providers and patients are needed to improve the utilization of home dialysis and ensure optimal outcomes.

背景:尽管家庭透析疗法具有公认的益处,如提高患者的独立性和多个领域的生活质量,并在某些系统中节约成本,但在大多数地区,家庭透析疗法的使用率有限:对已发表的文献进行范围界定,确定用于系统筛选和评估患者是否适合家庭透析的工具和指南。次要目的是探讨与家庭透析评估流程相关的障碍和促进因素。重要的是要找出当前研究中的不足,为该领域未来的工作提出相关问题:设计:使用在线数据库 Embase、Medline (Ovid) 和 CINAHL 查找 2007 年 1 月至 2023 年 5 月间发表的文章。共有 23 项经同行评审的主要和次要研究符合研究纳入标准,这些研究调查了筛选或选择 18 岁以上肾衰竭患者进行家庭透析的情况:这些研究包括二次研究(10 项)、观察性研究(8 项)和基于调查的研究(5 项)。已确定的影响患者筛查和评估是否适合家庭透析的主要主题包括:筛查工具和指南(8 项)、相对禁忌症(4 项)、患者或项目教育(9 项)以及社会经济因素(2 项):与范围界定综述方法一致,未对纳入研究的方法学质量进行评估。除英语外,可能遗漏了其他语言的证据:本次范围界定审查确定了可能指导家庭透析候选资格评估过程的工具和因素。患者筛查和家庭透析评估需要对临床、社会心理和后勤因素进行综合评估。需要进一步研究验证和完善现有工具,以建立标准化的患者筛选标准和评估流程。需要对医疗服务提供者和患者进行最新的培训和教育,以提高家庭透析的利用率并确保最佳治疗效果。
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引用次数: 0
Rationale and design of ELIXIR, a randomized, controlled trial to evaluate efficacy and safety of XyloCore, a glucose-sparing solution for peritoneal dialysis. ELIXIR 是一项随机对照试验,旨在评估 XyloCore(一种用于腹膜透析的葡萄糖稀释液)的有效性和安全性。
IF 2.7 3区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 Epub Date: 2024-08-28 DOI: 10.1177/08968608241274106
Mario Bonomini, Simon Davies, Werner Kleophas, Mark Lambie, Gianpaolo Reboldi, Lorenzo Di Liberato, Josè Carolino Divino-Filho, Olof Heimburger, Alberto Ortiz, Johan Povlsen, Massimo Iacobelli, Tommaso Prosdocimi, Arduino Arduini

Peritoneal dialysis adoption and technique survival is affected by limitations related to peritoneal membrane longevity and metabolic alterations. Indeed, almost all peritoneal dialysis fluids exploit glucose as an osmotic agent that rapidly diffuses across the peritoneal membrane, potentially resulting in metabolic abnormalities such as hyperglycemia, hyperinsulinemia, obesity, and hyperlipidemia. Moreover, glucose-degradation products generated during heat sterilization, other than glucose itself, induce significant morphological and functional changes in the peritoneum leading to ultrafiltration failure. The partial substitution of glucose with osmotic agents characterized by a better local and systemic biocompatibility has been suggested as a potential strategy to innovate peritoneal dialysis fluids. The approach aims to minimize glucose-associated toxicity, preserving the peritoneal membrane welfare and counteracting common comorbidities. In this work, we report the clinical trial design of ELIXIR, a phase III randomized, controlled, blinded outcome assessment study comparing Xylocore®, an innovative formulation based on Xylitol and l-carnitine, to standard glucose-based regimens, in end-stage kidney disease patients treated with continuous ambulatory peritoneal dialysis; 170 patients will be randomized (1:1) to receive XyloCore® or to continue their pre-randomization peritoneal dialysis (PD) therapy with glucose-only PD solutions, for 6 months. The primary study's objective is to demonstrate the noninferiority of XyloCore® in terms of Kt/V urea, for which a clinically acceptable noninferiority margin of -0.25 has been determined, assuming that all patients will be treated aiming to a minimum target of 1.7 and an optimal target of 2.0.

腹膜透析的采用和技术存活率受到与腹膜寿命和新陈代谢改变有关的限制因素的影响。事实上,几乎所有的腹膜透析液都利用葡萄糖作为渗透剂,快速扩散穿过腹膜,从而可能导致代谢异常,如高血糖、高胰岛素血症、肥胖和高脂血症。此外,除葡萄糖本身外,热消毒过程中产生的葡萄糖降解产物也会引起腹膜形态和功能的显著变化,导致超滤失败。有人建议用具有更好的局部和全身生物相容性的渗透剂部分替代葡萄糖,作为腹膜透析液创新的潜在策略。这种方法旨在最大限度地降低葡萄糖相关毒性,保护腹膜福利,并抵消常见的合并症。在这项工作中,我们报告了 ELIXIR 的临床试验设计,这是一项 III 期随机、对照、盲法结果评估研究,将基于木糖醇和左旋肉碱的创新配方 Xylocore® 与基于葡萄糖的标准方案进行比较,研究对象是接受持续非卧床腹膜透析治疗的终末期肾病患者;170 名患者将被随机分配(1:170 名患者将随机(1:1)接受 XyloCore® 或继续使用随机前的纯葡萄糖腹膜透析液进行腹膜透析 (PD) 治疗,为期 6 个月。该研究的主要目的是证明 XyloCore® 在 Kt/V 尿素方面的非劣效性,假定所有患者的治疗目标均为最低目标值 1.7 和最佳目标值 2.0,则临床上可接受的非劣效性差值为-0.25。
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引用次数: 0
Comparison of different peritoneal dialysis catheters on complications and catheter survival: A network meta-analysis of randomised controlled trials. 不同腹膜透析导管在并发症和导管存活率方面的比较:随机对照试验网络荟萃分析。
IF 2.7 3区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 Epub Date: 2024-02-15 DOI: 10.1177/08968608231224612
Lijuan Zhao, Zixian Yu, Xiayin Li, Jin Zhao, Yunlong Qin, Meilan Zhou, Ming Bai, Guoshuang Xu, Shiren Sun

Background: This network meta-analysis (NMA) aimed to compare the clinical advantage of four commonly used peritoneal dialysis catheters (PDCs) including the Swan neck segment with straight tip (Swan neck + S), Tenckhoff segment with straight tip (Tenckhoff + S), Swan neck segment with coiled tip (Swan neck + C) and Tenckhoff segment with coiled tip (Tenckhoff + C).

Methods: Randomised clinical trials were searched from PubMed, Embase, the Cochrane Register of clinical trials, China National Knowledge Infrastructure (CNKI) and ChinaInfo from their inception until July 31, 2022. Meta-analysis was performed using Stata 14.0 and RevMan 5.3.5 software to evaluate the four commonly used PDCs.

Results: Seventeen studies involved 1578 participants were included. NMA showed that compared with Swan neck + C, Swan neck + S significantly reduced catheter tip migration (OR 0.47 95% CI 0.22-0.99). Tenckhoff + S was more effective in reducing catheter dysfunction (OR 0.42, 95% CI 0.23-0.79), catheter tip migration with dysfunction (OR 0.19, 95% CI 0.05-0.78) and catheter removal (OR 0.56, 95% CI 0.34-0.93) which were consistent with the pairwise meta-analysis. According to the surface under the cumulative ranking curve, Swan neck + S emerged as the best PDC in the reduction of catheter tip migration (83.3%), followed by Tenckhoff + S (79.4%). Moreover, Tenckhoff + S (86.5%, 76.3%) and Swan neck + S (72.3, 86.9%) ranked as the first and second PDC for 1 and 2-year technique survival which was significantly higher than those of the other two PDCs.

Conclusion: Our NMA showed Swan neck + S and Tenckhoff + S tended to be more efficacious than Swan neck + C and Tenckhoff + C in lowering the mechanical dysfunction and prolonging the technique survival, which may contribute to better clinical decisions. More randomised controlled trials with larger scales and higher quality are needed in order to obtain more credible evidence.

背景:本网络荟萃分析(NMA)旨在比较四种常用腹膜透析导管(PDC)的临床优势,包括天鹅颈段带直头(Swan neck + S)、Tenckhoff段带直头(Tenckhoff + S)、天鹅颈段带螺旋头(Swan neck + C)和Tenckhoff段带螺旋头(Tenckhoff + C):从 PubMed、Embase、Cochrane 临床试验注册中心、中国国家知识基础设施(CNKI)和 ChinaInfo 中检索了从开始到 2022 年 7 月 31 日的随机临床试验。使用Stata 14.0和RevMan 5.3.5软件进行了元分析,以评估四种常用的PDCs:结果:共纳入 17 项研究,涉及 1578 名参与者。NMA显示,与天鹅颈+C相比,天鹅颈+S可显著减少导管尖端移位(OR 0.47 95% CI 0.22-0.99)。Tenckhoff + S 在减少导管功能障碍(OR 0.42,95% CI 0.23-0.79)、导管尖端移位与功能障碍(OR 0.19,95% CI 0.05-0.78)和导管移除(OR 0.56,95% CI 0.34-0.93)方面更为有效,这与成对荟萃分析结果一致。根据累积排名曲线的表面积,在减少导管尖端移位方面,Swan neck + S 是最好的 PDC(83.3%),其次是 Tenckhoff + S(79.4%)。此外,Tenckhoff + S(86.5%,76.3%)和 Swan neck + S(72.3%,86.9%)在 1 年和 2 年技术存活率方面排名第一和第二,明显高于其他两种 PDC:我们的 NMA 显示,在降低机械功能障碍和延长技术存活期方面,Swan neck + S 和 Tenckhoff + S 比 Swan neck + C 和 Tenckhoff + C 更有效,这可能有助于做出更好的临床决策。为了获得更可信的证据,需要更多规模更大、质量更高的随机对照试验。
{"title":"Comparison of different peritoneal dialysis catheters on complications and catheter survival: A network meta-analysis of randomised controlled trials.","authors":"Lijuan Zhao, Zixian Yu, Xiayin Li, Jin Zhao, Yunlong Qin, Meilan Zhou, Ming Bai, Guoshuang Xu, Shiren Sun","doi":"10.1177/08968608231224612","DOIUrl":"10.1177/08968608231224612","url":null,"abstract":"<p><strong>Background: </strong>This network meta-analysis (NMA) aimed to compare the clinical advantage of four commonly used peritoneal dialysis catheters (PDCs) including the Swan neck segment with straight tip (Swan neck + S), Tenckhoff segment with straight tip (Tenckhoff + S), Swan neck segment with coiled tip (Swan neck + C) and Tenckhoff segment with coiled tip (Tenckhoff + C).</p><p><strong>Methods: </strong>Randomised clinical trials were searched from PubMed, Embase, the Cochrane Register of clinical trials, China National Knowledge Infrastructure (CNKI) and ChinaInfo from their inception until July 31, 2022. Meta-analysis was performed using Stata 14.0 and RevMan 5.3.5 software to evaluate the four commonly used PDCs.</p><p><strong>Results: </strong>Seventeen studies involved 1578 participants were included. NMA showed that compared with Swan neck + C, Swan neck + S significantly reduced catheter tip migration (OR 0.47 95% CI 0.22-0.99). Tenckhoff + S was more effective in reducing catheter dysfunction (OR 0.42, 95% CI 0.23-0.79), catheter tip migration with dysfunction (OR 0.19, 95% CI 0.05-0.78) and catheter removal (OR 0.56, 95% CI 0.34-0.93) which were consistent with the pairwise meta-analysis. According to the surface under the cumulative ranking curve, Swan neck + S emerged as the best PDC in the reduction of catheter tip migration (83.3%), followed by Tenckhoff + S (79.4%). Moreover, Tenckhoff + S (86.5%, 76.3%) and Swan neck + S (72.3, 86.9%) ranked as the first and second PDC for 1 and 2-year technique survival which was significantly higher than those of the other two PDCs.</p><p><strong>Conclusion: </strong>Our NMA showed Swan neck + S and Tenckhoff + S tended to be more efficacious than Swan neck + C and Tenckhoff + C in lowering the mechanical dysfunction and prolonging the technique survival, which may contribute to better clinical decisions. More randomised controlled trials with larger scales and higher quality are needed in order to obtain more credible evidence.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"35-43"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139741738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of the Starting dialysis on Time, At home on the Right Therapy (START) project on the use of peritoneal dialysis. 按时开始透析、在家接受正确治疗(START)项目对腹膜透析使用的影响。
IF 2.7 3区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-01 Epub Date: 2024-02-20 DOI: 10.1177/08968608231225013
Robert R Quinn, Matthew J Oliver, Alix Clarke, Farah Mohamed, Scott W Klarenbach, Braden J Manns, Danielle E Fox, Nairne Scott-Douglas, Louise Morrin, Anita Kozinski, Tracy Schwartz, Robert Pauly

Background: Peritoneal dialysis (PD) is actively promoted, but increasing PD utilisation is difficult. The objective of this study was to determine if the Starting dialysis on Time, At Home, on the Right Therapy (START) project was associated with an increase in the proportion of dialysis patients receiving PD within 6 months of starting therapy.

Methods: Consecutive patients over age 18, with end-stage kidney failure, who started dialysis between 1 April 2015 and 31 March 2018 in the province of Alberta, Canada. Programmes were provided with high-quality data about the individual steps in the process of care that drive PD utilisation that were used to identify problem areas, design and implement interventions to address them, and then evaluate whether those interventions had impact. The primary outcome was the proportion of patients receiving PD within 6 months of starting dialysis. Secondary outcomes included hospitalisation, death or probability of transfer to haemodialysis (HD). Interrupted time series methodology was used to evaluate the impact of the quality improvement initiative on the primary and secondary outcomes.

Results: A total of 1962 patients started dialysis during the study period. Twenty-seven per cent of incident patients received PD at baseline, and there was a 5.4% (95% confidence interval: 1.5-9.2) increase in the use of PD in the province immediately after implementation. There were no changes in the rates of hospitalisation, death or probability of transfer to HD after the introduction of START.

Conclusions: The approach used in the START project was associated with an increase in the use of PD in a setting with high baseline utilisation.

背景:腹膜透析(PD)得到了积极推广,但提高腹膜透析利用率却很困难。本研究旨在确定 "按时、在家、按正确疗法开始透析(START)"项目是否与透析患者在开始治疗后 6 个月内接受腹膜透析的比例增加有关:2015年4月1日至2018年3月31日期间在加拿大艾伯塔省开始透析的18岁以上终末期肾衰竭患者。该计划获得了有关推动透析利用率的护理流程中各个步骤的高质量数据,这些数据用于确定问题领域、设计和实施干预措施来解决这些问题,然后评估这些干预措施是否产生了影响。主要结果是开始透析后 6 个月内接受透析治疗的患者比例。次要结果包括住院、死亡或转为血液透析(HD)的概率。采用间断时间序列法评估质量改进措施对主要和次要结果的影响:研究期间共有 1962 名患者开始透析。基线时,27%的患者接受了透析治疗,而在该省,透析治疗的使用率在实施后立即增加了 5.4%(95% 置信区间:1.5-9.2)。START 项目实施后,住院率、死亡率或转入 HD 的概率均无变化:结论:START 项目所采用的方法与在基线使用率较高的环境中增加使用腹膜透析有关。
{"title":"The impact of the Starting dialysis on Time, At home on the Right Therapy (START) project on the use of peritoneal dialysis.","authors":"Robert R Quinn, Matthew J Oliver, Alix Clarke, Farah Mohamed, Scott W Klarenbach, Braden J Manns, Danielle E Fox, Nairne Scott-Douglas, Louise Morrin, Anita Kozinski, Tracy Schwartz, Robert Pauly","doi":"10.1177/08968608231225013","DOIUrl":"10.1177/08968608231225013","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis (PD) is actively promoted, but increasing PD utilisation is difficult. The objective of this study was to determine if the Starting dialysis on Time, At Home, on the Right Therapy (START) project was associated with an increase in the proportion of dialysis patients receiving PD within 6 months of starting therapy.</p><p><strong>Methods: </strong>Consecutive patients over age 18, with end-stage kidney failure, who started dialysis between 1 April 2015 and 31 March 2018 in the province of Alberta, Canada. Programmes were provided with high-quality data about the individual steps in the process of care that drive PD utilisation that were used to identify problem areas, design and implement interventions to address them, and then evaluate whether those interventions had impact. The primary outcome was the proportion of patients receiving PD within 6 months of starting dialysis. Secondary outcomes included hospitalisation, death or probability of transfer to haemodialysis (HD). Interrupted time series methodology was used to evaluate the impact of the quality improvement initiative on the primary and secondary outcomes.</p><p><strong>Results: </strong>A total of 1962 patients started dialysis during the study period. Twenty-seven per cent of incident patients received PD at baseline, and there was a 5.4% (95% confidence interval: 1.5-9.2) increase in the use of PD in the province immediately after implementation. There were no changes in the rates of hospitalisation, death or probability of transfer to HD after the introduction of START.</p><p><strong>Conclusions: </strong>The approach used in the START project was associated with an increase in the use of PD in a setting with high baseline utilisation.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"26-34"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is cloudy peritoneal dialysate associated with adverse drug reactions to benidipine? 腹膜透析液混浊与苯地平不良反应有关吗?
IF 2.7 3区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-12-19 DOI: 10.1177/08968608241307829
Yun Lin, Shumin Huang, Xiaorui Cai, Xiaoling Tang, Haohao Chen

Cloudiness in peritoneal dialysate is a key clinical indicator of peritonitis. However, distinguishing between turbidity caused by peritonitis and that induced by drug administration can be challenging. To better understand this phenomenon, data were collected between April 2020 and March 2023 from 287 peritoneal dialysis (PD) patients undergoing benidipine-controlled blood pressure management in our PD center. Among these patients, 25 cases (8.71%) developed non-infectious chyloperitoneum as an adverse reaction to benidipine. Turbidity appeared, on average, 25.28 ± 60.55 days after starting benidipine. Switching to another antihypertensive drug cleared the dialysate within 12 to 36 hours. Laboratory results, including smears and cultures, were consistent with a non-infectious state. Elevated triglyceride (TG) levels were observed in the turbid dialysate (p < 0.0001), with a mean TG of 0.28 ± 0.17 mmol/L in cloudy samples, compared to 0.07 ± 0.03 mmol/L in clear samples. No significant changes in cholesterol or peripheral blood TG levels were found before or after the occurrence of turbidity. This study confirms that benidipine can cause non-infectious chyloperitoneum, underscoring the need for attention to adverse drug reactions to avoid unnecessary resource use. Further investigation is required to guide antihypertensive medication choices in PD patients.

腹膜透析液混浊是腹膜炎的重要临床指标。然而,区分由腹膜炎引起的浑浊和由药物引起的浑浊是具有挑战性的。为了更好地理解这一现象,我们收集了2020年4月至2023年3月期间在我们的腹膜透析中心接受苯尼地平控制血压管理的287例腹膜透析(PD)患者的数据。其中25例(8.71%)发生非感染性乳糜腹膜不良反应。开始使用贝尼地平后平均25.28±60.55天出现浑浊。改用另一种抗高血压药物后,透析液在12至36小时内被清除。实验室结果,包括涂片和培养,与非感染状态一致。在浑浊的透析液中观察到甘油三酯(TG)水平升高(p
{"title":"Is cloudy peritoneal dialysate associated with adverse drug reactions to benidipine?","authors":"Yun Lin, Shumin Huang, Xiaorui Cai, Xiaoling Tang, Haohao Chen","doi":"10.1177/08968608241307829","DOIUrl":"https://doi.org/10.1177/08968608241307829","url":null,"abstract":"<p><p>Cloudiness in peritoneal dialysate is a key clinical indicator of peritonitis. However, distinguishing between turbidity caused by peritonitis and that induced by drug administration can be challenging. To better understand this phenomenon, data were collected between April 2020 and March 2023 from 287 peritoneal dialysis (PD) patients undergoing benidipine-controlled blood pressure management in our PD center. Among these patients, 25 cases (8.71%) developed non-infectious chyloperitoneum as an adverse reaction to benidipine. Turbidity appeared, on average, 25.28 ± 60.55 days after starting benidipine. Switching to another antihypertensive drug cleared the dialysate within 12 to 36 hours. Laboratory results, including smears and cultures, were consistent with a non-infectious state. Elevated triglyceride (TG) levels were observed in the turbid dialysate (<i>p</i> < 0.0001), with a mean TG of 0.28 ± 0.17 mmol/L in cloudy samples, compared to 0.07 ± 0.03 mmol/L in clear samples. No significant changes in cholesterol or peripheral blood TG levels were found before or after the occurrence of turbidity. This study confirms that benidipine can cause non-infectious chyloperitoneum, underscoring the need for attention to adverse drug reactions to avoid unnecessary resource use. Further investigation is required to guide antihypertensive medication choices in PD patients.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608241307829"},"PeriodicalIF":2.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Peritoneal dialysis and its impact on intra-abdominal pressure and respiratory mechanics in the critically ill patient: Can PD take the pressure? 腹膜透析及其对危重病人腹内压和呼吸力学的影响:PD能承受压力吗?
IF 2.7 3区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-12-09 DOI: 10.1177/08968608241301688
Ryan J Chan, Robert R Quinn, Joanne M Bargman

Peritoneal dialysis (PD) was historically the initial kidney replacement modality of choice for patients admitted to the intensive care unit, and there are several advantages to maintaining critically ill PD patients on their usual dialysis therapy. However, in this patient population, there are two contentious questions: how are the respiratory dynamics of mechanical ventilation impacted by the presence of dialysate within the abdomen, and what can be done to mitigate these potential effects? This review discusses the theoretical impact of PD on intra-abdominal pressure (IAP) and evidence for the effect of IAP on respiratory mechanics in mechanically ventilated PD patients.

腹膜透析(PD)历来是重症监护病房患者最初选择的肾脏替代方式,对危重PD患者进行常规透析治疗有几个优势。然而,在这个患者群体中,有两个有争议的问题:机械通气的呼吸动力学如何受到腹部透析液的影响,以及如何减轻这些潜在的影响?本文综述了PD对腹内压(IAP)的理论影响,以及IAP对机械通气PD患者呼吸力学影响的证据。
{"title":"Peritoneal dialysis and its impact on intra-abdominal pressure and respiratory mechanics in the critically ill patient: Can PD take the pressure?","authors":"Ryan J Chan, Robert R Quinn, Joanne M Bargman","doi":"10.1177/08968608241301688","DOIUrl":"https://doi.org/10.1177/08968608241301688","url":null,"abstract":"<p><p>Peritoneal dialysis (PD) was historically the initial kidney replacement modality of choice for patients admitted to the intensive care unit, and there are several advantages to maintaining critically ill PD patients on their usual dialysis therapy. However, in this patient population, there are two contentious questions: how are the respiratory dynamics of mechanical ventilation impacted by the presence of dialysate within the abdomen, and what can be done to mitigate these potential effects? This review discusses the theoretical impact of PD on intra-abdominal pressure (IAP) and evidence for the effect of IAP on respiratory mechanics in mechanically ventilated PD patients.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608241301688"},"PeriodicalIF":2.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Peritoneal Dialysis International
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