Peritoneal dialysis has an important role to play in the ongoing coronavirus pandemic. It can help in maintaining social distancing goals in dialysis patients and hence should be considered as first line renal replacement therapy (RRT) in all incident ESRD patients. There is emerging interest in the role of PD for the treatment of Acute Kidney Injury especially in the setting of overburdened hemodialysis/CRRT services in the ICU. This article discusses the role of PD in managing critically ill COVID patients.
{"title":"Peritoneal dialysis – ideal renal replacement therapy during coronavirus (COVID-19) pandemic","authors":"J. Eapen","doi":"10.4103/IOPD.IOPD_5_20","DOIUrl":"https://doi.org/10.4103/IOPD.IOPD_5_20","url":null,"abstract":"Peritoneal dialysis has an important role to play in the ongoing coronavirus pandemic. It can help in maintaining social distancing goals in dialysis patients and hence should be considered as first line renal replacement therapy (RRT) in all incident ESRD patients. There is emerging interest in the role of PD for the treatment of Acute Kidney Injury especially in the setting of overburdened hemodialysis/CRRT services in the ICU. This article discusses the role of PD in managing critically ill COVID patients.","PeriodicalId":442296,"journal":{"name":"Indian Journal of Peritoneal dialysis","volume":"13 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133204301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Sood, R. Grover, Vivek Kumar, S. Singh, K. Gupta
Aim: Comparison of tolerability and efficacy of treatment with icodextrin vs. dextrose 2.5% amongst high risk cohort of chronic peritoneal dialysis patients (high/high average solute transport characteristics and low residual renal function) over 3 months. Study Design and Methodology: The study was an open-label, comparative, prospective, randomized controlled trial, conducted at department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. A total of 349 end stage renal disease patients on chronic peritoneal dialysis were screened for eligibility over a period of 6 months and 41 patients with high / high average solute transport characteristics and low residual renal function were randomized to receive either icodextrin 7.5% solution or 2.5% dextrose solution in long dwell. Patients were assessed for adequacy of peritoneal dialysis (creatinine & urea clearance), peritoneal membrane transport characteristics including solute clearance (standard peritoneal equilibration test), body composition, total body water, fat mass and fat free mass (using whole body tetrapolar bioimpedance analyzer) at baseline and at the end of 3 months. Statistical Analysis: Continuous variables were compared with independent samples paired t test if normally distributed, or with Mann–Whitney U test if the distribution was skewed. Categorical variables were analyzed with Chi-square test or Fisher exact test as appropriate. Pearson's correlation coefficient was calculated between different quantitative variables. Paired t test and Wilcoxon signed-rank test were used for within-group comparisons. Repeated measure ANOVA was used to compare bioelectrical impedance between intervention groups. Results: The study has shown that use of icodextrin based continuous ambulatory peritoneal dialysis resulted in better ultrafiltration and improved solute clearance when compared to 2.5% dextrose based peritoneal dialysis in a select cohort of patients having high/high average transporter characteristics with poor residual renal function, however, it didn't significantly alter total body water and failed to translate into improvements in either patient's or physician's assessment of global health of response to therapy atleast at 3 months. Conclusions: Although use of icodextrin based peritoneal dialysis solution for long dwell resulted in significant improvement in solute clearance and ultrafiltration nevertheless failed to translate into better hydration status or subjective improvement scores atleast at 3 months.
{"title":"Randomized controlled trial to compare the tolerability and efficacy of treatment with Icodextrin 7.5% versus Dextrose 2.5% in chronic peritoneal dialysis patients with high/high average solute transport characteristics and low residual renal function","authors":"V. Sood, R. Grover, Vivek Kumar, S. Singh, K. Gupta","doi":"10.4103/IOPD.IOPD_5_19","DOIUrl":"https://doi.org/10.4103/IOPD.IOPD_5_19","url":null,"abstract":"Aim: Comparison of tolerability and efficacy of treatment with icodextrin vs. dextrose 2.5% amongst high risk cohort of chronic peritoneal dialysis patients (high/high average solute transport characteristics and low residual renal function) over 3 months. Study Design and Methodology: The study was an open-label, comparative, prospective, randomized controlled trial, conducted at department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. A total of 349 end stage renal disease patients on chronic peritoneal dialysis were screened for eligibility over a period of 6 months and 41 patients with high / high average solute transport characteristics and low residual renal function were randomized to receive either icodextrin 7.5% solution or 2.5% dextrose solution in long dwell. Patients were assessed for adequacy of peritoneal dialysis (creatinine & urea clearance), peritoneal membrane transport characteristics including solute clearance (standard peritoneal equilibration test), body composition, total body water, fat mass and fat free mass (using whole body tetrapolar bioimpedance analyzer) at baseline and at the end of 3 months. Statistical Analysis: Continuous variables were compared with independent samples paired t test if normally distributed, or with Mann–Whitney U test if the distribution was skewed. Categorical variables were analyzed with Chi-square test or Fisher exact test as appropriate. Pearson's correlation coefficient was calculated between different quantitative variables. Paired t test and Wilcoxon signed-rank test were used for within-group comparisons. Repeated measure ANOVA was used to compare bioelectrical impedance between intervention groups. Results: The study has shown that use of icodextrin based continuous ambulatory peritoneal dialysis resulted in better ultrafiltration and improved solute clearance when compared to 2.5% dextrose based peritoneal dialysis in a select cohort of patients having high/high average transporter characteristics with poor residual renal function, however, it didn't significantly alter total body water and failed to translate into improvements in either patient's or physician's assessment of global health of response to therapy atleast at 3 months. Conclusions: Although use of icodextrin based peritoneal dialysis solution for long dwell resulted in significant improvement in solute clearance and ultrafiltration nevertheless failed to translate into better hydration status or subjective improvement scores atleast at 3 months.","PeriodicalId":442296,"journal":{"name":"Indian Journal of Peritoneal dialysis","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132357484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Continuous Ambulatory Peritoneal Dialysis is a recommended mode of renal replacement therapy in those with vascular access failures. Complications of Surgical placement of catheter and Percutaneous technique by Nephrologist are well described. Complications may occur during the procedure or after the procedure. During the placement of the catheter, hollow viscus perforation is known to occur. Patients are given instructions of using laxative , emptying bladder before surgery in order to avoid bladder or bowel injury. Bladder perforation is one of the rare complication of CAPD technique.It is expected to occur commonly with rigid catheters than the soft catheters used in CAPD. Herein we report a case of bladder perforation during the procedure of placement of percutaneous CAPD catheterization.
{"title":"An unusual complication of CAPD technique: Lesson to be learnt","authors":"Muzamil Ahmed, Manjusha Yadla","doi":"10.4103/IOPD.IOPD_1_19","DOIUrl":"https://doi.org/10.4103/IOPD.IOPD_1_19","url":null,"abstract":"Continuous Ambulatory Peritoneal Dialysis is a recommended mode of renal replacement therapy in those with vascular access failures. Complications of Surgical placement of catheter and Percutaneous technique by Nephrologist are well described. Complications may occur during the procedure or after the procedure. During the placement of the catheter, hollow viscus perforation is known to occur. Patients are given instructions of using laxative , emptying bladder before surgery in order to avoid bladder or bowel injury. Bladder perforation is one of the rare complication of CAPD technique.It is expected to occur commonly with rigid catheters than the soft catheters used in CAPD. Herein we report a case of bladder perforation during the procedure of placement of percutaneous CAPD catheterization.","PeriodicalId":442296,"journal":{"name":"Indian Journal of Peritoneal dialysis","volume":"223 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131598362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Sahoo, A. Achra, B. Muthukumar, Shiwangi Sharma
Continuous ambulatory peritoneal dialysis (CAPD) is one of the preferred forms of renal replacement therapy. However, peritonitis is the leading cause of morbidity and mortality associated with CAPD. Here, we report a case of Burkholderia cepacia peritonitis which required combination of antibiotics and catheter removal for its treatment.
{"title":"A rare case of early Burkholderia cepacia peritonitis in a chronic ambulatory peritoneal dialysis patient","authors":"S. Sahoo, A. Achra, B. Muthukumar, Shiwangi Sharma","doi":"10.4103/IOPD.IOPD_6_20","DOIUrl":"https://doi.org/10.4103/IOPD.IOPD_6_20","url":null,"abstract":"Continuous ambulatory peritoneal dialysis (CAPD) is one of the preferred forms of renal replacement therapy. However, peritonitis is the leading cause of morbidity and mortality associated with CAPD. Here, we report a case of Burkholderia cepacia peritonitis which required combination of antibiotics and catheter removal for its treatment.","PeriodicalId":442296,"journal":{"name":"Indian Journal of Peritoneal dialysis","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122153810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
>Peritoneal Dialysis is now an accepted mode of renal replacement therapy. The story of its development is a fascinating scientific journey of pioneers who have worked tirelessly to develop and extend the application of this technique which now plays such an important part in the treatment of patients with ESKD. This article reviews the milestones in the history of innovation of this life saving treatment in an attempt to understand to the hopes and ideas of our predecessors and build on them into the future to make peritoneal dialysis a more effective, safer, and inexpensive therapy for ESKD.
{"title":"History of peritoneal dialysis","authors":"S. Yusuf","doi":"10.4103/IOPD.IOPD_2_20","DOIUrl":"https://doi.org/10.4103/IOPD.IOPD_2_20","url":null,"abstract":">Peritoneal Dialysis is now an accepted mode of renal replacement therapy. The story of its development is a fascinating scientific journey of pioneers who have worked tirelessly to develop and extend the application of this technique which now plays such an important part in the treatment of patients with ESKD. This article reviews the milestones in the history of innovation of this life saving treatment in an attempt to understand to the hopes and ideas of our predecessors and build on them into the future to make peritoneal dialysis a more effective, safer, and inexpensive therapy for ESKD.","PeriodicalId":442296,"journal":{"name":"Indian Journal of Peritoneal dialysis","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116923022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sankarakumar GaneshAravind, A. Rohit, N. Gopalakrishnan, J. Dhanapriya, T. Dineshkumar, R. Sakthirajan, N. Malathy, T. Balasubramaniyan, A. Maasila
Peritonitis is an important cause for morbidity and mortality in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients. There is an emerging trend towards unusual organism causing CAPD peritonitis. We report our experience with unusual organisms and its impact on survival. We had 43 CAPD peritonitis episodes, out of which, six were due to unusual organisms. Although five patients responded to antibiotic therapy, one lost her CAPD access (catheter). Clinically, peritonitis caused by unusual organism is similar to that caused by other pathogens. Adherence to diligent hygienic practices while handling catheter and bag is most important in avoiding such peritonitis episodes.
{"title":"Unusual organisms causing continuous ambulatory peritoneal dialysis peritonitis","authors":"Sankarakumar GaneshAravind, A. Rohit, N. Gopalakrishnan, J. Dhanapriya, T. Dineshkumar, R. Sakthirajan, N. Malathy, T. Balasubramaniyan, A. Maasila","doi":"10.4103/IOPD.IOPD_1_20","DOIUrl":"https://doi.org/10.4103/IOPD.IOPD_1_20","url":null,"abstract":"Peritonitis is an important cause for morbidity and mortality in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients. There is an emerging trend towards unusual organism causing CAPD peritonitis. We report our experience with unusual organisms and its impact on survival. We had 43 CAPD peritonitis episodes, out of which, six were due to unusual organisms. Although five patients responded to antibiotic therapy, one lost her CAPD access (catheter). Clinically, peritonitis caused by unusual organism is similar to that caused by other pathogens. Adherence to diligent hygienic practices while handling catheter and bag is most important in avoiding such peritonitis episodes.","PeriodicalId":442296,"journal":{"name":"Indian Journal of Peritoneal dialysis","volume":"38 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114131293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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