Showing papers on "Peritoneal dialysis published in 1983"
TL;DR: A 26-year-old woman was transferred to New England Medical Center (NEMC) from another hospital with a diagnosis of acute renal failure complicating antepartum hemorrhage, abruptio placentae, and shock, and developed hypotension, oozing from the surgical site that required multiple transfusions, and acute oliguria.
555 citations
TL;DR: Life-table analysis showed a significant difference between the incidence of peritonitis in the two groups and the Y-system method is simple and economical and the frequency and the severity of side-effects appears to be acceptable.
220 citations
215 citations
TL;DR: Observations suggest that long-term irrigation of the peritoneal cavity leads to a progressive deterioration of theperitoneum resulting in its altered permeability with loss of the ability to ultrafiltrate.
Abstract: Permanent loss of the ultrafiltration (UF) capacity of the peritoneum has been observed with an increasing frequency among our patients treated by long-term intermittent (IPD) and/or continuous ambula
185 citations
Journal Article•
150 citations
01 Jan 1983
TL;DR: From the beginning of the dialysis treatment to the eighteenth month there was a significant and progressive decrease of GFR in the group of patients treated by haemodialysis, while in theperitoneal dialysis group GFR and peritoneal clearances remained stable.
Abstract: A study has been carried out to compare over an 18 month period the residual glomerular filtration rate (GFR) measured by the creatinine clearance in two matched groups of 25 patients with end-stage renal disease. One group was treated by continuous ambulatory peritoneal dialysis, the other one by maintenance haemodialysis. GFR was similar in both groups immediately before starting dialysis therapy, respectively 4.3 +/- 2.3 and 4.4 +/- 2.4 ml/min. From the beginning of the dialysis treatment to the eighteenth month there was a significant and progressive decrease of GFR in the group of patients treated by haemodialysis, while in the peritoneal dialysis group GFR and peritoneal clearances remained stable.
144 citations
Journal Article•
120 citations
TL;DR: Improved catheters and further reductions in the incidence of peritonitis will most likely result in a decreased number of patients who withdraw from continuous ambulatory peritoneal dialysis therapy.
100 citations
01 Jan 1983
98 citations
TL;DR: The most outstanding abnormality detected was the blood and tissue accumulation of aluminum, which has been linked with the development of dialysis dementia and bone disease.
95 citations
01 Jan 1983
TL;DR: It is postulate that the rapid decline in plasma levels of carnitine caused by hemodialysis initiates unilateral transport of the compound from muscle to the plasma, thus depleting the skeletal muscle stores of carnItine, and the plasma and muscle Carnival levels remained in the normal range in patients on intermittent peritoneal dialysis and CAPD.
Abstract: We studied plasma, dialysate, and muscle carnitine levels in patients with stable chronic renal failure on hemodialysis, and intermittent peritoneal, or continuous ambulatory peritoneal dialysis (CAPD
TL;DR: Data is presented on the improvement of histological renal osteodystrophy in CAPD patients and relate this to serum concentrations of calcium, phosphate, 25 hydroxycholecalciferol [25-(0H)CC] and immunoreactive parathormone (PTH) and sequential serum aluminum concentrations are reported.
TL;DR: Results show that a change in the nutritional habits is responsible for the adaptation to the peritoneal D-glucose uptake and hormone abnormalities, specific for uremia, are improved in CAPD, however, a significant rise in cholesterol serum concentration must be noticed.
TL;DR: Literature review reveals that infection due to Rhodotorula rubra is most unusual and occurs only in the hospital setting in patients with serious compromise of host defenses.
01 Oct 1983
TL;DR: The long-term potential of continuous ambulatory peritoneal dialysis remains uncertain at this point, but for most patients, adequate short-term treatment by this method is a reasonable alternative to hemodialysis.
Abstract: From January 1979 through January 1982, 69 patients with end-stage renal failure of various causes were treated by continuous ambulatory peritoneal dialysis. The dialysis was adequate and stable in all except four patients; two of these four became irreversibly uremic, and the other two had inadequate ultrafiltration. Hemoglobin levels increased initially and remained stable in all but two patients. In our experience, metabolic problems included control of secondary hyperparathyroidism, adequate protein nutrition, progressive neuropathy, abnormal lipoprotein profiles, and excessive weight gain. Technical problems included recurrent peritonitis, maintenance of adequate peritoneal access, and development of abdominal hernias. In general, all but two patients remained enthusiastic about this type of therapy despite inherent problems. The long-term potential of continuous ambulatory peritoneal dialysis remains uncertain at this point, but for most patients, adequate short-term treatment by this method is a reasonable alternative to hemodialysis.
Journal Article•
TL;DR: D-Xylose kinetics were studied in 12 normal subjects and in nine patients with chronic renal failure requiring dialysis (five hemodialysis and four peritoneal dialysis) to determine D-xylose bioavailability and the absolute bioavailability of this compound.
TL;DR: All patients were generally pleased with this form of dialysis and particularly enjoyed the greater mobility and decreased dietary restriction.
Abstract: Fifty-seven patients initiated continuous ambulatory peritoneal dialysis. All patients were generally pleased with this form of dialysis and particularly enjoyed the greater mobility and decreased dietary restriction. Complications associated with continuous ambulatory peritoneal dialysis include peritonitis, pericatheter infection, catheter malfunction, dialysate leak, and hernias of the abdominal wall.
TL;DR: Four co-operating centers evaluated the effects of a new dialysis solution containing 40 mEq/1 of lactate and 0.5 mEQ/ 1 of magnesium on serum total CO2 and magnesium concentrations, which yielded significant increases in serum CO 2 and decreases in serum magnesium.
Abstract: Four co-operating centers evaluated the effects of a new dialysis solution containing 40 mEq/1 of lactate and 0.5 mEq/1 of magnesium on serum total CO2 and magnesium concentrations. The new solutio...
TL;DR: Serial dietetic assessments and measurements of total body nitrogen as well as adherence to an adequate protein intake will assist in the prevention of malnutrition in CAPD patients.
Abstract: Nutritional follow-up of 20 CAPD patients for 18–24 months showed a decrease in total body nitrogen, increase in total body potassium and body weight, and a decrease in protein intake over time. Th...
TL;DR: Appropriate management of renal osteodystrophy combined with adequate energy and protein intake were important factors in the growth of patients receiving CAPD.
TL;DR: The aim of this investigation was to study insulin regulation of blood glucose when administered continuously via dialysate during CAPD versus when given intermittently and subcutaneously before CAPD; the degree of insulin retention in plastic CAPD bags after complete drainage of the dialysis fluid; and absorption of diabetes and nondiabetic patients treated with CAPD.
TL;DR: Evaluation for mycobacteria is recommended in all cases of CAPD-associated peritonitis where no organism is identified, or where no improvement is noted after 48 hours of therapy.
TL;DR: Continued expansion of the technique demands advances in prevention of peritonitis, adequate facilities for admission and particularly an expanding hospital haemodialysis programme to accept the less successful patients from CAPD.
Abstract: We review the experience of the Renal Unit at Newcastle upon Tyne over the three years 1979-1981, during which 122 patients with chronic renal failure were treated by continuous ambulatory peritoneal dialysis (CAPD). Advantages of the technique included wide acceptability to a cross-section of patients reaching the renal unit, including the elderly and diabetics. Patients who experienced both techniques preferred CAPD to haemodialysis because of the greater freedom and sense of well-being. Patient survival was 94 per cent at two years and rehabilitation was as good as could be expected for the age and primary medical complications of the patients. Control of plasma potassium and phosphate was easier than with haemodialysis. Renal osteodystrophy responded well to a combination of CAPD and alfacalcidol therapy over the two year period for which we have performed serial bone biopsies. Serum aluminium was slightly raised as a result of consumption of phosphate binders and presumed uptake from dialysis fluid but no aluminium related disease has yet been encountered. Anaemia was partly corrected by CAPD with haemoglobin rising to about 10 g/dl on average. CAPD was less costly than home haemodialysis over the first three years and has been adopted as our standard treatment for patients who can expect an early transplant. Disadvantages were persisting problems with peritonitis which still occurred at an incidence of one attack per 39 patient weeks over the last two years, and an actuarial success rate for the technique of only 63 per cent at two years. Twenty patients developed hernias. Weight gain was common and occasionally gross. There was a significant rise in serum cholesterol. The arrival of CAPD has allowed us to increase the intake to our renal failure programme by 50 per cent. However, continued expansion of the technique demands advances in prevention of peritonitis, adequate facilities for admission and particularly an expanding hospital haemodialysis programme to accept the less successful patients from CAPD.
TL;DR: The quantitative and qualitative characteristics of cells in the peritoneal dialysate from 12 patients were examined and it was found that the number of Cells in each subsequent fraction of Dialysate decreased, while the total number of cells decreased.
Abstract: The quantitative and qualitative characteristics of cells in the peritoneal dialysate from 12 patients were examined. The number of cells in each subsequent fraction of dialysate decreased, while the
Journal Article•
TL;DR: It is concluded that permeability of the peritoneal membrane to middle-size proteins leads to loss of 25-OH-D binding protein, and this increases loss of 24-hydroxyvitamin D.
Abstract: Despite a good control of serum phosphate levels, bone disease still occurs in patients treated with chronic ambulatory peritoneal dialysis (CAPD). The purpose of this study was to determine if 25-hydroxyvitamin D (25-OH-D) penetrates through the peritoneal membrane and whether chronic peritoneal dialysis may thereby decrease the serum 25-OH-D levels. In 10 CAPD-treated patients the serum 25-OH-D was 8.8 +/- 1.1 ng/ml, which is significantly lower than in the hemodialysis-treated group (15.5 +/- 2.3 ng/ml) and lower than in healthy controls (30.3 +/- 3.6 ng/ml). The mean total daily loss of 25-OH-D in the peritoneal fluid was 1,491 +/- 260 ng/day. The serum 25-OH-D binding capacity was significantly lower in the CAPD group than in normal controls. The mean daily loss of 25-OH-D binding capacity in the dialysate was 153 +/- 28 nmol/day. We conclude that permeability of the peritoneal membrane to middle-size proteins leads to loss of 25-OH-D binding protein, and this increases loss of 25-OH-D. Low levels of 25-OH-D in plasma may aggravate the symptoms of osteodystrophy of renal failure in patients treated with CAPD.
TL;DR: In this article, the peritonitis in 29 children undergoing continuous ambulatory peritoneal dialysis during a 20-month period was one episode every 12.5 patient-months.
Abstract: The incidence of peritonitis in 29 children undergoing continuous ambulatory peritoneal dialysis during a 20-month period was one episode every 12.5 patient-months. Of the 20 episodes of peritonitis, seven (35%) were treated on an ambulatory basis, and 13 required patient hospitalization. The annualized hospitalization rate for the 29 patients during 252 patient-months was 3.8 days per patient. All patients recovered from peritonitis; the only complication was the need to replace two peritoneal catheters. These data would seem to indicate that the potential threat of peritonitis should not curtail continued utilization of continuous ambulatory peritoneal dialysis in children.
TL;DR: With CAPD, successful pregnancy is now possible in this group of patients, among whom fetal loss would otherwise be high, and targets for control of blood urea and hemoglobin were achieved.
Abstract: In this article we describe the successful management of pregnancy and delivery in a 26-yr-old patient with advanced diabetic nephropathy and chronic renal failure. Targets for control of blood urea and hemoglobin were achieved with the aid of continuous ambulatory peritoneal dialysis (CAPD). Peritoneal dialysis did not interfere with normal recovery from cesarean section. With CAPD, successful pregnancy is now possible in this group of patients, among whom fetal loss would otherwise be high.
TL;DR: Right-sided hydrothorax is a known complication in patients treated by peritoneal dialysis and usually appears during the first days of treatment.
Abstract: Right-sided hydrothorax is a known complication in patients treated by peritoneal dialysis. It usually appears during the first days of treatment. The cause has seldom been demonstrated. We report 2 c