Peritonitis, dialysis-related

Piraino B, Bailie GR, Bernardini J, et al. ISPD guidelines/recommen-dations peritoneal dialysis-related infections recommendations 2005 update. Perit Dial Int 2005 25 107-131. 

CLINICAL PRESENTATION OF PERITONEAL DIALYSIS-RELATED PERITONITIS... 

Keane WF, Bailie GR, Boeschoten E, et al. Adult peritoneal dialysis-related peritonitis treatment recommendations 2000 update. Pent Dial Int2000 20 396 11. 

Waite NM, Webster N, Laurel M et al. The efficacy of exit site povidone-iodine ointment in the prevention of early peritoneal dialysis-related infections. Am J Kidney Dis 1997 29 763-768. 

Piraino B, Bailie GR, Bemardini J et al. Peritoneal dialysis related infections 2005 update. Peril Dial Int (in press). 

Keene WE, Alexander SR, Baihe GR, et al. Peritoneal dialysis—Related peritonitis treatment recommendations 1996 update. Pent Dial Int 1996 16 557-573. 

Cano F, Morales M, Delucchi A. Amykacin-related apneic episode in an infant on peritoneal dialysis. Pediatr Nephrol... 

There is an increased incidence of peripheral vascular diseases in diabetic patients who receive peritoneal dialysis and epoetin (4). In these patients the time to a first vascular incident is shorter, the number of vascular events is increased, and more hospital days associated with vascular disease have been reported compared with patients receiving peritoneal dialysis without epoetin (4). Significant risk factors for the development of peripheral vascular disease are epoetin therapy, epoetin dose, and smoking (4). Peripheral vascular disease may be related to increased blood viscosity or other changes in blood rheology (4). 

Based on a study of 10 patients with automated peritoneal dialysis, it was recommended that for empirical treatment of dialysis-related peritonitis, the dosage of intermittent intraperitoneal tobramycin must be 1.5 mg/ kg for one exchange during the first day and then 0.5 mg/ kg thereafter, to reduce the risk of adverse effects (47). 

Renal replacement therapies (RRTs) like hemodialysis, peritoneal dialysis, and other related treatments have been available for decades, but have not resulted in dramatic improvements in patient outcomes. RRT can help patient management by normalizing blood electrolyte values, augmenting waste product removal, and maintaining fluid balance. Despite the supportive care that RRT offers, development of ARF is frequently a catastrophic event. 

The number of people diagnosed with end-stage kidney disease (ESKD) in 2002 exceeded 400,000. There were over 100,000 new cases of ESKD in 2002. The primary therapeutic options for these individuals are hemodialysis, peritoneal dialysis, and/or renal transplantation. Renal transplantation is the preferred long-term therapeutic option for most patients with ESKD because it provides patients with the greatest potential improvement in overall quality of life. Dialysis catheter-related infections, update peritoneal dialysis-associated peritonitis, and scheduled dialysis treatments are avoided, and dietary restrictions are fewer. While the analysis of quality of life is complex, patients generally report improved quality of life following transplantation as compared with patients on maintenance dialysis. ... 

Nescolarde, L., Garcfa-Gonz ez, M.A., Rosell-Eerrer, J., Donate, T., Querfeld, U., 2006. Thoracic vs whole-body bioimpedance measurements relation to hydration status and hypertension in peritoneal dialysis patients. Rhysiol. Meas. 27, 961—971. 

NIR has been applied to prediction of the concentrations of glucose and lactic acid in peritoneal dialysis solution, which is a medical product and not a fermentation broth (22). The peritoneal dialysis solution is introduced into the peritoneal cavity of renal failure patients, and waste materials in the blood are dialyzed into the solution through the peritoneum. MLR was used to obtain calibration equations relating the NIR spectral data and the glucose and lactic acid concentrations of a calibration sample set obtained by enzymatic methods. A calibration equation for glucose in peritoneal dialysis solution was formulated with second-derivative NIR spectral data at 2270 nm, and the values of r and SEC were 0.996 and 2.03 g-l respectively. A calibration equation for lactic acid in peritoneal dialysis solution was formulated with the second-derivative NIR spectral data at 1688 and 1268 nm, and the values of R and SEC were 0.997 and 0.178 g-C respectively. In the validation results of the calibration equations, excellent agreement between the results of the enzymatic method and the NIR method was also observed for these constituents. The values of r for glucose and lactic acid in the peritoneal dialysis solution were 0.996 and 0.996, respectively. 

Fong IW Prevention of haemodialysis and peritoneal dialysis catheter related infection by topical povidone-iodine. Postgrad Med J 1993 69(suppl 3) S15-S17. 

Hemodialysis (HD) catheter-associated bloodstream infections (BSls) are a type of CLABSI due to a central venous catheter (CVC) specifically designed for HD. In 2002, it was estimated that 50,000 CLABSIs occur in dialysis patients in the US annually. A more recent surveillance study found the rate of access-related BSIs to be 0.73 events per 100 patient-months [5]. Aside from catheters, patients in need of renal replacement therapy should eventually use arteriovenous fistula (AVF) or arteriovenous grafts (AVG) for HD, or alternatively, may receive peritoneal dialysis. All renal replacement therapies are associated with a risk of infection however, this risk varies with the method selected. Data from a CDC surveillance program display nicely how the type of access influences the BSI rate per 100 patient-months 0.5 (for AVFs), 0.9 (AVG), 4.2 (permanent CVCs), and an impressive 27.1 for temporary CVCs [6]. Another, more practi-... 

The disease is not sensitive to any medication used to treat nephrotic syndrome. Death is mostly related to lack of nutritional support or intercurrent disastrous infections even before ESRD starts at approximately 2-4 years of age. The currently most accepted treatment includes vigorous parenteral nutrition and protein replacement from birth on, bilateral nephrectomy and starting peritoneal dialysis during late infancy, and early planning of renal transplantation (Mahan et al. 1984 Holmberg et al. 1995). 

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