Under a conventional heparin regimen, the PMN variation during the course of the dialysis session suggests a more biocompatible effect of LMWH over UFH. In addition, the variation of elastase favours the lower dose, whatever the type of heparin. Heparin type and dose should therefore be considered in studies addressing biocompatibility in haemodialysis: a low dose of LMWH may be viewed as a better biocompatible treatment with regard to leukocyte stimulation.
We extracted data from the French Speaking Registry of Peritoneal Dialysis and retrospectively studied peritonitis and the outcome of 30 patients with polycystic kidney disease firstly treated with peritoneal dialysis within our dialysis unit since 1997.
There were 15 men and 15 women with a mean age of 54 years. Eighty-five per-cent of the patients had hepatic impairment. Ten patients did not suffer from comorbidities. Charlson comorbidity index was greater than or equal to 4 in five patients. Most of the patients was treated with automated peritoneal dialysis during the night. Only one patient was not autonomous with peritoneal dialysis. The whole medical monitoring lasted 836 months, representing an average of 28 months per patient. Eleven patients had a total of 24 peritonitis, 9 with gram negative bacillus. The incidence of peritonitis was one episode every 35 months-patient. Peritonitis was responsible for sudden admission in hemodialysis unit in two cases and death in one case. Fifteen patients (50%) benefited from renal transplantation. Only one patient had to undergo nephrectomy prior to renal transplantation. Seven patients were admitted to hemodialysis unit (the median duration time on peritoneal dialysis was 36 months). Four patients died. Four patients are currently treated with peritoneal dialysis.
In conclusion, this retrospective study points out that peritoneal dialysis, especially automated peritoneal dialysis, is a good option for patients with polycystic kidney disease necessitating dialysis.
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