A peritoneal dialysis patient with suspected allergic liver damage and renal dysfunction due to icodextrin dialysate

Nanamatsu, Azuma; Katsuragawa, Fumiko; Kawai, Saki; Yanagi, Tomoki; Higuchi, Shinichi; Yajima, Yu; Aki, Shota; Aoyagi, Makoto; Tanaka, Hiroyuki

doi:10.4009/jsdt.50.309

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…A response by Terumo indicated that since their product went on sale in December 2014, only one case of whole-body exfoliative dermatitis occurred in 2015, a decidedly small percentage. A case report by Nanamatsu et al on icodextrin dialysis solution allergies also indicated that they occur most often between 7 and 10 days after beginning the treatment, and nearly all cases resolve quickly after stopping treatment [13]. From the above, we determined that the occurrence of undesirable effects due to the use of icodextrin dialysis solution is by no means common.…”

Section: Basis Of Judgmentmentioning

confidence: 78%

Peritoneal Dialysis Guidelines 2019 Part 2: Main Text (Position paper of the Japanese Society for Dialysis Therapy)

Ryuzaki¹,

Ito²,

Nakamoto³

et al. 2021

Ren Replace Ther

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Background This article is a duplicated publication from the Japanese version of “2019 JSDT Guidelines for Peritoneal Dialysis” with permission from the Japanese Society for Dialysis Therapy (JSDT). This clinical practice guideline (CPG) was developed primarily by the Working Group on Revision of Peritoneal Dialysis (PD) Guidelines of the Japanese Society for Dialysis Therapy. Recently, the definition and creation process for CPGs have become far more rigorous; traditional methods and formats no longer adhere to current standards. To improve the reliability of international transmission of our findings, CPGs are created in compliance with the methodologies developed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) working group. Part 2 of this PD guideline is the first CPG developed by our society that conforms to the GRADE approach. Methods Detailed processes were created in accordance with the Cochrane handbook and the GRADE approach developed by the GRADE working group. Results Clinical question (CQ)1: Is the use of renin-angiotensin system inhibitors (RAS inhibitors), such as angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB), effective in PD patients? Recommendation: We suggest the usage of RAS inhibitors (ACEI and ARB) in PD patients (GRADE 2C). CQ2: Icodextrin or glucose solution: which is more useful as a dialysate among patients with PD? Recommendation: We suggest using icodextrin when managing body fluids in PD patients (GRADE 2C). CQ3: Is it better to apply or not apply mupirocin/gentamicin ointment to the exit site? Recommendation: We suggest not applying mupirocin/gentamicin ointment to the exit sites of PD patients (GRADE 2C). CQ4: Which surgical approach is more desirable when a PD catheter is placed, open surgery or laparoscopic surgery? No recommendation. CQ5: Which administration route of antibiotics is better in PD patients with peritonitis, intravenous or intraperitoneal? Recommendation: We suggest intraperitoneal administration of antibiotics in PD patients with peritonitis (GRADE 2C). Note: The National Insurance does not currently cover intraperitoneal administration. CQ6: Is peritoneal dialysis or hemodialysis better as the first renal replacement therapy in diabetic patients? No recommendation. Conclusions In the future, we suggest that society members construct their own evidence to answer CQs not brought up in this guideline, and thereby show the achievements of Japan worldwide.

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Section: Basis Of Judgmentmentioning

confidence: 78%

Peritoneal Dialysis Guidelines 2019 Part 2: Main Text (Position paper of the Japanese Society for Dialysis Therapy)

Ryuzaki¹,

Ito²,

Nakamoto³

et al. 2021

Ren Replace Ther

View full text Add to dashboard Cite

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Severe eosinophilic pneumonia during the initiation of peritoneal dialysis：a case report and literature review

Morita

Yamamoto

Ishida

et al. 2022

Nihon Toseki Igakkai Zasshi

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Keywords： eosinophilic pneumonia, peritoneal dialysis, hemodialysis, allergy 〈Abstract〉 A 79 year old male with end stage renal disease due to IgA nephropathy was admitted to hospital so that peritoneal dialysis (PD) could be initiated. He had undergone PD catheter insertion four months earlier. An exit site was created, and he started undergoing PD using glucose based PD solutions. Ten days after the initiation of PD, he developed a cough and fever. He was diagnosed with pneumonia, but antibiotics were ineffective. Bronchoscopy revealed marked eosinophilia (67％) in his bronchoalveolar lavage fluid, and a diagnosis of eosinophilic pneumonia (EP) was confirmed. It was considered unlikely that the EP had been caused by drugs or environmental factors. Instead, we suspected that the dialysate or PD catheter had triggered the onset of EP. Non invasive positive pressure ventilation and transient hemodialysis (HD) were needed. However, after high dose steroid therapy, his symptoms immediately improved, although he still needed home oxygen therapy. After his condition improved, he hoped to resume PD until he was discharged. He resumed PD without any recurrence of the EP until discharge. He was subsequently readmitted for vertebral compression fractures. His pneumonia relapsed during steroid tapering. He died of respiratory failure despite intensive treatment. Only four cases of PD associated EP have been reported. In all of these cases, the patients were successfully treated with steroids or the removal of the suspected cause, and PD was resumed without the EP going into remission. However, when such patients are in incomplete remission, we should consider transitioning from PD to HD because relapsed pneumonia can be fatal.

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A peritoneal dialysis patient with suspected allergic liver damage and renal dysfunction due to icodextrin dialysate

Cited by 2 publications

References 10 publications

Peritoneal Dialysis Guidelines 2019 Part 2: Main Text (Position paper of the Japanese Society for Dialysis Therapy)

Peritoneal Dialysis Guidelines 2019 Part 2: Main Text (Position paper of the Japanese Society for Dialysis Therapy)

Severe eosinophilic pneumonia during the initiation of peritoneal dialysis：a case report and literature review

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