Continuous Ambulatory Peritoneal Dialysis: Three-Year Experience at One Center

Nolph, Karl D.; Sorkin, Michael; Rubin, Jack; Arfania, Dariush; Prowant, Barbara F.; Fruto, Leonor; Kennedy, Dee

doi:10.7326/0003-4819-92-5-609

Cited by 175 publications

(43 citation statements)

References 5 publications

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“…However, the higher serum bicarbonate levels in CAPD patients indicate better control of the acidosis and this may have a good impact on the renal osteodystrophy, as was demonstrated by Gokal et al 8 There was no statistically significant difference in the mean hemoglobin value for the two groups. This is similar to what some observers have found, 9,10 but others 11,12 have reported a 5 to 7% increase in the average hematocrit readings at one year in patients initiated and maintained on CAPD. The reason for this increased hemoglobin concentration is not known, but it could be due to better fluid control or bone marrow responsiveness to erythropoietin.…”

Section: Discussionsupporting

confidence: 78%

Comparison Between Continuous Ambulatory Peritoneal Dialysis and in Center Hemodialysis

et al. 1990

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Section: Discussionsupporting

confidence: 78%

Comparison Between Continuous Ambulatory Peritoneal Dialysis and in Center Hemodialysis

et al. 1990

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“…[3] Nolph et al reported that protein loss in the continuous ambulatory peritoneal dialysis (CAPD) dialysate may be up to 15 g/day, and patients are required to ingest high-protein diets. [4] The development of amino acid solutions in the 1950s led to their use in patients with impossible or inadequate ingestion. Recently, some patho-specific amino acid solutions for renal failure were developed to study amino acid metabolism.…”

Section: Introductionmentioning

confidence: 99%

New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

et al. 2009

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Many peritoneal dialysis (PD) patients with chronic renal failure (CRF) suffer from metabolic and nutritional abnormalities. However, these abnormalities have been not sufficiently investigated. At present, the resolution of these issues in this field has been hindered by the lack of suitable PD models. We attempt to develop a rat model of PD under no constraints and under nonanesthetization to evaluate amino acid solution as suitable nutritional therapy for renal failure. In our model, bilateral nephrectomy rats were dialyzed 6 h per day for three days. The dialysate was infused and removed continually via a metering pump. Under fasting, rats were infused with 5% glucose or amino acid solution for renal failure, and they remained alive. This model can be used to examine bilateral nephrectomy in rats for three or more days. We were also able to determine protein and calorie malnutrition, negative nitrogen balance, abnormalities in the plasma amino acid pattern, and calcium and phosphorus metabolism. Thus, this model has the characteristics of renal failure in humans and may be used to easily examine the metabolic changes due to loss of kidney function.

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“…Since the introduction of continuous ambulatory PD, studies have explored the question of whether dialysis modality per se independently affects patient outcomes, including an early attempt at a randomized, controlled trial (5)(6)(7). In this review, we present our analysis of the current state of knowledge about the effects of dialysis modality on patient outcomes in context of the declining proportion of patients who undergo PD in many parts of the world.…”

mentioning

confidence: 99%

Is the Declining Use of Long-Term Peritoneal Dialysis Justified by Outcome Data?

Khawar

Kalantar-Zadeh

et al. 2007

Clinical Journal of the American Society of Nephrology

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In the past decade, peritoneal dialysis use among patients with end-stage renal disease has declined in many countries. Studies from the United States indicate that many academic centers do not have adequate resources to train fellows, most incident dialysis patients are not offered peritoneal dialysis, and more than half of dialysis clinics do not have the infrastructure to support peritoneal dialysis. Some are concerned that the outcomes of peritoneal dialysis and maintenance hemodialysis patients may not be equivalent, a notion that is not supported by outcome studies. Given the effect of modality selection on patients' lifestyle, attempts to conduct a randomized, controlled comparison of maintenance hemodialysis and peritoneal dialysis have been unsuccessful. Most observational studies showed that peritoneal dialysis is associated with a survival advantage that diminishes over time; it is unclear whether any of the differences over time are attributable to the modality. Between 1996 and 2003, the early outcomes of peritoneal dialysis patients further improved, whereas those for maintenance hemodialysis patients remained unchanged. Differences in outcomes may be due to residual statistical confounding; however, several biologic mechanisms can be postulated: The early survival advantage may be related to the better preservation of residual renal function with peritoneal dialysis, and the diminution of the survival advantage may be related to worsened volume control. There is a need for large observational and interventional studies among peritoneal dialysis patients to sustain and enforce the improvements in both dialysis therapies.

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Continuous Ambulatory Peritoneal Dialysis: Three-Year Experience at One Center

Cited by 175 publications

References 5 publications

Comparison Between Continuous Ambulatory Peritoneal Dialysis and in Center Hemodialysis

Comparison Between Continuous Ambulatory Peritoneal Dialysis and in Center Hemodialysis

New Peritoneal Dialysis Model in Rats with Bilateral Nephrectomy

Is the Declining Use of Long-Term Peritoneal Dialysis Justified by Outcome Data?

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