Integration of Peritoneal Dialysis in the Treatment of Uremia

Ronco, Claudio; Dell’Aquila, Roberto; Loreto, Pierluigi Di; Spanó, Emilia

doi:10.1159/000093598

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…With PD, holidays and travel are more flexible, because the individual is not confined to an area that has a renal unit. Potentially CAPD gives the patient more control over their own lives and should facilitate the chance of rehabilitation [53]. Some have suggested that individuals receiving PD are more likely to be employed than those on in-center HD [54,55].…”

Section: Quality Of Lifementioning

confidence: 99%

Home dialysis as a first option: a new paradigm

et al. 2009

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Traditionally, the initial choice of dialysis for patients with end stage renal disease (ESRD) has been in-center hemodialysis (HD) or peritoneal dialysis (PD). Usually, the choice between these (PD vs. HD) has been based on the characteristics of the dialysis techniques. Obviously the choice of peritoneal dialysis implied dialysis at home, but its geographic location has been only a secondary consideration. Peritoneal dialysis has evolved as a dependable mode that gives good outcomes. This method has become more attractive with the option of overnight cyclers and the recent use of home helpers in some jurisdictions. At the same time the interest in home hemodialysis was rekindled by reports of good outcomes with short daily or nocturnal hemodialysis. Home dialysis (PD or HD) offers high quality of treatment, a high degree of patient independence, and is financially attractive. Therefore, we propose a change in our approach to the choice of the initial form of dialysis for patients with ESRD. Instead of choosing between HD and PD we should present the new patients the advantage of dialysis at home and instead of asking them to choose between peritoneal dialysis or hemodialysis, they should be offered the option to choose between dialysis at home (PD or HD) or in-hospital. This paper will review the advantages of the home-based dialysis methods and the arguments for this simple but vital change in the process of choosing the method of dialysis.

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Section: Quality Of Lifementioning

confidence: 99%

Home dialysis as a first option: a new paradigm

et al. 2009

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“…Earlier reports on patient outcome of PD and HD gave conflicting results, ranging from favorable for HD over no difference to favorable for PD (4, 8, 10, 11, 13, 16-23). As pointed out by Port et al (21), correct interpretation of these studies is difficult because they differ in many aspects, such as type of statistical analysis (with or without correction for comorbidity, and presence of different factors of comorbidity), use of single center versus multicenter data, inclusion of incident or prevalent patients, and duration of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Survival Analysis of Korean End-Stage Renal Disease Patients According to Renal Replacement Therapy in a Single Center

et al. 2007

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This study was to investigate clinical characteristics and any differential trends in survival among renal replacement therapy (hemodialysis [HD], peritoneal dialysis [PD], and kidney transplantation [KT]) in Korean end-stage renal disease (ESRD) population. We tried to analyze retrospectively the survival rate adjusted by risk factors and the relative risk stratified by key risk factors among 447 ESRD patients who began dialysis or had a kidney transplant at Ajou University Hospital from 1994 to 2004. In adjusted Cox survival curves, the KT patients had the best survival rate, and the HD patients had better survival than PD patients. The consistent trends in different subgroups stratified by age and diabetes were as following: 1) The risk of death for PD and HD was not proportional over time, 2) The relative risk of PD was similar or lower than that of HD for the first 12 months, but it became higher at later period. The significant predictors for mortality were age (over 55 yr), presence of diabetes, cerebrovascular accident at ESRD onset, and more than one time of hospitalization caused by malnutrition. Further large-scaled, multicenter-based comparative study is needed in Korean ESRD patients and more meticulous attention is required in high-risk patients.

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“…Anemia of chronic kidney diseases is a state of anemia caused by various factors that interfere with the production and metabolism of RBC [ 20 ]. Patients with uremia have significant toxin accumulation, and most of the toxins can be effectively removed by PD [ 21 ]. However, some of the medium and large molecules may remain and inhibit the function of renal erythropoietin [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Low serum vitamin D concentration is correlated with anemia, microinflammation, and oxidative stress in patients with peritoneal dialysis

et al. 2021

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Background Peritoneal dialysis (PD) is a form of dialysis to replace the function of kidney, that uses the peritoneum as a dialysis membrane to remove metabolites and water retained in the body. Vitamin D deficiency is prevalent in patients treated with PD. This research investigated the correlation between serum 25-hydroxyvitamin D [25(OH)D] concentration and anemia, microinflammation, and oxidative stress in PD patients. Methods 62 PD patients and 56 healthy volunteers were recruited in this research. Serum concentrations of 25(OH)D and basic parameters of anemia were detected. The correlation between serum 25(OH)D concentration with anemia, oxidative stress, and microinflammatory state were analyzed. Results In the PD group, the concentration of 25(OH)D was lower than the healthy control (HC) group (p < 0.001). Hemoglobin, red blood cell count (RBC), and total iron binding capacity (TIBC) in the PD group was significantly lower (all p < 0.001), while high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) concentrations were significantly higher, than the HC group (all p < 0.001). In the PD group, malondialdehyde (MDA) concentration was higher than in the HC group (p < 0.001), while superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were lower (both p < 0.001). Serum 25(OH)D exhibited positive correlation with hemoglobin (r = 0.4509, p = 0.0002), RBC (r = 0.3712, p = 0.0030), TIBC (r = 0.4700, p = 0.0001), SOD (r = 0.4992, p < 0.0001) and GSH-Px (r = 0.4312, p = 0.0005), and negative correlation with hs-CRP (r = − 0.4040, p = 0.0011), TNF-α (r = − 0.4721, p = 0.0001), IL-6 (r = − 0.5378, p < 0.0001) and MDA (r = − 0.3056, p = 0.0157). Conclusion In conclusion, reduced serum 25(OH)D concentrations in PD patients contribute to anemia, oxidative stress and microinflammatory state.

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Integration of Peritoneal Dialysis in the Treatment of Uremia

Cited by 6 publications

References 7 publications

Home dialysis as a first option: a new paradigm

Home dialysis as a first option: a new paradigm

Survival Analysis of Korean End-Stage Renal Disease Patients According to Renal Replacement Therapy in a Single Center

Low serum vitamin D concentration is correlated with anemia, microinflammation, and oxidative stress in patients with peritoneal dialysis

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