Peritoneal Dialysis

Nolph, Karl D.

doi:10.1007/978-94-009-9327-3_16

Cited by 7 publications

(5 citation statements)

References 210 publications

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“…Therefore, other factors were then likely to affect these exchanges. Nolph [10] had already suspected the presence of a resistance induced by the aqueous film adhering to the mésothélium but had not defined its nature. By decreasing superficial tension, phosphatidylcholine would provoke a reduction in the thickness of the layer of fluid which stagnates on the peritoneum, thus favoring the diffusion and transport of water.…”

Section: Discussionmentioning

confidence: 99%

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Phosphatidylcholine and Peritoneal Transport during Peritoneal Dialysis

Paolo¹,

Buoncristiani²,

Capotondo³

et al. 1986

Nephron

102

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Peritoneal effluent of patients on chronic ambulatory peritoneal dialysis (CAPD) contains a surface-active material (SAM) made up of phospholipids and showing phosphatidylcholine on thin-layer chromatography. This substance drastically lowers surface tension, helps to repel water and has a lubricating effect. The presence of stratified phosphatidylcholine on the peritoneum might narrow the stagnant dialysate fluid layer and situations which can alter the quantity or composition of SAM may affect peritoneal transport and also, perhaps, the formation of adherences. This led us to verify, experimentally, the presence of phospholipids in basal conditions, after CAPD and during peritonitis and to check if addition of phosphatidylcholine to dialysis liquid is able to modify water transport in patients with low ultrafiltration and peritonitis. Phospholipids in the dialysis effluent of patients who have been on CAPD for a long time are lower than observed in the first days of peritoneal dialysis. A more drastic, significant decrease in phospholipids was observed in patients with low ultrafiltration and in patients with peritonitis. Mean ultrafiltration significantly increases in patients with low ultrafiltration and in those with peritonitis during dialysis exchanges containing phosphatidylcholine (50 mg/) indicating that the latter is able to restore normal physiological conditions.

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Section: Discussionmentioning

confidence: 99%

“…In fact, Nolph [10] assumed that the layer of liquid stagnating on the peritoneal surface creates a resistance to peritoneal transport.…”

mentioning

confidence: 99%

Phosphatidylcholine and Peritoneal Transport during Peritoneal Dialysis

Paolo¹,

Buoncristiani²,

Capotondo³

et al. 1986

Nephron

102

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“…Continuous ambulatory peritoneal dialysis (CAPD) is being used more frequently as a technique for chronic maintenance dialysis [1][2][3][4], The peritoneal membrane is much more permeable to proteins than cellulose mem branes [5]. Because of the continuous nature of this treat ment, protein losses are potentially greater than with inter mittent peritoneal dialysis [1].…”

Section: Introductionmentioning

confidence: 99%

Protein Losses in Continuous Ambulatory Peritoneal Dialysis

Rubin

Nolph

Arfania

et al. 1981

Nephron

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“…This suggests that most cases of tuberculous peritonitis complicating PD occur as a result of reactivation of a latent tuberculous focus. This is in contrast to peritonitis secondary to bacteria and fungi [1], including atypical mycobacteria [ 17,18], which are usually traced to a con taminated dialysate source. The cause of reactivation is unknown in our patients.…”

Section: Discussionmentioning

confidence: 99%

“…Although bacteria are the most common cause of peritonitis complicating peritoneal dialysis (PD), other microorganisms including yeasts and fungi have been increasingly recognized as possible offenders [1], Patients on long-term dialysis are prone to develop tuberculous infections [2][3][4], However, tuberculous peri tonitis complicating PD has rarely been reported [5][6][7][8][9][10][11]. The present report describes the characteristics of 5 such patients and compares them with those who have been reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

Tuberculous Peritonitis Complicating Long-Term Peritoneal Dialysis

Cheng

Chan

1989

Am J Nephrol

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The characteristics of 5 patients who developed tuberculous peritonitis while receiving long-term peritoneal dialysis (PD) are presented. There were 2 males and 3 females. 3 patients were on intermittent and 2 were on continuous ambulatory peritoneal dialysis when tuberculous peritonitis was first diagnosed. None of the patients had recently received immunosuppression therapy or were diabetics. The clinical presentations were similar to other forms of peritonitis complicating PD except for a more insidious onset. As extraperitoneal involvement and peritoneal lymphocytosis were rarely present, the diagnosis was mainly dependent on the direct demonstration of Mycobacterium tuberculosis with smear (1 patient) and culture (4 patients). In 1 patient with a pleuroperitoneal communication, the diagnosis was made by pleural biopsy and a positive response to antituberculous therapy. All patients responded to treatment with a combination of three antituberculous drugs which included streptomycin, isoniazid, rifampicin and pyrazinamide. Two patients were transferred to hemodialysis. In 3 patients, peritoneal dialysis was continued. Peritoneal clearance and ultrafiltration capacity were unchanged for up to 16 months after treatment in 2 patients who continued peritoneal dialysis but was reduced by 30 and 50%, respectively, in the remaining patient. Only 1 patient died, but her death was not directly related to tuberculous peritonitis. It was concluded that with a high index of suspicion and early institution of treatment, tuberculous peritonitis complicating PD can be successfully treated with low mortality and without compromising the dialysis capacity of the peritoneal membrane.

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Peritoneal Dialysis

Cited by 7 publications

References 210 publications

Phosphatidylcholine and Peritoneal Transport during Peritoneal Dialysis

Phosphatidylcholine and Peritoneal Transport during Peritoneal Dialysis

Protein Losses in Continuous Ambulatory Peritoneal Dialysis

Tuberculous Peritonitis Complicating Long-Term Peritoneal Dialysis

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