Peritoneal Dialysis as the First-Choice Treatment

Shetty, H G M; Gokal, Ram

doi:10.1159/000071394

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Recently, CAPD and automated PD at home were found to offer great benefits to patients such as (1) personal control of therapy, (2) no needles required, which decreases the risk of hepatitis (viral infection of the liver) and other bloodborne diseases, (3) preservation of remaining kidney function, (4) lower doses of medication required, and (5) better results after kidney transplantation. The policy of peritoneal dialysis first (PD first) has contributed significantly to a successful dialysis program, and the number of patients receiving CAPD treatment has also increased [16,17]. In our patient, CAPD was chosen because she was younger, had favorable activity of daily living (ADL), and the hope for kidney transplantation remained for the future.…”

Section: Discussionmentioning

confidence: 99%

Mizoribine therapy in a patient with lupus nephritis: the association between mizoribine concentration and peritoneal dialysis

et al. 2010

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We describe a 20-year-old female with systemic lupus erythematosus (SLE) who developed renal failure during continuous ambulatory peritoneal dialysis (CAPD). The patient was treated with mizoribine (MZR). MZR peak concentration was 1.8 mug/ml and was sufficient for clinical efficacy as measured by serological data. Treatment with MZR was safe and useful even while undergoing CAPD. Achieving optimal MZR blood concentration was important for treatment of SLE, even though the patient was in end-stage renal failure.

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Section: Discussionmentioning

confidence: 99%

Mizoribine therapy in a patient with lupus nephritis: the association between mizoribine concentration and peritoneal dialysis

et al. 2010

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“…Recent studies emphasized the role of reactive oxygen species and/or decreased activity of enzymatic and nonenzymatic antioxidant systems in the development of cardiovascular and cerebrovascular diseases. Accelerated ageing, atherosclerotic plaque formation, cataracts, β2-microglobulin arthropathy, reduction of erythrocyte wall deformability, and platelet dysfunction also result from increased oxidative stress (10-18). Neutrophils from patients with CKD produce an increased amount of reactive oxygen species that could diffuse and interact with other molecules, for example, membrane lipids and proteins.…”

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confidence: 99%

“…Peritoneal dialysis is an effective renal replacement therapy equal to hemodialysis (HD). It is suitable as the first method of renal replacement therapy treatment (14,15). Peritoneal dialysis is the method of choice especially in young infants and children before they will be ready to undergo transplantation.…”

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confidence: 99%

Oxidative Stress in Children on Peritoneal Dialysis

et al. 2008

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Objectives Enhanced oxidative stress has been observed in dialysis and predialysis adult patients with chronic kidney disease (CKD), which resulted in increased mortality and morbidity within this population. Not much attention in the literature has been paid to nonenzymatic antioxidant defense in children with CKD on peritoneal dialysis (PD). The aim of the present study was to describe the plasma, erythrocyte, and dialysate concentrations of oxidized (GSSG) and reduced glutathione (GSH) and vitamins A, E, and C in a pediatric PD population. Patients 10 children on PD and 27 age-matched healthy subjects were enrolled in the study. Results Erythrocyte and plasma GSH concentrations were lower in PD patients, erythrocyte concentration of GSSG remained unchanged, and plasma GSSG was significantly higher in children on PD. Children on PD exhibited decreased plasma concentrations of antioxidant vitamins compared to healthy subjects. Moreover, we documented loss of vitamins A, E, and C into ultrafiltrate. Conclusion Such low plasma levels of vitamins A, E, and C and simultaneously decreased activity of erythrocyte GSH may be responsible for the increased oxidative stress occurring in children with CKD on PD.

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“…Predicting renal transplant outcome according to whether a patient was being treated with HD or PD prior to the procedure is controversial, and outcome of pre‐dialysis patients undergoing transplants (pre‐emptive) has not been frequently reported. PD, in its different modalities, has been shown to be similar to HD in efficacy, but with the advantages of better quality of life and lower economic cost that make it considered a good option for starting dialysis therapy 1–3. In recent years, patients on PD have been shown to have survived longer than patients on HD in the first 2–3 years of treatment,4 the period during which renal transplant is most frequently performed, at least in our setting.…”

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confidence: 99%

Pre‐transplant treatment modality and renal transplant outcomes

Coronel

Sánchez‐Fructuoso

Conesa

et al. 2006

Dialysis & Transplantation

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Background The effect of pre‐transplant treatment modality on renal transplant outcomes is still controversial. A negative patient selection for treatment with peritoneal dialysis (PD) some years ago gave the impression of poorer transplant survival than with hemodialysis (HD). Objectives To evaluate the influence of pre‐transplant treatment (PD, HD, or patients who were pre‐dialysis) on initial delayed graft function (DGF), graft thrombosis (GT), global rejection rate, and survival among patients at a single university hospital with a strong tradition of performing renal transplants. Patients The study analyzed 563 renal transplants (HD: 80%, PD: 16.5%, pre‐dialysis: 3.5%) performed at a single center between January 1996 and May 2002. Results There were no differences in immunosuppressive protocol during the study. The HD patients were older (p=0.004). The proportion of diabetics was higher among patients who received PD (20%) than in those who underwent HD (8%) and in those who were pre‐dialysis (10%) (p=0.002). There were no differences between PD and HD patients in donor type (brain death: 55.6% PD vs. 55.6% HD; non‐heart‐beating [NHB]: 39% PD vs. 35% HD; dual pediatric: 6% PD vs. 7% HD; dual elderly: 0% PD vs. 2% HD). Despite the higher proportion of diabetics among PD patients, graft and patient survival did not differ between patients coming from PD, HD, and those who were pre‐dialysis. Patient/graft survival after 1 year was 100%/100% with Pre‐D, 96.5%/95% with PD, and 95.6%/92.5% with HD. Patient/graft survival after 3 years was 100%/100% with pre‐dialysis, 94.1%/94.1% with PD, and 91.7%/89% with HD. DGF incidence was higher in HD patients than in PD and pre‐dialysis patients (p<0.001) even when brain‐dead (p<0.01) and NHB (p<0.001) donors were analyzed separately. The global rejection rate was the same for all patients regardless of pre‐transplant treatment. There was a very low rate of graft thrombosis, with no statistical differences between the groups (0.9% PD and 1.3% HD). Conclusion Graft and patient survival was similar in patients previously treated with PD or HD and excellent in pre‐dialysis patients. A significantly higher rate of initial DGF was confirmed in HD patients, whereas rejection and GT rates were similar with all pre‐transplant treatment modalities.

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Peritoneal Dialysis as the First-Choice Treatment

Cited by 5 publications

References 14 publications

Mizoribine therapy in a patient with lupus nephritis: the association between mizoribine concentration and peritoneal dialysis

Mizoribine therapy in a patient with lupus nephritis: the association between mizoribine concentration and peritoneal dialysis

Oxidative Stress in Children on Peritoneal Dialysis

Pre‐transplant treatment modality and renal transplant outcomes

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