Peritoneal dialysis: The unique features by compartmental delivery of renal replacement therapy

Fülöp, Tibor; Zsom, Lajos; Tapolyai, Mihály; Molnar, Miklos Z.; Salim, Sohail Abdul; Arany, István; Hamrahian, Mehrdad; Rosivall, László

doi:10.1016/j.mehy.2017.09.005

Cited by 14 publications

(10 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, it is not difficult to understand that patients have better nutritional state may have more sufficient protein reserves, as well as more active protein metabolism in the peritoneal cavity and lead to more protein loss. Another hypothesis is that during PD albumin losses may established an effective removal of certain protein-bound uremic toxins [35]. Such process may potentially explain our results that higher lean body mass in those with larger protein losses.…”

Section: Discussionmentioning

confidence: 92%

Association of Lean Body Mass Index and Peritoneal Protein Clearance in Peritoneal Dialysis Patients

Fan¹,

Ye²,

Zhang³

et al. 2019

Kidney Blood Press Res

View full text Add to dashboard Cite

Background/Aims: The relationship between peritoneal protein clearance (PPCl) and nutritional status in peritoneal dialysis (PD) population have not been clarified. This study aims to investigate the relationship between PPCl and nutritional status in PD population. Methods: Prevalent PD patients were enrolled in the cross-sectional survey in a single center from April to November 2013. The total amount of protein loss in the dialysate was calculated. PPCl reflects the individual differences of peritoneal protein loss, and is calculated by the formula, that PPCl (ml/day)=24-h dialysate protein loss / (albumin/0.4783). Nutritional status measured by lean body mass index (LBMI) was assessed by multi-frequency bioelectrical impedance analysis (BIA). Results: Totally 351 PD patients (55% male, 17.1% with diabetes, mean age 47.7±14.3 years) were included. The median PPC l was 58 ml/day. Patients were divided into four groups for comparison according to the PPC quartiles. Compared with lower PPCl quartiles, patients with higher PPCl had higher body mass index (BMI) (P< 0.001), body surface area (BSA) (P < 0 .001), LBMI (P<0.001), 4-hour D/P creatinine ratio (P< 0.001), and lower residual renal CCl (P<0.001). Compared with conventional body index (BMI and BSA) in ROC analysis, LBMI (area under curve: 0.71, 95% confidence interval [CI]: 0.66-0.77) had better performance in predicting higher PPCl. After adjustment in logistic regression models, each 1 kg/m² increase of LBMI (odd ratio[OR] =1.37; 95% CI: 1.17-1.60), each 0.1 increase of 4-hour D/P creatinine ratio (OR =1.47; 95% CI: 1.11-1.93), and every 1 L/week/1.73m² decrease of residual renal CCl (OR =0.98; 95% CI: 0.96-0.99) were independently associated with higher PPCl (> 58 ml/day). Conclusion: Higher LBMI was independently associated with higher , indicating that better nutritional status dominates peritoneal protein metabolism in PD patients.

show abstract

Section: Discussionmentioning

confidence: 92%

Association of Lean Body Mass Index and Peritoneal Protein Clearance in Peritoneal Dialysis Patients

Fan¹,

Ye²,

Zhang³

et al. 2019

Kidney Blood Press Res

View full text Add to dashboard Cite

show abstract

“…The amount of transferable calcium in PD is limited by the global amount of PD fluid (generally <8–12 L/day). Therefore, assuming an identical amount of calcium deposition after PTX, there may be a disproportionate tendency for hypocalcemia after PTX in patients undergoing peritoneal dialysis . PD patients will be dependent on both the intake and intact absorption of exogenous calcium and VDA to maintain calcium at acceptable levels …”

Section: Discussionmentioning

confidence: 99%

Targeted surgical parathyroidectomy in end‐stage renal disease patients and long‐term metabolic control: A single‐center experience in the current era

Fülöp

Koch

Musa

et al. 2018

Hemodialysis International

Self Cite

View full text Add to dashboard Cite

show abstract

“…Using spironolactone in PD to treat hypokalemia is gaining more support. It seems not only to tackle urinary potassium loss through the distal tubule, but it also blocks potassium loss from the gastrointestinal track by increasing the apical potassium permeability of the large intestinal epithelium and also blocks loss in the sweat glands and skin [12][13][14]. Further benefits of spironolactone include reduction of blood pressure and improved survival in dialysis patients [15][16][17].…”

mentioning

confidence: 99%

Prevalence and Management of Hypokalemia in Peritoneal Dialysis Patients in Qatar

Hamad

Hussain

Elsanousi

et al. 2019

International Journal of Nephrology

View full text Add to dashboard Cite

Introduction. Hypokalemia is common in patients undergoing peritoneal dialysis (PD). It is associated with increased cardiovascular and all-cause mortality. Treatment usually includes oral potassium supplements, which are poorly tolerated. Our aim was to evaluate the prevalence of hypokalemia in PD patients in Qatar and to improve treatment measures. Methods. All PD patients in Qatar with persistent hypokalemia and on potassium supplement were included. We performed a root cause analysis, and a management pathway was created. We collected data before (Period 1) and after (Period 2) implementation of the new pathway. Results. A total of 143 patients with a mean age of 54 years (range 21–82 years) were included in the study. Initial results of Period 1 showed hypokalemia in 48 patients (34%); of these, 14 (29%) had hypomagnesemia. Hypokalemia resolved in 10 of the patients after correction of their hypomagnesemia. The remaining 4 patients continued to require potassium supplementation despite correction of their hypomagnesemia. We started spironolactone (25 mg daily) in 13 of the hypokalemia patients. After 3 months, their mean serum potassium level improved from 3.2 ± 0.3 mmol/L to 3.9 ± 0.4 mmol/L (p<0.001), and the prevalence of patients with persistent hypokalemia decreased from 36% to 21% (statistically significant with p= 0.006). No episodes of hypotension or hyperkalemia were observed. Only 1 patient developed mild gynecomastia without discontinuation of the medications. Conclusion. Our study showed that hypokalemia is a prevalent problem in PD patients in Qatar. Hypomagnesemia is a significant contributing factor to hypokalemia in PD and correcting it leads to improvement of hypokalemia. Addition of spironolactone is safe and effective in treating hypokalemia. Implementing a holistic pathway led to a significant improvement in hypokalemia prevalence in PD patients.

show abstract

Peritoneal dialysis: The unique features by compartmental delivery of renal replacement therapy

Cited by 14 publications

References 68 publications

Association of Lean Body Mass Index and Peritoneal Protein Clearance in Peritoneal Dialysis Patients

Association of Lean Body Mass Index and Peritoneal Protein Clearance in Peritoneal Dialysis Patients

Targeted surgical parathyroidectomy in end‐stage renal disease patients and long‐term metabolic control: A single‐center experience in the current era

Prevalence and Management of Hypokalemia in Peritoneal Dialysis Patients in Qatar

Contact Info

Product

Resources

About