The Latest in Peritoneal Dialysis

Peralta, Abelardo Aguilera

doi:10.5772/45910

2013

DOI: 10.5772/45910

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The Latest in Peritoneal Dialysis

Abelardo Aguilera Peralta¹

Abstract: since 2007. Dr. Aguilera has also more than 100 scientific articles published mainly in international journals, among which the New Engl J Med, J Am Soc Nephrol, Lab Investigation, Plos One, etc. He has received more than 25 national and international awards, has a degree in Physics. He is a specialist in family medicine and a Reviewer and editor of several international journals. Finally, his main research areas are epithelial-to-mesenchymal transition of mesothelial cells and peritoneal membrane failure, and… Show more

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Cited by 3 publications

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“…Nowadays it is well-known that the residual renal function (RRF) has a significant effect on both the frequency of fatal cardiovascular episodes and the nutritional status of patients treated with RRT dialysis methods. In particular, RRF loss is accompanied by an increase in the proportion of nutritional disorders and cardiovascular mortality in the population of ESRD patients treated with PD [6].…”

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Nutritional status and survival of End-Stage Renal Disease patients treated with continuous ambulatory peritoneal dialysis

Shymova

Shifris

Dudar

2019

Ukr. J. Nephrol. and Dial.

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The objective of the work was to study the survival peculiarities ofend-stage renal disease patients treated with continuous ambulatory peritoneal dialysis (CAPD) depending on the nutritional status and informative markers associated with it. Methods. 105 ESRD patients who received CAPD treatment during 2012 - 2017 years at the Kyiv Scientific and Practical Center of Nephrology and Dialysis, which is the clinical base of the State Institution "Institute of Nephrology National Academy of Medical Sciences of Ukraine" were included in the cohort prospective open study. The survival analysis was carried out both in the studied population as a whole and in groups depending on the nutritional status (NS) indicators defined basing on the calculation of the subjective global assessment (SGA) points: the first group (n = 51) consisted of patients without malnutrition, the second group (n = 30) - patients with a mild degree of malnutrition, the third group (n = 13) - patients with a moderate degree of malnutrition, and the fourth group (n = 11) - patients with a severe degree of malnutrition. The survival analysis was conducted both in the groups in compliance with NS, and depending on the informational markers associated with NS, in particular, albumin, body mass index (BMI), residual renal function (RRF). Survival were calculated using the Kaplan-Meier method, and the difference between survival rates was analyzed using the log-rank test and χ². The starting date of peritoneal dialysis treatment was considered as the starting point of the monitoring. The difference was considered to be accurate at p <0.05. Analyzed cases were included till January 7, 2019. The event risk assessment was carried out with the probability of relative risk (RR) values calculating their confidence intervals (95% CI). Results.Forty-three (40.95%) patients died during the current analysis, 17 patients were switched to the hemodialysis (HD), 4 patients had undergone kidney transplantations. Cardiovascular disease was the leading cause of death (41.9%), the second cause of death by frequency was bacterial infections (20.9%). Longer monitoring periods death rate was significantly higher in patients of group with an average (11/84.6% vs 14/27.45%, p <0.0001; RR - 3.08; 95% CI: 1.8 -5.09)and a mild degree of nutritional disorders (ND) (11/84.6% vs 11/36.7%, p = 0.0018, RR - 2.3, 95% CI: 1.36-3.89) compared with normal NS.Similarly, the percentage of died patients with a severe ND degree was significantly higher than those with a normal nutritional status (7/63.6% vs. 14/27.45%, p = 0.0091, RR - 2.31, 95% CI: 1.23 - 4.35). The cumulative survival during the 1- year amounted to 90% of patients for 3 and 5 years - 64% and 41%, respectively. It was found that the survival rate of PD patients is credibly higher in groups with normal NS ormild ND degree than patients of group with a moderate or severe degree of nutritional disorders (χ2 = 22,9; df = 3; p = 0,00004). The cumulative survival for 1 and 3 years was 97%, 98%, 70%, 81% and 76%, 70%, 24%, 36% in groups of patients without nutritional disorder, with mild nutritional disorders, moderate and severe disorders, respectively. The cumulative survival with serum albumin level <35 g/l and ≥ 35 g/l in 1 and 3 years was 73% vs 96% and 37% vs 74%, respectively (p = 0.00005, log-rank test). Similarly, the proportion of survivors with BMI > 24 kg/m2 was apparently higher than those with an indicatorBMI ≤ 24 kg/m2, and it was in 1 and 3 years 94% vs 86% and 79% vs 47%, respectively (p = 0.00321, log-rank test). Veritable differences have been registered in the cumulative frequencies of survivors depending on RRF value: the survival rate was significantly higher among patients with RRF ≥ 5 ml/min/1.73 m² and significantly lower among patients with RRF <2 ml/min/1.73 m2 (χ² = 17.4; df = 2; p = 0.00016). Conclusions.Thus, our studyfound that serum albumin level, BMI and RRF magnitude are the markers for the survival of ESRD patientstreated with PD. Veritable difference between the survival of patients depending on the nutritional status was stated. Three-year cumulative survival with mild degree of malnutrition group was twice as high as in severe nutritional disorders and it was 70% vs 36% (p <0.001). The relative risk of death from all causes increases by 3.1 and 2.32 times for moderate and severe nutritional disorders patients compared to the patients group with normal NS.

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confidence: 99%

Nutritional status and survival of End-Stage Renal Disease patients treated with continuous ambulatory peritoneal dialysis

Shymova

Shifris

Dudar

2019

Ukr. J. Nephrol. and Dial.

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Advanced Properties of Urine Derived Stem Cells Compared to Adipose Tissue Derived Stem Cells in Terms of Cell Proliferation, Immune Modulation and Multi Differentiation

et al. 2015

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Adipose tissue stem cells (ADSCs) would be an attractive autologous cell source. However, ADSCs require invasive procedures, and has potential complications. Recently, urine stem cells (USCs) have been proposed as an alternative stem cell source. In this study, we compared USCs and ADSCs collected from the same patients on stem cell characteristics and capacity to differentiate into various cell lineages to provide a useful guideline for selecting the appropriate type of cell source for use in clinical application. The urine samples were collected via urethral catheterization, and adipose tissue was obtained from subcutaneous fat tissue during elective laparoscopic kidney surgery from the same patient (n = 10). Both cells were plated for primary culture. Cell proliferation, colony formation, cell surface markers, immune modulation, chromosome stability and multi-lineage differentiation were analyzed for each USCs and ADSCs at cell passage 3, 5, and 7. USCs showed high cell proliferation rate, enhanced colony forming ability, strong positive for stem cell markers expression, high efficiency for inhibition of immune cell activation compared to ADSCs at cell passage 3, 5, and 7. In chromosome stability analysis, both cells showed normal karyotype through all passages. In analysis of multi-lineage capability, USCs showed higher myogenic, neurogenic, and endogenic differentiation rate, and lower osteogenic, adipogenic, and chondrogenic differentiation rate compared to ADSCs. Therefore, we expect that USC can be an alternative autologous stem cell source for muscle, neuron and endothelial tissue reconstruction instead of ADSCs.

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Management of the Failing Kidney Transplant: Challenges and Solutions

Aikpokpo¹,

Sharma²,

Halawa³

2022

Exp Clin Transplant

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The Latest in Peritoneal Dialysis

Cited by 3 publications

References 30 publications

Nutritional status and survival of End-Stage Renal Disease patients treated with continuous ambulatory peritoneal dialysis

Nutritional status and survival of End-Stage Renal Disease patients treated with continuous ambulatory peritoneal dialysis

Advanced Properties of Urine Derived Stem Cells Compared to Adipose Tissue Derived Stem Cells in Terms of Cell Proliferation, Immune Modulation and Multi Differentiation

Management of the Failing Kidney Transplant: Challenges and Solutions

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