PubMed Health⌕ Search

Biomedical subjects

D Arfania

Publications and source records attributed to D Arfania.

6 recordsLinked to original sources

Uncommon causes of peritonitis in patients undergoing peritoneal dialysis.

In five patients, peritonitis caused by uncommon agents was acquired during continuous ambulatory peritoneal dialysis. Three patients had yeast (two Candida albicans, one C parapsilosis), one Aspergillus fumigatus, and one Nocardia asteroides infections. A review of the literature indicates that yeasts are the most common cause of peritoneal dialysis-associated fungal peritonitis; only one other possible case of Aspergillus sp and no Nocardia infections have been proved, to our knowledge. Observations are recorded in reference to diagnosis and suggested methods of treatment.

Adult↗

Influence of patient characteristics on peritoneal clearances.

Few studies have explored how patient characteristics may influence clearances. We sought to determine if patient age, sex, size, renal disease, blood pressure, hematocrit, serum total proteins and albumin affected peritoneal clearances, drainage volumes or dialysate protein concentration. We found inulin clearances to be related to surface area and total serum proteins. Creatinine clearance was related to age, serum albumin and hematocrit. Sex, blood pressure or type of renal disease did not influence peritoneal clearances.

Adolescent↗

Continuous ambulatory peritoneal dialysis: three-year experience at one center.

Three years of clinical experience with continuous ambulatory peritoneal dialysis are summarized. Serum urea nitrogen, creatinine, hematocrit, nerve conduction velocity, calcium, inorganic phosphorus, serum proteins, and electrolytes have been maintained in acceptable ranges. Peritonitis, although reduced in incidence because of solutions in plastic bags and a new adapter, is still a problem. Excessive carbohydrate absorption, obesity, and high serum triglyceride concentrations may be long-term problems in some patients.

Adolescent↗

Follow-up of peritoneal clearances in patients undergoing continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) might result in peritoneal membrane changes. First, CAPD exposes essentially continuously the peritoneum to peritoneal dialysis solutions. Such solutions differ from the usual extracellular fluid bathing peritoneal tissues. Second, this technique may be complicated by an increased frequency of peritonitis when compared to intermittent peritoneal dialysis. We undertook a prospective study of patients undergoing CAPD to determine if there were decreases in peritoneal clearances and if the peritoneal microcirculation maintained its responsiveness to nitroprusside. Peritoneal transport, as assessed by the clearances of urea, creatinine, inulin, and dialysate protein concentration, with and without nitroprusside addition in the dialysis solution, is unchanged in patients undergoing CAPD for up to 1 year, despite frequent episodes of peritonitis.

Adult↗

Clinical studies with a nonvasoactive peritoneal dialysis solution.

Topical application of dialysis solution to the rat microcirculation causes a transient vasoconstriction for 2 to 3 min. We assessed the clinical importance of this vasoconstriction by developing a dialysis solution without vasoactive properties, as assessed in the microcirculatory laboratory. The solution was of similar composition to human extracellular fluid. We tested its effects on Cur, Ccr, Cin, and dialysate protein concentration. We found that compared to commercial solutions, the lower osmolality of the NVS resulted in loss of ultrafiltration and decreases in clearance of urea and creatinine. The clearance of inulin was unchanged, and dialysate protein increased, suggesting a major increase in diffusive transport of large solutes. Increased diffusive transport of large solutes with NVS suggests that initial vasoconstriction seen in the rat could be present and clinically important during peritoneal dialysis in humans.

Adolescent↗