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Results for “Peritoneal Dialysis, Continuous Ambulatory”

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At least 19 recordsLinked to original sources

PubMed1983

Continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis is a portable wearable method of treatment for patients with end-stage renal failure. We describe our experience with 42 patients treated by this technique. Continuous ambulatory peritoneal dialysis provided satisfactory biochemical control of uraemia. Major problems encountered were peritonitis, catheter malfunction and the effects of raised intra-abdominal pressure. Patient motivation, compliance and good family support help predict those patients in whom the technique will be successful.

Abdomen↗

PubMed1983

Tuberculous peritonitis in chronic renal failure managed by continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) is being increasingly used to treat chronic renal failure in New Zealand. Peritonitis due in particular to gram positive organisms remains the major complication. Three of 92 CAPD patients trained in the Wellington Renal Unit had tuberculous peritonitis, a previously rarely reported complication. Gram positive or Gram negative bacterial infections preceded or followed isolation of Mycobacterium tuberculosis. Differential peritoneal fluid leucocyte counts were not predictive of tuberculous infection and total leucocyte counts remained elevated in tuberculous patients treated for other concurrent bacterial peritonitides. Systemic toxicity was not encountered in these patients, symptoms being confined almost entirely to the peritoneum. CAPD was continued during treatment with anti-tuberculous therapy, in all three patients. However, peritoneal pain on dialysis fluid in-flow necessitated temporary hemodialysis management in two. Anti-tuberculous chemoprophylaxis may be prudent in the at-risk Polynesian patient with chronic renal failure who is being considered for CAPD management.

Antitubercular Agents↗

PubMedDate not supplied

[Infectious complications of continuous ambulatory peritoneal dialysis].

Continuous ambulatory peritoneal dialysis (CAPD) is of proven value in the treatment of many patients with chronic renal failure. Infective peritonitis remains the major complication of this form of therapy and repeated infections may result in catheter removal and conversion to haemodialysis. The most appropriate antibiotic treatment, the duration and route of administration are still areas of investigation. The aim of this paper is to discuss the diagnosis, management and prevention of peritonitis in CAPD.

Humans↗

PubMed2000

Changes of cytokine profiles during peritonitis in patients on continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) has emerged as an important dialysis treatment modality worldwide. One of the major complications is bacterial peritonitis, which may result in subsequent technique failure because of loss of peritoneal clearance or peritoneal fibrosis. Bacterial peritonitis leads to the release of proinflammatory cytokines from resident and infiltrating cells in the peritoneal cavity. We studied 35 patients undergoing CAPD with acute bacterial peritonitis. All patients treated with antibiotics for 2 weeks after the clinical diagnosis of peritonitis had a good recovery. Peritoneal dialysate effluent (PDE) was collected on days 1, 3, 5, 10, 21, and 42 after the start of treatment. Cell populations were monitored by flow cytometry. PDE levels of interleukin-1beta (IL-1), IL-6, transforming growth factor-beta (TGF-beta), and basic fibroblast growth factor (FGF) were measured by enzyme-linked immunosorbent assay. Gene transcription of TGF-beta in macrophages from PDE was measured by quantitative polymerase chain reaction. Bacterial peritonitis was associated with a sharp increase in total cell and neutrophil counts (400-fold) in PDE up to 3 weeks after peritonitis despite clinical remission (P < 0.0001). There was an increased absolute number of macrophages during the first 3 weeks despite the reduced percentage of macrophages among total cells in PDE compared with noninfective PDE. There was a progressive increase in the percentage of mesothelial cells or dead cells in the total cell population in PDE over the entire 6-week period. PDE levels of IL-1, IL-6, TGF-beta, and FGF increased markedly on day 1 before their levels decreased gradually. PDE levels of these cytokines or growth factors were significantly greater than those in noninfective PDE (n = 76) throughout the study period (P < 0.01). Similarly, TGF-beta complementary DNA (cDNA) molecules per macrophage were significantly greater than those of macrophages in noninfective PDE throughout this period (P < 0.01). There was no significant correlation between PDE levels of TGF-beta and TGF-beta cDNA molecules per macrophage, suggesting that peritoneal macrophages are not the only source of TGF-beta in PDE. We conclude there is an active release of proinflammatory cytokines and sclerogenic growth factors through at least 6 weeks despite apparent clinical remission of peritonitis. The peritoneal cytokine networks after peritonitis may potentially affect the physiological properties of the peritoneal membrane.

Bacterial Infections↗

PubMed1983

Plasma 18-hydroxycorticosterone during continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) entails the continuous presence of hypertonic dialysate in the peritoneal cavity. We postulated that the continuous, gradual ultrafiltration produces chronic activation of the renin-angiotensin system and the adrenal zona glomerulosa. To explore this hypothesis, we measured plasma levels of PRA, active renin (AR), total renin (TR), inactive renin (IR), 18-hydroxycorticosterone (18-OH-B), and aldosterone (PAC) under basal and stimulated conditions. At 0800 and 1200 hr after overnight recumbency, plasma levels of PRA, AR, TR, IR, and 18-OH-B were elevated above the range for sodium-replete recumbent normal subjects. PAC, however, was normal. The increase in TR was due predominantly to an increase in AR. After the combined stimulus of 4 hr ambulation and the ultrafiltration induced by a 2 L exchange, plasma levels of PRA, AR, TR, IR, and PAC were within the range for sodium-replete upright normal subjects. Plasma 18-OH-B levels, however, remained markedly elevated. Graded intravenous infusion of ACTH at rates of 0.03 to 10 ng/min demonstrated that the threshold for an ACTH-stimulated rise in plasma 18-OH-B and PAC is at least as low as that for cortisol and corticosterone. We conclude that CAPD produces activation of the renin-angiotensin system. The high circulating levels of PRA, AR, and, presumably, angiotensin II result in increased secretion of 18-OH-B by the adrenal zona glomerulosa.

18-Hydroxycorticosterone↗

PubMed1985

The use of technetium-99m sulfur colloid in the detection of patent processus vaginalis in patients on continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) is commonly used in patients with renal failure as an alternative to hemodialysis. A not infrequent complication is scrotal swelling due to bowel or fluid passing through a patent processus vaginalis secondary to increased abdominal pressure. A radionuclide study using Tc-99m sulfur colloid is a safe and simple method to determine if this complication is present or may be used as a pre-CAPD screening procedure.

Edema↗

PubMed1982

Preliminary experience with continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) was employed in seven patients of endstage renal failure (ESRF). All the patients had symptom-free ambulant life during CAPD. Blood pressure was well controlled and the haemoglobin level improved significantly. Blood urea and serum creatinine levels were maintained near normal levels. Metabolic acidosis was corrected. Recurrent peritonitis, heavy protein loss and catheter failure were the main complications of CAPD. It appears from these observations that CAPD may be helpful in patients with ESRF.

Abdomen↗

PubMed1988

Scintigraphic detection of abdominal wall and diaphragmatic peritoneal leaks in patients on continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) is utilized with increasing frequency for patients with end stage renal disease (ESRD). Several complications have been observed including catheter malfunction due to pericatheter leaks, abdominal wall and inguinal hernias and diaphragmatic leaks. Occasionally special diagnostic procedures are necessary to determine the nature of the abnormality and guide the surgical approach to correction. The four cases herein illustrate the usefulness of radionuclide imaging in diagnosing leakage of dialysate fluid in patients on CAPD.

Adult↗

PubMed2000

Peritoneal scintigraphy for diagnosing periumbilical leakage in a patient on continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) offers several advantages over hemodialysis for patients with end-stage renal disease; however, this technique also includes many documented complications. A case with clinical suspicion of dialysate leakage on CAPD was investigated by peritoneal scintigraphy using technetium-99m macroaggregated human albumin (99mTc-MAA). Peritoneal scintigraphy showed radiotracer accumulation over the periumbilical area at 2 hours 30 minutes after intraperitoneal infusion of 99mTc-MAA. Six hours of imaging revealed more apparent radioactivity at the same site. This study is to illustrate the simple diagnostic helpfulness of peritoneal scintigraphy in a patient with a CAPD-related structural defect.

Adult↗

PubMed1994

Sudden rupture of an indirect inguinal hernial sac with extravasation in two patients on continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) is commonly used to treat patients suffering from end-stage renal failure. This method can be used on a long-term basis and in the short term for patients awaiting renal transplantation. Inguinal hernias are a potential source of morbidity for these patients. Therefore, when patients with inguinal hernias require long-term peritoneal dialysis, the hernia should be repaired if the patient's medical status will allow it. The authors report on two patients maintained on CAPD who experienced rapid enlargement and perforation of a previously undiagnosed asymptomatic inguinal hernia. The hernia was repaired successfully, without complication, in both cases.

Adult↗

PubMed1996

Continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) was used as renal replacement therapy in 55 patients for 666 patient months. Thirty five patients had Type II diabetes. They ranged in age from 1-83 years. Majority of the patients were above 50 years of age who could not be transplanted due to various comorbid conditions. The incidence of peritonitis was 1 episode every 20 patient months. Twenty five patients dropped out during the observation period. The major cause of drop-out was death due to underlying coronary artery disease. Three patients underwent renal transplantation.

Adolescent↗

PubMed1995

[Continuous ambulatory peritoneal dialysis].

Continuous ambulatory peritoneal dialysis (CAPD) is an established effective method of maintenance dialysis in patients with end-stage renal failure. Because many of these patients refuse to return hemodialysis, it is essential to develop more techniques to overcome the problems inherent in CAPD. There were 143,709 patients currently undergoing dialysis including 7,509 (5.2%) patients on CAPD in Japan. Renal transplantation is uncommon (700-800 per year), and it is likely that CAPD is of more value than in western countries as a dialysis technique. The utilization rate of PD remain still 5.2%. However, there are a lot of advantages in CAPD in such as good QOL, good biocompatibility and good preservation of residual renal function. We should choose CAPD as a first line therapy in ESRD patients.

Female↗

PubMed1998

[Laparoscopic implantation of catheters for continuous ambulatory peritoneal dialysis].

Continuous ambulatory peritoneal dialysis (CAPD) has become an established procedure and is an equal alternative to haemodialysis (HD) in the management of terminal renal failure. Nevertheless CAPD still plays a minor role compared with HD (10% of all dialyses). CAPD offers advantages in quality of live but is still associated with a significant number of complications. The improvement of surgical technique and development of new peritoneal dialysis catheters (PDK) improved the results of peritoneal dialysis. 3 methods for implantation of PDK are used: the open surgical technique, the blind percutaneous procedure and the laparoscopic method. The latter technique is currently an accepted practice. 10 patients were treated by the laparoscopic method. Additionally to the PDK-tunnel of the abdominal wall we used 2 trocars (1 x 5 mm, 1 x 12 mm). Advantages of this technique are avoiding of perforating lesions, possibility for further operations and a safe implantation of the PDK. Peritoneal dialysis was started 7 days after operation with initially low dialysate volumes. The observed incidence of complications and removed catheters are comparable to the reports in the literature.

Catheters, Indwelling↗

PubMed1994

Abdominal wall hernia complicating continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) is a well-established treatment modality for end-stage renal disease. Abdominal wall hernia is not uncommon in patients on CAPD. Two factors are responsible for the occurrence of these hernias: anatomically weak sites and increased intraperitoneal pressure by the dialysate. Abdominal wall hernia was reviewed in 44 patients on CAPD from 1987 through 1991. Eight abdominal hernias (5 inguinal, 2 incisional and 1 umbilical) were found during CAPD treatment (18.18%). Surgical treatment was applied in 6 symptomatic hernias (5 inguinal and 1 incisional). After surgery, 5 patients returned to CAPD without recurrence and the remaining one died of strangulated incisional hernia. Our series shows that: (1) a detailed examination of the preexisting hernia and repair prior to CAPD treatment are suggested. (2) symptomatic abdominal wall hernia should be evaluated carefully and treated promptly. (3) awareness of the complication of these hernias can reduce the morbidity and mortality.

Adult↗

PubMed1985

Changes in left ventricular hypertrophy and function in hypertensive patients started on continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) often leads to better control of hypertension. In order to evaluate the effects of such improved blood pressure control on left ventricular (LV) hypertrophy and LV function, a group of 18 patients with a history of hypertension were followed for changes in LV anatomy and function (with M-mode echocardiography) over a 6 to 12 month period after initiation of CAPD. All patients had echocardiographic evidence of increased LV mass related to concentric and eccentric hypertrophy. On CAPD, blood pressure decreased (greater than 5 mm Hg) in 12 patients. LV mass decreased in 15 patients and increased in one. A decrease in both wall thickness and LV dimension contributed to the fall in LV mass on CAPD. Initially, LV dimension exceeded normal in 9 out of 18 patients. On CAPD, LV dimension decreased to near normal in size in six, and no patient developed LV dilation on CAPD. Four patients initially had a decreased fractional shortening and ejection fraction; three of these normalized while on CAPD and no patient deteriorated. These results indicate that CAPD improves LV hypertrophy by normalizing both volume and pressure overload. These effects may prevent deterioration in LV function in patients with still normal LV function, and may improve LV function in patients who already exhibit decreased LV performance.

Adult↗

PubMed1979

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↗

PubMed1979

Initial experiences with continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) has been initiated on 51 patients: 27 females (mean age -- 43.9 years) and 24 males (mean age -- 46.4 years). This group has been observed for a total of 1420 patient weeks of treatment (27.3 patient years). Thirty-six episodes of peritonitis have been noted among 19 patients. The overall incidence was one episode per 39.4 patient weeks. Recurrent episodes of peritonitis resulted in discontinuation of CAPD in five (9.8%) of the patients. Three (5.9%) of the patients were unable to continue with CAPD because of its inability to control extracellular fluid balance. In the patients who transferred from intermittent peritoneal dialysis to CAPD, there was a 4.5 mg/dl drop in serum creatinine and a 34 mg/dl drop in mean BUN values. There was a rise of approximately 2 gm in the hemoglobin levels of this group of patients. If the problem of peritonitis can be solved, CAPD will become the dialytic treatment of choice for the majority of patients with end-stage renal disease.

Adult↗

PubMed1985

Peritoneoscopy in the management of catheter malfunction during continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis is widely used in the maintenance of patients with chronic renal failure. Obstruction or displacement of the chronic dialysis catheter, which prevents dialysate drainage, can compromise ongoing dialysis. Conservative approaches (body position change, saline infusion, and enema) are often unsuccessful and more aggressive therapy may be required. We report the use of peritoneoscopy to reposition malfunctioning peritoneal dialysis catheters. The procedure proved to be safe and gave excellent long-term results.

Adult↗