Introduction. Ultrafiltration failure (UFF) in peritoneal dialysis (PD) patients is a reflection of changes in the peritoneal membrane, which can include mesothelial damage, neoangiogenesis, and occasionally, peritoneal fibrosis. These structural changes are probably induced by the use of bioincompatible dialysis solutions. Therefore, we investigated the effects of the treatment with a combinat...

There is increasing use of intermittent dosing of antibiotics to treat peritoneal dialysis (PD)-related peritonitis. The disposition of intravenous cefazolin and tobramycin was studied in automated PD (APD) patients. Ten patients were recruited and received a single intravenous dose of cefazolin (15 mg/kg) and tobramycin (0.6 mg/kg). Blood and dialysate samples were collected at the beginning, ...

Catheter-related complications--including infection, dialysate leak, subcutaneous leak, outflowfailure, and malfunction--are the principal causes of peritoneal dialysis (PD) failure. In the present retrospective study, we evaluated the catheter-related complications that occurred in children at our facility who were started on chronic PD during the period from July 1997 to August 2004. During t...

When encountering unusually appearing dialysate effluent from a patient doing peritoneal dialysis, it is important to review the patient’s recent exposures. In the case of “black”-appearing dialysate effluent, consideration needs to be given to the possibility of someone having undergone a colonoscopy and having tattooing with India ink. Nephrology nurses are frequently the first to be notified...

BACKGROUND Effects of long-term glucose load on peritoneal dialysis (PD) patient safety and outcomes have seldom been reported. This study demonstrates the influence of long-term glucose load on patient and technique survival. METHODS We surveyed 173 incident PD patients. Long-term glucose load was evaluated by calculating the average dialysate glucose concentration since initiation of PD. Ri...

An alternative method for detecting the production of slime by coagulase negative staphylococci was compared with the routinely used Christensen method on 124 isolates of coagulase negative staphylococci from carriage sites, blood cultures, and infected peritoneal dialysis fluids. The alternative method requires the use of a specially prepared solid medium--brain heart infusion broth, supplemen...

a. Disconnect systems of continuous ambulatory peritoneal dialysis (CAPD) result in lower rates of peritonitis than “spike” systems and this older system should no longer be used (Evidence level 1). b. Twin bag systems have lower rates of peritonitis than Y-disconnect systems (Evidence level 1) and are recommended as the preferred CAPD technique. c. There is insufficient high level evidence to ...

Alterations in the plasma water sodium concentration ([Na+]pw) result from changes in the total exchangeable sodium (Na e), total exchangeable potassium (K e), and total body water (TBW). The empirical relationship between the [Na+]pw and Na e, K e, and TBW was originally demonstrated (Edelman IS, Leibman J, O'Meara MP, and Birkenfeld LW. J Clin Invest 37: 1236-1256, 1958), where [Na+]pw = 1.11...

Excessive intraperitoneal absorption of glucose during peritoneal dialysis has both local cytotoxic and systemic metabolic effects. Here we evaluate peritoneal dialysis solutions containing L-carnitine, an osmotically active compound that induces fluid flow across the peritoneum. In rats, L-carnitine in the peritoneal cavity had a dose-dependent osmotic effect similar to glucose. Analogous ultr...

OBJECTIVES Protein-energy malnutrition as a consequence of deficient protein intake frequently occurs in peritoneal dialysis (PD) patients. Previously, we showed that peritoneal dialysate containing a mixture of amino acids (AA) and glucose has anabolic effects. However AA-dialysate has been reported to increase intraperitoneal protein and AA losses and the release of proinflammatory cytokines ...