Abstract:
BACKGROUND AND AIMS:Encapsulating peritoneal sclerosis (EPS) is an uncommon but severe complication of peritoneal dialysis (PD). A reliable screening tool to identify patients at risk of developing or not EPS is currently not available. We aimed to evaluate whether the reduction in dialysate sodium concentration (sodium sieving) at 60 min (ΔDNa60), during a peritoneal equilibration test with 3.86% glucose concentration (3.86%-PET) was able to early rule out patients who will not develop EPS. METHODS:Prospective controlled longitudinal (20-year) cohort study. All eligible incident PD patients attending the hospital underwent a 3.86%-PET during the first 3 months following start of PD and then once a year. The dip in ΔDNa60 and other factors were correlated with eventual EPS onset. RESULTS:Of 161 incident PD patients, with a median PD duration of 37.8 (24.7-58.3) months and 64.1 (34.5-108.3) months of follow-up, 13 patients (8%) developed EPS at a median PD duration of 72.7 (56.6-109.4) months and 105.0 (76.4-143.2) months of follow-up. ΔDNa60 demonstrated the best sensitivity and specificity values, estimated by conventional receiver operating characteristic (ROC) curve analysis with an area under the curve (AUC) of 0.90, 0.83 and 0.85 at 1, 2 and 3 years before the onset of EPS, respectively. Multifactorial analysis showed that the most useful factors for predicting EPS were age at start of PD, duration of PD, small solutes transport (D/PCreat) and ΔDNa60; the AUC at 1, 2 and 3 years before the onset of EPS was, respectively, 0.97, 0.96 and 0.94, the positive predictive value being 0.48, 0.57 and 0.42, and the negative predictive value 1.0, 1.0 and 1.0. CONCLUSIONS:It is possible to predict the occurrence and, better, the non-occurrence of EPS using simple parameters such as age at PD start, duration of PD, and parameters obtained by 3.86%-PET such as D/PCreat and ΔDNa60.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
La Milia V,Longhi S,Sironi E,Pontoriero Gdoi
10.1007/s40620-016-0371-9subject
Has Abstractpub_date
2018-02-01 00:00:00pages
137-145issue
1eissn
1121-8428issn
1724-6059pii
10.1007/s40620-016-0371-9journal_volume
31pub_type
杂志文章abstract:BACKGROUND:This study is part of a 3-country study testing whether normal levels of hemoglobin (Hgb) delay the progression of left ventricular (LV) growth in chronic kidney disease (CKD) patients not on dialysis. METHODS:This was an open-label, randomized, multicenter, controlled trial conducted in 27 tertiary-care ho...
journal_title:Journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2008-11-01 00:00:00
abstract::Cyclosporine A has been empirically used for more than 12 years in the treatment of idiopathic nephrotic syndrome, in both children and adults. There is consistent evidence, from both experimental and human studies, that the highly lipophilic cyclosporine molecule diminishes or abolishes proteinuria by two differing m...
journal_title:Journal of nephrology
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journal_title:Journal of nephrology
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abstract:BACKGROUND:Gut-derived uremic toxins have been associated with adverse outcomes in chronic kidney disease (CKD). Alterations in bowel habits, including constipation, seem to play an additional role in uremic toxicity. The aim of this study is to investigate the association of bowel habits with gut-derived uremic toxins...
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pub_type: 传,历史文章,杂志文章
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abstract::Icodextrin, a glucose polymer, is widely used as an alternative to glucose as the osmotic agent in peritoneal dialysis (PD). We describe a case of a continuous ambulatory peritoneal dialysis patient who developed severe cutaneous hypersensitivity after initiation of icodextrin PD solution. Erythematous skin lesions gr...
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journal_title:Journal of nephrology
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更新日期:2009-05-01 00:00:00
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更新日期:2006-07-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Journal of nephrology
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journal_title:Journal of nephrology
pub_type: 杂志文章
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doi:
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更新日期:2001-11-01 00:00:00
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journal_title:Journal of nephrology
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doi:10.1007/s40620-015-0229-6
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journal_title:Journal of nephrology
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doi:10.1007/s40620-014-0079-7
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journal_title:Journal of nephrology
pub_type: 杂志文章
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doi:
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doi:
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pub_type: 杂志文章,随机对照试验
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journal_title:Journal of nephrology
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更新日期:2008-09-01 00:00:00
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journal_title:Journal of nephrology
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doi:
更新日期:2010-11-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2005-07-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2010-03-01 00:00:00
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doi:10.1007/s40620-020-00912-z
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2007-09-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2009-11-01 00:00:00