Effect of prolonged subcutaneous implantation of peritoneal catheter on peritonitis rate during CAPD: a prospective randomized study.

Abstract:

:We conducted a prospective randomized controlled study to confirm our earlier observation that prolonged subcutaneous implantation of peritoneal catheter reduced peritonitis rate when compared to retrospective data from patients with catheters placed by conventional access technique. A total of 60 patients were randomized into two groups: 30 patients had catheters left implanted subcutaneously for 6 weeks (I) and the other 30 patients had catheters inserted by conventional technique and had 6 weeks of break-in period (C). Subgroups of 15 patients each with new and conventional techniques used Y-connector (IY, CY) and remaining patients used standard spikes (IS, CS). Mean age was 47.7 years (range 16-71); 61.0% were male and 44.1% diabetics. Peritonitis, exit site infection, simultaneous peritonitis and exit site infection, and complication related to Staphylococcus or Pseudomonas infections were observed for up to 2 years in each patient after initiation of bag exchange or until termination of CAPD by transfer to hemodialysis or by death. Total duration of observation was 493.2 patient-months for new access technique and 409.6 patient-months for conventional technique. Patients in IY group had the lowest incidence of peritonitis (1/14.9 patient-months) and exit site infection (1/16.8 patient-months) among four subgroups. Peritonitis rate in IY was significantly lower compared to CY or CS. The total peritonitis-free period in those patients who did not experience peritonitis during the observation period was also significantly longer in IY (120 patient-months) than in CY (26 patient-months), IS (10.6 patient-months), or CS (10.4 patient-months). Simultaneous peritonitis and exit site infection was observed in none of IY group but 3 episodes in CY, 4 episodes in IS, and 3 episodes in CS. The rates of complications related to Staphylococcus aureus and Pseudomonas infections were also significantly lower in IY than in CY, IS, or CS. Technique survival did not differ between the two groups. The present results confirm our previous observation that the new access technique reduces the incidence of peritonitis probably by reducing infection via periluminal route. The Y-connector system further reduces peritonitis rate by reducing infection via intraluminal route.

journal_name

Blood Purif

journal_title

Blood purification

authors

Park MS,Yim AS,Chung SH,Lee EY,Cha MK,Kim JH,Song KI,Han DC,Hwang SD,Moon C,Lee HB

doi

10.1159/000014331

subject

Has Abstract

pub_date

1998-01-01 00:00:00

pages

171-8

issue

3

eissn

0253-5068

issn

1421-9735

pii

bpu16171

journal_volume

16

pub_type

临床试验,杂志文章,随机对照试验
  • Middle-molecule clearance at 20 and 35 ml/kg/h in continuous venovenous hemodiafiltration.

    abstract:BACKGROUND:Of 5 clinical trials testing dose response of continuous renal replacement therapy (CRRT) in acute kidney injury, 2 showed a benefit, 2 showed none, and 1 appeared equivocal. However, blood-membrane interactions may dominate macromolecule transport in continuous venovenous hemodiafiltration, reducing the imp...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000266483

    authors: Hofmann CL,Fissell WH

    更新日期:2010-01-01 00:00:00

  • Cytokines and biocompatibility.

    abstract::Issues in biocompatibility have traditionally focused on the interaction of membranes or materials with the activation of complement, red blood cell destruction, clotting dysfunctions, and platelet activation. Other studies are concerned with the replacement fluid formulations and host responses. Recent attention has ...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000169968

    authors: Dinarello CA

    更新日期:1990-01-01 00:00:00

  • Prevention of Intradialytic Hypotension with Intermittent Back-Filtrate Infusion Haemodiafiltration: Insights into the Underlying Mechanism.

    abstract:BACKGROUND:Intradialytic hypotension (IDH) is a major challenge to safely performing haemodialysis. Blood volume depletion due to fluid removal is a major cause of hypotension, so more emphasis should be placed on finding alternative modalities to traditional constant rate ultrafiltration. SUMMARY:Intermittent back-fi...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000503878

    authors: Koda Y,Aoike I

    更新日期:2019-01-01 00:00:00

  • Paired filtration dialysis: studies on efficiency, flow dynamics and hydraulic properties of the system.

    abstract::Several strategies have been proposed to increase dialysis efficiency in order to reduce dialysis treatment time. Paired filtration dialysis (two-chamber technique) is a new technique combining the advantages of highly permeable membranes and convective transport with the high depurative efficacy of diffusion. The sys...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000169955

    authors: Ronco C,Feriani M,Brendolan A,Chiaramonte S,Milan M,Dell'Aquila R,Scabardi M,Bragantini L,Conz P,La Greca G

    更新日期:1990-01-01 00:00:00

  • Adequacy of peritoneal dialysis--where are we going?

    abstract::The present working hypothesis regarding adequacy issues in peritoneal dialysis is that dialysis is a major determinant of protein intake and therefore nutritional status in these patients. Present data however is controversial. This is in part due to differences in methodology and the calculations used for the data p...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000170201

    authors: Burkart JM

    更新日期:1995-01-01 00:00:00

  • Novel insights into the pathobiology of the vascular access - do they translate into improved care?

    abstract::While recent developments have allowed greater insight into the vascular pathobiology and intimal hyperplasia, very few of these advances have led to improved clinical care of hemodialysis vascular accesses. Indeed the most common procedure for the treatment of access stenosis and thrombosis is the same model for the ...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000245650

    authors: Diskin CJ

    更新日期:2010-01-01 00:00:00

  • Plasma C-reactive protein in hemodialysis patients: a cross-sectional, longitudinal clinical survey.

    abstract::In hemodialysis patients, C-reactive protein (CRP), an acute-phase reactant, is a sensitive and independent marker of malnutrition, anemia, and amyloidosis. The aim of the present studies was to evaluate CRP and interleukin 6 levels in plasma samples from long-term hemodialysis patients on different extracorporeal mod...

    journal_title:Blood purification

    pub_type: 杂志文章,多中心研究

    doi:10.1159/000014405

    authors: Panichi V,Migliori M,De Pietro S,Metelli MR,Taccola D,Perez R,Palla R,Rindi P,Cristofani R,Tetta C

    更新日期:2000-01-01 00:00:00

  • Significance of Content of the Reticulocyte Hemoglobin in the Management of Renal Anemia.

    abstract::Optimal iron level in hemodialysis patients remains a subject of debate. The reticulocyte hemoglobin content (CHr) is believed to reflect the concentration of iron required in the most recent hematopoiesis in the bone marrow. CHr is not influenced by any factors that measure direct hemoglobin (Hb) of reticulocytes and...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000496641

    authors: Ogawa C,Tsuchiya K,Nitta K,Maeda K

    更新日期:2019-01-01 00:00:00

  • Influence of plasma exchange on serum levels of cytokines and adhesion molecules in ANCA-positive renal vasculitis.

    abstract:BACKGROUND:Increased serum levels of proinflammatory cytokines may contribute to the organ damage in active antineutrophil cytoplasmic antigen (ANCA)-positive renal vasculitis. Plasma exchange (PE) may influence the activity of vasculitis not only by removing pathogenic autoantibodies, but also by lowering the serum le...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000014316

    authors: Tesar V,Jelínková E,Masek Z,Jirsa M Jr,Zabka J,Bartůnková J,Stejskalová A,Janatková I,Zima T

    更新日期:1998-01-01 00:00:00

  • A target-orientated algorithm for regional citrate-calcium anticoagulation in extracorporeal therapies.

    abstract:BACKGROUND:Citrate anticoagulation offers several advantages in comparison to conventional anticoagulation. Most algorithms for regional citrate-calcium anticoagulation are based on citrate and calcium chloride infusion coupled in a fixed proportion to the blood flow without considering the hematocrit (Hct)/plasma flow...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000332394

    authors: Brandl M,Strobl K,Hartmann J,Kellner K,Posnicek T,Falkenhagen D

    更新日期:2012-01-01 00:00:00

  • Proteome patterns in uremic plasma.

    abstract::In patients with chronic kidney disease (CKD), peptides and proteins circulate at altered concentrations versus in healthy individuals. We have characterized proteome samples from 7 pooled CKD stage 5 patients not yet on dialysis and with no known co-morbidities. We also analyzed pooled plasma samples from 7 healthy a...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000178773

    authors: Naseeb U,Shafqat J,Jägerbrink T,Zarina S,Alvestrand A,Jörnvall H,Axelsson J

    更新日期:2008-01-01 00:00:00

  • Spontaneous Left Renal Subcapsular Hematoma and Right Hip Hematoma in a Hemodialysis Patient: A Case Report and Review of the Literature.

    abstract::For maintenance hemodialysis (MHD) patients, the blood is in low hypercoagulable state due to the use of heparin or low molecular weight heparin during dialysis. It is not rare to see hematoma in the puncture site. In recent years, several cases have been reported of spontaneous kidney rupture, but no hip hematoma, le...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000446177

    authors: Ye M,Liu Y,Zhou L,Wang C,Fu X,Peng Y,Liu H

    更新日期:2016-01-01 00:00:00

  • Intravenous iron sucrose changes the intraperitoneal homeostasis.

    abstract:BACKGROUND/AIMS:Intravenous iron infusion is the accepted way of supplementation of that compound in uremic patients. The aim of the study was to evaluate whether this treatment affects intraperitoneal homeostasis in patients on peritoneal dialysis. METHODS:Blood and peritoneal dialysate samples were collected from 10...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000210038

    authors: Breborowicz A,Połubinska A,Kupczyk M,Wanic-Kossowka M,Oreopoulos DG

    更新日期:2009-01-01 00:00:00

  • Comparison of bioimpedance and clinical methods for dry weight prediction in maintenance hemodialysis patients.

    abstract:BACKGROUND:Bioelectrical impedance analysis (BIA) is a promising technique to evaluate dry weight. We compared the dry weight calculated by the three BIA equations Carlo Basile (CB) , Yanna Dou (YD) and the body composition spectroscopy (BCS) with clinical evaluation in maintenance hemodialysis (MHD) patients. METHODS...

    journal_title:Blood purification

    pub_type: 临床试验,杂志文章

    doi:10.1159/000362109

    authors: Jian Y,Li X,Cheng X,Chen Y,Liu L,Tao Z,Zuo L

    更新日期:2014-01-01 00:00:00

  • Biomaterials for hemodialysis access.

    abstract::While the optimal vascular conduit for hemodialysis is undeniably an arterialized autogenous subcutaneous vein, only a minority of end-stage renal disease patients can count on such access: the remainder require implantation of a biomaterial conduit. This paper will briefly survey current biografts used for hemodialys...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000170148

    authors: Johansen K,Lyman D,Sauvage L

    更新日期:1994-01-01 00:00:00

  • Nocturnal Hemodialysis Compared with Conventional Dialysis for End-Stage Renal Disease Treatment in Polycystic Kidney Disease Patients.

    abstract:BACKGROUND:Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary cause of end-stage renal disease (ESRD). Little is known about outcomes after in-center nocturnal hemodialysis (NHD) treatment in ADPKD patients with ESRD. OBJECTIVES:This study aimed to evaluate the effects of in-center NHD ...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000503679

    authors: Xue C,Sun B,Ye X,Zhou C,Yang B,Zhang L,Yu S

    更新日期:2020-01-01 00:00:00

  • Therapeutic Plasma Exchange in Neonates and Infants: Successful Use of a Miniaturized Machine.

    abstract::Therapeutic plasma exchange (TPE) in neonates and small infants is a treatment method at the forefront that may become a potentially life-saving procedure in a wide array of severe conditions. Indications for TPE in the pediatric population have been mainly derived from adult literature, with neonatal hyperbilirubinem...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000470827

    authors: Vidal E,Garzotto F,Parolin M,Manenti C,Zanin A,Bellettato M,Remuzzi G,Goldstein SL,Murer L,Ronco C

    更新日期:2017-01-01 00:00:00

  • Current Focuses in Serum Lipid Abnormalities in Dialysis Patients.

    abstract:BACKGROUND:Dyslipidemia is a common metabolic complication in patients with chronic kidney disease and is detected as changes in lipoprotein concentrations in serum. SUMMARY:Recently, other features of lipid abnormalities have been described, such as alterations in serum n-3 polyunsaturated fatty acids, cholesterol me...

    journal_title:Blood purification

    pub_type: 评论,杂志文章

    doi:10.1159/000441581

    authors: Shoji T

    更新日期:2015-01-01 00:00:00

  • Is the efficacy of LDL apheresis in ischemic optic neuropathy linked to a reduction in endothelial activation markers?

    abstract::Endothelial dysfunction of the optic microcirculation is considered to be the main pathogenetic mechanism in nonarteritic ischemic optic neuropathy. The aim of the present work was to assess whether a clinical improvement is correlated with a reduction in the endothelial activation markers by means of LDL apheresis (L...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000094574

    authors: Ramunni A,Ranieri G,Giancipoli G,Guerriero S,Ria R,Saliani MT,Sborgia L,Ranieri P,Coratelli P

    更新日期:2006-01-01 00:00:00

  • Homocysteine-lowering vitamin B treatment decreases cardiovascular events in hemodialysis patients.

    abstract:BACKGROUND:Dialysis patients have higher cardiovascular events rate than patients with normal renal function. Hyperhomocysteinemia, a risk factor for cardiovascular disease, is frequently detected in dialysis patients. Vitamin B supplementation lowers hyperhomocysteinemia, but it is unknown whether it reduces cardiovas...

    journal_title:Blood purification

    pub_type: 杂志文章,随机对照试验

    doi:10.1159/000093680

    authors: Righetti M,Serbelloni P,Milani S,Ferrario G

    更新日期:2006-01-01 00:00:00

  • Plasmapheresis for the Treatment of Acute Pancreatitis due to Severe Hypertriglyceridemia.

    abstract::Severe hypertriglyceridemia (HTG) is associated with acute pancreatitis (AP). Treatment options include total plasma exchange (TPE). We report a case of AP due to severe HTG treated with TPE. ...

    journal_title:Blood purification

    pub_type:

    doi:10.1159/000510647

    authors: Ruiz-Rodríguez JC,Chiscano-Camón LS,Palmada C,Pons V,Ferrer R

    更新日期:2020-11-24 00:00:00

  • In vitro clearance and hemocompatibility assessment of ultrathin nanoporous silicon membranes for hemodialysis applications using human whole blood.

    abstract:BACKGROUND/AIMS:Recent advances in nanotechnology have made it possible to mass-produce ultrathin silicon membranes with pore sizes in the range of nanometers. In this study, we investigate the possibility of employing ultrathin nanoporous silicon membranes with pore diameters of 5 and 20 nm for dialysis of human whole...

    journal_title:Blood purification

    pub_type: 临床试验,杂志文章

    doi:10.1159/000350613

    authors: Ahmadi M,Gorbet M,Yeow JT

    更新日期:2013-01-01 00:00:00

  • Clinical value of standardized equilibration tests in CAPD patients.

    abstract::Peritoneal transport rates, a critical determinant of peritoneal dialysis efficiency, vary widely among patients and may be easily categorized by standardized peritoneal equilibration test. Measurements of creatinine and glucose transfer are particularly useful in selecting optimal dialysis prescription. Patients with...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000169582

    authors: Twardowski ZJ

    更新日期:1989-01-01 00:00:00

  • Failure of naloxone in reversal hemodialysis-induced hypotension.

    abstract::In 5 uremic patients the role of opioid peptides in dialysis-induced hypotension was investigated through the administration of naloxone. An intravenous bolus injection of 1 mg of naloxone was administered immediately before starting a routine hemodialysis session and was repeated when the patients' systolic arterial ...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000169411

    authors: Sturani A,Degli Esposti E,Chiarini C,Spongano M,Santoro A,Zucchelli P

    更新日期:1985-01-01 00:00:00

  • Angiotensin Converting Enzyme Inhibitor Dialyzability and Outcomes in Older Patients Receiving Hemodialysis.

    abstract:BACKGROUND/AIMS:Some angiotensin converting enzyme (ACE) inhibitors are efficiently removed from circulation by hemodialysis ('high dialyzability'), whereas others are not ('low dialyzability'). In patients receiving hemodialysis, this may influence the effectiveness of ACE inhibitors. METHODS:Using linked healthcare ...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000438821

    authors: Weir MA,Fleet JL,Dixon SN,Jain AK,Oliver M,Wald R,McIntyre C,Garg AX

    更新日期:2015-01-01 00:00:00

  • Anticoagulation for continuous arteriovenous hemofiltration in children.

    abstract::Continuous arteriovenous hemofiltration requires continuous anticoagulation to prevent early hemofilter clotting. We used heparin given continuously in the arterial line of the extracorporeal circuit as anticoagulant in children with initially normal coagulation status, and heparin and/or prostacyclin in high-risk ble...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000169489

    authors: Zobel G,Trop M,Muntean W,Ring E,Gleispach H

    更新日期:1988-01-01 00:00:00

  • Ischemic Heart Disease in Patients with End-Stage Kidney Disease.

    abstract:BACKGROUND:It was recently reported that the severity of coronary and carotid atherosclerosis in patients with end-stage kidney disease (ESKD) has improved over the last two decades. However, the frequency of coronary artery events observed at the initiation of dialysis remains high. SUMMARY:Recently, 5 different clin...

    journal_title:Blood purification

    pub_type: 评论,杂志文章

    doi:10.1159/000441582

    authors: Tanaka Y,Joki N,Hase H

    更新日期:2015-01-01 00:00:00

  • Enhanced biocompatibility with a new cellulosic membrane: Cuprophan versus Hemophan.

    abstract::Recently, a new type of modified cellulosic membrane (Hemophan) has been made available for the first clinical trials. In contrast to cellulose acetate membranes only about 5% of the hydroxyl groups of cellulose are substituted by tertiary amino groups. Objective of the present study was to assess the compatibility pe...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000169475

    authors: Schaefer RM,Hörl WH,Kokot K,Heidland A

    更新日期:1987-01-01 00:00:00

  • High Ferritin Level and Malnutrition Predict High Risk of Infection-Related Hospitalization in Incident Dialysis Patients: A Japanese Prospective Cohort Study.

    abstract:AIMS:The aim of the study was to clarify the relationship between serum ferritin and infectious risks. METHODS:We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months. RESULTS:Kaplan-Meier analys...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000445424

    authors: Kato S,Lindholm B,Yuzawa Y,Tsuruta Y,Nakauchi K,Yasuda K,Sugiura S,Morozumi K,Tsuboi N,Maruyama S

    更新日期:2016-01-01 00:00:00

  • Alleviation of cisplatin nephrotoxicity: efficacy of local intra-arterial injection concomitant with hemodialysis.

    abstract::Although cis-diamminedichloroplatinum (cisplatin) is widely used in the treatment of malignant tumors, the dose administered is limited because of side effects such as nephrotoxicity. The plasma levels of non-protein-bound platinum, which can be removed by dialysis, play an important role in the antitumor effects and ...

    journal_title:Blood purification

    pub_type: 临床试验,杂志文章

    doi:10.1159/000170256

    authors: Yura T,Badr KF,Yuasa S,Kurose T,Ohkawa M,Hando T,Fukunaga M,Matsuo H

    更新日期:1996-01-01 00:00:00