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 Purifjournal_title
Blood purificationauthors
Park MS,Yim AS,Chung SH,Lee EY,Cha MK,Kim JH,Song KI,Han DC,Hwang SD,Moon C,Lee HBdoi
10.1159/000014331subject
Has Abstractpub_date
1998-01-01 00:00:00pages
171-8issue
3eissn
0253-5068issn
1421-9735pii
bpu16171journal_volume
16pub_type
临床试验,杂志文章,随机对照试验abstract::The greatest benefit of PD ist the continuous maintenance of a stable electrolyte and acid-base balance, as well as a continuous solute, sodium and water removal. Moreover, PD is effective in preserving residual renal function (RRF). However, when RRF declines, complications will occur if not compensated for by an inc...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000081871
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND/AIMS:Hemoadsorption may improve outcomes for sepsis by removing circulating cytokines. We tested a new sorbent used for hemoadsorption. METHODS:CTR sorbent beads were filled into columns of three sizes: CTR0.5 (0.5 ml), CTR1 (1.0 ml) and CTR2 (2.0 ml) and tested using IL-6 capture in vitro. Next, rats were ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000381006
更新日期:2015-01-01 00:00:00
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
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The incidence of central venous catheter-related bloodstream infection (CRBSI) for continuous renal replacement therapy (CRRT) in kidney intensive care unit (ICU) patients is worthy of particular attention and recently, we analyzed clinical characteristics and risk factors of CRBSI for CRRT in our kidney ICU...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000495024
更新日期:2019-01-01 00:00:00
abstract::Uremic patients suffer from a secondary form of complex dyslipidemia consisting of quantitative and qualitative abnormalities in serum lipoproteins resulting in altered lipoprotein composition and metabolism. The most prominent are an increase in serum triglyceride levels (due to elevated very-low-density lipoprotein ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000063557
更新日期:2002-01-01 00:00:00
abstract::Despite advancements in dialysis therapy, the subjective clinical examination still remains the standard of care in managing volume removal in chronic dialysis. While there is no definitive trial establishing that dry weight management guided by an assistive technology is superior to the clinical method, there is ampl...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000321840
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND AND AIMS:We aimed to examine the association between daily protein intake (DPI) and outcomes in patients from the Randomized Evaluation of Normal versus Augmented Level (RENAL) trial. METHODS:We analyzed the association between DPI and clinical outcomes using multivariable logistic regression, Cox proportio...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1159/000363175
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND/AIMS:Secondary hyperparathyroidism (SHP) is characterized by high bone turnover and elevated serum bone remodeling markers. Elevation of serum interleukin-6 (IL-6) levels is also characteristic of end-stage renal disease. This study investigates the effects of intravenous calcitriol on serum bone resorptive ...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000094899
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND/AIMS:N-Terminal pro-brain natriuretic peptide (NT-proBNP) is a predictor of cardiac events and death in the general population and in chronic kidney disease. There is limited information on how natriuretic peptides vary in dialysis patients. The aim of this study was to analyze NT-proBNP variability, factors...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000360267
更新日期:2014-01-01 00:00:00
abstract::Activation of polymorphonuclear leukocytes with subsequent production of reactive oxygen metabolites has been reported to occur during hemodialysis related to a membrane bioincompatibility. We used an experimental dialysis model to evaluate, by chemiluminescence, the production of reactive oxygen metabolites and, by C...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169604
更新日期:1989-01-01 00:00:00
abstract::Cuprophane hemodialysis is associated with an early fall of leukocyte counts and an intradialytic rise in serum beta 2-microglobulin (beta 2M), in contrast to dialysis with more compatible dialyzers. It has been suggested that these two phenomena may be related. This study sets out to verify this hypothesis by compari...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169922
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Numerous studies have suggested a possible role for acute kidney injury (AKI) biomarkers in predicting renal recovery both before and after renal replacement therapy (RRT). However, definitions for recovery and whether to include patients dying but free of RRT may influence results. OBJECTIVES:To validate p...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000500423
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Glucose absorbed from conventional peritoneal dialysis (PD) solutions contributes to unfavorable metabolic effects. Its replacement with a glucose-free osmotic agent such as icodextrin (ID) or amino acids (AA) may have some benefit on glucose and lipid metabolism. METHODS:Serum lipids, insulin sensitivity a...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000086553
更新日期:2005-01-01 00:00:00
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
更新日期:1995-01-01 00:00:00
abstract::Medicare pays 80% of the cost of dialysis treatment and associated medications. Congress directed the Centers for Medicare and Medicaid Services (CMS) to develop both a process of regular and more or less "automatic" updates of composite rate setting and "bundling" as much of the laboratory and ancillary medications a...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000096390
更新日期:2007-01-01 00:00:00
abstract::The administration of intravenous fluids is perhaps the most common treatment given in the intensive care unit. According to biologic rationale, ongoing fluid losses should be replaced to maintain fluid homeostasis and relative or absolute deficiencies in circulating blood volume should be prevented or rapidly correct...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000047015
更新日期:2002-01-01 00:00:00
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
更新日期:2016-01-01 00:00:00
abstract::Along with the numerous technological improvements in molecular biology, polymerase chain reaction, which permits analysis of sequences of a very small amount of biological material, enables evaluation of hemodialysis-induced gene transcription of inflammatory cytokines. Blood samples drawn from 22 hemodialysis patien...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000014310
更新日期:1998-01-01 00:00:00
abstract::Guidelines have been developed in nephrology and medicine developed to assist practitioners and patients in making decisions about healthcare for specific clinical circumstances. There has been a proliferation of guidelines over the last decade in all areas of medicine, including nephrology. Many of the nephrology gui...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000110568
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND/AIMS:Cardiovascular diseases (CVD) are the leading cause of mortality in hemodialysis (HD) patients. Recently, non-alcoholic fatty liver disease (NAFLD) has been recognized as a new risk factor for adverse CVD events in the general population. Our aim was to analyze the incidence of NAFLD in HD patients by u...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000360270
更新日期:2014-01-01 00:00:00
abstract::Clinical trials using very low protein supply supplemented with amino acid or keto acid preparations have shown the possibility of slowing the rate of decline of renal function in patients with advanced chronic renal failure together with preservation of nutritional status. The possible mechanisms by which this effect...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,评审
doi:10.1159/000169557
更新日期:1988-01-01 00:00:00
abstract::The number of geriatric patients on dialysis is increasing. This is due to demographic factors, a wider acceptance of elderly patients on dialysis, and an earlier start of dialysis in this patient group. Recent studies have questioned the effect of dialysis on quality of life in elderly patients with severe comorbidit...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000334153
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Dialysate fluid connection to the membrane in continuous dialysis may affect solute clearance. Although circuit connections are routinely made counter-current to blood flow in intermittent dialysis, no study has assessed the effect of this dialysate fluid flow direction on removal of small solutes creatinine...
journal_title:Blood purification
pub_type: 杂志文章,多中心研究
doi:10.1159/000441270
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Wilson's disease (WD) can present in a fulminant form with hepatocellular dysfunction, hemolysis and multiorgan failure (Wilson's crisis). We present a previously healthy young woman with severe WD whose WD severity score was 13. A score >11 indicates a poor chance of survival and liver transplantation will ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000218090
更新日期:2009-01-01 00:00:00
abstract::Plasma exchange (PE) is an effective therapeutic method used in patients with myasthenia gravis (MG) refractory to common therapy and/or with life-threatening respiratory complications. Except for acetylcholine receptor antibodies (AChRAbs), some other inflammatory mediators possibly activated in MG may also be remove...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000014434
更新日期:2000-01-01 00:00:00
abstract::Chronic kidney disease (CKD) is associated with multiple detrimental consequences to the cardiovascular and musculoskeletal systems. The effects of CKD are even more significant when they begin in childhood as they affect growth and (neuro-) development as well. The division into stages of CKD serves as a guideline fo...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000321850
更新日期:2011-01-01 00:00:00
abstract::Fluid overload may occur in critically ill patients as a result of aggressive resuscitation therapies. In such circumstances, persistent fluid overload must be avoided since it does not benefit the patient while it may be harmful. In the septic patient, early volume expansion seems to be beneficial. Beyond that thresh...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000287776
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The number of patients with peritoneal dialysis (PD) in China has been increasing year after year, but there are still some challenge in the management of PD patients, and the efficient and effective method has yet to be developed. Multidisciplinary team (MDT) is to create a standardized, individualized, and...
journal_title:Blood purification
pub_type: 杂志文章,随机对照试验
doi:10.1159/000496823
更新日期:2019-01-01 00:00:00
abstract::Kidney transplantation (KT) is considered an optimal treatment strategy for end-stage renal disease. But human leukocyte antigen-sensitized, ABO-incompatible and antibody-mediated rejection might be the alarming hurdles in KT. Therapeutic plasma exchange is the mainstay of the antibody reduction therapy for reducing a...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000493521
更新日期:2019-01-01 00:00:00
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
更新日期:2013-01-01 00:00:00