Journal Watch
Encapsulating Peritoneal Sclerosis Linked to Vasculopathy
EPS is a rare but devastating complication of PD. Tissue samples from 223 people with EPS who had surgery to remove adhesions were analyzed under a microscope. In the 174 samples that could be evaluated, the individuals who had used conventional PD fluid had more severe vasculopathy and longer PD durations than those who used pH neutral PD fluid.
Read the abstract » | (added 2021-08-12)
Genes Help Predict Peritoneal Transport Rates
Among 2,850 people on PD who had complete genetic data, 5 single nucleotide variants at four loci had suggestive associations with the peritoneal solute transfer rate (PSTR), in particular rs28644184 at the KDM2B locus.
Read the abstract » | (added 2021-07-12)
Tags: Genetic Variants, Peritoneal Solute Transfer Rates, Kidney Failure, Peritoneal Dialysis
PDOPPS Findings of Factors Important to Peritonitis Outcomes
The Peritoneal Dialysis Outcomes and Practice Patterns Study analyzed factors in the outcomes variations among 1,631 peritonitis episodes in 1,190 patients in seven countries. About 2/3 of the bouts were successfully cured, which was more likely with Gram-positive organisms, automated PD, and use of icodextrin (facility level), aminoglycosides, and ciprofloxacin vs. ceftazidime for Gram-negative organisms.
Read the abstract » | (added 2021-06-15)
Tags: Peritoneal Dialysis, Peritonitis, Peritoneal Dialysis And Outcomes Practice Patterns Study
Complications in Planned vs. Unplanned Peritoneal Dialysis Starts
A metaanalysis of 14 papers totalling 2,401 PD patients looked at the outcomes and safety of unplanned PD starts within 7 days of catheter placement vs. 7-14 days. Early-start PD was linked with more leaks, omental wrap, and—for CAPD—catheter malposition. There were no significant differences in infectious complications, but the risk of transition to HD and mortality were higher. More studies are needed.
Read the abstract » | (added 2020-11-12)
Warming PD Fluid to Body Temperature Does Not Improve Clearance
There may not be a clear benefit to warming PD fluid to body temperature, suggests a small (N=18) single blind randomized controlled trial. Participants were assigned to have a peritoneal equilibrium test with fluid at 37°C or warmed with conventional methods. The two groups had similar outcomes for peritoneal clearance, abdominal discomfort, body temperature, blood pressure, and other parameters.
Read the abstract » | (added 2020-11-12)
10-year PD Survival
In a group of 533 incident PD patients (mean starting age of 48 +16 years) followed from 2006 until 2018, survival at 1 year was 93%, at 3 years 81%, at 5 years 64%, and at 10 years 36%. Encapsulating peritoneal sclerosis (EPS) occurred in 1.3%.
Read the abstract » | (added 2020-06-10)
Blood Vessel Damage Key to Encapsulating Peritoneal Sclerosis (EPS)
A study evaluated tissue samples from 174 PD patients with EDS and had used either conventional or neutral pH, low glucose degradation product PD solution. The conventional PD solution group had less angiogenesis but more severe blood vessel damage (P <0.001) and a higher rate of EPS relapse. Blood vessel damage was milder in the neutral pH group.
Read the abstract » | (added 2020-06-10)
Glucose Degradation Product (GDP) Disrupts Peritoneal Membrane Function
Growth of new, immature blood vessels on the peritoneal membrane is linked with ultrafiltration failure. Exposure to the GDP methylgyoxal (MGO) up-regulated both vascular endothelial growth factor (VEGF) and suppressed platelet-derived growth factor (PDGF) in vitro, potentially disrupting the balance of angiogenesis.
Read the abstract » | (added 2020-03-16)
Tags: Peritoneal Membrane, Ultrafiltration Failure, Methylgyoxal, Angiogenesis
Some PD PETs Are Better Than Others
There are three ways to do a peritoneal equilibrium test (PET) to measure how well someone’s peritoneum is able to transport water and wastes. Compared to a traditional PET, a modified PET had good agreement in 21 patients—but the so-called mini-PET did not.
Read the abstract » | (added 2019-08-14)
Tags: Peritoneal Equilibrium Test, PET, Peritoneal Membrane Transport
Will Zinc Supplements One Day Help Prevent Peritoneal Sclerosis?
Ironically, PD saves lives, but high-glucose PD fluid damages the peritoneum, leading to fibrosis that can make PD impossible. By activating a complex metabolic pathway, a study in rats found that supplementing with zinc helped prevent fibrosis.
Read the abstract » | (added 2019-06-13)
Tags: High glucose PD Fluid, Peritoneum, Fibrosis, Zinc