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Battista C, Kane MP, Moon DG, Bailie GR. Stability of Ofloxacin in Peritoneal Dialysis Solutions. Perit Dial Int 2020. [DOI: 10.1177/089686089501500115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Michael P. Kane
- Department of Pharmacy Practice, Albany College of Pharmacy Albany, New York, U.S.A
| | - Dudley G. Moon
- Department of Pharmacy Practice, Albany College of Pharmacy Albany, New York, U.S.A
| | - George R. Bailie
- Department of Pharmacy Practice, Albany College of Pharmacy Albany, New York, U.S.A
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Goffin E, Pouthier D, Vandercam B, Gigi J. IV Vancomycin-Oral Ciprofloxacin: A Safe and Efficient Therapeutic Protocol for Capd Peritonitis (Preliminary Report). Perit Dial Int 2020. [DOI: 10.1177/089686089601600216] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Eric Goffin
- Departments of Nephrology Universitaires St. Luc Bruxelles, Belgium
| | | | | | - Jacques Gigi
- Microbiology Cliniques Universitaires St. Luc Bruxelles, Belgium
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Fluoroscopic Guide Wire Manipulation of Malfunctioning Peritoneal Dialysis Catheters Initially Placed by Interventional Radiologists. J Vasc Interv Radiol 2014; 25:904-10. [DOI: 10.1016/j.jvir.2014.02.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 02/12/2014] [Accepted: 02/12/2014] [Indexed: 11/18/2022] Open
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Bae IE, Chung WK, Choi ST, Kang J. Laparoscopic internal fixation is a viable alternative option for continuous ambulatory peritoneal dialysis catheter insertion. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2012; 83:381-7. [PMID: 23230557 PMCID: PMC3514481 DOI: 10.4174/jkss.2012.83.6.381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 09/09/2012] [Accepted: 09/22/2012] [Indexed: 12/14/2022]
Abstract
Purpose One of the major drawbacks of peritoneal dialysis (PD) is catheter migration and dysfunction. Preventing catheter migration is one of the main concerns. We compared laparoscopic internal fixation method with open surgical method for catheter migration rates. Methods From January 2008 to August 2009, PD catheters were inserted by laparoscopic fixation (LF) method in 22 patients and by open surgery (OS) in 32 patients. Clinical data were reviewed retrospectively. The frequency of migration, peritonitis, and other complications were compared. Catheter and patient survival rates were also compared. Results The mean age and sex ratio were not different between groups. Mean follow-up duration was 29.1 months in LF group and 26.1 months in OS group. More patients in LF group (27.3%) had history of laparotomy than in OS group (3.1%) (P = 0.01). The mean operation time was significantly longer in LF group (101.6 ± 30.4 minutes) than in OS group (72.4 ± 26.03 minutes) (P = 0.00). The cumulative incidence of catheter migration was 65.6% in OS group and 13.6% in LF group (P = 0.00). Migration-free catheter survival was higher in LF group (P = 0.001). There were no differences in complication rates between groups. Overall catheter survival was similar (P = 0.93). Patient survival rate at 2 years was not different (P = 0.13). Conclusion Laparoscopic internal fixation of continuous ambulatory peritoneal dialysis catheter significantly reduces migration rates without any addition of complications. Also, laparoscopic technique did not incur patient morbidity or mortality despite the requirement for general endotracheal anesthesia and longer operation time. Therefore, internal fixation can be afforded safely in patients with previous abdominal surgery as either a salvage or preventive measure in patients with repeated catheter migration.
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Affiliation(s)
- In Eui Bae
- Department of Surgery, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Inchon, Korea
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Al-Allak A, Jones R, Stiff R, Dharmasena D, Morris-Stiff G. Long-term outcome of continuous ambulatory peritoneal dialysis (CAPD) peritonitis: surgery can be avoided. Ann R Coll Surg Engl 2008; 91:118-22. [PMID: 19102818 DOI: 10.1308/003588409x359088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Continuous ambulatory peritoneal dialysis (CAPD) has become the preferred method of home dialysis for patients with end-stage renal failure. Peritonitis is a common and serious complication and requires prompt diagnosis and treatment. The aim of this study was to assess what proportion of patients with CAPD peritonitis that required surgical intervention for on-going sepsis or for peritonitis-related bowel obstruction. PATIENTS AND METHODS All patients presenting with a first episode of CAPD peritonitis during the 5-year period from 1994-1998 were identified from a prospectively maintained database. Data collected included patient demographics, details of peritonitis episodes and their treatment, and details of any surgical intervention undertaken. RESULTS A total of 500 episodes were identified in 168 patients of whom 162 had complete follow-up representing 488 peritonitis episodes. Sixty-three patients experienced one episode of peritonitis, 33 two episodes, 20 had three episodes, and 46 had more than three episodes. None of the patients underwent surgery either primarily or for complications of the infective episode. A total of 465 episodes were due to a single organism (95%) and the remainder were due to multiple organisms (5%). The most common causative organisms were Gram-positive cocci (308 episodes; 71%) followed by Gram-negative bacilli (106 episodes; 24%). In 55 patients (34%), the same organism was implicated in consecutive admissions. Patients with autosomal dominant polycystic kidney disease (ADPKD), whilst accounting for 12 of 169 (7%) patients in the cohort, experienced 23 of 125 (18.4%) episodes of peritonitis by Gram-negative cocci. Such infections were seen in 8 of 12 (66.7%) ADPKD patients and accounted for 23 of 40 (57.5%) infections experienced by the ADPKD patients. CONCLUSIONS Whilst CAPD peritonitis is a common problem in the renal failure population, with almost 100 episodes per year, it would appear that most episodes can be managed using intraperitoneal antibiotics without the need for surgical intervention.
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Affiliation(s)
- A Al-Allak
- Department of Surgery, Princess of Wales Hospital, Bridgend, UK
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6
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Savader SJ. Radiologic Manipulation of Failed Peritoneal Dialysis Catheters. Semin Dial 2007. [DOI: 10.1111/j.1525-139x.1998.tb00397.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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7
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TANG S, LO WK, HUI WM, YEUNG H, LAI KC, Po CHENG IK. Gastric emptying in diabetic and non-diabetic patients on continuous ambulatory peritoneal dialysis. Nephrology (Carlton) 2007. [DOI: 10.1111/j.1440-1797.1997.tb00209.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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8
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Savin MA, Kirsch MJ, Romano WJ, Wang SK, Arpasi PJ, Mazon CD. Peritoneal Ports for Treatment of Intractable Ascites. J Vasc Interv Radiol 2005; 16:363-8. [PMID: 15758132 DOI: 10.1097/01.rvi.0000147082.05392.2b] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To present clinical data for a new peritoneal port for minimally invasive treatment of intractable ascites that can be used for aspiration in a patient's home. MATERIALS AND METHODS Twenty-eight consecutive peritoneal ports were placed in 27 patients with intractable ascites. Ascites etiology was malignancy in 22 patients, cirrhosis in three, pancreatic duct injury in one, and unknown in one. Technical and clinical success and complications were evaluated until the time of death or the end of the study. RESULTS All ports were inserted successfully with removal of all ascites, and all patients had immediate and complete symptom relief. Ascites was managed by periodic drainage, typically by a visiting nurse in the patient's home. The long-term clinical success rate was 96%, with 26 of 27 patients exhibiting maintained relief of symptoms until death or the end of the study. The long-term patency rate was 100% after 1,810 patient-days. Only one patient (4%) had a major complication. This was a port leak that required port exchange. Subsequently, the patient developed bacterial peritonitis. CONCLUSION Peritoneal ports appear to be a safe, effective, minimally invasive treatment for intractable ascites. This device allows for reliable ascites aspiration in the patient's home.
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Affiliation(s)
- Michael A Savin
- Department of Radiology, William Beaumont Hospital, 3601 West 13 Mile Road, Royal Oak, Michigan 48073, USA.
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Comert M, Borazan A, Kulah E, Uçan BH. A new laparoscopic technique for the placement of a permanent peritoneal dialysis catheter: the preperitoneal tunneling method. Surg Endosc 2004; 19:245-8. [PMID: 15529192 DOI: 10.1007/s00464-003-9302-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2003] [Accepted: 03/17/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Mechanical outflow obstruction and leakage from the exit site of the catheter are two common complications of continuous ambulatory peritoneal dialysis. To lessen these complications and to achieve immediate use of the catheter, we developed a new laparoscopic technique for catheter placement. METHODS A total of 12 consecutive patients with end-stage renal failure were included in this study between April 2003 and July 2003. The average age of the patients was 42.4 years (range, 37-72). Patients were excluded only if a serious risk for general anesthesia was found. Using two 5-mm ports and a 3.3-mm mini-laparoscope, a peritoneal dialysis catheter was passed through a preperitoneal tunnel before the tip of the catheter was introduced into the pelvis. Routine peritoneal dialysis was started immediately after the operation while the patients were still in the operating room. RESULTS The mean operating time was 18.6 min (range, 12-37). There was no operative morbidity. The mean follow-up period was 4.3 months (range, 3-7). No leakage of the dialysate liquid or outflow obstruction was observed during this period. CONCLUSION The advantages of this method include accurate placement, preperitoneal fixation, and immediate use of the catheter for routine peritoneal dialysis. We also believe that because of the preperitoneal fixation of the catheter, this technique will decrease outflow obstruction, which usually occurs due to omental wrapping or displacement of the catheter tip.
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Affiliation(s)
- M Comert
- Department of surgery, School of Medicine, Z.K.U. Arastrima Ve Uygulama Hastanesi Bashekimligi, 67700 Zonguldak, Kozlu, Turkey.
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O'Neill MJ, Weissleder R, Gervais DA, Hahn PF, Mueller PR. Tunneled peritoneal catheter placement under sonographic and fluoroscopic guidance in the palliative treatment of malignant ascites. AJR Am J Roentgenol 2001; 177:615-8. [PMID: 11517056 DOI: 10.2214/ajr.177.3.1770615] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We present a treatment for recurrent, symptomatic ascites in patients with malignant disease. This report summarizes our experience with percutaneous tunneled peritoneal catheters in 24 patients. SUBJECTS AND METHODS Of the 40 consecutive patients who presented with at least four therapeutic paracenteses in a 4-week period, 24 patients underwent the percutaneous tunneled procedure. All had malignant ascites. RESULTS All 24 patients had successful insertion of a permanent tunneled peritoneal drainage catheter. Eighteen were outpatients and six were inpatients. All patients were relieved of their clinical symptoms, including abdominal distention and dyspnea, and were relieved of lower extremity discomfort. The mean life span after catheter placement was 7.2 weeks. Twenty (83%) of the 24 patients were treated at home with their catheters in place. Three patients experienced minor complications from bacterial peritonitis, which responded to antibiotics. One patient had to have his catheter removed. CONCLUSION Percutaneous placement of specialized tunneled catheters appears to be a viable and safe technique in patients who have symptomatic ascites that require frequent therapeutic paracentesis for relief of symptoms.
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Affiliation(s)
- M J O'Neill
- Department of Radiology, Massachusetts General Hospital, White 270, 55 Fruit St., Boston, MA 02114, USA
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Savader SJ, Geschwind JF, Lund GB, Scheel PJ. Percutaneous radiologic placement of peritoneal dialysis catheters: long-term results. J Vasc Interv Radiol 2000; 11:965-70. [PMID: 10997457 DOI: 10.1016/s1051-0443(07)61323-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To evaluate the efficacy of percutaneous radiologic placement of peritoneal dialysis (PD) catheters. MATERIAL AND METHODS Nineteen patients with end-stage renal disease were referred for percutaneous radiologic placement of a commercially available PD catheter. The patient group consisted of 11 men and eight women with a mean age of 58 years (range, 38-85 y). All procedures were performed on an outpatient basis with use of conscious sedation. Patients were followed up to determine technical success, complication rate, catheter survival (continuous patency without infection or mechanical dysfunction), and long-term outcome. RESULTS The technical success rate for catheter placement was 95% (18 of 19). Complications included one (5%) failed attempt at catheter placement and one (5%) case of postplacement peritonitis. Mean and median catheter survival durations were 320 and 289 days, respectively (range, 33-823 d). A Kaplan-Meier survival analysis yielded 6-, 12-, and 24-month probabilities of catheter survival of 0.89 +/- 0.15, 0.81 +/- 0.20, and 0.81 +/- 0.20, respectively. Long-term outcomes included: continued PD, n = 9 (47%); death, n = 6 (32%; all related to comorbid disease); successful renal transplant, n = 2 (10.5%); and continued or resumed hemodialysis, n = 2 (10.5%). CONCLUSION Percutaneous radiologic placement of PD catheters has a high technical success rate, low complication rate, and can be performed on an outpatient basis. Catheter survival is comparable to that achieved with surgical and percutaneous endoscopic methods of catheter placement.
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Affiliation(s)
- S J Savader
- Department of Radiology, Methodist Hospital, Indianapolis, Indiana 46202, USA.
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Affiliation(s)
- S J Savader
- Russell H. Morgan Department of Radiology, Johns Hopkins Hospital, Baltimore, MD 21287, USA
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Savader SJ, Lund G, Scheel PJ, Prescott C, Feeley N, Singh H, Osterman FA. Guide wire directed manipulation of malfunctioning peritoneal dialysis catheters: a critical analysis. J Vasc Interv Radiol 1997; 8:957-63. [PMID: 9399464 DOI: 10.1016/s1051-0443(97)70693-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To evaluate patency rates after guide wire directed manipulation of malfunctioning continuous ambulatory peritoneal dialysis (CAPD) catheters. MATERIALS AND METHODS During a 58-month period, 23 patients underwent 34 outpatient guide wire directed manipulations of their CAPD catheter to improve function (n = 30) or reduce pain and improve function (n = 4) during dialysis. Catheter patency rates were subsequently determined by review of departmental, hospital, and dialysis center charts; procedural reports; and patient telephone interviews. RESULTS Among 12 patients who underwent a single guide wire directed manipulation, long-term (> 30 days) catheter patency was achieved in seven (58%). With use of the Kaplan-Meier survival method, the 3-, 6-, and 12-month probability of patency after a single guide wire manipulation was 0.61, 0.54, and 0.11, respectively. The mean duration of patency achieved in this group was 131 days (range, 2-421 days). In those patients (n = 8) who underwent multiple catheter manipulations (n = 19), 11 (58%) procedures resulted in long-term patency, with each patient (100%) achieving at least one such period. The Kaplan-Meier survival method determined the probability of patency in this group at 3, 6, and 12 months to be 0.75, 0.69, and 0.54, respectively. The mean secondary catheter patency was 235 days (range, 2-646 days). Overall, 75% of patients followed up achieved at least one period of long-term catheter patency during the time of this study. One (3%) episode of postprocedure peritonitis occurred. CONCLUSION Guide wire directed CAPD catheter manipulation is a relatively simple outpatient procedure that restores long-term catheter function for most patients with minimal risk for a major complication. Patients with nonfunctioning CAPD catheters who do not have peritonitis or sepsis will most likely benefit from at least one attempt at radiologic manipulation of their catheter.
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Affiliation(s)
- S J Savader
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA
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Forest JM, Mailhot C, Cartier P, Sirois G. Comparison of a fluorescence polarization immunoassay of netilmicin in plasma, peritoneal dialysate, and urine with a high-performance liquid chromatographic method. Ther Drug Monit 1997; 19:74-8. [PMID: 9029751 DOI: 10.1097/00007691-199702000-00013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The quantitative analysis of netilmicin in plasma, peritoneal dialysate, and urine using the fluorescence polarization immunoassay (FPIA) of the Abbott TDx system is compared with the modified high-performance liquid chromatography (HPLC) method of Peng et al., which was chosen as a reference. Using the least square method, we found that the results of the FPIA (y) correlated well with those obtained with HPLC (x). The three regression equations for the plasma, peritoneal dialysate, and urine samples, respectively, were y = 0.71x + 0.44 with r = 0.88 and n = 45; y = 0.94x + 1.22 with r = 0.93 and n = 95; and y = 0.92x + 0.70 with r = 0.93 and n = 61. The corresponding mean errors (FPIA-HPLC) with their 95% confidence intervals were -0.19 (-0.38 to -0.02), 0.69 (-0.42 to 1.81), and -0.13 (-1.13 to 0.87) microgram/ml. According to results of the Wilcoxon matched-pairs signed-ranks test, these errors did not represent a significant bias. The FPIA is thus suitable for analyzing netilmicin in the three biological fluids studied except when dialysate is contaminated with Amuchina. In this case, HPLC should be used.
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Affiliation(s)
- J M Forest
- Hôpital Ste-Justine, Montréal, Québec, Canada
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Haycox A, Jones D. The cost effectiveness of renal provision in the UK. JOURNAL OF MANAGEMENT IN MEDICINE 1995; 10:6-15. [PMID: 10162928 DOI: 10.1108/02689239610113487] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Discusses the need for reliable research-based evidence detailing the costs and benefits provided by different operational and strategic structures of renal replacement therapy. Suggests that in choosing the most appropriate form of dialysis the treatment options may be limited for clinical, practical or financial reasons. Proposes that the renal services must support patients in empowering them to make informed choices concerning the dialysis modality which offers them the highest quality of life. Brings into perspective the need for a balance between patients' quality of life and the financial constraints on the NHS.
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Affiliation(s)
- A Haycox
- Department of Pharmacology and Therapeutics, University of Liverpool, UK
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