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Nakayama T, Morimoto K, Uchiyama K, Washida N, Kusahana E, Hama EY, Mitsuno R, Tonomura S, Yoshimoto N, Hishikawa A, Hagiwara A, Azegami T, Yoshino J, Monkawa T, Yoshida T, Yamaguchi S, Hayashi K. Efficacy of sucrose and povidone-iodine mixtures in peritoneal dialysis catheter exit-site care. BMC Nephrol 2024; 25:151. [PMID: 38698327 PMCID: PMC11064401 DOI: 10.1186/s12882-024-03591-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/29/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Exit-site infection (ESI) is a common recurring complication in patients undergoing peritoneal dialysis (PD). Sucrose and povidone-iodine (SPI) mixtures, antimicrobial ointments that promote wound healing, have been used for the treatment of ulcers and burns, but their efficacy in exit-site care is still unclear. METHODS This single-center retrospective observational study included patients who underwent PD between May 2010 and June 2022 and presented with episodes of ESI. Patients were divided into SPI and non-SPI groups and followed up from initial ESI onset until PD cessation, death, transfer to another facility, or June 2023. RESULTS Among the 82 patients (mean age 62, [54-72] years), 23 were treated with SPI. The median follow-up duration was 39 months (range, 14-64), with an overall ESI incidence of 0.70 episodes per patient-year. Additionally, 43.1% of second and 25.6% of third ESI were caused by the same pathogen as the first. The log-rank test demonstrated significantly better second and third ESI-free survival in the SPI group than that in the non-SPI group (p < 0.01 and p < 0.01, respectively). In a Cox regression analysis, adjusting for potential confounders, SPI use was a significant predictor of decreased second and third ESI episodes (hazard ratio [HR], 0.22; 95% confidence interval [CI], 0.10-0.52 and HR, 0.22; 95%CI, 0.07-0.73, respectively). CONCLUSIONS Our results showed that the use of SPI may be a promising option for preventing the incidence of ESI in patients with PD. TRIAL REGISTRATION This study was approved by the Keio University School of Medicine Ethics Committee (approval number 20231078) on August 28, 2023. Retrospectively registered.
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Affiliation(s)
- Takashin Nakayama
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Kohkichi Morimoto
- Apheresis and Dialysis Center, Keio University School of Medicine, Tokyo, Japan
| | - Kiyotaka Uchiyama
- Department of Nephrology, International University of Health and Welfare School of Medicine, Chiba, Japan
| | - Naoki Washida
- Department of Nephrology, International University of Health and Welfare School of Medicine, Chiba, Japan
| | - Ei Kusahana
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Eriko Yoshida Hama
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Ryunosuke Mitsuno
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Shun Tonomura
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Norifumi Yoshimoto
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Akihito Hishikawa
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Aika Hagiwara
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Tatsuhiko Azegami
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Jun Yoshino
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Toshiaki Monkawa
- Medical Education Center, Keio University School of Medicine, Tokyo, Japan
| | - Tadashi Yoshida
- Apheresis and Dialysis Center, Keio University School of Medicine, Tokyo, Japan
| | - Shintaro Yamaguchi
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
- Medical Education Center, Keio University School of Medicine, Tokyo, Japan.
| | - Kaori Hayashi
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
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Nagai K, Ueda A. Effect of proactive combination therapy with peritoneal dialysis and hemodialysis on technique survival and mortality. J Artif Organs 2024:10.1007/s10047-024-01437-z. [PMID: 38514529 DOI: 10.1007/s10047-024-01437-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 02/18/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE Clinically relevant evidence for the timing of starting combination therapy with peritoneal dialysis and hemodialysis remains scarce. We retrospectively examined whether combination therapy during the induction phase of dialysis prolongs peritoneal dialysis duration. METHODS This retrospective study includes 160 patients who underwent combination therapy from 20 dialysis facilities. Four groups were categorized: combination at peritoneal dialysis induction (n = 12, Proactive combination group), and combination following peritoneal dialysis durations of < 2 years (n = 65), 2-5 years (n = 70), or > 5 years (n = 13). Differences in technique survival of dialysis, mortality, and hospitalization due to cardiovascular events in the groups were observed. RESULTS The Proactive combination group had the longer mean duration of combination therapy (3.18 years) comparing to that of combination therapy following peritoneal dialysis (1.45 years), but total peritoneal dialysis duration was shorter than in control groups (4.02 years). Of the 160 cases in the entire cohort, there were 8 deaths, 18 ischemic heart disease hospitalizations, and 18 stroke hospitalizations. The Proactive group had lower crude mortality rate (0/12 cases, 0.0%) and crude hospitalization rate for ischemic heart disease (1/11, 8.3%) than the other groups. However, this cohort study did not have enough statistical power to adjust for patients' background, and we were unable to fully examine the differences in such clinical outcomes by the timing of initiation of combination therapy. CONCLUSION Use of combination therapy in the induction phase might prolong the duration of combination therapy, but is not necessarily effective for prolonging peritoneal dialysis technique survival.
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Affiliation(s)
- Kei Nagai
- Department of Nephrology, Hitachi General Hospital, 2-1-1 Johnan-Cho, Hitachi, Ibaraki, 317-0077, Japan.
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
| | - Atsushi Ueda
- Department of Nephrology, Hitachi General Hospital, 2-1-1 Johnan-Cho, Hitachi, Ibaraki, 317-0077, Japan
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Shinzawa M, Matsumoto A, Kitamura H, Sakaguchi Y, Takahashi A, Matsui I, Mizui M, Yamamoto R, Isaka Y. The association between embedded catheter implantation and hospitalization costs for peritoneal dialysis initiation: a retrospective cohort study. Clin Exp Nephrol 2024; 28:245-253. [PMID: 37962745 PMCID: PMC10881681 DOI: 10.1007/s10157-023-02416-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/25/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Compared with the conventional peritoneal dialysis (PD) catheter insertion, embedding PD catheter implantation is one of the procedures for planned PD initiation. However, facilities where embedded PD catheter implantation is available are limited, and the impact of embedded PD catheter implantation on hospitalization cost and length of hospitalization is unknown. METHODS This retrospective single-center cohort study included 132 patients with PD initiation between 2005 and 2020. The patients were divided into two groups: 64 patients in the embedding group and 68 patients in the conventional insertion group. We created a multivariable generalized linear model (GLM) with the gamma family and log-link function to evaluate the association among catheter embedding, the duration and medical costs of hospitalization for PD initiation. We also evaluated the effect modification between age and catheter embedding. RESULTS Catheter embedding (β coefficient - 0.13 [95% confidence interval - 0.21, - 0.05]) and age (per 10 years 0.08 [0.03, 0.14]) were significantly associated with hospitalization costs. Catheter embedding (- 0.21 [- 0.32, - 0.10]) and age (0.11 [0.03, 0.19]) were also identified as factors significantly associated with length of hospitalization. The difference between the embedding group and the conventional insertion group in hospitalization costs for PD initiation (P for interaction = 0.060) and the length of hospitalization (P for interaction = 0.027) was larger in young-to-middle-aged patients than in elderly patients. CONCLUSIONS Catheter embedding was associated with lower hospitalization cost and shorter length of hospitalization for PD initiation than conventional PD catheter insertion, especially in young-to-middle-aged patients.
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Affiliation(s)
- Maki Shinzawa
- Department of Nephrology, Osaka University Graduate School of Medicine, D-11 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
- Health and Counseling Center, Osaka University, Toyonaka, Japan.
| | - Ayumi Matsumoto
- Department of Nephrology, Osaka University Graduate School of Medicine, D-11 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Harumi Kitamura
- Department of Nephrology, Osaka University Graduate School of Medicine, D-11 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yusuke Sakaguchi
- Department of Inter-Organ Communication Research in Kidney Disease, Osaka University Graduate School of Medicine, Suita, Japan
| | - Atsushi Takahashi
- Department of Nephrology, Osaka University Graduate School of Medicine, D-11 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Isao Matsui
- Department of Nephrology, Osaka University Graduate School of Medicine, D-11 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masayuki Mizui
- Department of Nephrology, Osaka University Graduate School of Medicine, D-11 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Ryohei Yamamoto
- Health and Counseling Center, Osaka University, Toyonaka, Japan
- Laboratory of Behavioral Health Promotion, Department of Health Promotion Medicine , Osaka University Graduate School of Medicine, Toyonaka, Japan
| | - Yoshitaka Isaka
- Department of Nephrology, Osaka University Graduate School of Medicine, D-11 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Maeda T, Io H, Hara K, Nakata J, Ishizaka M, Shimizu Y, Shirotani Y, Fukuzaki H, Suzuki Y. Laparoscopic observations of adhesions between peritoneal dialysis catheters and intraperitoneal organs: A retrospective, observational study. Nephrology (Carlton) 2023; 28:684-687. [PMID: 37602968 DOI: 10.1111/nep.14230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/25/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023]
Abstract
Laparoscopy provides extensive data for the decannulation of a peritoneal dialysis catheter and is being increasingly used to diagnose encapsulating peritoneal sclerosis. However, there are few reports on the methods of decannulation of peritoneal dialysis catheters. In this study, we examined the laparoscopic findings and postoperative complications of patients undergoing peritoneal dialysis catheter removal. A total of 119 laparoscopic decannulations of peritoneal dialysis catheters were performed between 2003 and 2018 at the Juntendo University Hospital and Juntendo University Nerima Hospital. Laparoscopy was performed during peritoneal dialysis catheter removal by a gastrointestinal surgeon. Patient characteristics such as age, sex, duration of peritoneal dialysis, history of peritonitis and age at the time of peritoneal dialysis termination were assessed. Of these 119 cases, 19 (16.0%) showed adhesion between the peritoneal dialysis catheter and intraperitoneal organs. There were 13 (10.9%) cases involving a tangled omentum, 4 (3.4%) cases involving the small intestine and 2 (1.7%) cases of adhesions extending from the bowels to the abdominal wall. No postoperative complications were associated with the laparoscopic surgery. In these cases, blind decannulation of the peritoneal dialysis catheter may result in injury to the gastrointestinal tract in patients with adhesions. Therefore, we need to pay attention to adhesions between peritoneal dialysis catheters and intraperitoneal organs, and laparoscopy could be a valuable tool in detecting such adhesions and ensuring patient safety.
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Affiliation(s)
- Takuya Maeda
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Nephrology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Hiroaki Io
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Nephrology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Kazuaki Hara
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Junichiro Nakata
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Masanori Ishizaka
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Nephrology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Yuki Shimizu
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuka Shirotani
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Haruna Fukuzaki
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yusuke Suzuki
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
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Nagai K, Ueda A. Sustainability of peritoneal dialysis and renal function with proactive combination therapy. J Artif Organs 2023; 26:335-339. [PMID: 36472679 DOI: 10.1007/s10047-022-01375-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Most combined peritoneal dialysis and hemodialysis therapies are used to compensate for the lack of dialysis volume and efficiency in pre-started peritoneal dialysis patients. The aim was to determine the effects on both peritoneal dialysis and residual renal function when proactively combined therapy is started at dialysis induction. This report was based on observation of 10 patients who initiated dialysis therapy with a combination of peritoneal and hemodialysis at induction, and the control group consisted of 24 patients with peritoneal monotherapy in a single dialysis center. The technical survival of peritoneal dialysis therapy and urinary volume and creatinine clearance as residual renal function were assessed. Technical survival of peritoneal dialysis during the 5-year observation period was much better in patients who started with proactive combination therapy than with peritoneal dialysis monotherapy. Between induction and 24 months later, median urinary volume (interquartile value) changed from 1500 (1100-1583) to 800 (545-1875) mL/day and from 1600 (1300-2150) to 1480 (115-1885) mL/day for peritoneal alone and for combination therapy, respectively. Creatinine clearance values changed from 7.0 (6.0-8.7) to 2.0 (1.0-3.0) mL/min for peritoneal alone and from 6.0 (4.0-7.3) to 3.0 (0.5-4.0) mL/min for combination therapy. Though some possible confounding factors, including selection bias, cannot be ruled out, this investigation suggests the benefit of proactive combination dialysis therapy on the sustainability of peritoneal dialysis and residual renal function.
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Affiliation(s)
- Kei Nagai
- Department of Nephrology, Hitachi General Hospital, 2-1-1 Johnan-Cho, Hitachi, Ibaraki, 317-0077, Japan.
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
| | - Atsushi Ueda
- Department of Nephrology, Hitachi General Hospital, 2-1-1 Johnan-Cho, Hitachi, Ibaraki, 317-0077, Japan.
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Maruyama Y, Yokoyama K, Higuchi C, Sanaka T, Tanaka Y, Sakai K, Kanno Y, Ryuzaki M, Sakurada T, Hosoya T, Nakayama M. Changes in erythropoiesis-stimulating agent responsiveness after transfer to combined therapy with peritoneal dialysis and hemodialysis for patients on peritoneal dialysis: A prospective multicenter study in Japan. Ther Apher Dial 2023. [PMID: 36897071 DOI: 10.1111/1744-9987.13981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Inadequate dialysis and fluid overload are corrected after starting combined therapy with peritoneal dialysis (PD) and hemodialysis (HD). However, the effects on anemia management has not been elucidated. METHODS We conducted a prospective, multicenter, observational cohort study of 40 PD patients (age, 60 ± 10 years; male, 88%; median PD duration, 28 months) starting combined therapy and investigated changes in several clinical parameters, including erythropoiesis-stimulating agent (ESA) resistance index (ERI). RESULTS ERI decreased significantly during 6 months after switching to combined therapy (from 11.8 [IQR 8.0-20.4] units/week/kg/(g/dL) to 7.8 [IQR 3.9-18.6] units/week/kg/(g/dL), p = 0.047). Body weight, urinary volume, serum creatinine and the dialysate-to-plasma creatinine ratio (D/P Cr) decreased, whereas hemoglobin and serum albumin increased. In subgroup analysis, the changes in ERI were not affected by cause for starting combined therapy, PD holiday and D/P Cr. CONCLUSION Although detailed mechanism was unclear, ESA responsiveness improved after switching from PD alone to combined therapy.
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Affiliation(s)
- Yukio Maruyama
- Division of Nephrology and Hypertension, Department of Internal Medicine, Tokyo, Japan
| | - Keitaro Yokoyama
- Division of Nephrology and Hypertension, Department of Internal Medicine, Tokyo, Japan
| | | | - Tsutomu Sanaka
- Center of CKD and Lifestyle Related Diseases, Edogawa Hospital, Ichikawa, Japan
| | - Yoshihide Tanaka
- Department of Nephrology, Toho University School of Medicine, Tokyo, Japan
| | - Ken Sakai
- Department of Nephrology, Toho University School of Medicine, Tokyo, Japan
| | - Yoshihiko Kanno
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Munekazu Ryuzaki
- Division of Nephrology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Tsutomu Sakurada
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Tatsuo Hosoya
- Division of Nephrology and Hypertension, Department of Internal Medicine, Tokyo, Japan
| | - Masaaki Nakayama
- Department of Nephrology, St. Luke's International Hospital, Tokyo, Japan
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Nakayama T, Nishioka K, Uchiyama K, Morimoto K, Kusahana E, Washida N, Yamaguchi S, Azegami T, Yoshida T, Itoh H. Late Dialysis Modality Education Could Negatively Predict Peritoneal Dialysis Selection. J Clin Med 2022; 11. [PMID: 35887805 DOI: 10.3390/jcm11144042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
Patients with end-stage renal disease are less likely to choose peritoneal dialysis (PD) as renal replacement therapy (RRT). The reasons for this biased selection are still poorly understood. In this study, we evaluated the effect of the timing of RRT education on PD selection. This single-center retrospective observational study included patients who initiated maintenance dialysis at our hospital between April 2014 and July 2021. A logistic regression analysis was performed to investigate the association of RRT education timing with PD selection. Among the 355 participants (median age [IQR] 70 (59−79) years; 28.7% female), 53 patients (14.9%) and 302 patients (85.1%) selected PD and hemodialysis, respectively. Multivariate analysis demonstrated that high estimated glomerular filtration (eGFR) at RRT education positively predicted PD selection (p < 0.05), whereas old age (p < 0.01) and high Charlson comorbidity index (p < 0.05) were negative predictors of PD selection. Female sex (p = 0.44), welfare public assistance (p = 0.78), living alone (p = 0.25), high geriatric nutritional risk index (p = 0.10) and high eGFR at first visit to the nephrology department (p = 0.83) were not significantly associated with PD selection. Late RRT education could increase the biased selection of dialysis modality.
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Kouno N, Takahashi R, Furuya T, Fujikawa T. Perioperative Management and Surgical Outcomes of Colorectal Cancer Patients Undergoing Peritoneal Dialysis for End-Stage Kidney Disease. Cureus 2022; 14:e26708. [PMID: 35959175 PMCID: PMC9360629 DOI: 10.7759/cureus.26708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction: Despite the fact that the number of peritoneal dialysis (PD) patients is increasing, there is little evidence on the surgical outcomes of PD patients who have colorectal cancer surgery, and there is no consensus on the safety and practicality of continuing PD. Methods: We retrospectively evaluated the short- and long-term results, as well as the feasibility of continuing PD, in eight patients with PD who had colorectal cancer surgery at our institution between January 2010 and January 2021. Results: The scheduled open-fashioned resection was performed in one patient, whereas the other seven surgeries were all conducted laparoscopically, with no intraoperative conversion to laparotomy necessary. Except for one patient with a history of recurring PD-related peritonitis, the PD catheter was kept in seven of the eight cases. Five of the seven patients continuing PD underwent temporary postoperative hemodialysis. At a median of 24.5 months of postoperative monitoring, no infectious complications were observed, six cases continued PD, and no recurrence of colorectal cancer was observed in all cases. Conclusions: Routine curative-intent colorectal cancer surgery with the preservation of the PD catheter is possible and safe in individuals receiving PD. This patient population's short- and long-term oncological results are comparable to general surgical outcomes of those without chronic kidney disease. PD can be maintained for a long period of time following major colorectal cancer surgery.
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Nakamura Y, Watanabe T, Takizawa N, Fujita Y. Importance of ultrasound examination: A case of peritoneal catheter tunnel infection. Clin Case Rep 2021; 9:e05200. [PMID: 34963803 PMCID: PMC8710707 DOI: 10.1002/ccr3.5200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 11/09/2022] Open
Abstract
Some peritoneal dialysis catheter infections cannot be detected via a physical examination. Ultrasound of the PD catheter tunnel should be performed in cases of suspected infection or clinical abnormality at the catheter tunnel site.
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Affiliation(s)
| | | | | | - Yoshiro Fujita
- Department of Rheumatology NagoyaNagoyaJapan
- Department of NephrologyChubu Rosai HospitalNagoyaJapan
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