BACKGROUND: Compelling data underscore the bioincompatible nature of glucose-based peritoneal dialysis (PD) solutions and their detrimental effects on peritoneal physiology and morphology. New PD solutions have been formulated to tackle common clinical problems such as inadequate ultrafiltration or malnutrition, and to improve biocompatibility-the latter aimed at preserving the structural and ...

During peritoneal dialysis, peritoneal cells are repeatedly exposed to a non-physiologic hypertonic environment with high glucose content and low pH. Current sterile dialysis solutions cause inflammation in the submesothelial compact zone, leading to fibrosis, angiogenesis, and, eventually, ultrafiltration failure. Although the normal interstitium separates the peritoneal microvasculature from the dialysis ...

Diabetic nephropathy has been increasing in prevalence in recent years, and it is now the dominant cause of end-stage renal disease (ESRD) worldwide. Because diabetes is frequently associated with multiple complications, nephrologists must be alert to the selection of dialysis modality so as to reduce the accompanying risks. The present ...

Antibacterial activity of 4 commercial bleaching agents (Day White, Colgate Platinum, Whiteness 10% and 16%) on 6 oral pathogens (Streptococcus mutans, Streptococcus sobrinus, Streptococcus sanguinis, Candida albicans, Lactobacillus casei, and Lactobacillus acidophilus) and Staphylococcus aureus were evaluated. A chlorhexidine solution was used as a positive control, while distilled water was ...

Although the survival of diabetic peritoneal dialysis (PD) patients has improved, it is still much worse than the survival of nondiabetic patients. Diabetes has its own risks for cardiovascular disease (CVD), such as increased levels of advanced glycation end-products, carbonyl and oxidative stress, and low-grade inflammation. An independent, graded association ...

We report a 78-year-old woman on hemodialysis who presented with refractory multiple pruritic vesicles and bullae on her trunk and extremities for 2 months. Histopathologic examination of skin biopsy specimen showed subepidermal bullae with many amyloid deposits in the papillary dermis. No evidence of systemic amyloidosis could be found on ...

Diabetic patients are often affected by comorbid conditions that influence clinical outcome. Taking care of diabetic peritoneal dialysis (PD) patients is a challenge for nephrologists, not only because these patients have more complications and comorbidities, but also because of their difficulties in maintaining glycemic control with the use of current ...

BACKGROUND: Loss of residual renal function (RRF) contributes to anaemia, inflammation and malnutrition and is also a strong predictor of mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. However, the role of RRF on peritonitis is not yet clearly established. This study aimed to evaluate the effect of RRF on ...

BACKGROUND: Optimization of ultrafiltration and preservation of the peritoneal membrane are desirable objectives in peritoneal dialysis (PD) patients. Mixtures of glucose- and non-glucose-based solutions may help to meet both targets simultaneously. AIM: To analyze the effects, in terms of ultrafiltration and peritoneal glucose load, of including icodextrin-based dialysate in the ...

OBJECTIVE: Heat sterilization of glucose peritoneal dialysis (PD) fluid generates reactive carbonyl compounds (RCOs), which have been implicated in the formation of advanced glycation end products (AGEs) on peritoneal proteins, with an attendant deterioration of peritoneal permeability in PD patients. To reduce their levels in PD fluid, we had previously ...

Peripheral artery stiffness is altered in diabetic patients with end-stage renal disease (ESRD), whereas few data exist to confirm this trend for proximal aortic stiffness. The pulse wave velocity of the proximal aorta (PWVr) and of the carotid-to-femoral aortic segment (PWVcf) were determined by ultrasound imaging in 160 patients with ...

The mesothelium is part of the peritoneal water and ion transport barrier essential for peritoneal dialysis (PD) treatment and has a central role in the pathogenesis of peritoneal fibrosis and ultrafiltration failure observed in many PD patients. We investigated the effect of amiloride on the transmesothelial electrical resistance (RTM) of ...

Peritoneal dialysis (PD) solutions containing glucose are considered to cause peritoneal fibrosis. Plasminogen activator inhibitor-1 (PAI-1) and tissue-type plasminogen activator (t-PA) participate in fibrogenesis of various organs, and human peritoneal mesothelial cells (HPMC) can produce PAI-1 and t-PA following glucose stimulation. Icodextrin has been widely used as an alternative osmotic ...

In recent years, there have been some interesting advances in the science and practice of peritoneal dialysis (PD). This review focuses on selected technological advances and the impact that these changes may have on this modality. New, so-called "biocompatible" fluids have more physiologic pH and reduced glucose degradation products. These ...

BACKGROUND: Human RBC are frozen at a mean temperature of -80 degrees C (with a range of -65 degrees C to -90 degrees C) with a mean concentration of 40% w/v glycerol (with a range from 36% w/v to 45% w/v) for at least 10 years. After thawing and deglycerolization ...

AIM: Darbepoetin alfa has a longer half-life than epoetin-(EPO) alfa or beta, allowing administration at less frequent intervals for the treatment of renal anemia. The aim of the present analysis was to evaluate the efficacy and tolerability of an every-2-week (Q2W) schedule of darbepoetin alfa in a large cohort of ...

BACKGROUND: The clinical determinants of intraperitoneal pressure (IPP) are ill defined, and the potential impact of elevated IPP on peritoneal dialysis (PD)-related complications is still a matter of debate. We measured IPP in newly started PD patients, assessed its clinical determinants and analysed the incidence of PD-related complications. METHOD: IPP ...

BACKGROUND: The objectives of the present study were to investigate the possible adverse effects of ciclosporin A (CsA, Sandimmun Neoral) on insulin secretion and insulin sensitivity (IS) in man. METHODS: A total of 11 Caucasian non-diabetic haemodialysis (HD) patients were recruited from the Norwegian transplant waiting list to participate in ...

The aim of the in vitro studies was to examine the effect of sodium deoxycholate, glucose, and methylglyoxal on icodextrin peritoneal transfer. The rabbit peritoneum in a modified Ussing chamber was an experimental model. Transport and morphometric analyses were performed. In the first of them, the icodextrin (7.5 g/dL) diffusion ...

BACKGROUND: Hypoglycaemia (HG) has been demonstrated during chronic haemodialysis (HD). These events may become more frequent with the current use of glucose-free bicarbonate dialysis solution, the standard formula in most dialysis facilities in the last decade. On the other hand, HG-related symptoms are unusual among patients during or just after ...

A 64-year-old man was admitted because of abdominal fullness, edema and anorexia. He had come to our hospital for treatment of liver cirrhosis and diabetic nephropathy for 1 year. We started diuretics and human albumin intravenous administration. Although the edema disappeared and abdominal fullness improved a little, blood urea nitrogen ...

In the present study, we examined the effects of a new peritoneal dialysis fluid (PDF) with a low level of low glucose degradation products (GDP) on the functional and structural stability of the peritoneal membrane (PM). Male Sprague-Dawley rats were divided into three groups: group C (n = 8), without ...

BACKGROUND: Diabetic patients often have reduced insulin requirements when they progress to renal failure. Since peritoneal dialysis (PD) solution contains glucose, the insulin requirement of these patients often increases after commenced on PD. However, the change in insulin requirement has not been studied systematically. METHODS: We study 60 consecutive patients ...

BACKGROUND: A poor nutritional status reduces the life expectancy of diabetes patients undergoing hemodialysis. OBJECTIVE: The study objective was to specify the nutritional outcome in patients with chronic kidney disease (CKD) and well-controlled diabetes. DESIGN: Forty-five diabetes patients with CKD were enrolled in a cooperative-care program designed to control glucose, ...

BACKGROUND: Atherosclerotic vascular change affecting the lower extremities is the most common peripheral vascular disease. Ankle-brachial index (ABI) and toe-brachial index (TBI) are common, non-invasive diagnostic tests for atherosclerosis in the lower extremities. Peritoneum is a vascular-based structure. The use of glucose-based hyperosmolar solutions for PD patients results in a ...

Among the different cardiovascular risk factors, lipid abnormalities dominate the high mortality in chronic ambulatory peritoneal dialysis patients. So far, no data comparing the effect of standard glucose-containing, amino acid-containing, and icodextrin-containing peritoneal dialysis solutions on serum lipid concentrations in a chronic ambulatory peritoneal dialysis population are available. To determine ...

BACKGROUND: To assess the effect of seasonal temperature on the interdialytic body weight gain (deltaBW), %deltaBW/dry weight (DW), and pre-dialysis blood pressure in chronic hemodialysis (HD) patients with different degrees of overhydration. METHOD: Year 2005 was divided into two seasons: 'cold' (the coolest 5 months) and 'hot' (the hottest 5 ...

Calcium-phosphate disorders and vascular calcification are highly prevalent in patients with diabetes mellitus and nephropathy. The aim of the study was to compare the prevalence and advancement of vascular calcification in patients with end-stage diabetic nephropathy on peritoneal dialysis and diabetic patients with chronic renal disease stages 2-4. The study ...

BACKGROUND/AIM: The determinants of baseline fast solute transport are still unclear. We prospectively investigated the relationship of peritoneal solute transport with markers of inflammation, angiogenesis, and membrane status, with a focus on fast transporters. METHODS: Seventy-one incident peritoneal dialysis patients were assessed with baseline and annual peritoneal equilibration tests, using ...

Insulin resistance is commonly observed in uremic patients. Glucose-based peritoneal dialysis solutions have long-term metabolic complications like hyperinsulinemia, hyperlipidemia, and obesity. The purpose of this study was to examine the insulin resistance in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) with standard glucose and icodextrin containing solutions. The entire non ...

Although quality of life (QoL) is an important outcome measure, there are few studies of QoL in diabetic patients. We performed a cross-sectional study to assess QoL in such patients comparable for age, sex, and co-morbidity. PATIENTS: Group CAPD: DM (n = 19, 12 males), diabetic CAPD patients; group CAPD: ...

AIM: Icodextrin reduces glucose absorption from the peritoneal dialysate. We conducted this prospective, open-labeled, multicenter study to determine the effects of icodextrin on glycemic and lipid parameters in diabetic patients undergoing continuous ambulatory peritoneal dialysis (PD) or automated PD. METHODS: Patients were recruited from 15 institutions in Japan, and a ...

BACKGROUND: Vascular calcifications are related to cardiovascular mortality and morbidity in dialysis patients. Limited data exist on the role of calcification inhibitors, such as matrix-carboxyglutamic acid protein (MGP) in dialysis patients. METHODS: In 120 dialysis patients and 41 age-matched healthy controls, circulating undercarboxylated (uc) MGP levels were measured with a ...

BACKGROUND: This study sought to examine the associations of traditional and non-traditional cardiovascular risk factors with carotid intima-media thickening and plaque in peritoneal dialysis (PD) patients. METHODS: A cross-sectional study was performed in 147 PD patients with carotid intima-media thickness (IMT) and plaque assessed by B-mode ultrasonography and fasting blood ...

BACKGROUND/AIMS: The aim of this study was to assess the multifaceted influence of glucose present in dialyzing fluid on erythrocytes of patients with chronic renal failure (CRF) undergoing regular hemodialysis. METHODS: A group of 44 subjects with CRF undergoing regular hemodialysis was studied. Two tests were used: osmotic fragility and ...

AIMS: We designed a study to evaluate whether erythropoietin (EPO), given to patients on continuousambulatory peritoneal dialysis (CAPD) both with and without diabetes mellitus (DM), influences tissue factor (TF), tissue factor pathway inhibitor (TFPI) and oxidative stress (SOX). METHODS: We assessed TF, TFPI and a marker of SOX, Cu/Zn superoxide ...

The prevalence of diabetes mellitus (DM) is very high worldwide. According to the World Health Organization in 2000 the worldwide prevalence of DM was 171,000,000. Diabetic nephropathy is a major vascular complication of DM. If DM is not treated early and adequately, many diabetic patients may reach end-stage renal disease ...

BACKGROUND AND OBJECTIVE: Moxifloxacin is a new fluorquinolone with broad-spectrum activity. It is suitable for treating peritonitis in peritoneal dialysis (PD) patients. The objective of this study was to test stability of moxifloxacin in PD solutions stored at different temperatures. METHODS: Dialysis solution bags were used at two glucose concentrations; ...

As a strategy to prevent the progression of diabetes mellitus, it is important to screen out the subjects who will develop a pre-diabetic state (PDS) in the future. To find out the potential risk factors for PDS, we employed the values of fasting plasma glucose and hemoglobin A1c (HbA1c), which ...

Massive pleural effusion occurring during continuous peritoneal dialysis (PD) is a rare, life-endangering complication of this procedure. We describe a case of a patient with type 2 diabetic end-stage renal disease (ESRD) treated by PD who had new-onset dyspnea, right pleural effusion, and uncontrolled hyperglycemia. Respiratory distress and pleural effusion ...

BACKGROUND: Continuous ambulatory peritoneal dialysis (CAPD) may exert significant effects on systemic haemodynamics. We have previously demonstrated that hypertonic glucose solutions are associated with higher blood pressure (BP) due to a rise in stroke volume (SV) and cardiac output (CO). However, the mechanisms underlying these changes have not been established. ...

Several recent large-scale epidemiological studies comparing mortality among end-stage renal disease (ESRD) patients receiving hemodialysis (HD) versus peritoneal dialysis (PD) show conflicting results. In this paper, we undertake a critical review of these studies. Our goal is to determine if there are any consistent trends in outcomes between HD and ...

Glucose sparing is a central component of modern peritoneal dialysis therapy, necessary to reduce the trade-offs of the therapy in terms of membrane protection and alleviation of systemic consequences. We present a detailed exploration of a metric for this approach in the form of the index of ultrafiltration efficiency, that ...

Good control of blood glucose obtains both with subcutaneus and with intraperitoneal insulin administration. Intraperitoneally administered insulin is absorbed more rapidly and evenly than subcutaneously administered insulin. It passes directly into the portal vein system. But insulin requirement in peritoneal insulin administration is higher then in subcutaneous. Factors affecting this ...

Recently a number of glucose dehydrogenase-based point of care (POCT) systems for glucose monitoring were successfully introduced on the market. Icodextrin, a glucose polymer is widely used as an osmotic agent in continuous ambulatory peritoneal dialysis (CAPD). Its metabolites are substrates for glucose dehydrogenase, inducing an analytical error which is ...

PURPOSE: Peritoneal dialysis patients have particular risks with respect to their lipid status and hyperinsulinemia. The aim of this study was to investigate the relation between insulin resistance and the type of the peritoneal dialysis solution. MATERIALS: 41 randomly selected non-diabetic patient cohort who were already under treatment with continuous ...

The influence of the initial reactant concentrations on the composition of the solid phases formed in the precipitation system MgCl(2)-NH(4)H(2)PO(4)-NaOH-H(2)O was investigated. The precipitation diagram constructed shows the approximate concentration regions within which struvite, newberyite, and their mixtures exist at 25 degrees C and an aging time of 60 min. ...

The propensity of various insulins and their analogs to oligomerize was investigated by mass spectrometric methods including measurement of the relative abundances of oligomers in the gas phase and the kinetics of H/D amide exchange. The kinetics of deuterium uptake show a good fit when the exchanging amides are placed ...

Hepatic subcapsular steatosis is a rare and specific form of fatty change in the liver. It is a unique finding in diabetic patients receiving continuous ambulatory peritoneal dialysis (CAPD) and intraperitoneal insulin treatment. Intraperitoneal administration of insulin causes a unique pattern of fatty infiltration in the subcapsular location of the ...

To evaluate the protoscolicidal effects of various concentrations of hypertonic glucose, live protoscolices of sheep were exposed to 10%, 15%, 25% and 50% glucose solutions. Cetrimide (0.5%), silver nitrate (0.5%) and hypertonic saline (20%) were used as positive controls, while physiological saline was used as a negative control. After 1, ...