Document Detail


Preservation of peritoneal catheter for prevention of encapsulating peritoneal sclerosis.
MedLine Citation:
PMID:  12402608     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We evaluated the usefulness of periodic abdominal irrigation through the peritoneal catheter preserved after termination of peritoneal dialysis (PD) to prevent encapsulating peritoneal sclerosis (EPS). The study group included 8 patients in whom PD had been terminated (mean age: 53.1 +/- 7.1 years; mean PD duration: 119.6 +/- 37.8 months). The abdominal cavity was periodically irrigated through the peritoneal catheter preserved after PD discontinuation. The appearance rate of cancer antigen 125 (CA125-AR), corrected by body surface area, was obtained every 3 months from 4-hour dwells. Based on the creatinine levels in 4-hour dwells and plasma, the dialysate-to-plasma creatinine (D/P Cr) was also obtained. Following abdominal irrigation for more than 12 months, the peritoneal catheter was removed and a biopsy specimen was taken from the peritoneum. The CA125-AR increased 3 months after PD discontinuation, but decreased thereafter. Encapsulating peritoneal sclerosis developed in 3 of 4 patients who lacked parietal mesothelial cells (PMCs) in a peritoneal specimen. In contrast, a good prognosis was obtained in 4 patients who had PMCs. The maximum value of the change in CA125-AR (delta CA125-AR, as compared with the value at PD discontinuation) was significantly greater in the PMC+ group than in the PMC- group (8.0 +/- 2.7 vs. 3.4 +/- 3.1, p < 0.001). The D/P Cr at catheter removal was lower in the PMC+ group than in the PMC- group (0.45 +/- 0.21 vs. 0.85 +/- 0.18, p < 0.05). Our findings suggest that periodic abdominal irrigation through the peritoneal catheter preserved after PD enhances the recovery of peritoneal damage. The CA125-AR value is a useful marker of viability and proliferation of PMCs.
Authors:
Misaki Moriishi; Hideki Kawanishi; Toru Kawai; Syunsake Takahashi; Takayuki Hirai; Masayuki Shishida; Hiroshi Watanabe; Naoko Takahashi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Advances in peritoneal dialysis. Conference on Peritoneal Dialysis     Volume:  18     ISSN:  1197-8554     ISO Abbreviation:  Adv Perit Dial     Publication Date:  2002  
Date Detail:
Created Date:  2002-10-29     Completed Date:  2002-11-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9104803     Medline TA:  Adv Perit Dial     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  149-53     Citation Subset:  IM    
Affiliation:
Department of Artificial Organs, Akane Foundation, Tsuchiya General Hospital, Hiroshima, Japan.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Cavity*
CA-125 Antigen / metabolism
Creatinine / metabolism
Dialysis Solutions / administration & dosage
Female
Humans
Irrigation*
Male
Middle Aged
Peritoneal Dialysis / adverse effects*
Peritoneum / metabolism,  pathology*
Renal Dialysis
Sclerosis
Chemical
Reg. No./Substance:
0/CA-125 Antigen; 0/Dialysis Solutions; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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