Cover

Contents

Preface

The International Vicenza Course on Peritoneal Dialysis – 30 Year Anniversary

Peritoneal Dialysis Solutions

Twenty Years of Bicarbonate Solutions

Abstract

Chemical Principle of the Bicarbonate Solution

Early Studies with the Bicarbonate Solution

Studies with the Modern Bicarbonate Solution

Conclusions

References

Peritoneal Dialysis Solution and Nutrition

Abstract

Preliminary Known Context

Effect of Dialysis Solution on Nutritional Status

References

Alternative Dialysis Strategies with Icodextrin

Abstract

Use of Icodextrin in Low Transporters

Use of Icodextrin in Combination with Glucose-Based Dialysate

Twice-Daily Icodextrin

Cardiac Outcomes with Twice-Daily Icodextrin

Surgical Indications for the Use of Icodextrin: Reduction of Adhesions

Conclusion

References

Are Current Peritoneal Dialysis Solutions Adequate for Pediatric Use?

Abstract

Choice of PD Solution Type in Children

Conclusions and Future Prospects

References

New Challenges for PD and Home Therapies

Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD): From Conception to Execution of a National Peritoneal Dialysis Reality Check

Abstract

Study Design, Data Collection and Analysis

Published Papers

Unpublished Data

Future Studies, Postgraduate Studies and International Cooperation

Conclusions

Acknowledgements

Disclosure Statement

References

Comparing Outcomes of Hemodialysis and Peritoneal Dialysis Patients: Consider the Pitfalls

Abstract

Adjusting Inter-Modality Comparisons for Confounding from Baseline and Time-Varying Differences in Patients Who Dialyze In-Center or at Home

Contemporary Comparisons of HD and PD Survival

How Should the Data from Survival Studies Be Used to Make Treatment Recommendations for Patients?

Disclosure Statement

References

Hypogonadism in Males with Chronic Kidney Disease: Another Cause of Resistance to Erythropoiesis-Stimulating Agents?

Abstract

High Prevalence of ESA Resistance in Dialysis Patients

Androgens Stimulate Erythropoiesis

Hypogonadism: A Neglected Cause of ESA Resistance?

Hypogonadism and Vitamin D: Is There a Link?

Conclusion

Disclosure Statement

References

Practical Issues in Peritoneal Dialysis 1

Getting the Right Patient on the Right Renal Replacement Therapy

Abstract

Targeting RRT in the Patient Receiving Predialysis Care

Absolute Contraindications and Indications for PD

Controversial Contraindications and Indications for PD

Favorable and Unfavorable Settings for PD

Planning RRT in the Patient Who Starts Unplanned

Anticipating Failure with Planned Technique Transfer

Conclusions

References

Doubts on the Long-Term Survival of Peritoneal Dialysis Patients Are No Longera Medical Barrier to Home Dialysis

Abstract

References

How to Avoid Technique Failure in Peritoneal Dialysis Patients?

Abstract

Catheter Dysfunction

Psychosocial Problems

Dialysis Adequacy

Ultrafiltration Failure

Promoting a Real Transition

References

Clinical Practice Guidelines: An Important Tool in Improving Dialysis Quality

Abstract

Definitions of Clinical Practice Guidelines

Why Do We Need Clinical Practice Guidelines?

Characteristics of Good CPGs

What CPGs Should Not Be

Methodology of CPGs

Potential Benefits of CPGs in Nephrology

Criticisms and Concerns on CPGs in Nephrology

Implementation of Guidelines

Conclusion

References

Telemedicine and e-Health in PD

Remote Monitoring for Continuous Peritoneal Dialysis

Abstract

Treatment Monitoring

Experience with Monitoring of Peritoneal Dialysis

Designing the Ideal System

Barriers to Implementation

Conclusion

References

e-Health: Remote Health Care Models in Peritoneal Dialysis

Abstract

Literature Search Strategy

Forms of e-Health

Policy Issues

Conclusions

References

Remote Monitoring of Peritoneal Dialysis in Special Locations

Abstract

Home Visit Protocols

Remote Monitoring System

Our Study

Conclusions

References

Lipid Disorders, Inflammation and Anemia

Dialysis Modality Choice for the Elderly Patient with End- Stage Renal Disease

Abstract

Conservative, Nondialytic Therapy

Hemodialysis

Peritoneal Dialysis

Conclusions

References

Anemia Management in Patients on Peritoneal Dialysis

Abstract

Contributing Factors to Anemia in Patients Receiving Peritoneal Dialysis

Anemia and Increased Mortality: Is It Also True for Peritoneal Dialysis Patients?

The Hemoglobin Target Approach: Is It Still Actual?

Clinical Management of Peritoneal Dialysis Patients with Erythropoiesis-Stimulating Agents

Conclusions

References

Maximizing the Erythropoietin Response: Iron Strategies

Abstract

Iron Deficiency in Chronic Kidney Disease

Intravenous Iron Therapy

Dosage Regimens and Adverse Reactions

Our Experience

Newer Preparations-Ferric Carboxymaltose, Ferumoxytol and Iron Isomaltoside

Conclusions

Disclosure Statement

References

Lipid Disorders in Uremia and Dialysis

Abstract

Importance of Lipid Control in Chronic Kidney Disease

More Recent CKD Statin Trials: The SHARP Study

Dosing of Statins in CKD

Additional Lipid Control Considerations in CKD

Treating High Triglycerides

References

Statins and Lipid-Lowering Strategies in PD

Abstract

Dyslipidemia in PD Patients

Use of Statins to Treat Lipid Disorders in PD Patients

Additional Therapeutic Strategies

References

Statin Therapy Is Associated with Decreased Small, Dense Low-Density Lipoprotein Levels in Patients Undergoing Peritoneal Dialysis

Abstract

Study Population

Materials and Methods

Results

Discussion

Limitations of the Study

Conclusion

References

CKD-MBD and Inflammation Management in PD

Phosphate Control in Peritoneal Dialysis

Abstract

Phosphate Balance in Peritoneal Dialysis

Phosphate Binders in Peritoneal Dialysis

Calcium-Containing Phosphate Binders

Calcium-Free Phosphate Binders

Lanthanum Carbonate

Conclusions

References

Role of Vitamin D Receptor Activators in Peritoneal Dialysis

Abstract

Vitamin D Deficiency and Disease

Vitamin D Deficiency in Dialysis Patients

Other Pleiotropic Effects of Vitamin D

Peritoneal Dialysis and Low PTH Levels

Vitamin D and Association with Survival

Treatment with Vitamin D and Survival

Administration of VDRAs in PD Patients

Conclusions

Acknowledgements

Disclosure Statement

References

Calcimimetics in Peritoneal Dialysis Patients

Abstract

Background

Specific Aspects of CKD-MBD in Peritoneal Dialysis

Conclusions and Opinions

Acknowledgements

References

Factors Affecting Loss of Residual Renal Function(s) in Dialysis

Abstract

Excretory Functions

Endocrine Functions

Factors Affecting Residual Renal Function

Strategies to Preserve Residual Renal Function

References

Prospective Safety Study of Bardoxolone Methyl in Patients with Type 2 Diabetes Mellitus, End-Stage Renal Disease and Peritoneal Dialysis

Abstract

Inflammation in Peritoneal Dialysis Patients and the Link to Residual Renal Function

Bardoxolone Methyl: An Antioxidant and Inflammation Modulator

Clinical Experience with Bardoxolone Methyl

Safety Study of Bardoxolone Methyl in Patients with Type 2 Diabetes Mellitus and End-Stage Renal Disease Treated with Peritoneal Dialysis

Study Design and Objectives

Inclusion and Exclusion Criteria

Study Procedures

Early Study Termination

Sample Size and Intention-to-Treat Analysis

Discussion

References

Fluid Overload and Cardiovascular Events

Assessment of Fluid Status in Peritoneal Dialysis

Abstract

Normal Body Fluid Content

Assessment Techniques

Bioelectrical Impedance Analysis

Expressions of Hydration and Defining Ideal Dry Weight

Conclusion

References

Fluid Transport and Homeostasis in Peritoneal Dialysis

Abstract

Water Pathways in PD

Methods Used to Estimate Water Transport

Disturbances in Water Transport

Mechanisms of Ultrafiltration Failure

Can We Prevent Ultrafiltration Failure?

Achieving or Maintaining Fluid Homeostasis

Conclusions

References

Bioimpedance and Brain Natriuretic Peptide in Peritoneal Dialysis Patients

Abstract

Fluid Overload, Hypertension and Cardiovascular Abnormalities in Peritoneal Dialysis Patients

Bioimpedance

Natriuretic Peptides

Conclusions

References

Role of Peritoneal Dialysis as a Chronic Renal Replacement Therapy in Cardiorenal Patients

Abstract

Cardiorenal Syndrome Type II: Definition

Pathophysiology and the Role of Ultrafiltration in CRS

Relevance of Hemofiltration in Acute Exacerbations of CRS Type II

Role of Peritoneal Dialysis in the Management of CRS Type II

Controversies in Studies with Cardiorenal Patients

Importance of the Right Hydration Target

Future Strategies to Improve the Role of Peritoneal Dialysis in Cardiorenal Syndrome Patients

Conclusion

References

Vascular and Arterial Calcificationin Peritoneal Dialysis Patientsb – State-of-the-Art 2012

Abstract

Methods of Detection of Vascular Calcification

Recent Clinical Studies and Findings – Focusing on Peritoneal Dialysis

Conclusions

References

Practical Issues in Peritoneal Dialysis 2

Adequacy in Peritoneal Dialysis

Abstract

Small Solute Clearances

Ultrafiltration

Peritoneal Dialysis Adequacy and Inflammation

Peritoneal Dialysis Adequacy and Nutrition

Recommendations

References

Setting Up Research in Peritoneal Dialysis

Abstract

Peritoneal Cytokine

Peritoneal Cell

Peritoneal Foreign Body

Conclusion

References

Peritoneal Dialysis Technology

Continuous Flow Peritoneal Dialysis: Update 2012

Abstract

Kinetics and Ultrafiltration in Continuous Flow Peritoneal Dialysis

Catheter Design for CFPD

Applications

Discussion

References

Combination Therapy: Five Days PD and One Day HD – What Are the Benefits?

Abstract

Experience with Combined Dialysis

Reported Indications for Combined Modality Approach

Reported Benefits of Combined Modality Approach

Possible Complications

Possible Regimens

Conclusions

Disclosure Statement

References

Peritoneal Dialysis Access: What’s the Best Approach?

Abstract

Peritoneal Dialysis Access Techniques

Which Is the Best Technique?

References

Time between Peritoneal Dialysis Catheter Insertion and Use

Abstract

Embedding the Peritoneal Catheter

Does Embedding the Catheter Worsen Outcomes?

Conclusion

References

Peritoneal Dialysis Membrane Evaluation in Clinical Practice

Abstract

Peritoneal Equilibration Test

Personal Dialysis Capacity Test

Standardized Peritoneal Permeability Analysis

Refinements of the PET

Effluent Biomarkers

Conclusion

References

Bioelectrical Impedance Analysis in the Assessment of Hydration Status in Peritoneal Dialysis Patients

Abstract

Patients and Methods

Results

Discussion

Conclusions

Acknowledgments

Disclosure Statement

References

Peritonitis and Other Clinical Outcomes

Today’s Approaches to Prevent Peritonitis

Abstract

Measuring a Center’s Peritonitis Rates

Interventions to Lower Peritonitis Due to Contamination: Training Methods

Connectology to Prevent Peritonitis

Protocols to Prevent Peritonitis due to Catheter Exit Site and Tunnel Infections

Preventing Peritonitis from Gastrointestinal Sources

Preventing Relapsing and Repeat Peritonitis

Conclusion

References

Transplant Outcomes and Dialysis Modality

Abstract

Does Dialysis Modality Influence the Likelihood of Transplantation or Mortality While on the Wait-List?

Are Short- Term Transplant Outcomes Affected by Previous Dialysis Modality?

Are Long-Term Transplant Outcomes Affected by Previous Dialysis Modality?

Conclusion

References

Neutrophil Gelatinase- Associated Lipocalin in the Early Diagnosis of Peritonitis: The Case of Neutrophil Gelatinase-Associated Lipocalin

Abstract

Neutrophil Gelatinase-Associated Lipocalin and Its Biological Role

Peritoneum during Peritonitis

Why Could NGAL Be a Good Marker in Peritonitis?

NGAL in Peritoneal Dialysis Effluent and Systemic Condition

Why Could NGAL Be Useful in Peritonitis Management?

NGAL as Marker of Peritonitis: Preliminary Results

Material and Methods

Results

Discussion

Disclosure Statement

References

Prognostic Factors for Peritonitis Outcome

Abstract

Age at Onset of Peritonitis and Age at Start of Peritoneal Dialysis

Gender

Race

Diabetes, History of Steroid Use, Previous Renal Transplantation, Malignancy

Residual Renal Function

Time on Peritoneal Dialysis

Number of Peritonitis Episodes Previously Experienced

Concurrent Exit Site Infection

Peritoneal Dialysis Fluid Cell Count

Growth Factors, Cytokines, Adhesion Molecules, Inflammatory Markers

Causative Organism

Fungal Peritonitis

Culture-Negative Peritonitis

Recurrent and Relapsing Peritonitis

Risk Factors for Adverse Outcomes after Peritonitis-Related Technique Failure

References

Improving the Care of Diabetic Patients on Peritoneal Dialysis

Abstract

Patient and Technique Survival in Diabetes

Key Factors that Determine Outcomes in the Diabetic PD Patient

Blood Sugar Control in the Diabetic Patient on Peritoneal Dialysis

Other Possible Benefits of Peritoneal Dialysis in the Diabetic Patient

References

How to Select among Dialysis Options

Abstract

Background to Decision Making

Designing Effective Patient Information

Patient Decision Aids

Conclusions

Acknowledgements

References

Author Index

Subject Index

Cover