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Life
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Current Progress in Peritoneal Dialysis
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Current Progress in Peritoneal Dialysis

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 3353

Special Issue Editors

Prof. Dr. Hiroyuki Terawaki

E-Mail Website
Guest Editor
Clinical Laboratory Department, St. Luke’s International University, Tokyo, Japan
Interests: nephrology; oxidative stress; hyperuricemia; diabetic nephropathy; renal replacement therapy (hemodialysis, peritoneal dialysis); chronic kidney disease
Prof. Dr. Takafumi Ito

E-Mail Website
Guest Editor
Division of Nephrology, School of Medicine, Teikyo University, Ichihara, Japan
Interests: nephrology

Special Issue Information

Dear Colleagues,

Peritoneal dialysis (PD) has several advantages over hemodialysis (HD), both in medical and social aspects. In terms of medical aspects, PD is superior in stable hemodynamics, which allows clients of PD therapy to maintain residual kidney function and cognitive function and to be free from pain that accompany a puncture of the vascular access and from severe fatigue after the HD session. The worldwide progress of ‘social aging’ enhances the importance of PD as a ‘hemodynamically gentle’ therapy. In terms of social aspects, PD enables clients to participate in social activity more easily than HD.

However, the wide use of PD is being hampered by its self-management nature and by some potential complications, such as peritoneal damage leading to serious small bowel obstruction, and infectious complications, such as peritonitis and catheter-related infections.

The aim of this Special Issue is to share (1) fundamental knowledge about PD therapy; (2) a potential social approach for widespread PD utilization; (3) novel progress to suppress medical complications of PD; and (4) future perspectives. To this end, we asked some professionals in the field about authoring articles. We hope that this Special Issue encourages doctors, nurses, and medical staff to utilize PD more widely.

Prof. Dr. Hiroyuki Terawaki
Prof. Dr. Takafumi Ito
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • peritoneal dialysis
  • chronic kidney disease
  • nephrology

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Published Papers (4 papers)

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Research

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11 pages, 230 KiB  
Article
Management and Outcomes for Peritoneal Dialysis Patients Diagnosed with Abdominal Hernias
by Cristian Iorga, Cristina Raluca Iorga, Iuliana Andreiana, Simona Hildegard Stancu, Iustinian Bengulescu and Victor Strambu
Life 2024, 14(8), 1003; https://doi.org/10.3390/life14081003 - 13 Aug 2024
Viewed by 878
Abstract
Background/Objectives: The success of peritoneal dialysis is highly dependent on the integrity of the abdominal wall. Therefore, routine examination and treatment of abdominal hernias can prevent peritoneal dialysis (PD) failure, discontinuation, and conversion to hemodialysis. In this present study, we present our examination [...] Read more.
Background/Objectives: The success of peritoneal dialysis is highly dependent on the integrity of the abdominal wall. Therefore, routine examination and treatment of abdominal hernias can prevent peritoneal dialysis (PD) failure, discontinuation, and conversion to hemodialysis. In this present study, we present our examination protocol for patients proposed for PD and our attitude in treating parietal defects in patients on peritoneal dialysis. Objectives: highlight whether PD is a risk factor for the occurrence of ventral hernias, the relationship between associated pathologies and the occurrence of hernias and the need for an HD switch in the postoperative period. Methods: Between January 2016 and December 2022, a group of 133 patients proposed for insertion of a PD catheter were evaluated according to the protocol established by our hospital. Routine examination for the diagnosis of abdominal hernias and repair before starting the DP is part of the procedure. We included patients with a 3 year minimum follow-up after insertion and evaluated the incidence of parietal defects that appeared during PD treatment. Results: Nine patients were diagnosed and operated on for abdominal hernia before starting peritoneal dialysis and none of them had a recurrence of hernia during PD. Twelve patients were diagnosed with abdominal hernias during dialysis treatment (9% incidence) and the median length of time at which parietal defects occur during PD is 12.5 months [range 2–48]. Median BMI is 27.12 [range 22.3–31.24], with a female–male ratio of 2:1 Five patients were transferred to HD, three permanently and two patients temporarily. No patient abandoned PD treatment due to the presence of an abdominal parietal defect. Conclusions: Diagnosis of ventral hernias prior to the time of catheterization for PD leads to a decrease in the incidence of parietal defects during PD and is mandatory in patients who are candidates for PD. Open alloplastic surgical procedures are safe procedures with a low recurrence rate in PD patients. The postoperative continuation of PD is feasible but the decision is to be made by the multidisciplinary team and individualized for each patient. Full article
(This article belongs to the Special Issue Current Progress in Peritoneal Dialysis)
11 pages, 4491 KiB  
Article
The Role of Daily Dialysate Calcium Exposure in Phosphaturic Hormones in Dialysis Patients
by Francesca K. Martino, Valentina di Vico, Anna Basso, Laura Gobbi, Lucia Federica Stefanelli, Martina Cacciapuoti, Elisabetta Bettin, Dorella Del Prete, Giuseppe Scaparrotta, Federico Nalesso and Lorenzo A. Calò
Life 2024, 14(8), 964; https://doi.org/10.3390/life14080964 - 31 Jul 2024
Viewed by 772
Abstract
Managing mineral bone disease (MBD) could reduce cardiovascular risk and improve the survival of dialysis patients. Our study focuses on the impact of calcium bath exposure in dialysis patients by comparing peritoneal dialysis patients (PD, intervention group) and hemodialysis patients (HD, control group). [...] Read more.
Managing mineral bone disease (MBD) could reduce cardiovascular risk and improve the survival of dialysis patients. Our study focuses on the impact of calcium bath exposure in dialysis patients by comparing peritoneal dialysis patients (PD, intervention group) and hemodialysis patients (HD, control group). We assessed various factors, including calcium, phosphorus, magnesium, PTH, vitamin D 25-OH, C-terminal telopeptide (CTX), and FGF-23 levels, as well as the calcium bath six hours before the blood sample and the length of daily calcium exposure. We enrolled 40 PD and 31 HD patients with a mean age of 68.7 ± 13.6 years. Our cohort had median PTH and FGF-23 levels of 194 ng/L (Interquartile range [IQR] 130-316) and 1296 pg/mL (IQR 396-2698), respectively. We identified the length of exposure to a 1.25 mmol/L calcium bath, phosphate levels, and CTX as independent predictors of PTH (OR 0.279, p = 0.011; OR 0.277, p = 0.012; OR 0.11, p = 0.01, respectively). In contrast, independent predictors of FGF-23 were phosphate levels (OR 0.48, p < 0.001) and serum calcium levels (OR 0.25, p = 0.015), which were affected by the calcium bath. These findings suggest that managing dialysate calcium baths impacts phosphaturic hormones and could be a critical factor in optimizing CKD-MBD treatment in PD patients, sparking a new avenue of research and potential interventions. Full article
(This article belongs to the Special Issue Current Progress in Peritoneal Dialysis)
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Review

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12 pages, 3079 KiB  
Review
Peritoneal Catheters Malposition/Dysfunction and Their Approach with Catheterography and Radiologic Manipulation in Peritoneal Dialysis: A Minireview and Case Series
by Martina Cacciapuoti, Anna Basso, Lucia Federica Stefanelli, Federico Nalesso and Lorenzo A. Calò
Life 2024, 14(11), 1475; https://doi.org/10.3390/life14111475 - 13 Nov 2024
Viewed by 391
Abstract
Peritoneal catheter dysfunction is one of the most frequent complications of peritoneal dialysis. The malposition of a peritoneal catheter may cause one- or two-way obstruction with fluid outflow or inflow problems, large residual volumes, and, therefore, reduced ultrafiltration and sometimes abdominal pain. Standard [...] Read more.
Peritoneal catheter dysfunction is one of the most frequent complications of peritoneal dialysis. The malposition of a peritoneal catheter may cause one- or two-way obstruction with fluid outflow or inflow problems, large residual volumes, and, therefore, reduced ultrafiltration and sometimes abdominal pain. Standard procedures may often fail to solve the dysfunction. Catheterography is an interventional radiologic procedure based on the infusion under aseptic conditions of iodated contrast into the peritoneal catheter, followed by the introduction of a guidewire into the catheter for guidewire manipulation. The available literature about catheterography is quite scarce and mainly based on case reports, case series, and small retrospective studies. In this minireview, we describe the guidewire manipulation techniques explored so far and their pros and cons. In addition, four interesting cases of catheterography performed in our center are also reported. In conclusion, in this minireview, the pros and cons of catheterography have been outpointed. Radiologic manipulation of peritoneal catheters may represent an effective and safe solution for malfunctioning peritoneal catheters and may also be exploited as “bridge therapy” to laparotomy in patients temporarily unsuitable for surgery. The advantages of this procedure are that it does not require long-term hospitalization and allows immediate resume of peritoneal dialysis. Full article
(This article belongs to the Special Issue Current Progress in Peritoneal Dialysis)
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Other

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8 pages, 228 KiB  
Opinion
Glucose-Free Solutions Mediated Inhibition of Oxidative Stress and Oxidative Stress-Related Damages in Peritoneal Dialysis: A Promising Solution
by Anna Basso, Martina Cacciapuoti, Lucia Federica Stefanelli, Federico Nalesso and Lorenzo A. Calò
Life 2024, 14(9), 1173; https://doi.org/10.3390/life14091173 - 18 Sep 2024
Viewed by 684
Abstract
Oxidative stress (OxSt) and inflammation are common in end-stage renal disease and dialysis patients; they are known risk factors for cardiovascular disease and mortality. In peritoneal dialysis (PD), OxSt and inflammation are even further increased compared to the already increased oxidative stress of [...] Read more.
Oxidative stress (OxSt) and inflammation are common in end-stage renal disease and dialysis patients; they are known risk factors for cardiovascular disease and mortality. In peritoneal dialysis (PD), OxSt and inflammation are even further increased compared to the already increased oxidative stress of their pre-dialysis phase. This is due to the high glucose-based solutions currently used, whose continuous contact with the peritoneal membrane can induce significant long-term morphological and functional changes (mesothelial to mesenchymal transition, thickening, neo-angiogenesis and fibrosis) of the peritoneal membrane. Oxidative stress plays a very important role in these processes, which may compromise the peritoneal dialysis procedure. There is, therefore, the need for more biocompatible dialysis fluids with polymers other than glucose to prevent and treat OxSt and inflammation. The most known and used of such glucose-free and more biocompatible peritoneal dialysis solutions is icodextrin, which has shown a protective effect from oxidative stress. This has supported the consideration of the use of glucose-free-based peritoneal dialysis fluids in order to reduce oxidative stress and improve peritoneal membrane survival. Studies investigating peritoneal dialysis with the use of osmo-metabolic agents (L-carnitine, xylitol and their combination) in peritoneal fluids replacing glucose-based fluids are, in fact, ongoing. They represent a promising strategy to reduce OxSt, preserve the peritoneal membrane’s integrity and improve patients’ outcome. Full article
(This article belongs to the Special Issue Current Progress in Peritoneal Dialysis)
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