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Your search keyword '"continuous flow peritoneal dialysis"' showing total 2 results
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2 results on '"continuous flow peritoneal dialysis"'

1. Continuous flow peritoneal dialysis (CFPD) improves ultrafiltration in children with acute kidney injury on conventional PD using a 4.25 % dextrose solution.

Author

Nourse, Peter, Sinclair, Gina, Gajjar, Priya, Plessis, Mandi, and Argent, Andrew

Subjects
*CREATININE, *DRUGS, *GLUCOSE, *HEMODIALYSIS, *LONGITUDINAL method, *PERITONEAL dialysis, *PROBABILITY theory, *SOLUTION (Chemistry), *STATISTICS, *ULTRAFILTRATION, *UREA, *DATA analysis, *TREATMENT effectiveness, *DIALYSIS catheters, *DESCRIPTIVE statistics, *CHILDREN, TREATMENT of acute kidney failure
Abstract

Background: Criticism against the use of acute peritoneal dialysis (PD) has been its low clearance and low ultrafiltration (UF) volumes compared to extracorporeal techniques. The aim of our study was to determine whether continuous flow peritoneal dialysis (CFPD) would improve UF in children with acute kidney injury (AKI) in cases where UF on conventional PD was inadequate using 4.25 % glucose concentrations. Methods: Five infants were prospectively studied. All had AKI with fluid overload. The median age of the patients was 6 (range 0.43-9) months; the median weight was 6.5 (range 2.7-8.4) kg. Each patient served as his or her own control, undergoing both CFPD and conventional PD. CFPD was performed with two bedside-placed catheters using a 2.5 % glucose concentration. After initial filling, a dialysate flow rate of 100 ml/min/1.73 m was maintained with an adapted continuous venovenous haemofiltration machine. The UF flow rate was set at 2.5 ml/min/1.73 m and adapted as necessary. UF and clearance rates were measured for both PD and CFPD. Results: The median UF rate achieved was 1.7 (range 0.01-5.30) mg/kg/h with conventional PD versus 6.7 (range 2.17-15.7) mg/kg/h with CFPD ( p = 0.042). The clearances of urea and creatinine were 6.89 (range 4.50-7.55) and 7.46 (range 4.79-10.50) mL/min/1.73 m, respectively, with conventional PD and 19 (17.0-30.0) and 41 (standard deviation17.4, range 12.0-52.0) mL/min/1.73 m, respectively, with CFPD (both p = 0.043). Conclusion: Continuous flow peritoneal dialysis improves UF in fluid overloaded infants who are not achieving adequate UF on conventional PD. [ABSTRACT FROM AUTHOR]

Published
2016
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2. Evaluation of a system for sorbent‐assisted peritoneal dialysis in a uremic pig model

Author

Silvia Giovanella, Marianne C. Verhaar, Rafael Selgas, Frank Simonis, Jaap A. Joles, Maaike K. van Gelder, Diënty H M Hazenbrink, Giulia Ligabue, Anneke S Monninkhof, Joost C de Vries, Karin G.F. Gerritsen, Maria Auxiliadora Bajo Rubio, and Gianni Cappelli

Subjects
kidneys, Sorbent, Catheters, Physiology, Swine, medicine.medical_treatment, Potassium, artificial, chemistry.chemical_element, 030204 cardiovascular system & hematology, Peritoneal dialysis, Phosphates, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Chlorides, continuous flow peritoneal dialysis, Physiology (medical), medicine, chronic, kidney failure, peritoneal dialysis, sorbent, Animals, Urea, Anion Exchange Resins, Original Research, Uremia, Plasma clearance, Creatinine, Chromatography, Pig model, Phosphate, chemistry, Female, 030217 neurology & neurosurgery
Abstract

A system for sorbent‐assisted peritoneal dialysis (SAPD) has been developed that continuously recirculates dialysate via a tidal mode using a single‐lumen peritoneal catheter with the regeneration of spent dialysate by means of sorbents. SAPD treatment may improve plasma clearance by the maintenance of a high plasma‐to‐dialysate concentration gradient and by increasing the mass transfer area coefficient (MTAC) of solutes. The system is designed for daily 8‐hr treatment (12 kg, nighttime system). A wearable system (2.3 kg, daytime system) may further enhance the clearance of phosphate and organic waste solutes during the day. Uremic pigs (n = 3) were treated with the day‐ (n = 3) and nighttime system (n = 15) for 4–8 hr per treatment. Plasma clearance (Cl), MTAC, and total mass transport (MT) of urea, creatinine, phosphate, and potassium were compared with a static dwell (n = 28). Cl, MTAC, and MT of urea, creatinine, phosphate, and potassium were low in the pig as compared to humans due to the pig's low peritoneal transport status and could be enhanced only to a limited extent by SAPD treatment compared with a static dwell (nighttime system: Cl urea: ×1.5 (p = .029), Cl creatinine: ×1.7 (p = .054), Cl phosphate: ×1.5 (p = .158), Cl potassium: ×1.6 (p = .011); daytime system: Cl creatinine: ×2.7 (p = .040), Cl phosphate: ×2.2 (p = .039)). Sorbent‐assisted peritoneal dialysis treatment in a uremic pig model is safe and enhances small solute clearance as compared to a static dwell. Future studies in humans or animal species with higher peritoneal transport should elucidate whether our SAPD system enhances clearance to a clinically relevant extent as compared to conventional PD., A system for sorbent‐assisted peritoneal dialysis (SAPD) has been developed that continuously recirculates dialysate via a tidal mode using a single lumen peritoneal catheter with regeneration of spent dialysate by means of sorbents. SAPD treatment may improve plasma clearance by maintenance of a high plasma‐to‐dialysate concentration gradient and by increasing the mass transfer area coefficient (MTAC) of solutes. The system is designed for daily 8‐hr treatment (12 kg, nighttime system). A wearable system (2.3 kg, daytime system) may further enhance clearance of phosphate and organic waste solutes during the day.

Published
2020

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