• Title/Summary/Keyword: CAPD

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A Study on Nutritional Status during Dialysis in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis (지속성 외래 복막투석 환자의 투석기간에 따른 영양상태)

  • Seo, Ji-Yeon;Kim, Nam-Ho;Heo, Young-Ran
    • Journal of Nutrition and Health
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    • v.45 no.1
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    • pp.30-43
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    • 2012
  • Patients undergoing peritoneal dialysis are at risk for protein-energy malnutrition because of nutrient losses during dialysis. This study determined the nutritional status of patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Forty-four patients receiving CAPD were divided into two groups according to dialysis period. We investigated the nutritional status of the patients by measuring anthropometric and biochemical parameters, as well as food intake, self-appetite, dietary habits, a subjective global assessment, and a total nutritional status assessment. Group I subjects (7 males, 13 females) had received dialysis for < 2 years, whereas the group II subjects (18 males, 6 females) received dialysis for ${\geq}$ 2 years. Energy intake with added dextrose in the dialysate per kg of body weight was $30.3{\pm}5.8$ kcal in group I and $29.0{\pm}8.1$ kcal in group II. The average protein intake per kg of weight was $1.0{\pm}0.3$ g in group I and $1.0{\pm}0.4$ g in group II, which were less than the recommended protein intake for patients undergoing CAPD (1.2-1.5 g/kg). Mean serum albumin level was significantly lower in group II than that in group I (p < 0.05). A recent self-appetite score was significantly higher in group II than that in group I (p < 0.01). The dietary habits score was significantly lower in group II than that in group I (p < 0.05). The subjective global assessment was significantly higher in group I (85.0%) than that in group II (54.2%) under normal nutrition status (p < 0.05). The dialysis period was significantly and negatively correlated with the subjective global assessment (r = -0.502, p < 0.01) and the total nutritional status assessment (r = -0.575, p < 0.01). These results demonstrated that patients undergoing CAPD for ${\geq}$ 2 years had worse nutritional status than those who had been undergoing dialysis for < 2 years. Good nutritional status can predict the long-term survival of patients undergoing peritoneal dialysis. Additionally, the exact evaluation of nutritional status before 2 years will be important to maintain long-term dialysis therapy in patients undergoing CAPD.

Dependence of Elderly Peritoneal Dialysis Patients and Burden on Family Caregivers (노인 복막투석 환자의 의존성과 가족의 부담감)

  • Kim, Hyewon
    • Journal of Digital Convergence
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    • v.10 no.9
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    • pp.429-434
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    • 2012
  • This study was performed to examine the relationship between dependence of elderly peritoneal dialysis patients and burden on family caregivers. The subjects for this study were 50 elderly patients on Continuous ambulatory peritoneal dialysis(CAPD) who were registered in a hospital in Seoul and 50 their family caregivers. The data were collected from April 4 to August 15, 2011. The collected data were analyzed by the SPSS WIN 12.0 program. The mean score of dependence was 139.6 which means their experience of high level dependence. The mean score of burden was 84.2 which means their family caregivers experience of high level burden. Positive correlation was found between dependence of elderly peritoneal dialysis patients and burden on their family caregivers (r=.61, p=.000). It is considered that the study emphasizes for the healthcare providers to recognize dependence as the important nursing issue for elderly CAPD patients. And it is necessary to develop an nursing intervention for decreasing dependence of elderly CAPD patients and burden on their family caregivers.

A Case of Neurotoxicity Induced by Valaciclovir in a Continuous Ambulatory Peritoneal Dialysis Patient (Valaciclovir 복용 후 중추신경계 부작용을 보였던 복막투석 환자 1예)

  • Kim, Joon-Seok;Yang, Jee Eun;Lee, Bo Young;Lee, Seohyun;Park, Hee Jung;Lee, Sunpyo;Lee, Sang Koo
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.121-124
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    • 2012
  • Valaciclovir is metabolized to acyclovir after ingestion and thereafter exerts its antiviral activity. Because of its superior pharmacokinetic profile, it has quickly replaced acyclovir in the treatment of herpesvirus infection. Neurotoxicity caused by valaciclovir has been reported, however, among patients with pre-existing impaired renal function. This paper reports a case of neurotoxicity of valaciclovir in a patient with end-stage renal disease who was undergoing continuous ambulatory peritoneal dialysis (CAPD). A 67-year-old female on CAPD took 500 mg of valaciclovir twice for herpes zoster. After she took her second dose orally, she developed confusion and disorientation, along with involuntary movements. Her mental confusion progressed to a coma. Discontinuation of valaciclovir showed no rapid improvement. There- fore, hemodialysis was started. After two sessions of hemodialysis, the patient became alert; and after four sessions of hemodialysis, her neurological abnormalities were completely reversed. In conclusion, valaciclovir can induce life-threatening neurotoxicity, especially in CAPD patients, even with appropriate dose reduction, which can be effectively managed by hemodialysis.

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Pediatric Peritoneal Dialysis in Korea : Practical Solution to the Problems of Peritoneal Dialysis for Children (한국 소아복막투석의 현황 - 다기관 공동연구 결과보고 -)

  • Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.95-103
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    • 1998
  • Purpose : To find and solve the common problems of peritoneal dialysis(PD) by analysing the clinical data of pediatric PD performed in Korea. Methods : 264 cases of CAPD and acute PD had been performed from Nov.1987 to Oct. 1997 in 17 institutions of pediatric nephrology in Korea. Results : CAPD was performed in 114 cases. The mean age of the patients was $10.5{\pm}6.6$ years and male to female ratio was 1.4:1. The original renal diseases of ESRD were proven in 92 cases($80\%$). The common renal disease of ESRD were FSGS($17\%$), reflux nephropathy ($11\%$), chronic glomerulonephritis($9.6\%$). Mean duration of CAPD was $20{\pm}16.9$ months. Peritonitis was the most common complication and incidence was one episode/18.2 patient-months. Other complications were exit site infection in 10 cases, obstruction in 7 cases, leakage of dialysate in 6 cases. The most common etiologic organism of peritonitis was staphylococcus aureus and the next was staphylococcus coagulase(-). Acute PD was performed in 150 cases. Most common underlying causes were congenital heart disease, hemolytic uremic syndrome, sepsis and dehydration. The mean duration was $10.3{\pm}11.3$ days. The most common complication was peritonitis($20.6\%$). The most common etiologic organism was staphylococcus aureus and coagulase(-), acinetobactor and pseudomonas. Conclusion : Reflux nephropathy should be emphasized in early diagnosis and treatment to prevent ESRD. Incidence of congenital anomaly($7\%$) as a original disease of ESRD was relatively low in Korea. Growth status was not significantly improved after CAPD. In acute PD, the incidence of peritonitis was rapidly increased at 2weeks after beginning of dialysis.

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Outcomes of Chronic Peritoneal Dialysis by Various Modalities in Korean Children - A Single Center Study (소아 환자에서 다양한 복막투석 방법간의 결과 비교-단일기관 연구)

  • Lee, Sung-Ha;Baek, Jae-Suk;Lee, Hyun-Kyung;Han, Kyoung-Hee;Choi, Hyun-Jin;Lee, Bum-Hee;Cho, Hee-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.255-263
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    • 2007
  • Purpose : A single center cross sectional retrospective study was performed to compare the outcomes of different peritoneal dialysis(PD) modalities in Korean children. Methods : Among children dialyzed with PD between the year 2004 and 2007, 35 children had reliable data on PD adequacy after 3 to 15 months of dialysis. Subjects were grouped by their modalities; 17, 13 and 5 children were on continuous ambulatory PD(CAPD), continuous cyclic PD(CCPD) and nightly intermittent PD(NIPD), respectively. Body weight and height, number of patients taking anti-hypertensives and laboratory data including biochemical and hemoglobin levels were compared. Dialysis adequacy including weekly Kt/Vurea, creatinine clearance (Ccr) and daily water removal were also compared. Patients were sub-grouped by their peritoneal permeability characteristics. Results : The percentage of patients taking anti-hypertensives, monthly change in Z-scores of body weight and height and laboratory data did not differ among the groups. Patients on CAPD and CCPD showed similar dialysis adequacies. Weekly dialytic Ccr was significantly lower in the NIPD group compared to the others. But total Ccr was not different when residual renal function was added. Weekly dialytic Ccr by CAPD was significantly higher than that of CCPD in low and low-average transporters. Conclusion : We propose that modality can be selected flexibly according to the patients' preferences. And peritoneal permeability characteristics provide valuable information for adjusting PD prescriptions in ultrafiltration failure or in inadequate dialysis. Further study of other clinical performance measures should be performed to clarify the comparable outcomes in different PD modalities.

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Patent Processus Vaginalis in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis - Two Cases Confirmed by Radionuclide Peritoneal Scintiscan - (복막투석환자에서의 개존된 Processus Vaginalis -방사성핵종복막촬영술로 확진된 2예-)

  • Lee, Jae-Tae;Son, Sang-Kyun;Lee, Kyu-Bo;Whang, Kee-Suk;Cho, Dong-Kyu;Koh, Chul-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.2
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    • pp.231-236
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    • 1989
  • Continuous ambulatory peritoneal dialysis (CAPD) is a well established method of treating end stage renal failure, and is commonly used as an alternative to hemodialysis. Several complications have been observed. These include catheter malfunction, abdominal and inguinal hernia, and peritonitis. A relatively frequent complication is swelling of external genitalia, due to bowel fluid passing through a patent processus vaginalis. Special diagnostic procedures are necessary to determine the nature of the abnormality and to guide the surgical correction. We reported two cases of patent processus vaginalis in patient on CAPD proved by radionuclide peritoneal scintiscan using Tc-99 m-tin colloid.

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Discrimination of Insulation Defects in a Gas Insulated Switchgear (GIS) by use of a Neural Network Based on a Chaos Analysis of Partial Discharge (CAPD)

  • Jung, Seoung-Yong;Ryu, Cheol-Hwi;Lim, Yun-Sok;Lee, Ja-Ho;Koo, Ja-Yoon
    • Journal of Electrical Engineering and Technology
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    • v.2 no.1
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    • pp.118-122
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    • 2007
  • In this work, experimental investigation is carried out in order to design and fabricate the UHF sensor that is able to detect the partial discharges produced from 10 artificial defects introduced into the real scale 70kV GIS mock-up under high voltage within a well shielded room. As well, in order to verify the on-site applicability of our method, the newly proposed CAPD (chaos analysis of partial discharge) is combined with spectral analysis for identifying the nature of 10 artificial defects under investigation. The PD pattern recognition of each defect has been fulfilled by applying our ANN software. The result indicates that the recognition rate reaches up to 80% by the newly proposed method while the traditional PRPD analysis method allows us to obtain 41%. In consequence, it can be pointed out that the proposed method seems likely to be applicable to the real GIS at the site.

Discrimination of insulation defects in a Gas Insulated Switchgear (GIS) by use of a neural network based on a Chaos Analysis of Partial Discharge(CAPD) (카오스이론을 이용한 GIS 내부 절연결함 판별)

  • Lim, Yun-Seok;Lee, Dong-Il;Koo, Ja-Yoon;Kim, Jeong-Tae;Bang, Hang-Kwon
    • Proceedings of the KIEE Conference
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    • 2005.07c
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    • pp.2223-2225
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    • 2005
  • In this work, experimental investigation has been mainly done. For this purpose, UHF sensor has been designed and fabricated to detect the partial discharges produced from the 10 artificial defects introduced into the real scale 70kV GIS mock-up under the high voltage at the well shielded room. And also, in order to verify the applicability of the proposed method at the site, the proposed CAPD (chaos analysis of partial discharge) is combined with spectral analysis method in order to identify the nature of the above 10 defects. The PD pattern recognition of each defect has been fulfilled by applying self developed artificial neural network soft ware. The result shows that the recognition rate is reached to be 80% by newly proposed method while the traditional PRPD analysis method leads us to obtain 41%. In consequence, it can be pointed out that the proposed method seems likely to be applicable to the real GIS at the site.

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Nutritional Status of Continuous Ambulatory Peritoneal Dialysis Patients (지속성복막투석 환자의 영양상태에 관한 연구)

  • Park, Jin-Kyung;Son, Sook-Mee
    • Journal of Nutrition and Health
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    • v.39 no.7
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    • pp.624-640
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    • 2006
  • Dialysis patients are at risk of malnutrition not only because of losses of nutrients during peritoneal dialysis but also because of anorexia that results in inadequate nutrient intakes. The aim of this study was to estimate the nutritional status of 154 patients receiving continuous ambulatory peritoneal dialysis (CAPD), especially focused on protein-energy malnutrition and vitamin and mineral status. The mean age of the subjects was $5.12\;{\pm}\;12.4\;y$ with educational years of $12.3\;{\pm}\;0.4\;y$ for male and $9.6\;{\pm}\;0.4\;y$ for female. The mean duration of dialysis was $22.7\;{\pm}\;21.7\;mo$. The causes of renal failure included diabetes (32.7), chronic glomerulonephritis (15.0%), and hypertension (8.5%). The main complications associated with chronic renal failure were hypertension (86.1%), diabetes (35.4%) and liver disease (9.0%). The mean daily energy intake was $1216.8\;{\pm}\;457.3\;kcal$ and increased to $1509.2\;{\pm}\;457.2\;kcal$ when added with the energy from dextrose in dialysate. The latter was still much lower than estimated energy requirement but energy intake per kg of body weight (28.1 kcal/1 g) was within the range of that recommended for CAPD patients' diet therapy (25 - 30 kcal/kg). The average daily intake of protein was $49.2\;{\pm}\;25.1\;g$ with 37.6% of the patients showing their intakes less than Estimated Average Requirement. The average protein intake per kg of weight was 0.9 g/kg, which is less than that recommended for CAPD patients (1.2-1.5g/kg) with mean serum albumin level $3.2\;{\pm}\;0.5\;g/dl$. The proportion of the patients with dietary calcium intake less than EAR was 90.9%, but when added with supplementary calcium (phosphorus binder), most patients showed their total calcium intake between EAR and UL. Fifty percent of the patients were observed with dietary iron intake less than EAR, however most patients revealed their total iron intake with supplementation above UL. The addition of folic acid with supplementation increased mean total folic intake to $1126.0\;{\pm}\;152.4\;{\mu}g$ and ninety eight percent of the subjects showed their total folic acid intake above UL. The prevalence of anemia was 83.1 % assessed with hemoglobin level, even with high intakes of iron with supplementation. Thirty four percent of the patients showed their fasting blood glucose was not under control $(\geq\;126\;mg/dl)$ even with medication or insulin probably due to dextrose from dialysate. The mean blood lipid levels were within the reference levels of hyperlipidemia, but with 72.1 % of the patients showing lower HDL-C. In conclusion, Fairly large proportion of the patients were observed with protein malnutrition with low intake of protein and serum albumin level. Few patients showed their vitamins and minerals intake less than EAR with supplementation. For iron and folic acid, their intakes were increased to above UL for large proportion of he patients. However, more than eighty percent of the patients were still anemic associated with decreased renal function. The serum blood glucose and lipid level were not under control for some patients with medication. It seems that supplementation and medications that patients are taking should be considered for dietary consulting of CAPD patients.