• Title/Summary/Keyword: Peritoneal dialysis, Continuous ambulatory

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Characteristics in Nutritional Status of Patients on Hemodialysis and Continuous Ambulatory Peritoneal Patients in Chonbuk Area (전북지역 혈액투석 환자와 지속성 외래 복막 투석 환자의 영양상태 비교)

  • 김선형;김숙배
    • Journal of Nutrition and Health
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    • v.36 no.4
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    • pp.397-404
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    • 2003
  • The present study was designed to compare the nutritional status of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. Subjects were 58 HD patients (male/female = 29/29) and 33 CAPD patients (male/female = 23/10) undergoing dialysis treatment in Artificial Kidney Unit of Chonbuk National University Hospital. For nutritional assessment, %IBW (ideal body weight), %TSF (tricep skin fold), %MAC (mid arm circumference), %MAMC (mid arm muscle circumference), serum albumin, serum transferrin, TLC (total lymphocyte count), SGA (subjective global assessment) and estimated energy and protein intakes by 1-month food frequency method were used. Between HD and CAPD group, mean age (50 $\pm$ 12 vs. 52 $\pm$ 12 yr), dialysis durations (37 $\pm$ 36 vs. 30 $\pm$ 26 mon), dietary energy intakes (28.3 $\pm$ 9.0 vs. 28.8 $\pm$ 8.6 kcal/kg/day), dietary protein intakes (1.1 $\pm$ 0.4 vs. 1.2 $\pm$ 0.3 g/kg/day) and incidence of co-morbid conditions (69.0% vs. 69.7%) were not significantly different. Data by using SGA showed a higher incidence of malnutrition in CAPD patients (45.6%) than in HD patients (36.2%). %IBW (p < 0.001), %TSF (p < 0.001) and %MAC (p < 0.001) were higher in CAPD patients than were in HD patients. But serum albumin (p < 0.001) and transferrin (p < 0.001) were significantly lower in CAPD patients than were in HD patients. A higher incidence of malnutrition was shown in CAPD Patients than in HD Patients due to different dialysis type. A significant finding was that CAPD showed protein deficient malnutrition and HD did calorie deficient malnutrition. It suggests that an adequate dietary intake considering dialysis type prevents a prevalence of malnutrition.

A Case of Continuous Ambulatory Peritonitis Dialysis Peritonitis Due to Stenotrophomonas maltophilia Using Antibiotic Combination (항생제 병용요법으로 치료한 Stenotrophomonas maltophilia 복막투석 복막염 1예)

  • Ko, Hee Sung;Choi, Ah Ran;Kim, Tae Hoon;Kyung, Chan Hee;Cho, Jang Ho;Kim, Yong Hoon;Lee, Jung Eun
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.109-111
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    • 2013
  • Continuous ambulatory peritoneal dialysis (CAPD) peritonitis is a major complication of peritoneal dialysis (PD) and leads to the discontinuation of PD. Despite its limited pathogenicity, CAPD peritonitis caused by Stenotrophomonas maltophilia (S. maltophilia), an important nosocomial pathogen that is present in nature and is usually associated with plastic indwelling devices. Infection of S. maltophilia is associated with a poor prognosis, including inability to maintain the CAPD catheter, because of its resistance to multiple antibiotics. We report a case of CAPD peritonitis due to S. maltophilia that was treated successfully using oral Trimethoprim-sulfamethoxazole and intraperitoneal Ticarcillin/clavulanate without removing the dialysis catheter.

Incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis patient

  • Jeong, Yo-Han;Do, Jun-Young;Hwang, Mun-Ju;Kim, Min-Jung;Gu, Min Geun;Park, Byung-Sam;Choi, Jung-Eun;Kim, Tae-Woo
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.25-27
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    • 2014
  • Patients treated with peritoneal dialysis have increased intra-abdominal pressure and a high prevalence of abdominal wall complications. Hernias can lead to significant morbidity in patients on peritoneal dialysis. Hernias are clinically important because of the risk of incarceration, strangulation and subsequent bowel obstruction, rupture, and peritonitis. In this paper, a case of incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis (CAPD) patient is reported. The small bowel obstruction improved after herniorrhaphy, and the peritoneal dialysis was resumed 2 weeks after the herniorrhaphy. The patient had been undergoing CAPD without technical failure until the 2 months follow-up after the herniorrhaphy. This case shows that early detection of incarcerated umbilical hernia and herniorrhaphy can prevent resection of a strangulated small bowel so that it can remain on CAPD without post-operative technical failure. Umbilical hernias should be carefully observed and intestinal obstruction should be considered when a CAPD patient with an umbilical hernia has abdominal pain.

Complications of Continuous Ambulatory Peritoneal Dialysis in Children (소아에서의 지속적 외래 복막 투석의 합병증)

  • Park, Sung-Chan;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.9 no.2
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    • pp.77-80
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    • 2003
  • Continuous Ambulatory Peritoneal Dialysis (CAPD) has now become an established form of renal replacement therapy in children. Despite of technical improvements, there are various complications in CAPD. We reviewed medical records of children who received CAPD at Seoul National University Children's Hospital in the period between May 1991 and June 2002. Ninety-three procedures of CAPD catheter insertion in 70 patients were included in this study. Complication rate was 64.5%, and CAPD catheter related peritonitis was most common. In conclusion, CAPD catheter related peritonitis develops in considerable number of pediatric patients. Although the peritonitis could be treated with empirical antibiotics therapy, further investigation to prevent complication is required.

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Bilateral Inguinal Hernias Detected by Peritoneal Scintigraphy during the Evaluation of Scrotal Swelling in a Patient on Continuous Ambulatory Peritoneal Dialysis (지속적 복막 투석 환자의 음낭부종 검사시 복막 신티그라피에 의해 발견된 양측성 서혜부 탈장)

  • Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.1
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    • pp.81-82
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    • 2001
  • A 47-year-old man with end-stage renal disease due to diabetic nephropathy underwent a peritoneal scintigraphy to evaluate the cause of recently developed scrotal swelling. Two liters of dialysate mixed with 111 MBq of Tc-99m sulfur colloid were administered into the peritoneal cavity via the dialysis catheter. Various anterior images of the abdomen and pelvis were obtained at 15 min, 2 hr and 4 hr after the tracer instillation. At 15 min, anterior images of the abdomen and pelvis demonstrated linear tracts of activity through both inguinal canals, which were more prominent in the right side (A). Images at 2 hr revealed a passage of the radioactive fluid into the right hemiscrotum. At the same time, there was a considerable accumulation of activity in the right inguinal canal (B). In the delayed image, there was a progressive accumulation of activity in the inguinal canals and a prominent passage of the tracer into the scrotum (C). Both abdominal and inguinal hernias are commonly associated with continuous ambulatory peritoneal dialysis (CAPD). Overall incidence of CAPD-induced hernia ranges from 2.7% to 25%.$^{1)}$ Inguinal hernias were frequently manifested as scrotal swelling. Leakages of dialysate fluid into the scrotum has been noted in CAPD patients with scrotal swelling, with or without clinical findings of inguinal hernia.$^{1,2)}$ In the present case, the right side had leakage from a clinical inguinal hernia and the left side, leakage from a subclinial inguinal hernia. A subclinical inguinal hernia was easily demonstrable with peritoneal scintigraphy. Peritoneal scintigraphy is extremely helpful in the evaluation of scrotal swelling in a patient on CAPD.

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Two Cases of Massive Hydrothorax Complicating Peritoneal Dialysis (CAPD중에 생긴 흉막삼출 2예)

  • Bae, Sang-Kyun;Yum, Ha-Yong;Rim, Hark
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.153-156
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    • 1994
  • Massive hydrothorax complicating continuous ambulatory peritoneal dialysis (CAPD) is relatively rare. A 67-year-old male and a 23-year-old female patients during CAPD presented massive pleural effusion. They have been performing peritoneal dialysis due to end-stage renal disease for 8 months and 2 weeks respectively. We injected $^{99m}Tc$-labelled radiopharmaceutiral (phytate and MAA, respectively) into peritoneal cavity with the dialysate. The anterior, posterior and right lateral images were obtained. The studies reveal visible radioactivity in the right chest indicating the communication between the peritoneal and the pleural space. After sclerotherapy with tetracycline, the same studies reveal no radioactivity in the right chest suggesting successful therapy. We think nuclear imaging is a simple and noninvasive method for the differential diagnosis of pleural effusion in patients during CAPD and the evaluation of therapy.

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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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Effects of a Telephone Follow-up Program on Patient Compliance, Urea Kinetic Modeling and Incidence of Infection in Patients with Continuous Ambulatory Peritoneal Dialysis (CAPD) (전화추후관리 프로그램이 복막투석환자의 치료지속이행, 투석적절도와 감염발생도에 미치는 효과)

  • Chon, Si-Ja;Shin, Sug-Kyun;Roh, Young-Sook;Lee, Suk-Jeong;Park, Ai-Hee;Park, Yang-Sook;Park, Young-Mi
    • Journal of Home Health Care Nursing
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    • v.16 no.2
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    • pp.98-107
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    • 2009
  • Purpose: The objective of this study was to identify the effects of a telephone follow-up program on patient compliance, urea kinetic modeling and incidence of infection in patients with continuous ambulatory peritoneal dialysis (CAPD). Method: A pretest-posttest design with a nonequivalent control group was used to examine the effects of a telephone follow-up program for 12 weeks in a group of 39 CAPD patients. The telephone follow-up group of 17 patients received telephone follow-up 10 min once a week for 1 month and 10 min twice a month for 2 months during 12 weeks compared to control group of 22 who patients received usual care. Results: The telephone follow-up group showed no significant changes in patient compliance and urea kinetic modeling, although patients with CAPD receiving a telephone follow-up showed reduced incidence of exit site infection during the intervention compared with the control group. Conclusion: Telephone follow-up program for CAPD patients may decrease the incidence of exit site infection. Future studies with a larger sample be done utilizing diet and exercise reinforcement program combined with telephone follow-up as a nursing intervention for patients with 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.