BACKGROUND: The peritoneal catheter of the continuous ambulatory peritoneal dialysis(CAPD) is patients' lifeline. A significant number of complications and catheter failures in CAPD are due to mechanical problems. We describe our retrospective experience with CAPD focusing on the rate of catheter displacement and survival according to the site of catheter tip placement in 70 cases of CAPD in Kyunghee University Hospital between November 1994 and February 2000. METHODS: We describe our retrospective experience with CAPD focusing on the rate of catheter displacement and survival according to the site of catheter tip placement in 70 cases of CAPD in Kyunghee University Hospital between November 1994 and February 2000. RESULTS: Among 70 cases of CAPD, 46 cases were right pelvic cavity tip placement and 24 cases were left. Causes of chronic renal failure(CRF) were diabetes mellitus in 29 cases(63%), hypertension in 13 cases (28%), glomerulonephritis in 4 cases(9%) in right pelvic cavity catheter tip placement and diabetes mellitus in 13(54%), hypertension in 10(42%), renal tuberculosis in 1 case(4%) left pelvic cavity catheter tip. There were no difference in causative diseases of CRF between both groups. Incidence of CAPD catheter tip displacement were 17.4%(8/46) at right and 4.2%(1/24) at left catheter(p=0.01). Methods for treatment of displacement were fluoroscopic brushing, laparoscopic manipulation and operation. Of the 9 cases, 5 case were received fluoroscopic brushing, 3 case were laparoscopic manipulation and 1 case was received operation. Other complication were peritonitis, catheter obstruction, hernia, death. Overall survival of catheter were 65%(30/46) at right and 71 %(17/24) at left catheter(p=NS). CONCLUSION: The incidence of CAPD catheter tip displacement was higher with catheter tip at the right pelvis than left(p=0.01). But there is no difference in the catheter survival.
Catheter Obstruction ; Catheters* ; Diabetes Mellitus ; Glomerulonephritis ; Hernia ; Hypertension ; Incidence ; Pelvis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Retrospective Studies ; Tuberculosis, Renal

BACKGROUND: The peritoneal catheter of the continuous ambulatory peritoneal dialysis(CAPD) is patients' lifeline. A significant number of complications and catheter failures in CAPD are due to mechanical problems. We describe our retrospective experience with CAPD focusing on the rate of catheter displacement and survival according to the site of catheter tip placement in 70 cases of CAPD in Kyunghee University Hospital between November 1994 and February 2000. METHODS: We describe our retrospective experience with CAPD focusing on the rate of catheter displacement and survival according to the site of catheter tip placement in 70 cases of CAPD in Kyunghee University Hospital between November 1994 and February 2000. RESULTS: Among 70 cases of CAPD, 46 cases were right pelvic cavity tip placement and 24 cases were left. Causes of chronic renal failure(CRF) were diabetes mellitus in 29 cases(63%), hypertension in 13 cases (28%), glomerulonephritis in 4 cases(9%) in right pelvic cavity catheter tip placement and diabetes mellitus in 13(54%), hypertension in 10(42%), renal tuberculosis in 1 case(4%) left pelvic cavity catheter tip. There were no difference in causative diseases of CRF between both groups. Incidence of CAPD catheter tip displacement were 17.4%(8/46) at right and 4.2%(1/24) at left catheter(p=0.01). Methods for treatment of displacement were fluoroscopic brushing, laparoscopic manipulation and operation. Of the 9 cases, 5 case were received fluoroscopic brushing, 3 case were laparoscopic manipulation and 1 case was received operation. Other complication were peritonitis, catheter obstruction, hernia, death. Overall survival of catheter were 65%(30/46) at right and 71 %(17/24) at left catheter(p=NS). CONCLUSION: The incidence of CAPD catheter tip displacement was higher with catheter tip at the right pelvis than left(p=0.01). But there is no difference in the catheter survival.
Catheter Obstruction ; Catheters* ; Diabetes Mellitus ; Glomerulonephritis ; Hernia ; Hypertension ; Incidence ; Pelvis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Retrospective Studies ; Tuberculosis, Renal

A multicenter prospective study was done in four-university hospital to evaluate the efficacy and safety of cyclosporin A(CyA, Cipol-N(R)) in 64 patients with adult nephrotic syndrome mean age 34.8 years, male:female 2.4:1, duration of disease 38.0+/-40.9months, 31 patients with MCD, 33 patients with Non-MCD (8 FSGS, 14 MGN, 7 MPGN, 2 lupus nephritis, 1 HBsAg associated GN)]. The prior steroid responses of these patients were 17 steroid dependent, 9 frequent relapser, 4 steroid resistant and 1 other in MCD patients, and 5 steroid dependent, 5 frequent relapser, 22 steroid resistant and 1 other in Non-MCD patients. After a 2-week steroid (predni-solon 10mg/day or deflazacort 12mg/day) run-in period, CyA 5mg/kg/day and prednisolone 10mg/day (or deflazacort 12mg/day) were administered for up to 16 weeks. Of the 64 patients enrolled, ll patients were dropped out prematurely due to adverse events or protocol violation. Of the 53 patients who completed the study, 27 had MCD and 26 had Non- MCD. High response (CR and PR) rate of 68% (36/53) were obtained with CyA treatment in all patients. Although the response rate in MCD was significantly higher than that in Non-MCD (89 vs. 46%, p<0.05) and response rates were significantly different according to the previous steroid responses by univariate analysis, only previous steroid responses affected the response to CyA significantly by Logistic multiple regression analysis (p=0.03, RR 7.08); responses were 84% (27/32) in steroid dependent and frequent relapser patients, and 37% (7/19) in steroid resistant patients. 24-hr proteinuria significantly decreased after 2 weeks and serum albumin and cholesteroi increased significantly after 4 weeks of treatment compared to baseline level. The serum creatinine level was not changed during the study. No serious and unexpected side event was observed. In conclusion, cyclosporine therapy is a safe and effective mode of treatment in patients with ne-phrotic syndrome, especially in those who need prolonged administration of steroids with resulting in unavoidable steroid complications such as frequent relapser and steroid dependent type. The patients with steroid resistant type and contraidications of steroid administration such as DM, aseptic bone neerosis etc. can also be candidates for this treatment.
Adult* ; Creatinine ; Cyclosporine* ; Glomerulonephritis, Membranoproliferative ; Hepatitis B Surface Antigens ; Humans ; Lupus Nephritis ; Nephrotic Syndrome ; Prednisolone ; Prospective Studies ; Proteinuria ; Serum Albumin ; Steroids

We report here on a rare case of membranous nephropathy occurring concurrently with salivary gland cancer. A 67-year-old woman was admitted to our department for nephrotic syndrome. She was diagnosed with membranous nephropathy and this was initially managed with steroids and cyclophosphamide, which started in 2003 and continued for about 10 months, without deriving any therapeutic benefits. During the treatment, the patient was diagnosed with salivary gland cancer when an incidental salivary gland mass was discovered in 2005. The patient's urinary protein level began to decrease following resection of the malignant mass. The clinical findings represent an interesting case of secondary membranous nephropathy that was diagnosed prior to the incidental discovery of malignancy.
Aged ; Cyclophosphamide ; Female ; Glomerulonephritis, Membranous ; Humans ; Incidental Findings ; Nephrotic Syndrome ; Salivary Gland Neoplasms ; Salivary Glands ; Steroids