No abstract available.
Peritoneal Dialysis, Continuous Ambulatory* ; Pharmacokinetics* ; Renal Dialysis*

No abstract available.
Anemia* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis*

We report a case of genital swelling in a patient receiving continuous ambulatory peritoneal dialysis. A physical examination did not identify any defect. Ultrasonography revealed a large hydrocele, and surgical repair brought resolution of the genital swelling. Two months later, however, the genital swelling had recurred and was not improved until peritoneal dialysis was replaced by hemodialysis 3 months later.
Genitalia ; Humans ; Ligation ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Physical Examination ; Renal Dialysis ; Testicular Hydrocele

PURPOSE: The object of the present study were to clarify the effect of dialysis treatment and residual renal function on olfactory function of patients with chronic renal failure and to assess the correlations between the Cross Cultural Smell Identification Test (CC-SIT) scores and various clinical variables. METHODS: Ninety subjects were studied and divided four groups; age- and sex-matched healthy controls (Control, n=20), patients with varying degree of renal insufficiency but not on dialysis (Pre- dialysis, n=20), patients on CAPD (PD, n=22), and patients on hemodialysis (HD, n=28). We performed olfactory function test using the CC-SIT kit and compared the CC-SIT scores of each of the groups. RESULTS: The CC-SIT scores of each of the groups were; Control : 8.6+/-1.5, Pre-dialysis : 7.2+/-2.0, PD : 8.1+/-1.2, HD : 8.5+/-1.4. In Pre-dialysis group, the CC-SIT scores were significantly lower than Control group (p=0.01). But, no significant difference was observed in the CC-SIT scores between HD and PD group and control group (p>0.05). Creatinine clearance was positively correlated with the CC-SIT scores in control and Pre-dialysis group (r=0.58, p= 0.0001). Total Kt/V was positively correlated with the CC-SIT scores only in HD group (r=0.39, p= 0.03). But, no correlation was found between Kt/ Vurea, URR or residual renal function and the CC- SIT scores in HD and PD group (p>0.05). Age was negatively correlated with the CC-SIT scores only in Control group (r=-0.76, p=0.0001). CONCLUSION: Our results indicate that smell disturbance in patients with chronic renal faliure can be recovered by adequate dialysis treatment.
Creatinine ; Dialysis* ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis ; Renal Insufficiency ; Smell

The changes of thyroid hormones are expected in patients with chronic renal failure(CRF) because the kidney plays an important role in metabolism and excretion of thyroid hormones. In spite of many studies about this issue, there have not been full consensus about the nature and mechanism of thyroid hormone changes. We undertook the present study to reveal the dialysis effects on these hormones. We measured basal levels of serum total T3 (T3), total T4(T4), free T4(FT4), reverse T3(rT3) and TSH, and then calculated the ratio of T3/T4, rT3/T3 and rT3/T4. The following groups were identifed : Group I-10 cases of normal controls, Group II-18 cases of pre-dialysis or treated conservatively, Group III-20 cases treated by maintenance hemodialysis(HD), Group IV-18 cases treated by continuous ambulatory peritoneal dialysis(CAPD). Patients from group II, III and IV revealed significantly decreased levels of T3 and T4, and increased ratio of rT3/T4 in comparison to the control group(P<0.05). Especially, CAPD group revealed significantly increased levels of T4 and FT4 in comparison to HD group(P<0.05). In the long-term dialysis group(>36months), the mean concentrations of free T4 levels revealed signifcantly decreased in comparison to the short-term dialysis group(P<0.05). Thyroid dysfunction are observed in CRF patients with partial recovery after dialysis therapy. Especially, CAPD achieves significantly improved thyroid dysfunction compared to HD, but further study would be necessary.
Consensus ; Dialysis ; Humans ; Kidney ; Kidney Failure, Chronic* ; Metabolism ; Peritoneal Dialysis* ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis* ; Thyroid Gland* ; Thyroid Hormones

BACKGROUND: Direct measurements of ionized magnesium (iMg) in serum by ion-selective electrodes have recently become available in clinical practice, and its usefulness needs to be investigated in dialysis patients because chronic renal failure is associated with disturbances in magnesium metabolism. METHODS: We measured serum iMg in 29 hemodialysis (HD) patients and 24 peritoneal dialysis (CAPD) patients using an ion-selective electrode. The results were compared with those from 30 age- matched control patients who were admitted due to non-renal diseases and were confirmed to have normal serum total magnesium (tMg) levels. RESULTS: Serum tMg was significantly higher in both HD (0.95 [0.81-1.06] mmol/L) and CAPD (0.86 [0.74-0.99] mmol/L) patients compared with the controls (0.74 [0.70-0.78] mmol/L). Serum iMg was significantly higher in HD patients (0.65 [0.60-0.72] mmol/L) compared with the controls (0.55 [0.51-0.57] mmol/L), but was not higher in CAPD patients (0.54 [0.50-0.60] mmol/L). Thus, the ionized fraction of serum magnesium (iMg/tMg) was significantly lower in CAPD patients (65.3 [58.8-68.2]%), but not in HD patients (68.7 [63.6-77.0]%), compared with the controls (72.2 [67.2-78.3]%). In dialysis patients, iMg/ tMg was significantly lower in those with residual renal function than in anuric patients (67.5 [63.6-74.8]% vs. 61.4 [56.4-70.7]%). CONCLUSION: In current practice, true hypermagnesemia may exist frequently in HD patients (at predialysis), but not in CAPD patients. The ionized fraction of serum magnesium may be reduced in CAPD patients, but not in HD patients.
Dialysis* ; Humans ; Ion-Selective Electrodes ; Kidney Failure, Chronic ; Magnesium* ; Metabolism ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis

Encapsulating peritoneal sclerosis (EPS) is a rare but fatal complication of continuous ambulatory peritoneal dialysis (CAPD). There are some reports on the effect of immunosuppressant therapy including steroid, but the results have not always been promising. Recently, owing to the advance of surgical techniques, there are some reports of the EPS cases significantly improved after successful surgery. A 30-year old man developed EPS after 9 years of peritoneal dialysis, and switched to hemodialysis. In spite of repetitive conservative management and immunosuppressant therapy, there was no improvement. His body weight decreased from 50 kg to 40 kg (BMI 14.2 kg/m2) due to severe malnutrition, so we decided to perform surgery. Total intestinal enterolysis was done successfully without concomitant enterectomy, and his general condition improved dramatically. Four months after surgery, the serum albumin concentration increased from 3.1 g/dL to 4.3 g/dL, cholesterol from 92 mg/dL to 208 mg/dL, and hemoglobin from 9.2 g/dL to 12.5 g/dL. His body weight increased to 61 kg (BMI 21.6 kg/m2), and there was not any fluid collection or bowel obstruction seen on the abdominal CT scan. We experienced a case of EPS which was significantly improved after enterolysis. We report this case with review of the literature.
Body Weight ; Cholesterol ; Hemoglobins ; Malnutrition ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritoneal Fibrosis ; Peritonitis ; Renal Dialysis ; Serum Albumin

In end-stage renal disease (ESRD) patients regardless of dialysis modes, i.e. maintenance hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD), potassium (K) homeostasis is regulated primarily via dialysis and extrarenal K regulation in the diverse daily K intake. However, K metabolism has been known to differ greatly between the two main methods of dialysis. Hyperkalemia is a common complication (10-24%) and the most common cause of the death (3-5%) among electrolyte disorders in patients on maintenance HD. On the contrary, hypokalemia (10-36%) is responsible for a rather common complication and independent prognostic factor on CAPD. Although excessive K intake or inadequate dialysis on maintenance HD and poor nutritional K intake on CAPD are accused without doubts upto 50% of ESRD patients as a primary cause of the K-imbalance, i.e. hyperkalemia on HD and hypokalemia on CAPD, other contributory factors including certain medications and unknown causes remain still to be resolved. Accordingly, the effects of medications as another source of K-imbalance on HD with RAS blockades and beta blockers as well as those of conventional and glucose-free dialysates (Icodextrin) for internal K-redistribution on CAPD were evaluated with reviewing the literatures and our data. Furthermore, new developments in the clinical managements of hyperkalemia on HD following the exclusion of pseudohyperkalemia before the initiation of dialysis were suggested, especially, by the comparison of the effects between mono- and dual-therapy with medications for transcellular K shifting in the emergent situation. Also, the intraperitoneal K administration via conventional glucose-containing (2.5%) and glucose-free dialysates (Icodextrin) as a specific route of K-supplementation for hypokalemia on CAPD was examined for its efficiency and the degree of intracellular K shift between these two different types of dialysates.
Dialysis ; Dialysis Solutions ; Homeostasis ; Humans ; Hyperkalemia ; Hypokalemia ; Kidney Failure, Chronic ; Metabolism ; Peritoneal Dialysis, Continuous Ambulatory* ; Potassium ; Renal Dialysis*

Visible fungal colonization on peritoneal dialysis catheter is a rare complication and it was not reported yet in Korea. We here report a case of Alternaria spp. colonization on peritoneal dialysis catheter without peritonitis. A 58-year-old man on continuous ambulatory peritoneal dialysis for 2 years, noticed 3-4 mm sized two black-brown immobile fungal colonization plaque on peritoneal catheter lumen (15 cm distal from catheter exit site). The dialysate effluent was clear and culture for fungus and bacteria was negative. Peritoneal catheter was removed and culture from the plaque revealed saprophytic fungus, Alternaria species. The catheter removal alone was sufficient for the treatment. He is on hemodialysis thereafter.
Alternaria* ; Bacteria ; Catheters* ; Colon* ; Fungi ; Humans ; Korea ; Middle Aged ; Peritoneal Dialysis* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Renal Dialysis

BACKGROUND: The clinical manifestations of peritonitis in long-term PD patients may be more severe due to structural and functional alterations of the peritoneum caused by repeated exposure to the bioincompatible dialysate. However, the study in which outcome of peritonitis was compared to the duration of PD has been reported rarely. This study was performed to evaluate the effect of PD duration on the outcome of peritonitis. METHODS: Medical records of patients cared for in Kyungpook University Hospital between June 1998 and May 2001 were reviewed retrospectively. Patients were divided into three groups by PD duration: group 1, < or =12 months; group 2, 13-36 months; group 3, > or =37 months. RESULTS: There were 303 episodes (156 patients) of peritonitis during the study periods: 77 episodes in group 1, 115 episodes in group 2 and 111 episodes in group 3. There was no difference in gram- positive, gram-negative or fungal rate of peritonitis among three groups. In group 3, 16.2% of the patients transferred to hemodialysis, while 3.9% and 7.0% of patients in group 1 and 2 transferred to hemodialysis (p<0.05). CONCLUSION: Patients maintained on PD for over three years are associated with higher rate of technique failure than patients maintained on PD for less than three years. PD duration may be considered as a factor for predicting prognosis of peritonitis. Peritonitis in patients on long-term PD needs special attention.
Gyeongsangbuk-do ; Humans ; Medical Records ; Peritoneal Dialysis* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritoneum ; Peritonitis* ; Prognosis ; Renal Dialysis ; Retrospective Studies