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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Albumin loss in the dialysate was evaluated during a total of 5 peritoneal dialyses carried out on 3 uraemic patients. The measurements were made by two different methods, the first based on the evaluation in the dialysate of intravenously injected radioiodinated albumin, the second one based on a radioimmunoassay of the protein in the dialysate. The results obtained showed three main mechanisms of protein loss during peritoneal dialysis: 1) albumin shift from extravascular sites adjacent to the peritoneum, 2) direct passage of albumin from blood stream to peritoneal cavity, and 3) tendency of the inter-dialysis peritoneal fluid to equilibrate with plasma proteins. Furthermore, the observations made on a patient with evident peritonitis proved the importance of the intrinsic biological properties of the peritoneum in determining the amplitude of protein wasting by the dialysate.
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PMID:Mechanisms of albumin loss during peritoneal dialysis in man. 118 76

This study was conducted to assess quantitative and qualitative changes in serum albumin in CAPD patients. For twenty-six CAPD patients as well as age-, sex- and dialysis history-matched HD patients, biochemical and physiological parameters including urea kinetics were determined. Albumin was qualitatively evaluated by HPLC. The CAPD patients showed significant decreases in serum albumin and the reduced form of albumin accompanied by a lower protein catabolic rate(PCR) compared to the HD patients. Thirty five % of CAPD patients showed mild to moderate hypoalbuminemia, associated with a higher incidence of peritonitis and longer hospital stay. Patients with hypoalbuminemia had less of the reduced form of albumin. A weak positive correlation was found between serum albumin concentration and KT/V, and PCR. Thus, in CAPD patients, there occur quantitative and qualitative changes in serum albumin. Hypoalbuminemia may be a risk factor for peritonitis and is due in part to insufficient dialysis and protein intake. Intermolecular change in albumin may possibly be due to uremia per se.
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PMID:Quantitative and qualitative changes of serum albumin in CAPD patients. 136 68

In order to determine the long-term effects of continuous peritoneal dialysis on weight, 100 consecutive patients entering our program in 1988 were studied and followed for a maximum of 36 months. All patients underwent monthly evaluations including weight and biochemical surveys. Peritoneal equilibration tests were performed in 75 patients. A definite and significant trend was noted for weight gain during the first 17 months with a mean weight gain of 6.41 +/- 8.36 kg or 6.4% increase (p < 0.01). This was followed by a downward trend with a nadir on month 21 (p < 0.05). There were no significant differences in the change in weight for small or large patients. A positive correlation was noted between weight change and D/P creatinine at 12 and 24 months. Albumin concentrations remained stable throughout the period of observation. Serum albumin did not correlate with percent weight change nor with D/P creatinine. The frequency of peritonitis did not influence weight change in this population. The data suggest that there is marked interpatient variation, but the majority of patients on chronic peritoneal dialysis experience significant weight gain upon initiation of therapy. The trend is reversed after approximately 1.5 years of therapy raising the question of underdialysis due to loss of residual renal function or from patient selection after transfer of the healthier patients to transplantation and/or hemodialysis.
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PMID:Is weight gain inevitable in most chronic peritoneal dialysis patients? 136 18

The rates of disappearance of sulfamethoxazole and albumin from the peritoneal cavity were measured in humans. Albumin was added to the peritoneal cavity in concentrations commonly found during peritonitis (250-500 mg/100 ml) to ascertain if protein binding within the peritoneal cavity inhibited absorption from the peritoneal cavity. There were no statistical differences between the removal rates; 64-70% of the administered dose was absorbed after 180 min of intraperitoneal residence. The addition of albumin to the peritoneal cavity did not alter absorption of sulfamethoxazole. The total protein removed in dialysate effluent in the absence of albumin was 1,653 +/- 906 mg. The protein losses when albumin was added to dialysate [( albumin + control losses] - losses in dialysate drainage) were 1,037 +/- 2,305 mg and 1,364 +/- 1,653 mg for the 6 and 12 g studies.
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PMID:Absorption of sulfamethoxazole and albumin from the peritoneal cavity. 226 89

Anthropometric measurements, sixteen specific plasma proteins, triglycerides, cholesterol, urea and creatinine were measured at 4-monthly intervals for 1 year in 15 patients on CAPD. Delayed hypersensitivity skin tests were performed on 11 patients at the start and after 4 and 12 months. Body weight increased due mainly to a mean increase in 'calculated' body fat of 2.0 kg with increases in cholesterol, triglycerides and apolipoprotein B. Gain in fat correlated with the daily supply of dextrose in the dialysis fluid. Albumin, transferrin, prealbumin and retinol-binding protein decreased in 8 patients who intermittently ate less than 1.3 g protein/kg/day. A high concentration of dextrose in the dialysis fluid probably caused loss of appetite. Peritonitis resulted in increases in acute phase proteins although other plasma proteins decreased. Skin test responses indicated improvement in cell-mediated immunity during continuous ambulatory peritoneal dialysis (CAPD). The incidence of peritonitis and length of stay in hospital were greater in the patients who were hypoalbuminaemic probably due to impairment of the humoral mechanism. Dextrose in dialysis fluid may contribute to hyperlipidaemia and malnutrition with impairment of immunocompetence.
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PMID:Nutrition and delayed hypersensitivity during continuous ambulatory peritoneal dialysis in relation to peritonitis. 372 25

Hemoglobin, but not albumin, has long been recognized as an infection potentiating factor in experimental Escherichia coli peritonitis, but the mechanism has defied definition. We have shown previously that stroma-free hemoglobin is not toxic to polymorphonuclear neutrophils. To test the hypothesis that hemoglobin provides a nutritional boost to the growth of E. coli in vivo, we inoculated E. coli into dialysis bags containing equivalent amounts of stroma-free hemoglobin or albumin. These bags were implanted into the peritoneal cavity of rats and at intervals the fluid was removed and the bacteria enumerated. This technique allows for intraperitoneal bacterial growth but eliminates the variables of lymphatic clearance and phagocytic ingestion. The growth rate of E. coli was the same irrespective of the nutritional supplement in the bag. Thus there is no experimental support for the notion that hemoglobin directly accelerates E. coli proliferation under in vivo conditions. To test the hypothesis that a leukocyte toxin may result from E. coli growth in hemoglobin, we exposed normal human neutrophils to the sterilized contents of the peritoneal dialysis bags. In vitro function of the neutrophils (viability, random migration, chemotaxis, phagocytosis, bacterial killing, and chemiluminescence) was significantly depressed by prior exposure to hemoglobin supernatants that had supported E. coli proliferation in vivo. Stroma-free hemoglobin had minimal adverse effects. Albumin supernatants that had supported E. coli proliferation in vivo had significantly less effect on neutrophil function even though the endotoxin levels were identical to the hemoglobin E. coli solutions. We must conclude that leukotoxins result from E. coli growth in solutions of pure hemoglobin. The data support the idea that the infection potentiating effect of hemoglobin in vivo is due to such leukotoxins.
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PMID:Mechanism of the adjuvant effect of hemoglobin in experimental peritonitis: VIII. A leukotoxin is produced by Escherichia coli metabolism in hemoglobin. 637 61

An increased rate of obstruction of peritoneal dialysis catheters is observed during peritonitis. Hypercoagulation and hypofibrinolysis may explain this increased occurrence. We studied plasminogen activator inhibitor type 1 antigen (PAI-1), tissue-type plasminogen activator antigen (t-PA), D-dimer (DD), plasmin-alpha2-antiplasmin complexes (PAP), and thrombin-antithrombin III complexes (TAT) in 7 children with peritonitis (group A) and 12 children during stable peritoneal dialysis (group B). Albumin, beta2-microglobulin, IgG, and alpha2-macroglobulin were measured for baseline transperitoneal protein transport. After a dwell of 6 h with 1.36% Dianeal, dialysate and serum samples were collected. Dialysate to plasma ratios of all proteins were calculated. During peritonitis (group A) TAT was higher: 34.7 versus 22.0 (P=0.01). PAI-1 was increased in group A: 76.5 versus 22.9 (P=0.004). PAP was decreased during peritonitis (group A): 24.9 versus 39.3 (P=0.01). In group A, DD were decreased. 10.8 versus 26.7 (P=0.002). t-PA was similar in both groups (23.7 in group A vs. 27.7 in group B; P=0.26). In both groups TAT, PAI-1, t-PA, PAP, and DD were significantly higher than in baseline transperitoneal transport, suggesting intraperitoneal production. Hypercoagulability and hypofibrinolysis were present during peritonitis compared with the control situation.
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PMID:Intraperitoneal hypercoagulation and hypofibrinolysis is present in childhood peritonitis. 1045 74

In patients with cirrhosis, ascites accumulates because of sodium retention, triggered by a reduction of the effective arterial blood volume, and imbalanced Starling forces in the splanchnic area due to portal hypertension and hypoalbuminemia. Albumin is the ideal plasma expander in this setting, since it ameliorates systemic and reneal haemodynamics, so reducing sodium retention, and increases oncotic pressure in the splanchnic compartment. In particular, albumin proved useful in patients treated with diuretics, as demonstrated by a randomised study performed at our Instituition in which 126 ascitic inpatients were treated according to a stepped-care diuretic regimen. In fact, patients receiving diuretics plus albumin (n = 63) had a higher cummulative rate of response (p < 0.05) and a shorter hospital stay (20 +/- 1 versus 24 +/- 2 days, p < 0.05) than those given diuretics alone. Treatment with albumin on an outpatient basis (25 g/week) resulted in a lower probability of developing ascites (p < 0.02 vs. patients not given albumin) and a lower probability of readmission (p < 0.02). Patients given albumin also had a better quality of life. As discussed in another article, evidence also supports the use of albumin in patients treated for paracentesis, as well as in patients with spontaneous peritonitis or hepatorenal syndrome.
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PMID:Is the use of albumin of value in the treatment of ascites in cirrhosis? The case in favour. 1456 92

Antisense oligonucleotides offer great therapeutic potential provided adequate intracellular penetration can be achieved. In this study, we evaluated the effectiveness of microencapsulating antisense oligonucleotides to tumor necrosis factor (TNF) in suppressing TNF release in vitro and in vivo. Microencapsulation of TNF oligomers was performed using albumin to produce microcapsules 0.6-1.0 mum in size that target phagocytic cells. Albumin microcapsules containing fluoresceinated TNF oligomers were incubated with U-937 cells to observe uptake. Microcapsules were added to whole blood and stimulated with Escherichia coli endotoxin. Endotoxin was given intravenously (i.v.) to rats along with 100 mug microencapsulated TNF oligomers to determine TNF inhibition and animal survival. E. coli was given intraperitoneally (i.p.) along with gentamicin and microencapsulated TNF oligomers to assess TNF inhibition and animal survival. The duration of microencapsulated antisense TNF oligomers was also determined in vivo. The results demonstrated rapid uptake of the microcapsules by macrophages after 2 h and 4 h incubation. There was improvement in TNF inhibition in vitro and improved animal survival by microencapsulated antisense in both endotoxin (100% survival) and peritonitis models (70% survival) compared with free antisense oligomers in solution. Microencapsulation extended the duration of action of the oligomers to 72 h. Intracellular targeting of macrophages with antisense oligomers to TNF by microencapsules as a delivery system improves TNF inhibition using the models of whole blood endotoxin stimulation and endotoxic shock and peritonitis in rats.
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PMID:Microencapsulation of tumor necrosis factor oligomers: a new approach to proinflammatory cytokine inhibition. 1456 62

Albumin in ascitic fluid has been evaluated as a discriminative diagnosis test, based on an observation and retrospective study, comparing it to that of total ascitis protein and albumin gradient, which are the most clinically used tests nowadays. The study involved a total of 45 patients, predominantly women, averaging 54 years of age, who were diagnosed through laparoscopy in a public hospital. The evaluation included: 19 patients suffering transudate type ascitis (chronic liver disease, n = 18), 23 patients with exudates type ascitis (peritoneal carcinomatosis, n = 12, tuberculous peritonitis, n = 11), and patients with mixedascitis. Sensibility, specificity and predictive values were obtained from the analysis of the tests, and they were represented through the distribution of averages and ROC curves, showing every time that these tests can be used in clinical practice because they have comparable sensibility and specificity values. As a new discriminative test of transudates and exudates the albumin test in ascitis proved to have a sensibility comparable to that of the protein in ascitic fluid but discreetly lower to that of albumin gradient. However, the ascitis albumin showed a better relation between the sensibility and specificity in the area under the ROC curves. Based on this study, the usefulness of the concentration of albumin in ascitic fluid is highlighted as a new test to discriminate exudates from transudates, which has been reported by very few authors in writing. In addition, this study shows that the albumin gradient can also be applied in the discrimination of exudates and transudates with efficacy comparable to its use in the discrimination of ascitis with or without portal hypertension.
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PMID:[Diagnosis effectiveness of albumin in ascitic fluid]. 1524 91


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