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

A retrospective survey has been undertaken in 7 different centers: 345 patients trained to CAPD between 1978 and 1983 were studied: technic success and survival rate were analysed using actuarial methods. Drop-out has dramatically decreased after May 1981 due to a lower mortality whatever the age. For all patients the actuarial survival at two years after 1981 is 87.1%. Related to a lower mortality, better results are obtained in patients younger than 55. However peritonitis is the main complication since they are involved in 1/3 of drop-out causes. It is concluded that CAPD might be used in almost 30% of chronic renal failure patients and that patients waiting for a kidney transplantation represent the best indication. In aged patients, nutritional status and psychosocial background must be carefully analysed before starting CAPD.
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PMID:[5 years of continuous ambulatory peritoneal dialysis (CAPD) (multicenter study of 345 patients)]. 400 Mar 77

The Deane peritoneal prosthesis has been used successfully in the treatment of 21 patients with chronic renal failure who were maintained on peritoneal dialysis for periods of up to 20 months. All patients were dialyzed for 24 hours twice weekly. While the prosthesis was still in place, transplantation was carried out in seven patients and laparotomy in three. The prosthesis was also used temporarily whenever a permanent peritoneal catheter (Tenckhoff's) failed because of infection; it was used until the signs of infection disappeared, then the permanent catheter could be replaced safely. From a total of 1136 dialyses 36 positive cultures were reported. Clinical peritonitis was found on only four occasions.
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PMID:Use of the Deane prosthesis in patients on long-term peritoneal dialysis. 458 55

Seven patients with acute or chronic renal failure who were receiving intermittent peritoneal dialysis and who required parenteral oxacillin, ampicillin or tetracycline were studied to determine the disposition of these antibiotics in severe renal disease and the effects of peritoneal dialysis. While severe renal impairment markedly prolongs persistence in the serum of ampicillin and tetracycline, there is little effect on oxacillin. Whereas required doses of ampicillin and tetracycline are lower in the presence of severe renal disease, oxacillin should be given in doses equivalent to those used for patients with normal renal function. Peritoneal dialysis does not alter these dosage requirements.Four patients receiving ampicillin or tetracycline in the infusing solution during peritoneal dialysis were studied to determine the amount of systemic absorption. Local prophylaxis alone is not achieved with this method of administration, since small amounts of both antibiotics are absorbed systemically from the infusing solution. The serum concentration of tetracycline attained is inadequate for treatment of systemic infections but is probably significant, with repeated use in intermittent dialysis, in causing adverse effects. Tetracycline should be abandoned in the local prophylaxis of peritonitis during peritoneal dialysis.
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PMID:The effects of peritoneal dialysis on the physiological disposition of oxacillin, ampicillin and tetracycline in patients with renal disease. 590 64

The outcome of the first 50 patients started on Continuous Ambulatory Peritoneal Dialysis (CAPD) in one centre is reported. The total treatment time was 779 months. Ten patients died while on CAPD. Thirteen patients were transplanted, 4 of whom returned to CAPD after graft failure, 7 were transferred to other forms of dialysis and one to another centre. Twenty-three patients remained on the method. Good control of the symptoms and biochemical parameters of uremia was achieved. The patients were content with a high degree of well-being and freedom from dietary and fluid restrictions. The costs were found to be low. Peritonitis was a major complication, accounting for one death and four transfers to hemodialysis. The total incidence was one episode per every sixth patient month. CAPD represents an important contribution to the treatment of chronic renal failure. Nevertheless peritonitis remains a serious problem and the long-term metabolic effects of CAPD are unknown.
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PMID:Clinical outcome of 50 patients started on continuous ambulatory peritoneal dialysis in a Swedish centre. 635 86

Nine patients with chronic renal failure associated with long-standing spinal cord injury were treated with peritoneal dialysis for periods ranging from 3 days to 12 months. Indwelling peritoneal catheters and automated peritoneal dialysis machines were used in the majority of cases. The procedure was generally used as an interim measure while awaiting placement or maturation of the blood access for hemodialysis. Several patients, however, underwent peritoneal dialysis for prolonged periods, including a patient who was on home-peritoneal dialysis for 12 months. The main complications resulting from 653 patient-day treatments consisted of six bouts of peritonitis and a single case of bowel perforation. Azotemia, fluid electrolytes and acid-base status were satisfactorily controlled with peritoneal dialysis. The results were comparable with those obtained during hemodialysis. Peritoneal dialysis, therefore, appears to be a reasonable alternative to hemodialysis in the management of chronic renal failure in spinal cord injured patients.
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PMID:Peritoneal dialysis in renal failure associated with spinal cord injury. 651 26

Continuous ambulatory peritoneal dialysis (CAPD) is being increasingly used to treat chronic renal failure in New Zealand. Peritonitis due in particular to gram positive organisms remains the major complication. Three of 92 CAPD patients trained in the Wellington Renal Unit had tuberculous peritonitis, a previously rarely reported complication. Gram positive or Gram negative bacterial infections preceded or followed isolation of Mycobacterium tuberculosis. Differential peritoneal fluid leucocyte counts were not predictive of tuberculous infection and total leucocyte counts remained elevated in tuberculous patients treated for other concurrent bacterial peritonitides. Systemic toxicity was not encountered in these patients, symptoms being confined almost entirely to the peritoneum. CAPD was continued during treatment with anti-tuberculous therapy, in all three patients. However, peritoneal pain on dialysis fluid in-flow necessitated temporary hemodialysis management in two. Anti-tuberculous chemoprophylaxis may be prudent in the at-risk Polynesian patient with chronic renal failure who is being considered for CAPD management.
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PMID:Tuberculous peritonitis in chronic renal failure managed by continuous ambulatory peritoneal dialysis. 658 Aug 57

We review the experience of the Renal Unit at Newcastle upon Tyne over the three years 1979-1981, during which 122 patients with chronic renal failure were treated by continuous ambulatory peritoneal dialysis (CAPD). Advantages of the technique included wide acceptability to a cross-section of patients reaching the renal unit, including the elderly and diabetics. Patients who experienced both techniques preferred CAPD to haemodialysis because of the greater freedom and sense of well-being. Patient survival was 94 per cent at two years and rehabilitation was as good as could be expected for the age and primary medical complications of the patients. Control of plasma potassium and phosphate was easier than with haemodialysis. Renal osteodystrophy responded well to a combination of CAPD and alfacalcidol therapy over the two year period for which we have performed serial bone biopsies. Serum aluminium was slightly raised as a result of consumption of phosphate binders and presumed uptake from dialysis fluid but no aluminium related disease has yet been encountered. Anaemia was partly corrected by CAPD with haemoglobin rising to about 10 g/dl on average. CAPD was less costly than home haemodialysis over the first three years and has been adopted as our standard treatment for patients who can expect an early transplant. Disadvantages were persisting problems with peritonitis which still occurred at an incidence of one attack per 39 patient weeks over the last two years, and an actuarial success rate for the technique of only 63 per cent at two years. Twenty patients developed hernias. Weight gain was common and occasionally gross. There was a significant rise in serum cholesterol. The arrival of CAPD has allowed us to increase the intake to our renal failure programme by 50 per cent. However, continued expansion of the technique demands advances in prevention of peritonitis, adequate facilities for admission and particularly an expanding hospital haemodialysis programme to accept the less successful patients from CAPD.
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PMID:Continuous ambulatory peritoneal dialysis: three years' experience. 661 39

A 3 1/2 year old child with chronic renal failure twice developed severe candida peritonitis in the course of treatment with continuous ambulatory peritoneal dialysis. Medical treatment was unsuccessful but removal of the catheter led to immediate cure. This case documents a long held clinical impression that the best, if not the only way of treatment of candida peritonitis is removal of the indwelling catheter. Thus, potentially hazardous, painful and costly medical treatment can and should be avoided.
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PMID:Candida peritonitis-inefficacy of amphotericin-B and 5-fluorocytosine treatment. 661 70

Home peritoneal dialysis has recently become an important addition to the therapy of chronic renal failure. Abdominal wall hernias have become more apparent as complications of this mode of dialysis, with isolated instances of incarcerations and one fatality. Results of our review of 276 patients receiving peritoneal dialysis revealed seven with hernias, an incidence of 2.5 per cent. Six patients with hernias were receiving c.a.p.d.; one patient was receiving c.c.p.d., and none was receiving i.p.d., for incidences of 17, 5 and zero per cent, respectively. All hernias found at presentation occurred within two to 20 months after peritoneal catheter placement. Most were ventral or umbilical, and all were repaired electively without serious complications. All patients with hernias had associated problems with leaks, peritonitis or predialysis hernias. In two of four patients with predialysis hernias, herniorrhaphy without catheter removal resulted in two recurrences. Abdominal wall hernias are a more frequent complication of c.a.p.d. and c.c.p.d., modalities which require large volumes of peritoneal dialysate during ambulatory hours. Review of the literature reveals that wound tensile strength and healing are decreased in those patients having renal disease with uremia, anemia and malnutrition. However, these factors do not increase the over-all incidence of hernias. Patients should be screened for hernias, and hernias should be repaired prior to catheter placement. Hernias presenting during dialysis are best treated by herniorrhaphy and hemodialysis postoperatively or low volume peritoneal dialysis to optimize the metabolic state.
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PMID:Abdominal wall hernias as a complication of peritoneal dialysis. 664 75

Since January 1979, 122 patients (mean age 38.5 years, range 5-72 years) with chronic renal failure have been treated with continuous ambulatory peritoneal dialysis (CAPD). Peritoneal access was achieved by inserting silicone rubber Tenckhoff peritoneal dialysis catheters (Quinton, Seattle, Washington) by an open (76 per cent) or closed technique. Actuarial analysis showed a patient survival of 98 and 94 per cent and a success rate of 88 and 64 per cent at 1 and 2 years, respectively. Currently, 74 patients are using CAPD and 8 have been treated for 30-36 months. Thirty-five patients (29 per cent) required two or more peritoneal catheters and 69 per cent of these patients are still on CAPD. Catheter-related peritonitis was the most frequent complication (233 separate episodes in 94 patients) and necessitated catheter removal in 16 per cent of episodes, although 37 per cent of patients from whom catheters were removed because of peritonitis later resumed CAPD. Extravasation of dialysate from the peritoneal cavity (31 episodes) and catheter obstruction (31 episodes) required surgical replacement of catheters in 8 and 23 cases, respectively. Twenty patients (16 per cent) developed 24 abdominal hernias, only one of which caused failure of CAPD. Infective and mechanical complications of CAPD frequently require surgical intervention but only occasionally result in failure of the technique, and even multiple catheter replacements are compatible with successful long term CAPD.
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PMID:Surgical aspects of continuous ambulatory peritoneal dialysis--3 years experience. 669 31


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