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Successful Treatment of Peritoneal dialysis Related Peritonitis from Multi-Drug Resistant Sphingomonas paucimobilis with Combination Therapy: A Case Report

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Open Journal of Nephrology 2022年第2期12卷 228-234页

作者： Gennaro Argentino Silvio Borrelli Ciro Paglionico Andrea Camocardi Mario Iorio Alessandra Antonia Mele Andrea Pota Adelia Sagliocca Stefania Brancaccio Lucia Di Micco “Ospedale del Mare” Nephrology and Dialysis Unit ASL Napoli 1 Centro Naples Italy Nephrology and dialysis Unit University of Studies of Campania “Luigi Vanvitelli” Naples Italy

Sphingomonas paucimobilis is an emerging gram-negative aerobic bacterium, generally causing infections in immunocompromised patients. Few data are available about peritonitis in peritoneal dialysis due to this pathogen. The clinical courses and outcomes of peritonitis are variable, with a high frequency of catheter removal and peritoneal dialysis withdrawal. No guidelines are available for the treatment of Sphingomonas paucimobilis related peritonitis, due to its emerging role as pathogen, the high antibiotic resistance and unpredictable antibiotic sensitivity. Here, we describe a case of Sphingomonas paucimobilis peritonitis in a 52-year-old diabetic patient in Continuous Cycler-Assisted Peritoneal dialysis (CCPD) for 4 months, successfully treated with a combined intraperitoneally administration of meropenem (250 mg/L) and ciprofloxacin (100 mg/L) for 21 days. No hospital admission and change of peritoneal dialysis scheme were needed;no relapses of peritonitis were observed during 18 months of follow-up.

关键词： Sphingomonas paucimobilis Peritoneal dialysis Peritonitis Antibiotic Therapy

The effect of different dialysis modalities on pruritus in patients with uremia

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China Medical Abstracts(Internal Medicine) 2013年第4期30卷 227-228页

作者：金东华 Dept dialysis Center 2nd HospSuzhou Univ

Objective To study the effects of different dialysis modalities on pruritus in patients with *** There were 19 hemodialysis (HD) patients,17 hemodialysis combined with hemodiafiltration (HD+HDF) patients and 20 peritoneal dialysis (PD) patients enrolled in for *** patients were suffering from skin ***β2-microglobulin (β2-MG) and intact parathyroid hormone (iPTH) were measured by using radio immunoassay before and 4 weeks,8 weeks after the initia-

关键词： modalities dialysis parathyroid peritoneal intact microglobulin immunoassay suffering creatinine enrolled

Peritoneo-Vaginal Leaks in Peritoneal dialysis: A Report of 3 Cases

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Open Journal of Nephrology 2024年第2期14卷 176-184页

作者： Mariam Jdidou Sara Elmakkoul Nabil Hmaidouch Naima Ouzeddoun Loubna Benamar Department of Nephrology Dialysis and Renal Transplantation Ibn Sina University Hospital Rabat Morocco

Introduction: Peritoneal dialysis (PD) is an extra-renal purification technique indicated for patients with end-stage kidney disease (ESKD). Although it has many advantages, it also has a number of complications, such as peritoneo-vaginal leakage of dialysate. Cases Reports: Three male patients, aged 70, 50 and 77 respectively, with ESKD were placed on PD. All three patients presented with inadequate drainage and the progressive appearance of bilateral hydrocele, which occurred one year (late leakage), two and four days (early leakage) respectively after the initiation of exchanges. The etiological investigation led to the conclusion of a peritoneo-vaginal leak associated with an inguinal hernia in only one case. The two cases of early leakage were treated by temporary suspension of PD, with a good response in one case and failure in the second, leading to hisdefinitive transfer to hemodialysis (HD);however, the hernia repair enabled immediate resumption of PD in the third patient. Discussion and Conclusion: Peritoneo-vaginal leakage is a rare mechanical complication in PD. The clinical examination plays an essential role in confirming the diagnosis and in the therapeutic decision. If the diagnosis is uncertain, or if there is a clinical need to show the anatomy of the leak, an imaging approach becomes desirable. This complication should not prevent the progression of PD in the management of patients with ESKD.

关键词： Peritoneal dialysis Peritoneal Leakage Hernia-Peritoneal Scintigraphy

Observation of tongue picture and tongue and nailbed microcirculation before and after blood dialysis in 125 uremic patients with deficiency of kidney-yang

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Journal of Medical Colleges of PLA(China) 1991年第1期6卷 39-43页

作者：喻方亭崔志英林跃萍林民专 Department of Traditional Chinese Internal Medicine First Military Medical UniversityGuangzhou 510515 Department of Diagnostics of Traditional Chinese Medicine Department of Blood dialysis Nanfang Hospital: Department of Blood dialysis Zhujiang Hospital

using a WZD—1 microcirculation microscope,we observed the tongue tipand nail-bed microcirculation of uremic patients with deficiency of kidney-yangbefore and after blood *** results showed that the pathological basis ofuremia with deficiency of kidney-yang may be microcirculation disturbance,in-crease of metabolites and water *** effusion from capillary loops intongue tip may be one of the pathogenetic factors of a swollen and *** flow rate of blood in capillary loops in the nail-bed was apparentlyabnormal and markedly improved after blood *** weighted integral ofnail-bed microcirculation decreased from moderately abnormal (4.99±1.52) toapproximately normal (1.98±0.97) (P<0.01).Microcirculation seems to be a sensi-tive criterion for reflecting the pathologic changes of uremia with deficiency ofkidney-yang.

关键词： uremia blood dialysis microcirculation deficiency of kidney-yang glossoscopy

Secondary Hyperparathyroidism in dialysis Patients: Short- and Long-Term Outcomes of Conservative Parathyroidectomy

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Open Journal of Nephrology 2024年第2期14卷 147-156页

作者： Imane Saidi Sara Elmaakoul Naima Ouzeddoun Loubna Benamar Department of Nephrology-dialysis-Renal Transplantation IbnSina Hospital Mohammed V University Rabat Morocco

Secondary hyperparathyroidism (HPT) is frequent in dialysis patients. Parathyroidectomy (PTX) is indicated for patients who failed medical therapy. We reviewed the data from 184 dialysis patients who underwent PTX between January 2015 and January 2023. We aimed to evaluate the short and long term outcomes of PTX in dialysis patients, comparing the conservative 3/4 versus 7/8 techniques in this population.166 dialysis patients with secondary HPT were included. A conservative subtotal PTX (sPTX) 7/8 was performed in 72% of patients and sPTX 3/4 in 28% of them. Severe postoperative hypocalcaemiaocurred in 45 patients (27%). Hypocalcaemia was significantly more frequent in the sPTX 7/8 group (p = 0.012). One case of persistent HPT (0.6%) and 20 cases of recurrence (12%) were diagnosed. Recurrence was more frequent in the sPTX 3/4 group (15%). No deaths were reported during the perioperative period.

关键词： Secondary Hyperparathyroidism dialysis Chronic Kidney Disease Conservative Subtotal Parathyroidectomy

Relationship of demoralization with anxiety, depression, and demographics of Chinese dialysis patients

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Journal of Integrative Nursing 2021年第4期3卷 155-160页

作者： Cai-Lan ZHUANG Juan-Lian ZHENG Lei GAO Ying-Ling HUANG Wen-Jing HU Department of Nursing Huizhou First HospitalHuizhouGuangdong ProvinceChina dialysis Center Huizhou First HospitalHuizhouGuangdong ProvinceChina Department of Nephrology Huizhou First HospitalHuizhouGuangdong ProvinceChina

Objective:The purpose of this study is to investigate the demoralization level of dialysis patients in China and analyze the influencing *** and Methods:A convenience sample of 278 dialysis patients from a tertiary hospital participated in a cross-sectional descriptive study using a structured questionnaire including assessments of demographic data,Demoralization Scale-II(DS-II),and Hospital Anxiety and Depression *** main analysis consisted of descriptive statistics,correlation coefficients,and multiple linear ***:The mean standard deviation DS-II score was 11.87(7.72).dialysis patients had a high level of *** from multiple linear regression indicated that demoralization was positively correlated with marital status(β=0.141;P=0.001),employment status(β=0.113;P=0.006),anxiety(β=0.393;Pdialysis patients and is associated with marital status,employment status,anxiety,and ***-care providers might regularly assess demoralization in dialysis patients,and develop related interventions to improve the quality of life.

关键词： Anxiety demoralization depression hemodialysis peritoneal dialysis

Recuperation of severe tumoral calcinosis in a dialysis patient: A case report

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World Journal of Clinical Cases 2019年第23期7卷 4004-4010页

作者： Lukas Westermann Lisa K Isbell Marie K Breitenfeldt Frederic Arnold Elvira Rothele Johanna Schneider Eugen Widmeier Department of Medicine IV Medical CenterUniversity of FreiburgFaculty of MedicineUniversity of FreiburgFreiburg 79106Germany Department of Medicine I Medical CenterUniversity of FreiburgFaculty of MedicineUniversity of FreiburgFreiburg 79106Germany dialysis Center Freiburg Freiburg 79100Germany

BACKGROUND One of the common late sequela in patients with end-stage renal disease(ESRD)is the calcium phosphate disorder leading to chronic hypercalcemia and hyperphosphatemia causing the precipitation of calcium salt in soft *** calcinosis is an extremely rare clinical manifestation of cyst-like soft tissue deposits in different periarticular regions in patients with ESRD and is characterized by extensive calcium salt containing space-consuming painful *** treatment of ESRD patients with tumoral calcinosis manifestation involves an increase in or switching of renal replacement therapy regimes and the adjustment of oral medication with the goal of improved hypercalcemia and *** SUMMARY We describe a 40-year-old woman with ESRD secondary to IgA-nephritis and severe bilateral manifestation of tumoral calcinosis associated with hypercalcemia,hyperphosphatemia and tertiary *** patient was on continuous ambulatory peritoneal dialysis and treatment with vitamin D *** switching her to a daily hemodialysis schedule and adjusting the medical treatment,the patient experienced a significant dissolution of her soft tissue calcifications within a couple of *** remission was achieved 11 mo after the initial *** Reduced patient compliance and subsequent insufficiency of dialysis regime quality contribute to the aggravation of calcium phosphate disorder in a patient with ESRD leading to the manifestation of tumoral ***,the improvement of the treatment strategy and reinforcement of patient compliance enabled complete remission of this rare disease entity.

关键词： End-stage renal disease Renal replacement therapy-dialysis Hyperparathyroidism Hypercalcemia Hyperphosphatemia Tumoral calcinosis Case report

Comamonas testosteroni-associated peritonitis in a pediatric peritoneal dialysis patient

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World Journal of Nephrology 2016年第2期5卷 220-223页

作者： Mattia Parolin Maura Baraldi Elena Valentini Luisa Murer Enrico Vidal Nephrology Dialysis and Transplant Unit Department of Women’s and Children’s Health University-Hospital of Padova

Comamonas testosteroni(C. testosteroni) has been rarely observed as an infectious agent in clinical practice. Few reports described its potential pathogenicity in bloodstream and abdominal infections. Here, we report our experience in the treatment of a C. testosteroni-associated peritonitis in a four-year-old girl receiving chronic peritoneal dialysis(PD). The organism was shown to be highly susceptible to appropriate antibiotic therapy. Infection responded promptly and the patient was managed conservatively without withdrawal from PD.

关键词： Comamonas Peritonitis Peritoneal dialysis Comorbidity Children

Does Current Nephrology Fellowship Training Affect Uti-lization of Peritoneal dialysis in the United States?

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Open Journal of Nephrology 2013年第2期3卷 109-114页

作者： Nand K. Wadhwa Catherine R. Messina Nasser M. Hebah Corporate Home dialysis Dialysis Clinic Inc. Nashville USA. Department of Preventive Medicine Stony Brook School of Medicine Stony Brook New York USA Division of Nephrology Stony Brook School of Medicine Stony Brook New York USA

Background: The 2010 US Renal Data System annual report revealed that peritoneal dialysis is used by only 7% of end-stage renal disease patients on chronic dialysis vs. hemodialysis which is used by 93% of such patients, despite documented benefits of peritoneal dialysis over hemodialysis in these cases. Purpose: We examined whether education of nephrology fellows contributed to underutilization of peritoneal dialysis in the US. Methods: Self-report questionnaires were administered electronically to nephrology fellowship training program directors, October 2010-March 2011 (55% response). Results: Median number of training faculty and patients/fellow were significantly lower for peritoneal-dialysis vs. hemodialysis training. Hours of didactic teaching for fellows over their 2-year training period were significantly lower for peritoneal dialysis vs. hemodialysis. Peritoneal dialysis training was 20% of total training vs. 80% for hemodialysis. Most program directors (87%) believed lack of trained faculty in peritoneal dialysis and insufficient peritoneal dialysis patient population contributed to inadequate fellows’ peritoneal dialysis training. Conclusions: Findings suggest that current nephrology fellowship training in peritoneal dialysis is inadequate and contributes to its underutilization.

关键词： Peritoneal dialysis Hemodialysis Utilization Nephrology Fellowship Training