1751
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Ruvinsky MJ, Bower JD, Holbert RD, Woolridge TD. Peritoneal dialysis: a review. JOURNAL OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 1977; 18:115-8, 124. [PMID: 327071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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1752
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1753
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Abstract
This article does not attempt to answer all the questions which might arise with the immediate management of a patient with acute renal failure but an effort has been made to lay down some guidelines and discuss some of the points of controversy. It should be remembered that the management of acute renal failure is an exercise in intensive care and that maintenance of non uraemic homeostasis is but one part in the overall management of the patient.
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1754
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Villarroel F. Kinetics of intermittent and continuous peritoneal dialysis. JOURNAL OF DIALYSIS 1977; 1:333-47. [PMID: 608856 DOI: 10.3109/08860227709038424] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Relations were developed for clearance under both intermittent and continuous flow peritoneal dialysis. The theoretical prediction was compared with data from other investigators. A mass transfer characteristic of 52 ml/min per 1.85 liters of dialysate was determined for urea from Boen's single batch experiment. This number was used to calculate the value of clearance for intermittent dialysis versus rate of dialysate exchange. The calculated clearances are in good agreement with Boen's experimental results. The calculated urea clearances for continuous flow dialysis were compared with Shinaberger's data. The predicted curve is in reasonable agreement with the data although there is a rather large scatter of the points. Some possible explanations for the scatter are provided as a caviat for future experimental research. A theoretical comparison between intermittent and continuous flow clearances shows that the latter is more efficient, particularly at higher flow rates.
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1755
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Zelman A, Gisser D, Whittam PJ, Parsons RH, Schuyler R. Augmentation of peritoneal dialysis efficiency with programmed hyper/hypoosmotic dialysates. TRANSACTIONS - AMERICAN SOCIETY FOR ARTIFICIAL INTERNAL ORGANS 1977; 23:203-9. [PMID: 910336 DOI: 10.1097/00002480-197700230-00055] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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1756
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Maher JF, Shea C, Cassetta M, Hohnadel DC. Isoproterenol enhancement of peritoneal permeability. JOURNAL OF DIALYSIS 1977; 1:319-31. [PMID: 608855 DOI: 10.3109/08860227709038423] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
As peritoneal dialysis is inefficient enouth to be time-consuming and sometimes clinically ineffective, we have evaluated pharmacologic enhancement of peritoneal permeability. Peritoneal dialyses were performed in New Zealand white rabbits by instillation of 50 ml/Kg of isotonic dialysis solution of standard composition. Mean peritoneal clearance of creatinine was 0.60 ml/Kg/min and urea was 0.80 ml/Kg/min, each decreasing as intraperitoneal dwell was prolonged (by .011 ml/Kg/min or less). With 0.04 micrometer/Kg of isoproterenol administered intraperitoneally, clearances increased to 0.91 and 1.30 ml/Kg/min (p less than 0.01). When isoproterenol was added to the dialysis solution one hour or more before instillation, the increment in clearances was less. Instillation of dialysis solution 24 hours after addition of a higher dose of isoproterenol (0.2 micrometer/Kg) did not increase clearances above control. No effect of isoproterenol on bulk flow of water, associated with the osmotic effect of dextrose, was demonstrated. As peritoneal clearances increased, the ratio creatinine clearance: urea clearance did not decrease, consistent with increased peritoneal permeability as well as blood flow.
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1757
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Di Paolo N, Acconcia A, Manganelli A. Acceleration of peritoneal dialysis with simple device. Nephron Clin Pract 1977; 19:271-7. [PMID: 917177 DOI: 10.1159/000180900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Peritoneal dialysis in acute and chronic renal failure has been greatly facilitated by the advent of Tenckhoff indwelling peritoneal catheters and by strict control of peritoneal infections. A number of reports on long-term treatment have been published. A simple device has been developed and tested for regular peritoneal dialysis in the hospital and in the home, in order to accelerate the time required. Employing a 'single needle apparatus', a rotary pump and a themostatic heating unit, it is possible to carry out a very efficacious peritoneal dialysis, similar to the 'continuous peritoneal dialysis'. The purpose of this paper is to discuss its use and its advantages in comparison with classic procedures.
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1758
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Beale MG, Salcedo JR. Peritoneal dialysis. Pediatr Clin North Am 1976; 23:902-3. [PMID: 995449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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1759
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Baker CR. Complications and management of methods of dialysis access for renal failure. Am Surg 1976; 42:859-62. [PMID: 984594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The management of dialysis access requires the awareness that any single access site is finite. A commitment to maintain access is reasonable with a planned approach. Dialysis for the end-stage renal disease patient must continue acutely during the management of access complications, and chronically. The goal of treatment is to return the patient to a routine dialysis regimen as soon as possible. Suspected infections should be treated immediately with systemic antibiotics specific for resistant Staphylococcus aureus. Systemic infection should be controlled before a new foreign body is implanted. My personal philosophy of access includes the following principles. (1) distal is good, (2) preserve all possible sites, (3) arm is better than leg, and (4) everything is relative.
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1760
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Sibilly A, Jung F, Chemorin C, Mathey B. [Peritoneal irrigation-dialysis as a complement to the treatment of systemic acute peritonitis]. LA NOUVELLE PRESSE MEDICALE 1976; 5:2371-4. [PMID: 1068624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A series of 30 cases of post-operative peritoneal irrigation dialysis for generalised peritonitis. In the light of peritoneal physiology, details are given of the technique for insertion of the peritoneal drains as well as the composition of the dialysate. In addition to its mechanical role, continuous lavage of this type is useful in restoring and maintaining water and electrolyte balance, the limitations of which are described, together with a direct anti-infectious action and temperature equilibration. P.I.D. seems to be associated with a considerable reduction in mortality from acute generalised peritonitis (1 case out of 30). It also limits morbidity, since only 5 minor complications were seen. The simplicity and harmlessness of the method makes it possible to widen, without major reservations, the scope of therapeutic solution to the problem of acute generalised peritonitis.
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1761
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Buoncristiani U, Losito A, Carobi C, Lorusso L. [1 year of clinical experience with high flow, short-term peritoneal dialysis]. MINERVA NEFROLOGICA 1976; 23:397-402. [PMID: 1018877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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1762
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1763
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Raja RM, Kramer MS, Rosenbaum JL. Recirculation peritoneal dialysis with sorbent Redy cartridge. Nephron Clin Pract 1976; 16:134-42. [PMID: 1244569 DOI: 10.1159/000180594] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Sorbent regeneration of peritoneal dialysate and use of small volume of dialysate for intermittent peritoneal dialysis (IPD) has been shown to be feasible. The present study compares the solute clearance (C) for urea (U) and creatinine (Cr) at varying flow rates in IPD and in recirculation peritoneal dialysis (RPD) utilizing Redy cartridge in ten dogs. Two silastic peritoneal catheters and one Sarns roller pump were used for RPD. CU was 12 +/- 2 ml/min (mean +/- 1SD),18 +/- 2 with IPD and 15 +/- 2,21 +/- 4 with RPD at flow rate of 66 and 100 ml/min, respectively, while CCr was 9 +/- 2,12 +/- 2 with IPD and 10 +/- 2, 13 +/- 3 with RPD. At increasing flow rates of 150,200 and 250 ml/min, CU was 27 +/- 3,31 +/- 4 and 32 +/- 6, and CCr was 17 +/- 2,20 +/- 3 and 22 +/- 3 with RPD. U and Cr were completely removed by the Redy. Glucose was not removed by the cartridge after initial saturation. Serum sodium concentration increased 2-3 mEq/l after 6 h of RPD. The data suggest that at comparable flow rates, RPD is relatively more efficient than IPD (p greater than 0.01). This may be due to continuous exchange across the peritoneal membrane in RPD. At high flow rate in RPD, solute removal is 2-3 times higher than the currently used IPD. RPD with Redy cartridge is mechanically simple, efficient, and may help reduce total peritoneal dialysis time.
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1764
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Brouhard BH, Berger M, Travis LB, Cunningham RJ, Carvajal HF. Chronic peritoneal dialysis in children. Tex Med 1976; 72:84-9. [PMID: 1246704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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1765
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Ackrill P, McIntosh CS, Nimmon C, Baker LR, Cattell WR. A comparison of the clearance of urographic contrast medium (sodium diatrizoate) by peritoneal and haemodialysis. CLINICAL SCIENCE AND MOLECULAR MEDICINE 1976; 50:69-74. [PMID: 1248204 DOI: 10.1042/cs0500069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
1. The clearance of isotopically labelled sodium diatrizoate by haemodialysis was measured in vitro, with simulated extracellular fluid, and in vivo in eleven patients, at varying rates of fluid or plasma flow. Clearance was also measured in five patients undergoing peritoneal dialysis. In all instances simultaneous measurements of urea clearance were made and the diatrizoate/urea clearance ratio was calculated. 2. In haemodialysis studies, diatrizoate and urea clearances showed a linear increase with increasing 'extracellular fluid' or plasma flow through the dialyser diatrizoate/urea clearance ratio fell. 3. The clearance of diatrizoate in vivo was slightly less than clearance in vitro at corresponding flow rates, but the diatrizoate/urea clearance ratio showed no significant difference. 4. Diatrizoate and urea clearances during peritoneal dialysis were very much lower than during haemodialysis but the diatrizoate/urea clearance ratios were within the same range. 5. The rapid removal of diatrizoate in patients with renal failure requires haemodialysis.
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1766
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Sarles HE, Lindley JD, Fish JC, Biggers JA, Cottom DL, Cotton JR, Mader JT, Dunaway JE, Remmers AR. Peritoneal dialysis utilizing a Millipore filter. Kidney Int 1976; 9:54-6. [PMID: 820918 DOI: 10.1038/ki.1976.7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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1767
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Gordon A, Maxwell MH, Lewin AJ. Sorbent regeneration of peritoneal dialysate: an approach to ambulatory dialysis. JOURNAL OF DIALYSIS 1976; 1:145-64. [PMID: 1052291 DOI: 10.3109/08860227609039142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Sorbent regeneration of peritoneal dialysate has been shown to be feasible in experimental and preliminary clinical studies and provides a realistic basis for the optimization of dialysis therapy and the potential development of an ambulatory dialysis system. Peritoneal dialysis efficiency can be significantly enhanced by continuous dialysate flow techniques and the mass transfer of uremic solutes can be theoretically augmented by the increased dialysis time made possible by a wearable design. Further optimization of end stage renal failure therapy may be achieved by the combined use of various methods for blood purification.
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1768
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1769
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Abstract
Children with severe renal failure face numerous problems which are unique to their age group. The physiological and psychosocial changes which characterize growth and development must be integrated into the medical care of children requiring dialysis and renal transplantation. Congenital abnormalities are of greater importance in the young age group and glomerulonephritis less frequent as a cause of terminal renal failure. The problems of children during chronic hemodialysis often include retarded growth, sexual maturation and emotional development. Modifications in medications, equipment and technique are required for infants undergoing dialysis or transplantation. Growth following renal transplantation has been variably and related to renal function, age at transplantation, steroid therapy, and serum somatomedin activity. Rehabilitation has been achieved with both modes of therapy but is more likely following successful renal transplantation.
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1770
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Delaitre B, Brun P, Makhloufi S, Rahal A. [Letter: Treatment of perforated ulcers with peritoneal dialysis combined with aspiration]. LA NOUVELLE PRESSE MEDICALE 1975; 4:3009-10. [PMID: 1221357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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1771
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Lankisch PG, Koop H, Winckler K, Quellhorst E, Schmidt H. Experimental model for peritoneal dialysis in small laboratory animals. Clin Nephrol 1975; 4:251-2. [PMID: 1204264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
A simple method of performing peritoneal dialysis in rats and guinea-pigs for 48 hours is described. The method appears to be suitable for the experimental investigation of clinical problems although the long term problem of protein loss should not be forgotten when assessing the results of these short term experiments.
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1772
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Vaamonde CA, Michael UF, Metzger RA, Carroll KE. Complications of acute peritoneal dialysis. JOURNAL OF CHRONIC DISEASES 1975; 28:637-59. [PMID: 1206087 DOI: 10.1016/0021-9681(75)90076-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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1773
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Hronszky I, Pintér J, Tóth L. [The use of the Tenckhoff catheter in the treatment of chronic renal failure]. Orv Hetil 1975; 116:2600-6. [PMID: 1196596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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1774
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Smith EC, Freedman P. Dialysis--current status and future trends. Heart Lung 1975; 4:879-84. [PMID: 1042021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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1775
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Höffler D, Quellhorst E. [Letter: Simplification of peritoneal dialysis]. Dtsch Med Wochenschr 1975; 100:1311. [PMID: 1140092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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