Masashi Mizuno1,2, Yasuhiko Ito3,4, Akio Tanaka5, Yasuhiro Suzuki3,4, Hideki Hiramatsu3, Midoriko Watanabe6, Yoshikazu Tsuruta7, Teppei Matsuoka8, Isao Ito4,9, Hiroshi Tamai10, Hirotake Kasuga11, Hideaki Shimizu5, Hisashi Kurata12, Daijo Inaguma13, Takeyuki Hiramatsu14, Masanobu Horie15, Tomohiko Naruse16, Shoichi Maruyama4, Enyu Imai4, Yukio Yuzawa4, Seiichi Matsuo4. 1. Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Tsurumai-cho 65, Showa-ku, Nagoya, Japan. mmizu@nagoya-u.ac.jp. 2. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan. mmizu@nagoya-u.ac.jp. 3. Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Tsurumai-cho 65, Showa-ku, Nagoya, Japan. 4. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 5. Chubu Rosai Hospital, Nagoya, Japan. 6. Handa City Hospital, Handa, Japan. 7. Minami Seikyo Hospital, Nagoya, Japan. 8. Ogaki Kita Clinic, Ogaki, Japan. 9. Yokkaichi Municipal Hospital, Yokkaichi, Japan. 10. Anjo Kosei Hospital, Anjo, Japan. 11. Nagoya Kyoritsu Hospital, Nagoya, Japan. 12. Toyota Kosei Hospital, Toyota, Japan. 13. Tosei General Hospital, Seto, Japan. 14. Konan Kosei Hospital, Konan, Japan. 15. Daiyukai Daiichi Hospital, Ichinomiya, Japan. 16. Kasugai Municipal Hospital, Kasugai, Japan.
Abstract
BACKGROUND: In Japan, the population of patients on peritoneal dialysis (PD) is <4% of the total number of patients with end-stage renal disease. Few systemic analyses have examined why the number of PD patients has not increased in Japan. We organized a registry to analyze PD patients and retrospectively investigated 561 PD patients (about 5% of all Japanese PD patients) from 13 hospitals in the Tokai area for 3 years from 2005. METHODS: We investigated background, physical status, laboratory data, status of PD therapy, and the occurrence of PD-related complications, and analyzed reasons for withdrawal from PD. RESULTS: Nutrition did not change significantly during our observation. Urinary volume showed continued decreases after the introduction period. In contrast, PD fluid demand and ultrafiltration volume were significantly increased. For calcium metabolism, multiple phosphate binders were required after the second year of PD therapy. Early drop-out within 3 years after starting PD therapy comprised 50.9% of total withdrawals, with PD-related peritonitis as the most common reason, mainly caused by Gram-positive organisms. Incidence of peritonitis was 42.8 months/patient. Culture-negative results were obtained for 32% of peritonitis cultures. Diabetes affects the prognosis of PD therapy, but not the incidence of peritonitis. CONCLUSION: We examined clinical status over 3 years in the Tokai area. The results suggest that the incidence of peritonitis needs to be decreased to prevent early withdrawal of PD patients. Education systems to decrease the incidence of peritonitis and techniques to decrease culture-negative results might be important for improving the prognosis of peritonitis.
BACKGROUND: In Japan, the population of patients on peritoneal dialysis (PD) is <4% of the total number of patients with end-stage renal disease. Few systemic analyses have examined why the number of PDpatients has not increased in Japan. We organized a registry to analyze PDpatients and retrospectively investigated 561 PDpatients (about 5% of all Japanese PDpatients) from 13 hospitals in the Tokai area for 3 years from 2005. METHODS: We investigated background, physical status, laboratory data, status of PD therapy, and the occurrence of PD-related complications, and analyzed reasons for withdrawal from PD. RESULTS: Nutrition did not change significantly during our observation. Urinary volume showed continued decreases after the introduction period. In contrast, PD fluid demand and ultrafiltration volume were significantly increased. For calcium metabolism, multiple phosphate binders were required after the second year of PD therapy. Early drop-out within 3 years after starting PD therapy comprised 50.9% of total withdrawals, with PD-related peritonitis as the most common reason, mainly caused by Gram-positive organisms. Incidence of peritonitis was 42.8 months/patient. Culture-negative results were obtained for 32% of peritonitis cultures. Diabetes affects the prognosis of PD therapy, but not the incidence of peritonitis. CONCLUSION: We examined clinical status over 3 years in the Tokai area. The results suggest that the incidence of peritonitis needs to be decreased to prevent early withdrawal of PDpatients. Education systems to decrease the incidence of peritonitis and techniques to decrease culture-negative results might be important for improving the prognosis of peritonitis.
Authors: Philip Kam-Tao Li; Cheuk Chun Szeto; Beth Piraino; Judith Bernardini; Ana E Figueiredo; Amit Gupta; David W Johnson; Ed J Kuijper; Wai-Choong Lye; William Salzer; Franz Schaefer; Dirk G Struijk Journal: Perit Dial Int Date: 2010 Jul-Aug Impact factor: 1.756
Authors: R Russo; L Manili; G Tiraboschi; K Amar; M De Luca; E Alberghini; P Ghiringhelli; A De Vecchi; M T Porri; G Marinangeli; R Rocca; V Paris; L Ballerini Journal: Kidney Int Suppl Date: 2006-11 Impact factor: 10.545