The Experts below are selected from a list of 1074 Experts worldwide ranked by ideXlab platform
Neesh Pannu - One of the best experts on this subject based on the ideXlab platform.
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Comparison of Volume Overload with Cycler-Assisted versus Continuous Ambulatory Peritoneal Dialysis
2016Co-Authors: Sara N Davison, Gian S Jhangri, Kailash Jindal, Neesh PannuAbstract:Background and objectives: Cycler-assisted peritoneal dialysis (CCPD) has been associated with decreased sodium removal compared with continuous ambulatory peritoneal dialysis (CAPD) as a result of peritoneal sodium sieving during the short dwells that are associated with CCPD. This may have adverse consequences for management of extracellular fluid volume (ECFV). This study compared ECFV in patients who received CAPD or CCPD; CCPD dwell times were maximized by limiting the number of exchanges, and the use of Icodextrin for the long daytime dwells was widespread. Design, setting, participants, & measurements: This was an observational, cross-sectional study of 158 prevalent patients (90 CAPD, 68 CCPD). Demographic data, blood work, and 24-h dialysate and urine samples were collected from all participants between January 2004 and July 2006. They subsequently underwent assessment of ECFV by multifrequency bioimpedance spectroscopy analysis. Multivariate analysis was used to determine the relationship between peritoneal dialysis modality and ECFV. Potential cofounders including age, comorbidity, time on dialysis, residual renal function, and Icodextrin use were identified a priori. Results: There were no differences in BP, use of antihypertensive medications, or the presence of peripheral edema between CAPD and CCPD patients. Similarly, there was no difference in the ratio of ECFV to total body water between CAPD (51.8%) and CCPD (51.9%) patients (P 0.929). Conclusions: There is no difference in BP, sodium removal, or volume control in patients who use a contemporary approac
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comparison of volume overload with cycler assisted versus continuous ambulatory peritoneal dialysis
Clinical Journal of The American Society of Nephrology, 2009Co-Authors: Sara N Davison, Gian S Jhangri, Kailash Jindal, Neesh PannuAbstract:Background and objectives: Cycler-assisted peritoneal dialysis (CCPD) has been associated with decreased sodium removal compared with continuous ambulatory peritoneal dialysis (CAPD) as a result of peritoneal sodium sieving during the short dwells that are associated with CCPD. This may have adverse consequences for management of extracellular fluid volume (ECFV). This study compared ECFV in patients who received CAPD or CCPD; CCPD dwell times were maximized by limiting the number of exchanges, and the use of Icodextrin for the long daytime dwells was widespread. Design, setting, participants, & measurements: This was an observational, cross-sectional study of 158 prevalent patients (90 CAPD, 68 CCPD). Demographic data, blood work, and 24-h dialysate and urine samples were collected from all participants between January 2004 and July 2006. They subsequently underwent assessment of ECFV by multifrequency bioimpedance spectroscopy analysis. Multivariate analysis was used to determine the relationship between peritoneal dialysis modality and ECFV. Potential cofounders including age, comorbidity, time on dialysis, residual renal function, and Icodextrin use were identified a priori. Results: There were no differences in BP, use of antihypertensive medications, or the presence of peripheral edema between CAPD and CCPD patients. Similarly, there was no difference in the ratio of ECFV to total body water between CAPD (51.8%) and CCPD (51.9%) patients (P = 0.929). Conclusions: There is no difference in BP, sodium removal, or volume control in patients who use a contemporary approach to CCPD that uses fewer night cycles and liberalizes the use of Icodextrin when compared with CAPD.
Sara N Davison - One of the best experts on this subject based on the ideXlab platform.
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Comparison of Volume Overload with Cycler-Assisted versus Continuous Ambulatory Peritoneal Dialysis
2016Co-Authors: Sara N Davison, Gian S Jhangri, Kailash Jindal, Neesh PannuAbstract:Background and objectives: Cycler-assisted peritoneal dialysis (CCPD) has been associated with decreased sodium removal compared with continuous ambulatory peritoneal dialysis (CAPD) as a result of peritoneal sodium sieving during the short dwells that are associated with CCPD. This may have adverse consequences for management of extracellular fluid volume (ECFV). This study compared ECFV in patients who received CAPD or CCPD; CCPD dwell times were maximized by limiting the number of exchanges, and the use of Icodextrin for the long daytime dwells was widespread. Design, setting, participants, & measurements: This was an observational, cross-sectional study of 158 prevalent patients (90 CAPD, 68 CCPD). Demographic data, blood work, and 24-h dialysate and urine samples were collected from all participants between January 2004 and July 2006. They subsequently underwent assessment of ECFV by multifrequency bioimpedance spectroscopy analysis. Multivariate analysis was used to determine the relationship between peritoneal dialysis modality and ECFV. Potential cofounders including age, comorbidity, time on dialysis, residual renal function, and Icodextrin use were identified a priori. Results: There were no differences in BP, use of antihypertensive medications, or the presence of peripheral edema between CAPD and CCPD patients. Similarly, there was no difference in the ratio of ECFV to total body water between CAPD (51.8%) and CCPD (51.9%) patients (P 0.929). Conclusions: There is no difference in BP, sodium removal, or volume control in patients who use a contemporary approac
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comparison of volume overload with cycler assisted versus continuous ambulatory peritoneal dialysis
Clinical Journal of The American Society of Nephrology, 2009Co-Authors: Sara N Davison, Gian S Jhangri, Kailash Jindal, Neesh PannuAbstract:Background and objectives: Cycler-assisted peritoneal dialysis (CCPD) has been associated with decreased sodium removal compared with continuous ambulatory peritoneal dialysis (CAPD) as a result of peritoneal sodium sieving during the short dwells that are associated with CCPD. This may have adverse consequences for management of extracellular fluid volume (ECFV). This study compared ECFV in patients who received CAPD or CCPD; CCPD dwell times were maximized by limiting the number of exchanges, and the use of Icodextrin for the long daytime dwells was widespread. Design, setting, participants, & measurements: This was an observational, cross-sectional study of 158 prevalent patients (90 CAPD, 68 CCPD). Demographic data, blood work, and 24-h dialysate and urine samples were collected from all participants between January 2004 and July 2006. They subsequently underwent assessment of ECFV by multifrequency bioimpedance spectroscopy analysis. Multivariate analysis was used to determine the relationship between peritoneal dialysis modality and ECFV. Potential cofounders including age, comorbidity, time on dialysis, residual renal function, and Icodextrin use were identified a priori. Results: There were no differences in BP, use of antihypertensive medications, or the presence of peripheral edema between CAPD and CCPD patients. Similarly, there was no difference in the ratio of ECFV to total body water between CAPD (51.8%) and CCPD (51.9%) patients (P = 0.929). Conclusions: There is no difference in BP, sodium removal, or volume control in patients who use a contemporary approach to CCPD that uses fewer night cycles and liberalizes the use of Icodextrin when compared with CAPD.
A J M Boulton - One of the best experts on this subject based on the ideXlab platform.
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blood glucose overestimation in diabetic patients on continuous ambulatory peritoneal dialysis for end stage renal disease
Diabetic Medicine, 2002Co-Authors: Samson O Oyibo, G M Pritchard, L Mclay, E James, I Laing, Ram Gokal, A J M BoultonAbstract:Aims Diabetic patients on continuous ambulatory peritoneal dialysis (CAPD) for renal failure depend on glucose analysers for regular monitoring of glycaemic control. We aim to inform health professionals of the potentially dangerous overestimation of blood glucose values by some analysers in patients using Icodextrin for dialysis. Methods Twenty-five patients on continuous ambulatory peritoneal dialysis (10 patients on an 8–12-h nocturnal exchange of Icodextrin) had random glucose analysis performed on venous blood using standardized reference laboratory (lab) technique (glucose oxidase GOD-PAP), and simultaneously on capillary blood using the Precision Q·I·D System (glucose oxidase method) and the Advantage meter (glucose dehydrogenase method). Results The Precision Q·I·D System agreed with the lab results in both the Icodextrin group and the non-Icodextrin group (80–90% of values fell within 20% of the corresponding lab result). In contrast, the Advantage meter agreed with the lab results only in the non-Icodextrin group (95% of values within 20% of the corresponding lab value), and not in the Icodextrin group, where only 5% of the analyser values fell within 20% of the corresponding lab value. Conclusions The Precision Q·I·D System, which utilizes glucose oxidase reaction, is safe for use in diabetic patients treated with Icodextrin. All analysers must be cross-checked with the laboratory reference method before use in these patients. Diabet. Med. 19, 693–696 (2002)
Salomone Di Saverio - One of the best experts on this subject based on the ideXlab platform.
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p o p a study prevention of postoperative abdominal adhesions by Icodextrin 4 solution after laparotomy for adhesive small bowel obstruction a prospective randomized controlled trial
Journal of Gastrointestinal Surgery, 2012Co-Authors: Salomone Di SaverioAbstract:Background Adhesive small bowel obstruction (ASBO) is an important cause of hospital admission, is associated with significant morbidity and mortality, and therefore is a substantial burden for healthcare systems worldwide. Icodextrin 4% solution (Adept, Shire Pharmaceuticals, UK) is a high-molecular-weight a-1,4 glucose polymer approved in Europe for use as intraoperative lavage and postoperative instillation to reduce the occurrence of post-surgery intra-abdominal adhesions. The present clinical study aimed to evaluate the safety and effectiveness of Icodextrin 4% in decreasing the incidence, extent, and severity of adhesions in patients after abdominal surgery for ASBO.
Andrew Davenport - One of the best experts on this subject based on the ideXlab platform.
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peritoneal sodium removal compared to glucose absorption in peritoneal dialysis patients treated by continuous ambulatory peritoneal dialysis and automated peritoneal dialysis with and without a daytime exchange
Therapeutic Apheresis and Dialysis, 2021Co-Authors: Theerasak Tangwonglert, Andrew DavenportAbstract:Sodium removal in peritoneal dialysis (PD) depends on convective clearance, typically generated by a glucose gradient, but this can result in glucose absorption. We wished to determine which factors determine peritoneal sodium losses to glucose absorption (PD Na/Gluc). Peritoneal sodium losses and glucose absorption were calculated from measured 24-h collections of PD effluent, in patients attending for assessment of peritoneal membrane function. Five hundred and fifty eight patients; 317 (56.8%) males, mean age 56.1 ± 16.0 years, were studied, 281 treated by automated peritoneal dialysis (APD) with a daytime exchange (50.4%); 179 (32.1%) by APD and 98 (17.6%) by continuous ambulatory peritoneal dialysis (CAPD). All patients used glucose containing dialysates, with 352 (63.1%) using Icodextrin and 210 (37.6%) hypertonic (22.7 g/L glucose) dialysates. The ratio of PD Na/Gluc was 0.14 (0.02-0.29). Patients using Icodextrin had a higher ratio (0.16 (0.03-0.32) versus 0.11 (-0.02-0.26), P < .001), as did those using 22.7 g/L glucose versus 13.6 g/L (0.16 (0.06-0.32) versus 0.13 (-0.01-0.19), P < .01), and CAPD versus APD (0.18 (0.05-0.36) versus 0.11 (0.0-0.27), P < .05), respectively. A multivariable model showed that 24-h ultrafiltration (odds ratio [OR] 7.6 (95% confidence interval [3.9-14.8]), P < .001 was associated with increased PD Na/Gluc, whereas APD (OR 0.19 (0.06-0.62), P < .01 and increased extracellular water to total body water (OR 0.001 [0-0.08], P = .03) were associated with lower ratios. Twenty four-hour peritoneal ultrafiltration was strongly associated with PD Na/Gluc, whereas patients treated with APD cyclers without a daytime Icodextrin exchange and those with an increased extracellular water to total body water had lower peritoneal sodium losses but with greater peritoneal glucose absorption.
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Icodextrin improves the fluid status of peritoneal dialysis patients results of a double blind randomized controlled trial
Journal of The American Society of Nephrology, 2003Co-Authors: Simon J Davies, Kieron Donovan, Graham Woodrow, Jorg Plum, Paul Williams, Ann Johansson, Hanspeter Bosselmann, Olof Heimburger, Ole Simonsen, Andrew DavenportAbstract:Worsening fluid balance results in reduced technique and patient survival in peritoneal dialysis. Under these condi- tions, the glucose polymer Icodextrin is known to enhance ultrafiltration in the long dwell. A multicenter, randomized, double-blind, controlled trial was undertaken to compare ico- dextrin versus 2.27% glucose to establish whether Icodextrin improves fluid status. Fifty patients with urine output 750 ml/d, high solute transport, and either treated hypertension or untreated BP 140/90 mmHg, or a requirement for the equiv- alent of all 2.27% glucose exchanges, were randomized 1:1 and evaluated at 1, 3, and 6 mo. Members of the Icodextrin group lost weight, whereas the control group gained weight. Similar differences in total body water were observed, largely ex- plained by reduced extracellular fluid volume in those receiv- ing Icodextrin, who also achieved better ultrafiltration and total sodium losses at 3 mo (P 0.05) and had better maintenance of urine volume at 6 mo (P 0.039). In patients fulfilling the study's inclusion criteria, the use of Icodextrin, when compared with 2.27% glucose, in the long exchange improves fluid removal and status in peritoneal dialysis. This effect is appar- ent within 1 mo of commencement and was sustained for 6 mo without harmful effects on residual renal function.
