Subject Index Acidosis, see Metabolic acidosis Activated carbon, sorbents 337 Adipokines adipose tissue and systemic inflammation 169 functions 167 169 prospects for study in renal patients 171 Adiponectin, functions 168 Advanced glycation end products (AGE) animal models of peritoneal dialysis 72, 73 formation 78, 79, 91 syndrome prevention 140 peritoneal dialysis accumulation 49 51, 77 receptor, see RAGE Albumin, serum levels and mortality risks 152, 153 Anemia etiology 205 prevalence in peritoneal dialysis 202 treatment dialysis adequacy 206 erythropoiesis-stimulating therapy administration route 208, 211 darbepoetin alfa 207, 208 epoetin alpha 207, 208 epoetin beta 207, 208 expected response 208 poor response 209, 210 initiation 203 iron replacement 206, 207 nutrition 206 peritonitis patients 210, 211 target hemoglobin concentration 203 205 Angiogenesis, see Vascular endothelial growth factor Angiotensin II, peritoneal dialysis induction and fibrosis 74 Angiotensin-converting enzyme (ACE) inhibitors mesothelial cell effects 163 renal function preservation after failed kidney transplant 275 Antibiotics, 142 peritonitis management 183 Aquaporin-1, peritoneum 33, 34, 98, 99 Atherosclerosis, see Malnutritioninflammation-atherosclerosis syndrome; Vascular calcification Automated peritoneal dialysis (APD) adequacy targets 281, 282, 285, 286 cyclers Home Choice 295 Home Choice Pro 295, 296 ideal criteria 300 overview 294 PD 100T 298 346
PD 101 298 PD 200 298, 299 PD Night 296, 297 Sleep Safe 297 historical perspective 292 294 indications 279 281 modes 279, 294 popularity 278, 279 prospects biosensors 305 continuous flow 306 dialysis fluids composition 304, 305 on-line preparations 305, 306 schedules anuric patients 286 BreakPoint automated peritoneal dialysis 288, 289 computer-assisted kinetic modeling301 drain profile management 288, 289 dwell volume prescription 287, 288, 301 total fill volume prescription 287, 300, 301 treatment monitoring301 304 ultrafiltration 282, 283 Balance solution, clinical studies 91, 92 Beta-blockers, sclerosis risks in peritoneal dialysis 66, 67 Bioimpedance analysis, see also Multifrequency bioimpedance analysis 50-kHz bioimpedance vector analysis 123, 124 fluid volume estimation 122 hydration indicator 123 peritoneal dialysis patient studies 124 127, 332 334 principles 120, 327 single-frequency bioimpedance analysis 122 whole-body versus segmental bioimpedance analysis 120 122 Body mass index (BMI), outcome correlation in dialysis patients 170, 171 Bone morphogenetic protein-7 (BMP-7), vascular calcification prevention 216, 217 Calcium handling calcium balance in peritoneal dialysis 219, 220 control in peritoneal dialysis 221, 222 phosphorus balance in peritoneal dialysis 220, 221 renal osteodystrophy 218, 219 serum levels and mortality risks 214 vascular calcification impact in dialysis patients 217, 218 pathogenesis 215 217 risks 215 Cardiovascular disease, chronic kidney disease 144, 145 Catheters, see also Tenckhoff catheter continuous-flow peritoneal dialysis 313 designs 198 double-lumen catheters for continuousflow peritoneal dialysis 199 historical perspective 195 197 Cbfa-1, vascular calcification role 216 Cloudy dialysate diagnostic algorithm 192, 193 infection 187 noninfectious causes eosinophils 190 fibrin 192 malignant cells 191 monocytes 190, 191 overview 187 189 polymorphonuclear leukocytes 189, 190 red blood cells 191 triglycerides 192 Congestive heart failure comorbidity 248 epidemiology 130, 247 fluid overload 129 hemodialysis treatment 132, 249 hemofiltration therapy 249 medical management 131 mortality 248 pathophysiology 130, 131 peritoneal dialysis treatment of refractory disease 132, 133, 249 252, 333, 334 pharmacotherapy 248 stages 130 Subject Index 347
Continuous cycling peritoneal dialysis, see Automated peritoneal dialysis Continuous flow peritoneal dialysis (CFPD) catheter design 313 dextrose as osmotic agent 314 dialysis adequacy 311 313 monitoring314, 315 rationale 310, 311, 317, 322 324 safety 315 scheduling323, 324 ultrafiltration control 313, 314 urea kinetics 315, 316 Convection hemodialysis 1 3 interference with diffusion 6 C-reactive protein (CRP) cardiac event prediction 153 inflammation marker 136, 145 147 mortality prediction 153, 158 Darbepoetin alpha, see Anemia Dialysate cloudy, see Cloudy dialysate regeneration with sorbents 340 Dialysis fluids automated peritoneal dialysis composition 304, 305 on-line preparations 305, 306 bicarbonate-based solutions in bone disease treatment and prevention 222 combinations of biocompatible fluids 94, 95 glucose-containing biocompatible fluids Balance 91, 92 Gambrosol Trio 91 Physioneal 92, 93 inflammation prevention 147, 148 low glucose degradation product solutions and biocompatibility 162, 163 syndrome prevention 140 mesothelial cell phenotype and peritoneal dialysis response 159, 160 non-glucose-containing biocompatible fluids Extraneal 94 Nutrineal 93, 94 ph effects on inflammation 160 Diffusion hemodialysis 1 3 interference with convection 6 solute transfer in peritoneal dialysis 15, 16 Dry body weight assessment 105, 106 definition 105 Elderly patients prevalence of chronic peritoneal dialysis utilization 240 prospects 244, 245 underutilization of chronic peritoneal dialysis reasons compliance 241, 242 dialysis adequacy and nutrition 242, 243 hospitalization 242 infectious complications 242 manual dexterity and neuropsychiatric function 241 overview 240, 241 patient survival 243, 244 technique survival 243 Eosinophils, cloudy dialysate 190 Epoetin, see Anemia Extraneal, clinical studies 94, 140 Fetuin, vascular calcification prevention 216, 217 Fibrin, cloudy dialysate 192 Fibrosis, peritoneum angiotensin II role 74 clinical correlates and mechanisms 178 hydrostatic pressure effects on avascular matrix 179 inflammation association 176 RAGE role 73, 74, 81 sclerosis etiology and pathogenesis 66, 67 solute clearance effects 179 sub-peritoneal compact zone alterations 176 178 transforming growth factor- role 73 Subject Index 348
Gambrosol Trio, clinical studies 91 Glitazone, malnutrition-inflammationatherosclerosis Glucose degradation products (GDPs) compounds 91 dialysis fluid as source 77 inflammation induction 146 mesothelial cell phenotype and peritoneal dialysis response 161 peritoneal membrane accumulation and effects 50, 51, 78, 79 Heart failure, see Congestive heart failure Hemodialysis blood compartment 4, 5 congestive heart failure management 132 convection 1 3, 6 dialysate compartment 5 diffusion 1 3, 6 kidney transplant outcome effects, see Kidney transplant membrane permeability 3, 4 peritoneal dialysis integration in uremia treatment, see Uremia solute clearance factors 2 solute diffusivity and sieving3 5 urea kinetics modeling, see Urea kinetics Home Choice, automated peritoneal dialysis cycler 295 Home Choice PRO, automated peritoneal dialysis cycler 295, 296 Hyaluronan, peritoneal transport effects 162 Hyperphosphatemia, see Phosphate handling Icodextrin, peritoneal dialysis use metabolism 100 overview 45, 94, 97 peritoneal transport with solutions clinical studies 101 high transporter patient use 101, 102 long-term effects 102 ultrafiltration 100, 101 structure 100 Inflammation, see also Malnutritioninflammation-atherosclerosis syndrome adipose tissue and systemic inflammation 169 etiology in peritoneal dialysis 145, 146, 167 genetic susceptibility 147 glucose degradation product induction 146 markers 136, 145, 153, 167 pathophysiology in peritoneal dialysis 160, 161 peritoneal dialysis failure role 156 prevention in peritoneal dialysis 147 149 Interleukin-6 (IL-6), gene polymorphisms 47, 158 Intravital microscopy, peritoneum acute effects of peritoneal dialysis fluid perfusion 86, 87 chronic dialysis fluid exposure studies 87, 88 glucose effects in diabetic rat model 86 technique 86 Iron, anemia management 206, 207 Kidney transplant failure rate 271, 272 patient selection for renal replacement therapy mode 261 peritoneal dialysis after failed transplant hemodialysis comparison 272, 273 immunosuppressive therapy 274, 275 recommendations 275, 276 residual renal function preservation 274, 275 technique failure 273, 274 peritoneal dialysis penetration and technique survival 260, 261 renal replacement therapy mode effect on outcomes cold ischemia time 261 combined kidney and pancreas transplantation after peritoneal dialysis 256 immediate post-transplant graft function 254 256, 262 264 long-term graft and patient survival 256, 257, 266, 267 vascular thrombosis 264 266 Subject Index 349
Knockout mouse, see RAGE Kt/V, see Urea kinetics Leptin, functions 167, 168 Macrophage, adipocyte interactions 169 Malnutrition-inflammation-atherosclerosis (MIA) syndrome atherosclerosis 137 inflammation markers 136 malnutrition 136, 137 metabolic acidosis 138 overview 135 peritoneal transport 137 residual renal function 137, 138 treatment angiotensin-converting enzyme inhibitors 141 antibiotics 141, 142 biocompatible peritoneal dialysis solutions 140 glitazone 141 inflammation nutrition 139 volume control 139 lifestyle modification 142 malnutrition acidosis 138, 139 appetite stimulants 139 dialysis adequacy 138 nutritional support 138 nonsteroidal anti-inflammatory drugs 141 statins 141 thalidomide 142 vitamin C 141 vitamin E 141 Matrix GLA protein (MGA), vascular calcification prevention 216, 217 Mesothelial monolayer animal model of peritoneal dialysis effects dialysis solution studies of repopulation and repair 57 59 homeostatic repopulation 57 preparation 55 cell phenotype and peritoneal dialysis response 49, 156, 157, 159 161 glucose degradation product effects 78, 79 Metabolic acidosis bicarbonate-based solutions in treatment and prevention 222 bone metabolism effects in peritoneal dialysis 222 syndrome 138 Monocytes, cloudy dialysate 190, 191 Multifrequency bioimpedance analysis (MF-BIA), see also Bioimpedance analysis dry body weight assessment 105, 106 personal impedance analyzer applications 332 334 overview 328, 329 study design 329 validation 330, 332 principles 122 Nonsteroidal anti-inflammatory drugs (NSAIDs), malnutrition-inflammationatherosclerosis Normalized protein equivalent of nitrogen appearance (npna), calculation and urea clearance relationship 20, 21 Nutrineal, clinical studies 93, 94, 140 Osteopontin, vascular calcification prevention 216 Overhydration causes 113 diagnosis 112, 113 peritoneal dialysis complication 111, 112 prevalence 112 treatment hypertonic glucose 114 peritoneal ultrafiltration 114, 115 residual renal function and diuresis effects 114, 115 sodium restriction 113, 114 Patient On Line (POL), peritoneal function testing39 PD 100T, automated peritoneal dialysis cycler 298 Subject Index 350
PD 101, automated peritoneal dialysis cycler 298 PD 200, automated peritoneal dialysis cycler 298, 299 PD-Adequest, peritoneal function testing39 PD Night, automated peritoneal dialysis cycler 296, 297 Peritoneal dialysis, see also Automated peritoneal dialysis; Continuous flow peritoneal dialysis access, see Catheters animal models acute models 72 ANIMOD collaboration 70, 71 chronic models 72 74 clinical relevance 71, 72 prospects 74 dialysis solutions, see Dialysis fluids failure rate 45 initiation 42 46 kidney transplant outcome effects, see Kidney transplant long-term effects on peritoneal function glucose degradation product accumulation 48 51 mesothelium effects, see Mesothelial monolayer overview 17 sclerosis, see Sclerosis, peritoneum lymphatic absorption 16 modes 43 solute transfer convection 16 diffusion 15, 16 solute transport factors dialysate compartment 6 8 membrane properties 8, 9 microcirculation 9 11 sorbents, see Sorbents urea kinetics modeling, see Urea kinetics Peritoneal equilibration test (PET) chronic peritoneal dialysis findings 157 peritoneal function testing37, 38, 40 Peritoneum anatomy 13, 14, 31 33 aquaporin-1 33, 34 cellular immune response 158, 159 fibrosis, see Fibrosis, peritoneum function 14 interstitium structure 175 transport role 175, 176 membrane function testing17, 37 40 properties 8, 9 vascular bed studies, see Intravital microscopy, peritoneum microcirculation 9 11, 33 resistance to solute and water transport 14, 15 sclerosis, see Sclerosis, peritoneum ultrafiltration, see Ultrafiltration, peritoneum Peritonitis anemia management 210, 211 catheter removal 184, 185 causes 182, 183 clinical presentation 182 cloudy dialysate, see Cloudy dialysate epidemiology 181, 182 fungal peritonitis 183, 184 management 183 mortality 181 mycobacterial peritonitis 184 peritoneal dialysis risks 45, 50, 51 sclerosis etiology 66 Personal Dialysis Capacity test (PDC), peritoneal function 39, 40 Personal impedance analyzer (PIA) applications 332 334 overview 328, 329 study design 329 validation 330, 332 Phosphate handling calcium balance in peritoneal dialysis 219, 220 control in peritoneal dialysis 221, 222 phosphorus balance in peritoneal dialysis 220, 221 serum levels and mortality risks 214, 215 vascular calcification impact in dialysis patients 217, 218 pathogenesis 215 217 risks 215 Subject Index 351
Physioneal, clinical studies 92, 93, 140 Pit-1, vascular calcification role 216 Polymorphonuclear leukocytes, cloudy dialysate 189, 190 RAGE knockout mouse studies peritoneal angiogenesis 80, 81 peritoneal fibrosis 81 peritoneal inflammation 80 ligands 79, 80 mesothelial cell effects 78, 79 peritoneal fibrosis role 73, 74 signal transduction 79, 80 structure 79 Red blood cells, cloudy dialysate 191 Residual renal function (RRF) kidney transplant failure and preservation with peritoneal dialysis 274, 275 malnutrition-inflammationatherosclerosis syndrome 137, 138 overhydration treatment effects 114, 115 prognostic value 153 Resistin, functions 168, 169 Sclerosis, peritoneum animal models 65 etiology and pathogenesis 66, 67 frequency in peritoneal dialysis 63 pathology 63 65 simple sclerosis versus sclerosing peritonitis 62, 63, 67 Shear rate value blood 4 solute transfer in peritoneal dialysis 16 Sleep Safe, automated peritoneal dialysis cycler 297 Sodium dietary intake recommendations 108 removal in peritoneal dialysis mortality relationship 108 target 106, 107 Sorbents activated carbon 337 dialysate regeneration 340 peritoneal dialysis utilization 340, 341 targets 337 types 337 339 Standardized peritoneal membrane assessment (SPA), peritoneal function testing38, 39 Statins, malnutrition-inflammationatherosclerosis Tenckhoff catheter development 197 modifications for complication avoidance 197 199 Thalidomide, malnutrition-inflammationatherosclerosis syndrome prevention 142 Transforming growth factor- (TGF- ) glucose degradation product induction 78 peritoneal dialysis induction and fibrosis 73 peritoneal membrane effects 85 Triglycerides, cloudy dialysate 192 Ultrafiltration, peritoneum automated peritoneal dialysis 282, 283 continuous flow peritoneal dialysis control 313, 314 fluid loss measurement 31 intraperitoneal hydrostatic pressure 31 lymph flow measurement 31 membrane model 29 net ultrafiltration equation 28 osmosis and fluid loss 29, 30 prospects for study 34, 35 overhydration treatment effects on residual renal function and diuresis 114, 115 overview 16 transport process 98 100 Urea kinetics blood urea versus blood urea nitrogen 23 clearance in normal kidney 21, 22 continuous flow peritoneal dialysis 315, 316 hemodialysis overview 22 simplified model peritoneal dialysis comparison 26 Subject Index 352
principles 23, 24 time-averaged blood urea nitrogen calculation 25, 26 time requirement to achieve Kt/V 1 25 indicators 20 normalized protein equivalent of nitrogen appearance calculation and urea clearance relationship 20, 21 peritoneal dialysis efficiency and survival 233, 234 overview 22 simplified model hemodialysis comparison 26 principles 23, 24 steady state blood urea nitrogen calculation 25 time requirement to achieve Kt/V 1 24 urea clearance needed to achieve Kt/V 2/week 24, 25 Uremia, peritoneal dialysis integration in treatment clinical parameters of adequacy 228, 229 education aspects 237 elderly patients, see Elderly patients full-treatment studies 230 234 institutional barriers 237 modes of peritoneal dialysis 231 mortality studies 237, 238 organizational aspects 227, 228 overview 226, 227 patient preferences 238 prevalence and trends of chronic peritoneal dialysis utilization 235 237 program 227 rehabilitation 229 technical issues 229, 230 Vascular calcification impact in dialysis patients 217, 218 pathogenesis 215 217 risks 215 Vascular endothelial growth factor (VEGF) chronic peritoneal dialysis fluid exposure effects in rats 87, 88 glucose degradation product induction 78, 81 peritoneal membrane effects 85 Vitamin C, malnutrition-inflammationatherosclerosis Vitamin E, malnutrition-inflammationatherosclerosis Water aquaporin-1 transport 33, 34, 98, 99 overhydration, see Overhydration removal target in peritoneal dialysis 106 Subject Index 353