Continuous ambulatory peritoneal dialysis telemonitoring and education:A scoping review

The risk of peritonitis complications in continuous ambulatory peritoneal dialysis(CAPD)can be prevented or reduced by providing proper education and continuous monitoring.Telemedicine and telemonitoring are methods that enable remote monitoring and patient care.This study aimed to determine the success and factors affecting telemonitoring in CAPD patient care.This study is a scoping review(ScR)using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-ScR method.Article searches were carried out on ProQuest,PubMed,and ScienceDirect with a time range of 2018-2023.Data extraction was performed regarding knowledge level,quality of life,clinical outcomes(peritonitis),and risk of hospitalization.Of the 12 articles and studies included,6 articles were related to the effect of telemonitoring on CAPD patient outcomes,and 6 articles were associated with the effect of education on CAPD patient outcomes.Education provided to patients can improve patient understanding of therapeutic modalities for renal disorders,reduce the potential for peritonitis and dialysis complications,and improve the quality of life of patients with CAPD.CAPD patients who received telemonitoring had a better quality of life,good clinical outcomes,and a lower risk of hospitalization than those who did not receive telemonitoring and had fewer health-care visits.In summary,the implementation of telemonitoring and education in chronic kidney disease patients with CAPD modality therapy has been proven effective in improving quality of life and reducing dialysis-related risks.

Effect of Continuous Nursing Model on Nursing Effect of Continuous Peritoneal Dialysis

Objective:To analyze and study the effect of continuous nursing mode for continuous peritoneal dialysis nursing.Methods:40 patients with continuous peritoneal dialysis received in our hospital were randomly selected as the research object.The research time was from June 2018 to June 2020.The patients were divided into two groups by random number table method.The patients with routine nursing mode were named as the control group and the patients with continuous nursing mode were named as the observation group(20 cases in each group).The clinical nursing effects of different nursing modes are compared.Results:After nursing,the nursing compliance of the observation group was 95%,which was higher than 70% of the control group.There was significant difference between the two groups(P<0.05).Comparing the blood routine related indexes of the two groups,the blood potassium,hemoglobin,serum creatinine and carbon dioxide binding force of the observation group were better than those of the control group(P<0.05).The incidence of peritonitis and rehospitalization rate in half a year in the observation group were lower than those in the control group(P<0.05).Conclusion:The continuous nursing model for patients undergoing continuous peritoneal dialysis can improve the treatment effect of patients,significantly improve the compliance of patients,significantly improve the serological indexes,promote the health of patients,reduce the incidence of peritonitis,and significantly reduce the rehospitalization rate in half a year.It has a broad prospect of clinical promotion.

TREATMENT OF COMPLICATIONS DUE TO PERITONEAL DIALYSIS FOR CHRONIC RENAL FAILURE WITH TRADITIONAL CHINESE MEDICINE

In this paper,the experience in the treatment of complications due to continuousambulatory peritoneal dialysis for chronic renal failure with traditional Chinese medicine(TCM)is reported.Modified Renshen Yangrong Tang(Ginseng Nutrition Decoction)wasused for anorexia and hypoproteinemia;modified Xiangsha Liujunzi Tang(Decoction ofCyperus and Amomum with Six Noble Ingredients)for abdominal pain and distension;modified Da Chaihu Tang(Major Bupleurum Decoction)for peritonitis;modifiedShenling Baizhu San(Powder of Ginseng,Poria and Atractylodes)for diarrhea due toinsufficiency of the spleen with abundance of dampness;Lizhong Tang(Decoction forRegulating the Function of Middle-jiao)and modified Sishen Wan(Pills of FourMiraculous Drugs)for insufficiency of both the spleen and the kidney;Siwu Tang(Decoction of Four Ingredients)added with other drugs for cutaneous pruritus,andGuishao Sijunzi Tang(Decoction of Four Noble Drugs added with Chinese Angelica Rootand white Peony Root)for renal anemia.The therapeutic principles of invigorating theliver and kidney,strengthening the bones and muscles,and promoting blood circulation toeliminate blood stasis were adopted in the treatment of renal osteopathy,and thetherapeutic principles of invigorating the liver and kidney,expelling phlegm and resolvingdampness,and promoting blood circulation to eliminate blood stasis in the treatment ofhyperlipemia.Shen Tekang capsules(capsules for improving the renal function)wasadministered to patients for strengthening the viability and improving the nutrition state,and the recipe for treating renal function failure(both formulated by the authors)forimproving the renal function so as to decrease the frequency and duration of dialysis.

Influence of peritoneal transfer status on fasting blood glucose in non-diabetic nephropathy patients on continuous ambulatory peritoneal dialysis

Background Extra glucose load in peritoneal dialysis is an important cause of newly-occurred diabetic mellitus, which initiates insulin treatment in some of the dialytic patients. The purpose of this study was to discuss the influence of the peritoneal transfer status on fasting blood glucose in non-diabetic nephropathy patients who are on continuous ambulatory peritoneal dialysis （CAPD）. Methods One hundred and forty-five patients with total KTN per week over 2.0 were recruited, including 60 males and 85 females. Fasting blood glucose （FBG）, creatinine, blood urea nitrogen （BUN）, blood albumin, blood lipid profile and blood C-reactive protein （CRP） were analyzed at the beginning of the peritoneal dialysis and after 12 months. A peritoneal equilibration test （PET） was carried out at the 3rd month of CAPD, and meantime residual renal function, peritoneal solute clearance rate, ultrafiltration volume and urine volume were also evaluated. Results Twenty-one cases were identified as a low transfer group （L）, 32 cases as a low average transfer group （LA）, 58 cases as a high average transfer group （HA） and 34 cases as a high transfer group （H）. At the end of the 12th month, 83 cases had elevated FBG. Through stepwise multiple regression analysis we found the FBG level in these patients was positively related to glucose load and CRP, and negatively related to glucose absorption in the peritoneum （D/D0） and blood albumin （P 〈0.05）. Kaplan-Meier analysis during a 48-month follow-up found the morbidity of hyperglycemia to be 17/34 cases （50.1%） in the high transfer group, 20/58 cases （34.5%） in the high average transfer group, 11/32 cases （34.3%） in the low average transfer group, and 1/21 cases （5.4%） in the low transfer group. Conclusions Patients with high peritoneal transfer capacity might have the highest morbidity from hyperglycemia among patients with these four different peritoneal transfer status. Glucose load, baseline CRP and FBG level before peritoneal dialysis, and D/D0 can efficiently predict hyperglycemia in CAPD patients.

Clinical Effect of Xinqingning (新清宁) Combined with Low Dose Continuous Gastrointestinal Dialysis in Treating Uremia

Objective: To investigate the clinical effect of Xinqingning (XQN), a preparation of rhubarb, combined with low dose continuous gastrointestinal dialysis in treating uremia.Methods: Patients of uremia were divided into three groups at random, 18 patients in group A were treated with 1000 ml gastrointestinal dialysate (non-absorbed mannitol solution) orally 2–3 times a day, 20 patients in group B treated with the same therapy as that in group A, also combined with XQN 5–10 tablets 3 times per day and 19 patients in group C treated with orally taken coated aldehyde oxystarch 5–10 g, 3 times a day. The therapeutic course for the three groups was 11 months. The changes in clinical manifestation, renal function, nutritional condition, and electrolytes before and after treatment were observed.Results: After treatment, significant improvement was revealed in aspects of uremic symptoms, quality of life, nutritional condition, serum creatinine, urea nitrogen, serum phosphate, uric acid, CO2 combining power, creatine clearance, body weight and arm muscular circumference in group A and B, as compared with those in group C. In comparison of group A with B, group B showed a lower serum triglyceride and a slower progression of chronic renal failure (CRF). All the criteria were not improved in group C and with serum creatinine being raised significantly.Conclusion: XQN combined with low dose continuous gastrointestinal dialysis therapy was definitely effective in treating uremia. It provides a new therapeutic means of non-replacement therapy for CRF with uremia.

Better renal replacement therapy to improve sexual function in female patients with end-stage renal disease:A cross-sectional study

Background Sexual dysfunction is commonly observed in patients with end-stage renal disease(ESRD).Sexual dysfunction in correlation with ESRD is associated with physiological and psychological problems resulting in low sexual desire,arousal,difficulties in achieving orgasm,and pain during intercourse.Studies on female sexual dysfunction(FSD)in correlation with renal replacement therapy are limited,and previous studies reporting contradictive results have indicated that the best modality for providing better outcomes(especially on FSD)remains unclear.Thus,this study aimed to compare the sexual function between female patients with ESRD who were on continuous ambulatory peritoneal dialysis(CAPD)and those on hemodialysis(HD).Materials and methods This study enrolled female patients who were randomly selected from the urology and renal division of the Internal Medicine Outpatient Clinic of our hospital from January 2020 to August 2021 and divided into the following groups:predialysis,HD,CAPD,and control groups.The participants were asked to fill out the Female Sexual Function Index(FSFI)questionnaires,and their data were recorded and analyzed using GraphPad Prism 9.0.0.Results Of the 280 patients,200 female patients were included in this study.The rate of FSD(cutoff:26.55)was 42%in the control group,72%in the predialysis group,62%in the CAPD group,and 66%the in HD group.The control group had a higher mean score in all parameters(p<0.05).The total FSFI mean score indicated no significant difference(p>0.05)between the patients on HD and those on CAPD;the mean of each point was almost identical except for satisfaction,which was higher among patients on CAPD(p<0.05).Significant differences in the components of desire,arousal,orgasm,and satisfaction were observed between the groups.Conclusions Patients on CAPD had better FSFI scores than the female patients with ESRD who were on HD,and the scores of both groups of patients were better than those of the predialysis group.

First Report of Tsukamurella conjunctivitidis CAPD-related Peritonitis

Introduction Using the information obtained from analysis of 16S rRNA gene sequences,Tsukamurella was first proposed as a genus in 1988,1 despite the fact that the first strain of this group of bacteria was described in 1941,2 and the first human isolate was reported in 1971.3 Similar to related genera of the order Corynebacteriales,such as Nocardia,Rhodococcus,and Gordonia,members of Tsukamurella are Gram-positive,aerobic,catalase-positive,and partially acid-fast as a result of the presence of mycolic acid in the cell envelope.Due to their similar phenotypic properties,differentiation of these genera and speciation within these genera is difficult in most clinical microbiology laboratories.