Evolving Concepts in Peritoneal Dialysis and Haemodialysis

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Urology & Nephrology".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 1648

Special Issue Editor

Department of Medical and Surgical Sciences, Nephrology and Dialysis Unit, “Magna Graecia” University of Catanzaro, Catanzaro, Italy
Interests: clinical epidemiology of cardiovascular and renal risk in renal diseases; chronic kidney disease; acute kidney injury; hypertension; renal replacement therapies

Special Issue Information

Dear Colleagues,

Significant advances in kidney replacement therapy (KRT) have been made in the last 60 years. Today, a bit less than 4 million people are alive thanks to KRT, the largest number among these being in the most developed countries. About 70% of people undergoing KRT are on dialysis, and among them about 10% are on peritoneal dialysis and 90% on haemodialysis.

Nephrologists and public health authorities will face major challenges in the future. The number of patients requiring KRT is going to increase. Most will be in low-income countries, where KRT is not yet widely available. In addition, the overall patient population is becoming older, with many already existing complications, particularly cardiovascular ones. Current dialysis methods, peritoneal and haemodialysis are big consumers of water, whereas haemodialysis needs a lot of electricity, as well. In addition, in both methods a large quantity of waste is being produced, especially hazardous waste. Unfortunately, both methods are also relatively expensive.

In this thematic issue of the journal, the current state of dialysis will be presented: haemodialysis and peritoneal dialysis. Future challenges and the latest research, as well as possibilities for the application of new dialysis membranes, dialysis machines, and peritoneal dialysis solutions, will be pointed out. The possibilities of saving water, electricity, as well as the possibilities of reducing hazardous waste would be emphasised.

Reviews of new drugs in the prevention and treatment of anaemia, disorders of mineral metabolism, and cardiovascular complications in patients on dialysis will be presented.

Dr. Davide Bolignano
Guest Editor

Manuscript Submission Information

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Keywords

  • challenges in kidney replacement therapy
  • haemodialysis
  • peritoneal dialysis
  • eco-dialysis
  • anaemia in CKD
  • CKD
  • MBD

Published Papers (1 paper)

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Research

10 pages, 401 KiB  
Article
Clinical Benefits of Laparoscopic Adhesiolysis during Peritoneal Dialysis Catheter Insertion: A Single-Center Experience
by Hao-Wei Kou, Chun-Nan Yeh, Chun-Yi Tsai, Shou-Hsuan Liu, Wen-Yu Ho, Chao-Wei Lee, Shang-Yu Wang, Ming-Yang Chang, Ya-Chung Tian, Jun-Te Hsu and Tsann-Long Hwang
Medicina 2023, 59(6), 1014; https://doi.org/10.3390/medicina59061014 - 24 May 2023
Cited by 1 | Viewed by 1198
Abstract
Background and Objectives: In peritoneal dialysis (PD) therapy, intra-abdominal adhesions (IAAs) can cause catheter insertion failure, poor dialysis function, and decreased PD adequacy. Unfortunately, IAAs are not readily visible to currently available imaging methods. The laparoscopic approach for inserting PD catheters enables direct [...] Read more.
Background and Objectives: In peritoneal dialysis (PD) therapy, intra-abdominal adhesions (IAAs) can cause catheter insertion failure, poor dialysis function, and decreased PD adequacy. Unfortunately, IAAs are not readily visible to currently available imaging methods. The laparoscopic approach for inserting PD catheters enables direct visualization of IAAs and simultaneously performs adhesiolysis. However, a limited number of studies have investigated the benefit/risk profile of laparoscopic adhesiolysis in patients receiving PD catheter placement. This retrospective study aimed to address this issue. Materials and Methods: This study enrolled 440 patients who received laparoscopic PD catheter insertion at our hospital between January 2013 and May 2020. Adhesiolysis was performed in all cases with IAA identified via laparoscopy. We retrospectively reviewed data, including clinical characteristics, operative details, and PD-related clinical outcomes. Results: These patients were classified into the adhesiolysis group (n = 47) and the non-IAA group (n = 393). The clinical characteristics and operative details had no remarkable between-group differences, except the percentage of prior abdominal operation history was higher and the median operative time was longer in the adhesiolysis group. PD-related clinical outcomes, including incidence rate of mechanical obstruction, PD adequacy (Kt/V urea and weekly creatinine clearance), and overall catheter survival, were all comparable between the adhesiolysis and non-IAA groups. None of the patients in the adhesiolysis group suffered adhesiolysis-related complications. Conclusions: Laparoscopic adhesiolysis in patients with IAA confers clinical benefits in achieving PD-related outcomes comparable to those without IAA. It is a safe and reasonable approach. Our findings provide new evidence to support the benefits of this laparoscopic approach, especially in patients with a risk of IAAs. Full article
(This article belongs to the Special Issue Evolving Concepts in Peritoneal Dialysis and Haemodialysis)
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