Continuous Ambulatory Peritoneal Dialysis in Diabetic End Stage Renal Disease

  • Ramesh Khanna
  • Dimitrios G. Oreopoulos
Chapter
Part of the International Yearbook of Nephrology 1991 book series (IYNE, volume 3)

Abstract

The management of the diabetic patients with end stage renal disease (ESRD) has undergone significant changes over the last 20 years. In the beginning, diabetics were not even considered for dialysis because of their extensive co-morbidity from other systemic diseases. Early attempts to treat these patients with chronic hemodialysis were faced with disappointing results (1). Intermittent peritoneal dialysis (IPD) performed either in hospital or at home with a cycler over 30-40 hours/week, had certain advantages such as the decline or even arrest of the deterioration of neuropathy and retinopathy. However, when the residual kidney function was no longer present, this dialysis was not adequate and the majority of patients were dying from either electrolytic abnormalities or cardiovascular complications. This high mortality make IPD an unattractive treatment for the diabetic patient with ESRD.

Keywords

Peritoneal Dialysis Continuous Ambulatory Peritoneal Dialysis Residual Renal Function Dialysis Solution Osmotic Agent 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kjellstrand CM: Dialysis in diabetes. In: “Strategy in Renal Failure”, EA Friedman (Ed), J. Wiley & Sons, New York, 1977, pp 345–391.Google Scholar
  2. 2.
    Kjellstrand CM: A comparison of dialysis and transplantation in patients with end-stage renal failure of diabetes. In: “Diabetic Renal-Retinal Syndrome” EA Friedman and FA L’Esperance (Eds), Grune & Stratton, Orlando, Florida, 1985, pp 333–340.Google Scholar
  3. 3.
    Tenckhoff H, Schechter H: A bacteriologically safe peritoneal access device. Trans ASAIO, 14:181, 1968.Google Scholar
  4. 4.
    Khanna R, Twardowski ZJ: Peritoneal Dialysis. In: “Peritoneal Dialysis”, KD Nolph (Ed), Kluwer Academic Publishers, Dordrecht, The Netherlands, 1989, pp 319–343.CrossRefGoogle Scholar
  5. 5.
    Ponce SP, Pierratos A, Izatt, Mathews R, Khanna R, Zellerman G, Oreopoulos DG: Comparison of the survival and complications of three permanent peritoneal dialysis catheters. Perit Dial Bull, 2: 82,1982.Google Scholar
  6. 6.
    Lindblad AS, Novak JW, Nolph KD, Stablein DM, Cutler SJ, Steinberg SM, Vena DA: In “Continuous Ambulatory Peritoneal Dialysis in the USA”, Kluwer Academic Publishers, Dordrecht, The Netherlands, 1989, pp 63–74.CrossRefGoogle Scholar
  7. 7.
    Katirtzoglou A, Izatt S, Oreopoulos DG: Chronic peritoneal dialysis in diabetics with end-stage renal failure. In: “Diabetic Renal-Retinal Syndrome”, EA Friedman (Ed), Grune & Stratton, Orlando, 1982, pp. 317–332.Google Scholar
  8. 8.
    Blumenkrantz MJ, Shapiro DJ, Minura N, Oreopoulos DG, Friedler RM, Levin S, Tenckhoff H, Coburn JW: Maintenance peritoneal dialysis as an alternative in the patients with diabetes mellitus and end-stage uremia. Kidney Int, 6(Suppl 1): S108,1974.Google Scholar
  9. 9.
    Quelhorst E, Schuenemann B, Mietzsch G, Jacob I: Hemo-and peritoneal dialysis treatment of patients with diabetic nephropathy. A comparative study. Proc of EDTA, 15: 205,1978.Google Scholar
  10. 10.
    Mion C, Slingeneyer A, Salem JL, Oules R, Mirouze J: Home peritoneal dialysis in end stage diabetic nephropathy. J of Dialysis, 2: 426–427,1978.Google Scholar
  11. 11.
    Warden GS, Maxwell JG, Stephen RL: The use of reciprocating peritoneal dialysis with a subcutaneous peritoneal dialysis in end stage renal failure in dialbetes mellitus. J Surg Res, 24: 495–500, 1978.PubMedCrossRefGoogle Scholar
  12. 12.
    Twardowski ZJ: New approaches to peritoneal dialysis. In: “Peritoneal Dialysis”, KD Nolph (Ed), Kluwer Academic Publishers, Dordrecht, The Netherlands, 1989,pp 133–151.CrossRefGoogle Scholar
  13. 13.
    Diaz-Buxo JA: Continuous cyclic peritoneal dialysis. In: “Dialysis”, KD Nolph (Ed), Kluwer Academic Publishers, Dordrecht, The Netherlands, 1989, pp 169–183.Google Scholar
  14. 14.
    Amair P, Khanna R, Leibel B, Pierratos A, Vas S, Meema G, Chisholm L, Vas M, Zingg W, Digenis G, Oreopoulos D: Continuous ambulatory peritoneal dialysis in diabetics with end-stage renal disease. N Engl J Med, 306: 625,1982.PubMedCrossRefGoogle Scholar
  15. 15.
    Perras ST, Zappacosta AR: Reduction of peritonitis with patients education and Travenol CAPD germicidal exchange system. Am Nephrol Nurses Ass, 13: 219,1986.Google Scholar
  16. 16.
    Hamilton RW: The sterile connection device: A review of its development and status report-1986. In: “Advances in Continuous Ambulatory Peritoneal Dialysis”, R Khanna, KD Nolph, BF Prowant, et al (Eds) Peritoneal Dialysis Bulletin, Inc., Toronto, 1986, pp 186–189.Google Scholar
  17. 17.
    Fenton SSA, Wu G, Bowman C, Cattran DC, Manuel A, Khanna R, Vas S, Oreopoulos DG: The reduction in the peritonitis rate among high-risk CAPD patients with the use of the Oreopoulos-Zellerman connector. Trans ASAIO, 31: 560,1985.Google Scholar
  18. 18.
    Buoncristiani U, Quintalinani G, Cozzari M, Carobia C: Current status of the Y-set. In: “Advances in Continuous Ambulatory Peritoneal Dialysis”, R Khanna, et al (Eds), Peritoneal Dialysis Bulletin Inc., Toronto, 1986, pp 165–171.Google Scholar
  19. 19.
    Flynn CT: The diabetics on CAPD. In: “ Renal-Retinal Syndrome”, EA Friedman (Ed) Grune & Stratton, Orlando, 1982, pp 321–330.Google Scholar
  20. 20.
    Stout RW: Diabetes and atherosclerosis-The role of insulin. Diabetologia, 16: 141,1979.PubMedCrossRefGoogle Scholar
  21. 21.
    Zavaroni A, Bonora E, Pagliara M, Dall’Aglio E, Luchetti L, Buonanno G, Bonati PA, Bergonzani M, Gnudi L, Passeri M, Reaven G: Risk factor for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance. N Engl J Med, 320: 702–706, 1989.PubMedCrossRefGoogle Scholar
  22. 22.
    Bazzato G, Coli U, Landini S: Zylitol and low doses of insulin: New perspectives for diabetic uremic patients on CAPD. Perit Dial Bull, 2: 161,1982.Google Scholar
  23. 23.
    Williams FP, Marliss EB, Anderson GH, et al: Amino acids absorption following intraperitoneal administration in CAPD patients. Perit Dial Bull, 2: 124,1982.Google Scholar
  24. 24.
    Twardowski ZJ, Khanna R, Nolph KD: Osmotic agents and ultrafiltration in peritoneal dialysis. Nephron, 42: 93,1986.PubMedCrossRefGoogle Scholar
  25. 25.
    Mistry CD, Mallick NP, Gokal R: The use of large molecular weight glucose polymer as an osmotic agent in CAPD. In: “Advances in Continuous Ambulatory Peritoneal Dialysis”, R Khanna, KD Nolph, BF Prowant, et al (Eds), Peritoneal Dialysis Bulletin, Inc., Toronto, 1986, pp7–11.Google Scholar
  26. 26.
    Matthys E, Dolkart R, Lameire N: Extended use of a glycerol containing dialysate in the treatment of diabetic CAPD patients. Perit Dial Bull, 7: 10,1987.Google Scholar
  27. 27.
    Felig P, Wahren J: The liver as site of insulin and glucagon action in normal, diabetic and obese humans. Israel J Med Sci, 11: 528,1975.PubMedGoogle Scholar
  28. 28.
    Shafrir E, Bergman M, Felig P: The Endocrine Pancreas; Diabetes Mellitus. In: “Endocrinology and Metabolism”, P Felig, JD Baxter, AE Broadus, LA Froahman (Eds) McGraw-Hill Book Company, New York, 1987, Ch. 19, pp 1043–1178.Google Scholar
  29. 29.
    Tamborlane WV, Sherwin RS, Genel M, Felig P: Reduction to normal of plasma glucose in juvenile diabetes by subcutaneous administration of insulin with a portable pump. N Engl J Med, 300: 573,1979.PubMedCrossRefGoogle Scholar
  30. 30.
    Greenwood RH, Davies CJ, Senator GB, O’Brien I, Hayes TM: The transport of peptide hormones across the peritoneal membrane in man. Clin Sci, 57: 28,1979.Google Scholar
  31. 31.
    Schade DS, Eaton RP: The peritoneum-a potential insulin delivery route for a mechanical pancreas. Diabetes Care, 3: 229,1980.PubMedCrossRefGoogle Scholar
  32. 32.
    Rasio EA, Hampers CL, Soeldner JS, Cahill GF: Diffusion of glucose, insulin, insulin and Evans blue protein into thoracic duct lymph of man. J Clin Invest, 46: 903,1967.PubMedCrossRefGoogle Scholar
  33. 33.
    Rubin J, Reed V, Adair C, Bower J, Klein E: Effect of intraperitoneal insulin on solute kinetics in CAPD: Insulin kinetics in CAPD. Am J Med Sci, 291: 81, 1986.PubMedCrossRefGoogle Scholar
  34. 34.
    Rubin J, Bell AH, Andrews M, Jones Q, Planch A: Intraperitoneal insulin-A dose response curve. Trans ASAIO, 35: 17–21,1989.CrossRefGoogle Scholar
  35. 35.
    Shapiro DJ, Blumenkrantz MJ, Levin SR, Cobum W: Absorption and action of insulin added to peritoneal dialysate in dogs. Nephron, 23:174,1979.Google Scholar
  36. 36.
    Wideroe T, Smeby LC, Berg KJ, Jorstad S, Svartas IM: Intraperitoneal insulin absorption during intermittent and continuous peritoneal dialysis. Kidney Int, 23: 22,1983.PubMedCrossRefGoogle Scholar
  37. 37.
    Henderson IS, Patterson KR, Leung ACT: Decreased intraperitoneal insulin requirements during peritonitis on continuous ambulatory peritoneal dialysis. Br Med J, 290: 474,1985.CrossRefGoogle Scholar
  38. 38.
    Rottembourg J, El Shahat Y, Agrafiotis A, Thuillier Y, de Groc F, Jacobs C, Legrain M: Continuous ambulatory peritoneal dialysis in insulin dependent diabetics: A 40 months experience. Kidney Int, 23: 40,1983.PubMedCrossRefGoogle Scholar
  39. 39.
    Harrison NA, Rainford DJ: Intraperitoneal insulin and the malignant omentum syndrome. Nephrol Dial Transplant, 3: 103,1988.PubMedGoogle Scholar
  40. 40.
    Madden MA, Zimmerman SW, Simpson DP: CAPD in diabetes mellitus-the risks and benefits of intraperitoneal insulin. Am J Nephrol, 2: 133, 1982.PubMedCrossRefGoogle Scholar
  41. 41.
    Wing AF, Broyer M, Brunner FP, et al: Combined report on regular dialysis and transplantation in Europe 1982. Proc EDTA-ERA, 20: 1, 1983.Google Scholar
  42. 42.
    Williams C and the University of Toronto Collaborative Dialysis Group: CAPD in Toronto-an overview. Perit Dial Bull, 35: 2,1983.Google Scholar
  43. 43.
    Nolph KD, Stolta M, Maher JF: Altered peritoneal permeability in patients with systemic vasculitis. Ann Intern Med, 78: 891,1973.PubMedGoogle Scholar
  44. 44.
    Twardowski ZJ, Nolph KD, Khanna R, Prowant BF, Ryan LP, Moore HL, Neilsen P: Peritoneal equilibration test. Perit Dial Bull, 7: 138,1987.Google Scholar
  45. 45.
    Gilmore J, Wu G, Khanna R, Oreopoulos DG: Long term CAPD. Perit Dial Bull, 5: 112, 1985.Google Scholar
  46. 46.
    Zimmerman SW, Johnson CA, O’Brien M: Survival of diabetic patients on continuous ambulatory peritoneal dialysis for over five years. Perit Dial Bull, 7: 26,1987.Google Scholar
  47. 47.
    Vas SI: Peritonitis. In: “Peritoneal Dialysisℍ, KD Nolph (Ed), Kluwer Academic Publishers, Dordrecht, The Netherlands, 1989, pp 261–288.CrossRefGoogle Scholar
  48. 48.
    Nolph KD, Cutler SJ Steinberg SM, Novak JW: Special studies from the NIH USA CAPD Registry. Perit Dial Bull, 6: 28–35, 1986.Google Scholar
  49. 49.
    Rottembourg J, Brouard R, Issad B, Allouache M, Jacobs C: Prospective randomized study about Y connectors in CAPD patients. In: “Advances in Continuous Ambulatory Peritoneal Dialysis”, R Khanna, KD Nolph, BF Prowant, ZJ Twardowski and DG Oreopoulos (Eds), Peritoneal Dialysis Bulletin, Inc., Toronto, 1987, pp 107–113.Google Scholar
  50. 50.
    Faller B, Marichal JD: Loss of ultrafiltration in CAPD. Clinical Data. In: “Advances in Peritoneal Dialysis”, G Gahl, M Kessel and KD Nolph (Eds), Excerpta Medica, Amsterdam, 1981, pp 227–232.Google Scholar
  51. 51.
    Slingeneyer A, Mion C, Mourad G, Canaud B, Faller B & Beraud JJ: Progressive sclerozing peritonitis: A late and severe complications of maintenance peritoneal dialysis. Trans ASAIO, 29: 633, 1983.Google Scholar
  52. 52.
    Rottembourg J, Brouard R, Issad B, Allouache M, Ghali B & Boudjemaa A: Role of acetate in loss of ultrafiltration during CAPD. In: “Contribution to Nephrology”, GM Berlyne and S Giovannetti (Eds), S. Karger AG, Switzerland, 1987, p 197.Google Scholar
  53. 53.
    Norbeck H: Lipid abnormalities in continuous ambulatory peritoneal dialysis patients. In: “Continuous Ambulatory Peritoneal Dialysis”, M Legrain (Ed), Excerpta Medica, Amsterdam. 1979, pp 298–301.Google Scholar
  54. 54.
    Khanna R, Brechenridge C, Roncari D, Digenis G, Oreopoulos DG: Lipid abnormalities in patients undergoing continuous ambulatory peritoneal dialysis. Perit Dial Bull, 3: 13–16,1983.Google Scholar
  55. 55.
    Norbeck H, Oro L, Carlson LA: Serum lipid and lipoprotein concentrations in chronic uremia. Acta Med Scand, 200:487–495,1976.PubMedCrossRefGoogle Scholar
  56. 56.
    Kagan A, Barkhayim Y, Schafer Z, Fainaru, M: Low level of plasma HDL in CAPD patients may be due to HDL loss in dialysate. Peritoneal Dial Internat, A: 79,1988 (abstract).Google Scholar
  57. 57.
    Diaz-Buxo JA, Burgess WP, Greenman M, Chandler JT, Farmer CD, Walker PJ: Visual function in diabetic patients undergoing dialysis: Comparison of peritoneal and hemodialysis. Internat J Artif Organs, 7: 257,1984.Google Scholar
  58. 58.
    Rottembourg J, Bellio P, Maiga K, Remaoun M, Rousselie F & Legrain M: Visual function, blood pressure and blood glucose in diabetic patients undergoing continuous ambulatory peritoneal dialysis. Proc EDTA, 21: 330,1984.Google Scholar
  59. 59.
    Khanna R, Wu G, Prowant B, Jastrzebska J, Nolph KD, Oreopoulos DG: A combined experience of two North American centers. In: “Diabetic Renal-Retinal Syndrome”, EA Friedman and FA L’Esperance, Jr (Eds), Grune & Stratton, Orlando, 1986, pp 363–382.Google Scholar
  60. 60.
    Rottembourg J, Issad B, Poignet JL, et al: Residual renal function and control of blood glucose levels in insulin-dependent diabetic patients treated by CAPD. In: “Prevention and Treatment of Diabetic Nephropathy”, H Keen and M Legrain (Eds), MTP Press Ltd, Boston, 1983, pp 339–352.Google Scholar
  61. 61.
    Cancarini GC, Brunori G, Camerini C, Brasa S, Manili L, Maiorca R: Renal function recovery and maintenance of residual diuresis in CAPD and hemodialysis. Perit Dial Bull 6: 77–79,1986.Google Scholar
  62. 62.
    Lysaght M, Pollock C, Schindaglm K, Ibeles L, Farrell P: The relevance of urea kinetic modeling to CAPD. ASAIO, Abstracts, 34: 84,1988.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1990

Authors and Affiliations

  • Ramesh Khanna
    • 1
  • Dimitrios G. Oreopoulos
    • 1
  1. 1.Division of NephrologyUniversity of Missouri, Columbia and Toronto Western HospitalTorontoCanada

Personalised recommendations