We report a case of Serratia marcescens peritonitis in a 45-year-old man with insulin-dependent diabetes mellitus undergoing continuous ambulatory peritoneal dialysis (CAPD). The patient presented with abdominal pain and cloudy dialysate. Empiric antibiotic therapy was initiated intraperitoneally with cefazolin and ceftazidime for 5 days. Cultures of the dialysate revealed S. marcescens, and th...

AIM Hyperkalemia increases the risk of sudden cardiac death (SCD) in hemodialysis patients. Our objective was to determine the association between administering low potassium dialysate to hyperkalemic hemodialysis patients and SCD. METHODS We conducted a retrospective cohort study with patients undergoing maintenance hemodialysis from May 1, 2006, through December 31, 2013. The dialysate comp...

Hypertension and chronic volume overload are complications often seen in hemodialysis patients. Current hemodialysis practices adopt a standard dialysate sodium prescription that is typically higher than the plasma sodium concentration of most patients. As a general rule, hemodialysis patients have stable predialysis plasma sodium concentrations, and each patient has a fixed "osmolar set point....

In addition to local causes--for example, leak of dialysate into an inguinal hernia sac or into the anterior abdominal wall through the track of the catheter for continuous peritoneal dialysis (CPD)--scrotal edema in CPD patients may result from generalized volume retention. We present 2 CPD patients with scrotal edema, illustrating the diagnosis and management of the mechanisms of volume reten...

With advances in hemodialysis technology and the desire to achieve cardiovascular stability during dialysis, prescribed dialysate sodium concentration has gradually increased over years. Short-term trials suggest low (<138 mEq/L) is beneficial reducing interdialytic weight gain, pre- post-dialysis BP, predialysis serum sodium; but it increases intradialytic hypotensive episodes. We believe p...

The goal of dialysis for patients with chronic renal failure is to restore the composition of the body’s fluid environment toward normal. This is accomplished principally by formulating a dialysate whose constituent concentrations are set to approximate normal values in the body. Over time, by diffusional transfer along favorable concentration gradients, the concentrations of solutes that were ...

INTRODUCTION Dialysis is an effective treatment for end-stage renal disease, but it is available to only approximately half of those who need it in the world. METHODS Two prototype passive-flow dialysate delivery systems were constructed. RESULTS Each dialysate delivery system provided a flow of dialysate in the range of 200-300 mL/minute. In one example, flow regulation was good, but ultra...

cluded that both dialysate calcium and plasma phosphate were important determinants of the parathyroid function in HD patients. During the last decade, several studies have demonstrated that this conclusion could be a subject for discussion. Recently, in a randomized clinical trial, Ok et al. [4] showed that lowering dialysate calcium levels slowed the progression of coronary artery calcificati...

An accurate evaluation of water content in the body of hemodialyzed patients seems to be an important problem in chronic dialysotherapy. Acute intradialytic hypotension observed in 20-33% of hemodialysis patients is a very common complication of this kind of renal replacement therapy. The study was performed in 40 uremic patients, treated with hemodialysis at the Nephrology Clinic of the Univer...