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      Catheter Design for Continuous Flow Peritoneal Dialysis

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          Abstract

          A new catheter for continuous flow peritoneal dialysis is presented. One of the main issues in this field is the safety and good clinical tolerance of the catheter. In this case, the size and diameter of the cannula has not been increased in comparison to previous PD catheters. Furthermore, the materials utilized are designed for maximum comfort of the patient and minimal traumatisation of the peritoneal membrane. Nevertheless, the two compartments of the catheter allow for high dialysate flows without creating high resistance and the rate of recirculation is minimal in conditions of simulated continuous flow PD. Furthermore, the characteristic of the new catheter is the presence in the inflow branch of a special diffuser designed like a shower cap that is intended to improve the dialysate inflow distribution in the peritoneal cavity and to increase the contact of the peritoneal membrane with the solution. At the same time, the diffuser prevents a traumatic effect of the inflow dialysate due to high speed infusion or jet flow conditions.

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          Most cited references3

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          Continuous-Flow Peritoneal Dialysis

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            Automated Peritoneal Dialysis

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              Delivered Dialysis Dose with PD Plus Therapy

              Aim: To evaluate the effect of PD Plus on weekly Kt/V urea and creatinine clearance (K cr ) among patients undergoing CAPD/CCPD (continuous ambulatory peritoneal dialysis/continuous cyclic peritoneal dialysis). Methods: The kinetic studies of 92 CAPD and 18 CCPD patients who transferred to PD Plus were analyzed. All patients underwent CAPD/CCPD and PD Plus for a minimum of 3 months. Standard collection methods were used and kinetic indices calculated with the Pack PD Kinetic Modeling program. 57 patients had transport data and were modeled for a target weekly Kt/V urea ≥2.1 using PD Plus with ≤15 liters dialysate/day. 6 patients were supervised during the collection periods by research nurses. The actual results for all patients (110) and for the supervised patients were compared against the modeled results. Results: 45% of the patients achieved a Kt/V urea ≥2.1 and 47% a K cr ≥60 liters/1.73 m 2 with PD Plus, but only 20% did so with CAPD/CCPD. A close correlation between the supervised patients and modeled therapy was observed. Conclusions: Adequate dialysis is possible by using higher fill volumes, the supine position, and optimal dwell times (PD Plus) in most patients. The discrepancy between modeled and achieved dose is likely due to poor compliance with therapy, inadequate training, or poor specimen collection.
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                Author and article information

                Journal
                BPU
                Blood Purif
                10.1159/issn.0253-5068
                Blood Purification
                S. Karger AG
                978-3-8055-7372-6
                978-3-318-00813-5
                0253-5068
                1421-9735
                2002
                2002
                17 January 2002
                : 20
                : 1
                : 40-44
                Affiliations
                aDepartment of Nephrology, St. Bortolo Hospital, Vicenza, Italy; bMedcomp, Medical Components, Inc., Harleysville, Pa., USA and cRenal Research Institute, New York, N.Y., USA
                Article
                46984 Blood Purif 2002;20:40–44
                10.1159/000046984
                11803158
                b1e8613b-4766-47cc-99d9-ecfd426d9771
                © 2002 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Page count
                Figures: 6, References: 20, Pages: 5
                Categories
                Paper

                Cardiovascular Medicine,Nephrology
                High-dose peritoneal dialysis,Peritoneal access,Peritoneal catheter,Adequacy of peritoneal dialysis,Continuous flow peritoneal dialysis

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