Displaying publications 1 - 20 of 88 in total

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  1. Segasothy M, Swaminathan M, Kong NC
    Med J Malaysia, 1994 Dec;49(4):412-5.
    PMID: 7674979
    We report two patients who had cerebral malaria, heavy parasitemia, hyperbilirubinemia, hypercatabolism with rapid rises of blood urea and serum creatinine and acute renal failure. There was no evidence of intravascular hemolysis. Renal biopsy was consistent with acute tubular necrosis. Both patients responded to treatment with intravenous quinine and dialysis.
    Matched MeSH terms: Peritoneal Dialysis
  2. Tan J
    Nephrology (Carlton), 2014 May;19(5):288-95.
    PMID: 24641721 DOI: 10.1111/nep.12228
    Brunei Darussalam is a small South East Asian country with a high prevalence and incidence of end stage kidney disease (ESRD). This study aims to compare key performance indicators recorded in the Brunei Dialysis and Transplant Registry and department records against international practice. Registries from the USA (USRDS), UK (UK Renal Registry), Australasia (ANZDATA), Europe (ERA-EDTA Registry) and Malaysia (MDTR) were used for comparisons.
    Matched MeSH terms: Peritoneal Dialysis/standards
  3. Gendeh BS, Gibb AG, Aziz NS, Kong N, Zahir ZM
    Otolaryngol Head Neck Surg, 1998 Apr;118(4):551-8.
    PMID: 9560111
    A prospective study was undertaken in 16 patients with chronic renal failure on continuous ambulatory peritoneal dialysis, with 22 episodes of peritonitis treated with vancomycin, a known ototoxic agent. Twelve patients had one episode each, and four had recurrent peritonitis. Each treatment course consisted of two infusions of vancomycin (30 mg/kg body weight) in 2 L of peritoneal dialysate administered at 6-day intervals. Serum vancomycin analyzed by enzyme immunoassay showed a mean trough level of 11.00 microg/ml on day 6 and mean serum levels of 33.8 and 38.6 microg/ml about 12 hours after administration on days 1 and 7, respectively. Similar levels, well within the therapeutic range, were encountered with repeated vancomycin therapy for recurrent episodes of peritonitis, suggesting that no changes occurred in the pharmacokinetic profile of the drug. Pure-tone audiometry, electronystagmography, and clinical assessment performed during each course of treatment showed no evidence of ototoxicity even on repeated courses of vancomycin therapy. The results suggest that vancomycin therapy when given in appropriate concentrations as a single therapeutic agent is both effective and safe. We believe, however, that vancomycin administered in combination with an aminoglycoside may produce ototoxic effects that may be greatly aggravated, possibly because of synergism.
    Matched MeSH terms: Peritoneal Dialysis, Continuous Ambulatory*
  4. Andy Tang SO, Carolisna YI, Sakura D, Yeo ST, Koh KH
    Med J Malaysia, 2019 08;74(4):270-274.
    PMID: 31424032
    INTRODUCTION: Sarawak has a population that is geographically and characteristically widely varied. In this study we aimed to determine the demographic characteristics of our patient population who undergo continuous ambulatory peritoneal dialysis (CAPD) and to study the incidence, the microbiology and the outcome of CAPD peritonitis.

    METHODS: A retrospective record review of all CAPD patients on follow-up at the Miri Hospital, Sarawak, Malaysia from 2014 until 2017 was done.

    RESULTS AND DISCUSSION: During the 4-year period, the overall peritonitis rate was 0.184 episodes per patient-year. Gram-positive and gram-negative bacteria each constituted one-third of the peritonitis; fungi (2.6%), Mycobacterium tuberculosis (MTB) (5.3%), polymicrobial (2.6%) and sterile culture (26.3%). The most commonly isolated gram-positive bacteria were coagulase-negative Staphylococcus. Our peritonitis rate is comparable to that of other centres i.e., Japan 0.195 and Indonesia 0.25. In comparison, countries like India (0.41), Korea (0.40) and Singapore (0.59) had relatively higher rate of PD-associated peritonitis. Two tuberculosis peritonitis patients died. The rate of catheter removal was approximately 20%. Gram-negative bacteria and MTB have a higher risk of catheter loss. About one-fifth used rainwater to clean their CAPD exit site. Out of this group, 33% did not boil the rainwater prior to usage.

    CONCLUSION: Patient's characteristics and microbial susceptibility vary in different places of practice. The high rates of culture-negative peritonitis and high mortality risks associated with TB peritonitis warrant special attention. In patients with refractory peritonitis, early catheter removal is warranted in order to reduce mortality and minimize damage to peritoneal membrane.

    Matched MeSH terms: Peritoneal Dialysis, Continuous Ambulatory/adverse effects*
  5. Jamaluddin EJ, Gafor AH, Yean LC, Cader R, Mohd R, Kong NC, et al.
    Clin Exp Nephrol, 2014 Jun;18(3):507-14.
    PMID: 23903802 DOI: 10.1007/s10157-013-0844-2
    Secondary hyperparathyroidism (SHPT) is common in end-stage renal disease. Our primary objective was to evaluate the efficacy of oral paricalcitol versus oral calcitriol on serum intact parathyroid hormone (iPTH) and mineral bone parameters in continuous ambulatory peritoneal dialysis (CAPD) patients with SHPT. The secondary objective was to analyze highly sensitive C-reactive protein (hsCRP) and peritoneal membrane function in both groups.
    Matched MeSH terms: Peritoneal Dialysis, Continuous Ambulatory*
  6. Faridah A, Jamaiyah H, Goh A, Soraya A
    Med J Malaysia, 2010 Jun;65 Suppl A:114-9.
    PMID: 21488470
    The EQ-5D is a quality of life instrument that measures five dimensions of health. This study investigated the reliability and validity of its use in the Malaysian dialysis population. Test-retest reliability, convergent and discriminant validity were assessed. Responses of 86 subjects who completed both surveys were used in analysis. Test-retest reliability using Cohen's kappa was acceptable in four out of five dimensions, with the exception of self-care. Convergent validity was present. Discriminant validity was found in only two out of six hypotheses tested. In conclusion, the EQ-5D has potential in this population but further study is required.
    Matched MeSH terms: Peritoneal Dialysis, Continuous Ambulatory
  7. Mah DY, Yia HJ, Cheong WS
    Med J Malaysia, 2016 04;71(2):91-2.
    PMID: 27326954 MyJurnal
    Dialysis disequilibrium syndrome (DDS) is a neurological disorder with varying severity that is postulated to be associated with cerebral oedema. We described a case of DDS resulting in irreversible brain injury and death following acute haemodialysis. A 13-year-old male with no past medical history and weighing 30kg, presented to hospital with severe urosepsis complicated by acute kidney injury (Creatinine 1422mmol/L; Urea 74.2mmol/L, Potassium 6.3mmol/L, Sodium 137mmol/L) and severe metabolic acidosis (pH 6.99, HC03 1.7mmol/L). Chest radiograph was normal. Elective intubation was done for respiratory distress. Acute haemodialysis performed due to refractory metabolic acidosis. Following haemodialysis, he became hypotensive which required inotropes. His Riker's score was low with absence of brainstem reflexes after withholding sedation. CT Brain showed generalised cerebral oedema consistent with global hypoxic changes involving the brainstem. The symptoms of DDS are caused by water movement into the brain causing cerebral oedema. Two theories have been proposed: reverse osmotic shift induced by urea removal and a fall in cerebral intracellular pH. Prevention is the key to the management of DDS. It is important to identify high risk patients and haemodialysis with reduced dialysis efficacy and gradual urea reduction is recommended. Patients who are vulnerable to DDS should be monitored closely. Low efficiency haemodialysis is recommended. Acute peritoneal dialysis might be an alternative option, but further studies are needed.
    Matched MeSH terms: Peritoneal Dialysis
  8. Ahmad M, Zin CS, Ab Rahman AF
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S737-S742.
    PMID: 33828370 DOI: 10.4103/jpbs.JPBS_298_19
    Introduction: Patients receiving continuous ambulatory peritoneal dialysis (CAPD) are commonly associated with peritonitis. However, little is known about the utilization of antibiotics for the treatment of peritonitis in these patients.

    Objectives: This study aimed to evaluate the patterns of intraperitoneal (IP) antibiotic utilization for the treatment of peritonitis in CAPD patients.

    Materials and Methods: This is a retrospective study conducted at a tertiary hospital setting in Malaysia. Medical records of CAPD patients who were diagnosed with peritonitis and registered with National Kidney Registry from 2013 to 2018 were reviewed. Types of antibiotics used and its dose and duration were recorded and reported using the anatomical therapeutic chemical/defined daily dose (ATC/DDD) system.

    Results: A total of 105 peritonitis episodes were recorded from 72 patients. The most common first-line empirical antibiotic combinations used were ceftazidime/cefazolin (40%, n = 42), followed by cefepime/cefazolin (30.5%, n = 32) and ceftazidime/cloxacillin (25.7%, n = 27). The definitive therapy for culture-proven CAPD-related peritonitis (CAPD-P) showed that vancomycin was the most frequently prescribed antibiotic (31.7%, n = 26/82), followed by amikacin (14.6%, n = 12/82), meropenem (11%, n = 9/82) and ampicillin (11%, n = 9/82). Ciprofloxacin was among the least prescribed definitive antibiotics for CAPD-P (2.4%, n = 2/82) but the DDD/100 patient-days estimates showed that it had the highest therapeutic intensity.

    Conclusion: There are various IP antibiotics used for CAPD-P and the most common empirical therapy was the combination of ceftazidime and cefazolin while vancomycin is predominantly used for definitive therapy. Future studies to evaluate the clinical outcomes of the antibiotic use should be conducted to have a better insight on the efficacy of the peritonitis treatment.

    Matched MeSH terms: Peritoneal Dialysis, Continuous Ambulatory
  9. Norazsida Ramli, Syafifa Rajiman, Mohd Ramli Seman
    MyJurnal
    Hyperphosphatemia is the key abnormality that sets off a cascade of metabolic events in chronic kidney disease (CKD). End stage renal disease (ESRD) patients that undergo Continuous Ambulatory Peritoneal Dialysis (CAPD) uses the peritoneal membrane for solutes filtration and clearance. The differences on the evaluation of peritoneal membrane transport status can affect the rate of toxin removal – serum phosphorus, from the systems. The present study aimed to determine the prevalence of CAPD patients presented with high phosphate level after starting the treatment, to identify the risk factors associated with hyperphosphatemia and to find the significant correlation between the phosphate level and the PET characteristics. A retrospective study was
    applied for this research where the medical records of patients were reviewed and analyzed between January 2011 to December 2016. Data were collected successfully from 74 adult CAPD patients (41 male, 55.4% and 33 females, 44.6%), with mean age of 51.34 ± 13.75 year-old. In this study, Malays (n= 65, 87.8%) are the largest subjects recruited, while Chinese (n= 6, 8.1%) and Indians (n= 3, 4.1%) made the rest of the subjects. PET characteristics of CAPD patients showed 11 patients had high characteristic (14.9%), 24 high average (32.4%), 26 low average (35.1%) and 5 low (6.8%). There were 37 CAPD patients (50%) presented with high phosphate level after starting the treatment. Simple linear regression revealed that age (p = 0.0052), serum calcium (p= 0.0090), serum albumin (p = 0.0244), normalized protein catabolic rate (nPCR) (p =0.0126), intact parathyroid hormone (iPTH) (p = 0.0012), total creatinine clearance (p =0.0470), residual renal creatinine clearance (p = 0.390) and 24-hours urine volume output (p = 0.0060) were risk factors associated with hyperphosphatemia. Pearson’s correlation analysis showed there was no significant correlation between phosphate level and PET characteristics (r = -.232, p = 0.070) while there was significant correlation between PET characteristics and peritoneal solute clearance (r = 0.4748, p < 0.001). In conclusion, serum phosphate level may be associated with daily dietary intake, metabolism and dialysis adequacy. There was no correlation between serum phosphate level and PET characteristic suggesting the rate of the toxin removal might not been affected by the
    differences on peritoneal membrane characteristics suggesting a further understanding on transport status in terms of its mechanism of toxin removal
    Matched MeSH terms: Peritoneal Dialysis, Continuous Ambulatory
  10. Sahay M, Jasuja S, Tang SCW, Alexander S, Jha V, Vachharajani T, et al.
    Nephrology (Carlton), 2021 Feb;26(2):142-152.
    PMID: 33169890 DOI: 10.1111/nep.13825
    AIM: There is paucity of data on the epidemiology of end-stage kidney disease (ESKD) from South Asia and South-East Asia. The objective of this study was to assess the aetiology, practice patterns and disease burden and growth of ESKD in the region comparing the economies.

    METHODS: The national nephrology societies of the region; responded to the questionnaire; based on latest registries, acceptable community-based studies and society perceptions. The countries in the region were classified into Group 1 (High|higher-middle-income) and Group 2 (lower|lowermiddle income). Student t-test, Mann-Whitney U test and Fisher's exact test were used for comparison.

    RESULTS: Fifteen countries provided the data. The average incidence of ESKD was estimated at 226.7 per million population (pmp), (Group 1 vs. Group 2, 305.8 vs. 167.8 pmp) and average prevalence at 940.8 pmp (Group 1 vs. Group 2, 1306 vs. 321 pmp). Group 1 countries had a higher incidence and prevalence of ESKD. Diabetes, hypertension and chronic glomerulonephritis were most common causes. The mean age in Group 2 was lower by a decade (Group 1 vs. Group 2-59.45 vs 47.7 years).

    CONCLUSION: Haemodialysis was the most common kidney replacement therapy in both groups and conservative management of ESKD was the second commonest available treatment option within Group 2. The disease burden was expected to grow >20% in 50% of Group 1 countries and 78% of Group 2 countries along with the parallel growth in haemodialysis and peritoneal dialysis.

    Matched MeSH terms: Peritoneal Dialysis
  11. Hamid, A.J., Azmi, M.T.
    MyJurnal
    Introduction : A retrospective cohort study was conducted among ESRD who received dialysis treatment (Haemodialysis and CAPD) in all government hospitals in the State of Pahang from 1st January 2000 to 31st December 2004.
    Objective : The aim of the study was to identify factors affecting the survival of patients undergoing dialysis in the state of Pahang.
    Methods : Survival time was measured from the date of dialysis until the subjects died, lost to follow up or until the end of the study period at 31st December 2004.
    Results : Diabetes mellitus was the major cause for ESRD (33%) out of 132 subjects eligible for the study. Seven (7.1%) and five (15.2%) deaths occurred among haemodialysis and CAPD patients respectively, but statistically of no difference between the two treatments (log-rank, p=0.093). Factors influencing the survival of haemodialysis patients were diabetes mellitus (p=0.014), albumin (p=0.0005), creatinine (p=0.020) and hemoglobin level (p=0.002), while age of treatment and diabetes mellitus affecting the survival of CAPD patient. Cox Proportional Hazard Regression showed that haemodialysis subjects with low albumin (HR 0.669 df 95% 0.513 - 0.873) and hemoglobin (HR 0.403 df 95% 0.225 - 0.720) level had lower survival rate but none for CAPD.
    Conclusion : Good nutritional status, higher hemoglobin level and prevention of diabetes mellitus are important for the survival of haemodialysis patient.
    Matched MeSH terms: Peritoneal Dialysis, Continuous Ambulatory
  12. Sreenevasan G
    Ann R Coll Surg Engl, 1974 Jul;55(1):3-12.
    PMID: 4845653
    Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968-May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V-Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed.
    Matched MeSH terms: Peritoneal Dialysis
  13. Anna Misya’il Abdul Rashid, Lim, Christopher Thiam Seong
    MyJurnal
    Enterobacter gergoviae is a gram negative rod-shaped opportunistic organism reported to cause urinary and respiratory tract infections, but peritonitis caused by this organism is unknown. We report a case of 50-year-old patient on peritoneal dialysis (PD) presented with Enterobacter gergoviae peritonitis with septic shock. Despite Intraperitoneal (IP) cloxacillin 250mg qid and IP ceftazidime 1gram q24h and subsequent escalation with IP amikacin 2mg/kg q24h and IP vancomycin 15mg/kg q24h within the next 48 hours, his peritonitis remained refractory and required catheter removal. Although Enterobacter gergoviae is naturally sensitive to aminoglycosides, carbapenems and quinolones, it reacts differently to the beta lactam antibiotics. Their resistance to third-generation cephalosporins is fast emerging and treatment with third-generation cephalosporins may cause AmpC-overproducing mutants. The majority of
    Enterobacteriaceae, including Extended-spectrum beta-lactamases producers, remain susceptible to carbapenems. Our report provides an unfavourable course of E. gergoviae peritonitis likely due to acquired secondary drug resistance during the therapy period.
    Matched MeSH terms: Peritoneal Dialysis
  14. Cader RA, Ibrahim OA, Paul S, Gafor HA, Mohd R
    Int Urol Nephrol, 2014 Jun;46(6):1209-15.
    PMID: 24307428 DOI: 10.1007/s11255-013-0615-8
    PURPOSE: Cardiovascular disease is the leading cause of mortality in dialysis patients with left ventricular hypertrophy (LVH) being an important predictor of mortality. We wanted to determine the prevalence of LVH in peritoneal dialysis (PD) patients and factors contributing to it.

    METHODS: This is a cross-sectional study assessing LVH using echocardiogram in PD patients. Left ventricular mass index (LVMI) was calculated to determine LVH. Chronic fluid overload (overhydration) was assessed using the body composition monitor, and blood pressure (BP) was measured using 24-h ambulatory BP monitoring.

    RESULTS: Thirty-one patients (21 females:10 males, 48.97 ± 14.50 years and dialysis vintage 40.0 ± 28.9 months) were studied. More than two-thirds (77.4 %) were hypertensive, and a third (35.5 %) were diabetic. Baseline data included mean serum albumin (37.34 ± 4.43 g/l), weekly Kt/V (2.02 ± 0.23), residual renal function of 68 (0-880) ml and ultrafiltration of 1,606.9 ± 548.6 ml. Majority of patients (80.6 %) had LVH on echocardiogram with LVMI of 136.5 ± 37.8 g/m(2) and overhydration of 2.23 ± 1.77 l. Average systolic BP, diastolic BP and mean arterial pressure were 141.2 ± 23.3, 90.8 ± 19.7 and 107.6 ± 19.6 mmHg, respectively. Patients with LVH had a lower serum albumin (p = 0.003), were more overhydrated (p = 0.010) and were on higher number of anti-hypertensive agents (p ≤ 0.001). Predictors of LVMI were overhydration (p = 0.002), the presence of diabetes (p = 0.008) and the number of anti-hypertensive agents used (p = 0.026). However, overhydration (p = 0.007) was the main predictor of LVH on multivariate analysis.

    CONCLUSION: Overhydration is strongly associated with LVH in PD patients.

    Matched MeSH terms: Peritoneal Dialysis/adverse effects*
  15. Ibrahim N, Kong NCT, Desa A, Razali R
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:35-40.
    PMID: 23857835 DOI: 10.1111/appy.12042
    Introduction: Research on depression in local patients with end-stage renal disease (ESRD) is sparse. Thus, this study aims to examine the frequency and severity of depression among ESRD patients and relate depression with their coping skills.
    Methods: A cross-sectional study using universal sampling method was conducted at several dialysis centers in Kuala Lumpur, Selangor and Johor, Malaysia. The Beck Depression Inventory II (BDI-II) and the Brief COPE scale were used to measure depression and coping skill, respectively.
    Results: The study involved 274 ESRD patients, comprising of 183 hemodialysis and 91 continuous ambulatory peritoneal dialysis patients. The result showed that 21.1% of the patients experienced moderate to severe depression. Several components of coping skill were associated with depression. However, only two components in the Brief COPE (behavioral disengagement and self-blame) were identified as predictors.
    Discussion: This study showed that depression is common in ESRD patients and is related to the types of coping skills adopted by patients. Hence, this study provides some insight into ESRD patients with depression. Appropriate counseling should be given to these patients to empower them to cope with the illness so as to enhance their quality of life.
    Matched MeSH terms: Peritoneal Dialysis, Continuous Ambulatory/psychology
  16. Goh BL, Ganeshadeva Yudisthra M, Lim TO
    Semin Dial, 2009 Mar-Apr;22(2):199-203.
    PMID: 19426429 DOI: 10.1111/j.1525-139X.2008.00536.x
    Peritoneal dialysis (PD) catheter insertion success rate is known to vary among different operators, and peritoneoscope PD catheter insertion demands mastery of a steep learning curve. Defining a learning curve using a continuous monitoring tool such as a Cumulative Summation (CUSUM) chart is useful for planning training programs. We aimed to analyze the learning curve of a trainee nephrologist in performing peritoneoscope PD catheter implantation with CUSUM chart. This was a descriptive single-center study using collected data from all PD patients who underwent peritoneoscope PD catheter insertion in our hospital. CUSUM model was used to evaluate the learning curve for peritoneoscope PD catheter insertion. Unacceptable primary failure rate (i.e., catheter malfunction within 1 month of insertion) was defined at >40% and acceptable performance was defined at <25%. CUSUM chart showed the learning curve of a trainee in acquiring new skill. As the trainee became more skillful with training, the CUSUM curve flattened. Technical proficiency of the trainee nephrologist in performing peritoneoscope Tenckhoff catheter insertion (<25% primary catheter malfunction) was attained after 23 procedures. We also noted earlier in our program that Tenckhoff catheters directed to the right iliac fossae had poorer survival as compared to catheters directed to the left iliac fossae. Survival of catheters directed to the left iliac fossae was 94.6% while the survival for catheters directed to the right iliac fossae was 48.6% (p < 0.01). We advocate that quality control of Tenckhoff catheter insertion is performed using CUSUM charting as described to monitor primary catheter dysfunction (i.e., failure of catheter function within 1 month of insertion), primary leak (i.e., within 1 month of catheter insertion), and primary peritonitis (i.e., within 2 weeks of catheter insertion).
    Matched MeSH terms: Peritoneal Dialysis/instrumentation*
  17. Johnson DW, Dent H, Yao Q, Tranaeus A, Huang CC, Han DS, et al.
    Nephrol Dial Transplant, 2009 May;24(5):1598-603.
    PMID: 19096083 DOI: 10.1093/ndt/gfn684
    The impact of dialysis modality on the rates and types of infectious complications has not been well studied. The aim of the present investigation was to evaluate the rates of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in peritoneal dialysis (PD) and haemodialysis (HD) patients in the Asia-Pacific region.
    Matched MeSH terms: Peritoneal Dialysis/adverse effects*
  18. Mushahar L, Mei LW, Yusuf WS, Sivathasan S, Kamaruddin N, Idzham NJ
    Perit Dial Int, 2015 09 15;36(2):135-9.
    PMID: 26374836 DOI: 10.3747/pdi.2014.00195

    OBJECTIVE: Peritoneal dialysis (PD)-related infection is a common cause of catheter loss and the main reason for PD drop-out. Exit-site infection (ESI) is a pathway to developing tunnel infection and peritonitis, hence rigorous exit-site care has always been emphasized in PD therapy. The aim of this study was to evaluate the effect of exit-site dressing vs non-dressing on the rate of PD-related infection. ♦

    METHODS: A prospective randomized controlled study was conducted in prevalent PD patients at the Hospital Tuanku Jaafar Seremban, Negeri Sembilan, Malaysia, from April 2011 until April 2013. All patients were required to perform daily washing of the exit site with antibacterial soap during a shower. In the dressing group (n = 54), patients were required to clean their exit site using povidone-iodine after drying, followed by topical mupirocin antibiotic application to the exit site. The exit site was then covered with a sterile gauze dressing and the catheter immobilized with tape. In the non-dressing group (n = 54), patients were not required to do any further dressing after drying. They were only required to apply mupirocin cream to the exit site and then left the exit site uncovered. The catheter was immobilized with tape. The primary outcome was ESI. The secondary outcomes were evidence of tunnel infection or peritonitis. ♦

    RESULTS: A total of 97 patients completed the study. There were a total of 12 ESI episodes: 4 episodes in 4 patients in the dressing group vs 8 episodes in 4 patients in the non-dressing group. This corresponds to 1 episode per 241.3 patient-months vs 1 episode per 111.1 patient-months in the dressing and non-dressing groups respectively. Median time to first ESI episode was shorter in the non-dressing than in the dressing group, but not significant (p = 0.25). The incidence of gram-positive ESI in both groups was similar. There were no gram-negative ESI in the non-dressing group compared with 2 in the dressing group. The peritonitis rate was 1 per 37.1 patient-month in the dressing group and 1 per 44.4 patient-months in the non-dressing group. Median time to first peritonitis episode was significantly shorter in the dressing group compared to non-dressing (p = 0.03). There was no impact of dressing disruptions in the occurrence of major PD catheter-related infection. ♦

    CONCLUSION: Use of a non-dressing technique with only prophylactic topical mupirocin cream application is effective in preventing PD-related infection. The non-dressing technique is more cost-effective and convenient for PD patients, with fewer disposables.

    Matched MeSH terms: Peritoneal Dialysis/adverse effects*
  19. Harvinder GS, Swee WC, Karupaiah T, Sahathevan S, Chinna K, Ahmad G, et al.
    Asia Pac J Clin Nutr, 2016;25(1):26-33.
    PMID: 26965758 DOI: 10.6133/apjcn.2016.25.1.01
    Malnutrition is highly prevalent in Malaysian dialysis patients and there is a need for a valid screening tool for early identification and management. This cross-sectional study aims to examine the sensitivity of the Dialysis Malnutrition Score (DMS) and Malnutrition Inflammation Score (MIS) tools in predicting protein-energy wasting (PEW) among Malaysian dialysis patients.
    Matched MeSH terms: Peritoneal Dialysis/adverse effects
  20. Gendeh BS, Said H, Gibb AG, Aziz NS, Kong N, Zahir ZM
    J Laryngol Otol, 1993 Aug;107(8):681-5.
    PMID: 8409715 DOI: 10.1017/s0022215100124132
    A prospective study was undertaken of 10 chronic renal failure patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) complicated by repeated bouts of peritonitis treated with gentamicin. Each 10-day treatment course consisted of a 120 mg loading dose, followed by 16 mg in 21 of peritoneal dialysate, given four times a day. Serum gentamicin analysed by enzyme immunoassay showed a mean level of 5.2 micrograms/ml, (range 3.7 to 6.6 mg/ml) four hours after the loading dose. Similar levels, well within the therapeutic range, were maintained on the 3rd, 5th, 7th and 9th days of intraperitoneal gentamicin therapy, suggesting no accumulation of gentamicin in the serum. Pure tone audiometry, electronystagmography and clinical assessment were performed during each course of treatment. Although no evidence of ototoxicity was found during the first two courses of gentamicin, but disequilibrium and bobbing oscillopsia were present during the third and fourth courses of gentamicin. These findings could be explained by cumulative injury to the vestibular apparatus caused by repeated therapeutic insults.
    Matched MeSH terms: Peritoneal Dialysis, Continuous Ambulatory/methods*
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