Colonic diverticulosis as a risk factor for peritonitis in Chinese peritoneal dialysis patients.

Objectives: The risk of development of enteric peritonitis in Chinese peritoneal dialysis (PD) patients with colonic diverticulosis is not known. There have been no reports on whether colonic diverticulosis may affect peritonitis outcomes. The objectives of this study were to examine whether colonic diverticulosis is a risk factor for the development of enteric peritonitis and to study its influence on the outcome of enteric peritonitis.

A prospective randomized study comparing tenckhoff catheters inserted using the triple incision method with standard swan neck catheters.

Background And Objective: The downward directed exit of the swan neck catheter may decrease the risk of exit-site infection (ESI). The percentage of migrations of the swan neck catheter seems to be less than the conventional Tenckhoff catheter and the swan neck catheter is more expensive and cannot be manipulated by guidewire technique if tip migration occurs. In this study, the conventional Tenckhoff catheter was used.

Epstein syndrome presenting as renal failure in young patients.

Two young Chinese patients presented with renal failure and thrombocytopenia. Further investigations showed the presence of large platelets and high-frequency sensorineural hearing deficit. Genetic studies confirmed mutations in the gene encoding the myosin heavy chain (MYH-9), and Epstein Syndrome was diagnosed.

Retroperitoneal leakage as a cause of acute ultrafiltration failure: its associated risk factors in peritoneal dialysis.

Background: Ultrafiltration failure is an important clinical problem in patients on maintenance peritoneal dialysis (PD) and is associated with high morbidity and mortality. Acute ultrafiltration failure (AUFF) is usually secondary to mechanical problems with the peritoneal catheter or peritoneal leakage. Retroperitoneal leakage (RPL) is an important cause of AUFF and often poses diagnostic difficulty.

Response to adefovir or entecavir in renal allograft recipients with hepatitic flare due to lamivudine-resistant hepatitis B.

We studied the effects of adefovir or entecavir in six kidney transplant recipients (mean age 45.7 +/- 7.8 yr) who developed hepatitic flare due to lamivudine-resistant hepatitis B virus (HBV) infection, with 18 months of follow-up.

Cost comparison between mycophenolate mofetil and cyclophosphamide-azathioprine in the treatment of lupus nephritis.

Objective: To compare the healthcare expenditure associated with mycophenolate mofetil (MMF)-based immunosuppression in contrast to conventional therapy in patients with lupus nephritis.

Methods: Our retrospective single-center study compared the major healthcare costs during the first 24 months of treatment incurred by immunosuppressive medications, hospitalization, and complications in patients with severe lupus nephritis who had been treated with prednisolone and either MMF or sequential cyclophosphamide induction followed by azathioprine maintenance (CTX-AZA).

Results: Forty-four patients were studied (22 in each group).

Procalcitonin fails to differentiate inflammatory status or predict long-term outcomes in peritoneal dialysis-associated peritonitis.

Background: Peritonitis is the major complication in patients undergoing maintenance peritoneal dialysis (PD) and is associated with a significant risk of mortality. Previously, we have shown that patients treated for peritonitis and having prolonged elevation of C-reactive protein (CRP) are associated with higher mortality. The underlying cause for the chronic systemic inflammation remains unknown.

Clinicopathologic analysis of renal biopsies after haematopoietic stem cell transplantation.

Aim: The ever-growing number and increasing survival of haematopoietic stem cell transplantation (HSCT) allow better recognition of its associated renal injuries. We aimed to study the clinicopathologic features of renal biopsies after HSCT by reviewing 13 percutaneous renal biopsies in our institute (Queen Mary Hospital).

Methods: A retrospective clinicopathologic study of all renal biopsies archived to the Department of Pathology, Queen Mary Hospital during the period January 1999 to December 2006 was performed.

Prospective controlled study on mycophenolate mofetil and prednisolone in the treatment of membranous nephropathy with nephrotic syndrome.

Background: Retrospective and anecdotal data suggest that mycophenolate mofetil (MMF) might be effective when given as rescue therapy for membranous nephropathy (MN). Prospective controlled data on MMF and prednisolone as primary therapy are lacking.

Methods: A prospective, randomized, controlled, open-label study was performed to investigate the efficacy and tolerability of MMF and prednisolone as primary treatment in MN with nephrotic syndrome.

Risks and outcomes of peritonitis after flexible colonoscopy in CAPD patients.

Objective: The ISPD 2005 guidelines for peritonitis recommend antibiotic prophylaxis for patients undergoing colonoscopy with polypectomy while on continuous ambulatory peritoneal dialysis (CAPD) but there is little literature to support this recommendation. This study aimed to look into the risks and outcomes of peritonitis after colonoscopy in CAPD patients.

Patients And Methods: All records of flexible colonoscopy performed on our CAPD patients from January 1994 to January 2006 were retrieved.

Tuberculous lymphadenitis in patients undergoing continuous ambulatory peritoneal dialysis.

The aim of this study was to review the clinical features of tuberculous (TB) lymphadenitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Nine cases of TB lymphadenitis were diagnosed among 910 patients over a period of 10 years. There were five men and four women with a mean age of 51 +/- 15.

Pilot study of pegylated interferon-alpha 2a in dialysis patients with chronic hepatitis C virus infection.

Aim: Pegylated interferon (PEG-IFN) combined with ribavirin is recommended for the treatment of chronic hepatitis C virus (HCV) infection in patients without renal failure. The optimal treatment of hepatitis C in dialysis patients remains to be established. A high incidence of adverse effects has been observed with conventional interferon and PEG-IFN alpha-2b in dialysis patients.

Hyperleptinaemia and chronic inflammation after peritonitis predicts poor nutritional status and mortality in patients on peritoneal dialysis.

Background: The serum leptin level is elevated in patients undergoing peritoneal dialysis (PD) and associated with a loss of lean body mass. The nutritional status of PD patients may further be worsened following peritonitis. We investigated the association between hyperleptinaemia, inflammation and malnourishment in PD-related peritonitis.

Inability to start hemodialysis after a smooth temporary hemodialysis catheter insertion procedure.

Cannulation of the central vein for placement of the temporary dual-lumen catheter for hemodialysis can usually be safely and reliably performed under ultrasonographic guidance. Here, we report a case of aberrant catheter entry into the internal thoracic vein during an apparently smooth procedure. The value of sonographic guidance, together with fluoroscopy with or without venography, will be discussed.

Conversion of ciclosporin A to tacrolimus in kidney transplant recipients with chronic allograft nephropathy.

Background: Tacrolimus and ciclosporin might have different effects on intra-renal fibrosis and allograft function in chronic allograft nephropathy (CAN). It is difficult to predict the response to calcineurin inhibitor minimization in patients with CAN.

Methods: This prospective randomized study compared ciclosporin A (CsA)-to-tacrolimus conversion (group A, target tacrolimus trough level 6-8 ng/ml) vs CsA minimization (group B, target CsA trough level 80-100 ng/ml) with regard to efficacy and safety in patients with CAN and deteriorating allograft function.

Treatment of refractory pseudomonas aeruginosa exit-site infection by simultaneous removal and reinsertion of peritoneal dialysis catheter.

Background: Patients on continuous ambulatory peritoneal dialysis (CAPD) with Pseudomonas aeruginosa exit-site infection (ESI) refractory to antibiotic treatment often require replacement of their peritoneal dialysis catheter (PDC). The optimal interval between removal and reinsertion of the PDC is not known. There are relatively few data on the feasibility of simultaneous removal and reinsertion of dialysis catheters for the treatment of P.

Cefazolin plus netilmicin versus cefazolin plus ceftazidime for treating CAPD peritonitis: effect on residual renal function.

Unlabelled: BACKGROUND. The International Society for Peritoneal Dialysis (ISPD) treatment guidelines for continuous ambulatory peritoneal dialysis (CAPD) peritonitis 2000 recommended the use of cefazolin plus ceftazidime as the initial empirical therapy in patients with residual renal function (RRF). However, this treatment regimen has not been compared with the conventional regimen of cefazolin plus netilmicin in prospective, randomized controlled trials.

Mannose binding lectin level and polymorphism in patients on long-term peritoneal dialysis.

Background: Infection is a leading cause of mortality and morbidity in patients with end-stage renal disease. The increased susceptibility to infection is probably secondary to the impaired immune defence in uraemia and other co-morbid factors such as diabetes mellitus. Peritonitis remains the most common and major complication in the treatment modality of peritoneal dialysis (PD) for uraemic patients.

Prospective study on lamivudine-resistant hepatitis B in renal allograft recipients.

The natural history of lamivudine-resistant hepatitis B virus (HBV) infection in renal transplant recipients (RTx) is unclear, despite its increasing incidence. Twenty-nine HBsAg-positive RTx with rising HBV DNA received lamivudine therapy. The course of lamivudine-resistant HBV infection was studied prospectively.

Incidence and outcome of antiglomerular basement membrane disease in Chinese.

Background: Antiglomerular basement membrane (anti-GBM) disease is an uncommon disease, especially among Asian population. Many reports and studies on this condition in the Caucasian population are available, but little information exists on anti-GBM disease in Asians. To study the incidence and clinical characteristics of anti-GBM disease among Chinese patients, we reviewed our experience of anti-GBM disease in our hospital (Queen Mary Hospital, Hong Kong) from 1992 to 2003.