Clinical application of computer-aided diagnostic system for harmonious introduction of complementary dialysis therapy.

In chronic peritoneal dialysis (PD) therapy, peritoneal permeability is gradually enhanced over the duration of the therapeutic course, leading to a grave decline in the therapeutic efficiency. In recent years, a novel therapy (CD therapy), which integrates PD therapy with hemodialysis therapy, is being applied to end-stage PD patients to complement the decline of therapeutic efficiency caused by the grave degeneration of the peritoneal tissue. To realize a harmonious introduction of the CD therapy, this study developed a useful index (KAu/c), which evaluates both therapeutic efficiency and degeneration of peritoneal tissue.

What is a surrogate marker for optimal dialysis?

To find a surrogate marker to obtain optimal dialysis delivery from the viewpoint of nutrition, 180 maintenance hemodialysis patients (109 males/71 females) were enrolled between October 1999 and June 2006 at our kidney center. In the 449 hemodialysis treatments, ultrapure dialysis solutions and high-flux synthetic membranes were utilized. Parameters were measured by Kt/V(urea) and postdialysis urea rebound, Kc (the cellular membrane clearance for urea), urea clear space (CS), %creatinine generation rate, %lean body mass, total body water, and so on.

Development of a computer-aided diagnosis system for continuous peritoneal dialysis: an availability of the simultaneous numerical optimization technique for kinetic parameters in the peritoneal dialysis model.

We developed a novel diagnostic system for continuous peritoneal dialysis, which evaluates the peritoneal permeability and hydraulic conductance (peritoneal function) by applying the kinetic model and a clinical test with minimum nursing time. Kinetic parameters for the peritoneal function were determined by the simultaneous numerical optimization techniques (SNOT). Furthermore dialysis outcome and ultrafiltration volume were estimated and predicted by using the kinetic model with a set of optimal kinetic parameters, which were in agreement with measured data (r(2)>0.

Dialysis adequacy targets in elderly chronic peritoneal dialysis patients.

We performed the present study to determine dialysis adequacy targets for improved clinical outcome in elderly chronic peritoneal dialysis (PD) patients. Since 1993, 19 elderly patients (14 men, 5 women; 5 with diabetes, 14 without diabetes; mean age: 78.9 +/- 7.

Development of a computer-aided diagnosis system for a new modality of renal replacement therapy: an integrated approach combining both peritoneal dialysis and hemodialysis.

The authors developed a computer-aided diagnosis system that includes a simple clinical test for the chronic renal disease patient who needs an integrated approach that combines both peritoneal dialysis and hemodialysis (PD-HD therapy). In this case study, the system simulated and estimated the dialysis outcome, the ultrafiltration volume and nutritional analysis by employing a pharmacokinetic model, and assessed the peritoneal permeable enhancement that can be a grave complication with peritoneal dialysis. This system requires only a minimum amount of nursing time and may be able to predict the optimal treatment schedule for PD-HD therapy and provide therapeutic monitoring in long-term peritoneal dialysis.

Dialysis dose and nutrition in Japanese peritoneal dialysis patients.

In the present study, we tried to determine the relationship between dialysis dose and nutrition in PD patients. We enrolled 100 Japanese outpatients, including 11 diabetic patients, who were on continuous ambulatory peritoneal dialysis [CAPD (n = 74)] and automated peritoneal dialysis [APD (n = 26)] at 49 local hospitals. In all patients, a peritoneal function test (PET) was performed using the PD NAVI software (JMS, Hiroshima, Japan).

Serum matrix metalloproteinase-3 in hemodialysis patients with dialysis-related amyloidosis.

Background: Matrix metalloproteinase-3 (MMP-3) has been linked to osteoarticular destruction in rheumatic arthritis. To investigate the role of MMP-3 in dialysis-related amyloidosis (DRA), we determined serum MMP-3 in long-term hemodialysis (HD) patients with and without clinical manifestations of DRA.

Methods: Thirty-three subjects (63% female, 3% diabetic) enrolled in the study between September 2001 and June 2003.

Re-evaluation of adequate dose in Japanese peritoneal dialysis patients.

Our objective in the present study was to evaluate the dialysis dose required to maintain Japanese peritoneal dialysis (PD) patients in good condition. From 32 local hospitals, we selected 100 stable patients without diabetes mellitus who were on continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD), and we performed the peritoneal function test using the newly developed PD NAVI software (JMS, Hiroshima, Japan). Weekly total Kt/V and creatinine clearance (CCr) were calculated and plotted against body weight (BW) to evaluate the PD dose.