Adequacy of peritoneal dialysis: beyond small solute clearance.

Peritoneal dialysis adequacy is monitored primarily by indices of small solute clearance, Kt/V(urea) and creatinine clearance (C(cr)). Once a threshold of adequacy has been obtained, however, increasing small solute clearance does not result in improved long-term outcomes of PD patients. There are several other factors that may affect optimal dialysis outcomes.

Peritoneal dialysis adequacy: not just small-solute clearance.

Two indices of small-solute clearance, Kt/V urea and creatinine clearance, are widely used as markers of peritoneal dialysis (PD) adequacy. It has become clear, however, that increasing the small-solute clearance above a minimum level does not result in improved long-term PD outcomes. Several other factors may affect optimal dialysis outcome.

Acute renal failure and chronic kidney disease following liver transplantation.

Acute renal failure (ARF) and chronic kidney disease (CKD) are common complications after liver transplantation (LTx). The incidence of ARF post-LTx varies between 48% and 94%; 8% to 17% of patients require renal replacement therapy (RRT). The most common cause of ARF early after LTx is ischemic acute tubular necrosis, followed later by cyclosporine toxicity and sepsis.

Urinary interleukin-18 is an acute kidney injury biomarker in critically ill children.

Background: Urinary interleukin-18 (uIL-18) is an earlier acute kidney injury (AKI) biomarker than serum creatinine (SCr) in specific populations. In the present study, the relationship between uIL-18 and AKI was determined in a heterogeneous group of critically ill children.

Methods: We studied critically ill children to determine whether uIL-18 was an early predictor of AKI.

Discrepancies in serum albumin measurements vary by dialysis modality.

Background: Serum albumin level is an important prognostic marker in patients with chronic renal failure. However there are discrepancies in the methods of estimation of serum albumin. The objective of this study is to evaluate the magnitude of the discrepancy in the serum albumin levels as measured by Bromcresol Green (BCG) and Bromcresol Purple (BCP) dye methods in patients on hemodialysis (HD) and peritoneal dialysis (PD) and to ascertain the clinical determinants of the discrepancy (deltaSA = BCG-BCP; g/dL) in each of the modalities.