Palliative peritoneal dialysis: Implementation of a home care programme for terminal patients treated with peritoneal dialysis (PD).

Terminal-stage patients on peritoneal dialysis (PD) are often transferred to haemodialysis as they are unable to perform the dialysis technique themselves since their functional capacities are reduced. We present our experience with five patients on PD with a shortterm life-threatening condition, whose treatment was shared by primary care units and who were treated with a PD modality adapted to their circumstances, which we call Palliative Peritoneal Dialysis.

Progression of residual renal function with an increase in dialysis: haemodialysis versus peritoneal dialysis.

Objective: The main objective of the study was to analyse the progression of residual renal function according to the dialysis technique (peritoneal dialysis or haemodialysis) and the frequency of treatment (two or three sessions of haemodialysis per week). As secondary objectives, we studied the progression of the serum concentration levels of β2 microglobulin and the response of anaemia to erythropoietic agents.

Material And Method: 193 non-anuric patients were included and began renal replacement therapy with dialysis in our hospital between 1 January 2006 and 31 December 2011, with a follow-up period of over three months.

Maintaining residual renal function in patients on haemodialysis: 5-year experience using a progressively increasing dialysis regimen.

Introduction: In contrast to patients treated with peritoneal dialysis, those on periodical haemodialysis (HD) do not receive programmed progressive increases in dialysis dosage, nor is residual renal function taken into account in the calculation of the total dialysis prescription; rather, only dialyser clearance is factored into the equation. In 2006, we decided to establish a progressively increasing dialysis regimen at the start of renal replacement therapy, evaluating the possibility of starting with 2 sessions of HD/week when renal clearance of urea was equal to or greater than 2.5 ml/min.

Analysis of concordance between the bioelectrical impedance vector analysis and the bioelectrical impedance spectroscopy in haemodialysis patients.

Introduction: The values of body composition provided by the two most commonly used bioelectrical impedance systems in Spain, single-frequency bioelectrical impedance vector analysis (SF-BIVA) and multi-frequency bioelectrical impedance spectroscopy (MF-BIS) are different and not comparable.

Objective: Analyse whether the inter-method variability is due to bioelectrical variables measured by the different monitors, or rather due to the equations used to calculate body volume and mass. Another objective was to determine whether, despite the inter-method variability, the classification of hydration status by the two methods is consistent.

Recovery of renal function in patients receiving haemodialysis treatment.

The aim of this study was to review all cases of recovery of renal function in chronic haemodialysis patients, observed in the last ten years. During the study period, 218 chronic renal failure patients were managed on haemodialysis for a minimum of 90 days. In 17 cases (8%), it was possible to interrupt dialysis after 95 to 529 days.

Causes of unplanned hemodialysis initiation.

Half of patients starting chronic hemodialysis used a transient vascular catheter as a vascular access (unplanned initiation). An objective of the Quality Management Group of the Spanish Society of Nephrology is to achieve that 80% of the patients starting hemodialysis do it with an arteriovenous fistula. We want to review the causes of non-planned hemodialysis nowadays.

Validation of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in advanced chronic renal failure.

Introduction: The aim of this work was to study the accuracy of the CKD-EPI equation to estimate the glomerular filtrate in patients with advanced chronic renal failure.

Objective: We compared the estimations of Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockcroft-Gault (CG) equations to a glomerular filtration rate measured as the arithmetic mean of the urea and creatinine clearances (ClUrCr).

Material And Methods: The study was made in 89 nondialyzed patients with chronic renal disease in stage 4 or 5.

Patients with a failed renal transplant.

Despite the advances in the care of recipients and in immunosuppression, long-term graft survival has experienced little improvement in the last 10 years. An important number of recipients present progressive loss of graft function and have to be readmitted on dialysis therapy. Before starting dialysis, these patients are re-exposed to the complications of chronic renal failure but there are no specific guidelines for their treatment.

Dialysis after kidney transplant failure: do patients start in a worse condition than the general population with chronic kidney disease?

Background: Patients with renal graft dysfunction constitute an increasingly prevalent group of end-stage kidney disease (ESKD) patients that require dialysis therapy. These patients have special characteristics that set them apart from the ESKD general population. The aim of this study was to analyse the clinical condition and evolution of patients entering dialysis with a failed kidney graft at the time of restarting dialysis and over a year of therapy according to the K/DOQI guidelines, and to compare them with incidental patients with end-stage kidney disease.

[Outcome of HIV-infected patients of peritoneal dialysis: experience in a center and literature review].

Overall survival of HIV-infected has increased over the last ten years. In parallel a higher need for renal replacement therapy (RRT) in this population has been more observed. RRT associated complications and outcomes greatly varied since the introduction of highly active antiretroviral therapy (HAART) and scarce data is available regarding the outcome of peritoneal dialysis (PD) in HIV-infected patients under HAART.