Prevalence and Severity of Itching in Patients with End-Stage Renal Disease: Treatment with Nalfurafine Hydrochloride.

Background/aims: In this study, we investigated the severity and frequency of uremic pruritus and itch-associated insomnia in patients with end-stage renal disease (ESRD) or chronic kidney disease (CKD).

Methods: This questionnaire-based study included outpatients with ESRD or CKD who were attending Tokorozawa Renal Clinic in Saitama Prefecture or Musashi Ranzan Hospital and were stable on treatment. The questionnaire was completed by patients on hemodialysis (HD) before a dialysis session and by patients on peritoneal dialysis (PD) or conservative treatment at the time of an outpatient hospital visit.

Successful use of icodextrin in elderly patients on continuous ambulatory peritoneal dialysis.

In peritoneal dialysis (PD), a 7.5% polyglucose-containing dialysis solution (icodextrin) provides prolonged ultrafiltration as compared with glucose-based dialysis solutions. In the present study, we attempted to clarify the safety and effectiveness of icodextrin in elderly patients on continuous ambulatory peritoneal dialysis (CAPD).

Encapsulating peritoneal sclerosis--a clinician's approach to diagnosis and medical treatment.

Encapsulating peritoneal sclerosis (EPS) is recognized as a serious complication of continuous peritoneal dialysis. A preliminary diagnosis of EPSis usually based on clinical signs and symptoms, which commonly include abdominal pain, nausea, vomiting, anorexia, abdominal fullness, an abdominal mass, bowel obstruction, and radiologic findings, including abdominal roentgenogram, contrast studies, ultrasound studies, and computed tomography. The diagnosis is confirmed by laparoscopy or laparotomy showing the characteristic gross thickening of the peritoneum enclosing some or all of the small intestine in a cocoon of opaque tissue.

Role of platelet factor 4-heparin complex antibody (HIT antibody) in the pathogenesis of thrombotic episodes in patients on hemodialysis.

Heparin-induced thrombocytopenia (HIT) is a severe complication in patients on hemodialysis (HD). It has been reported that platelet factor-4 (PF-4)-heparin complex antibody (HIT antibody) plays an important role in the pathogenesis of this serious complication. In the present study, we investigated the role of HIT antibody in the pathogenesis of thrombotic complications including shunt failure, cerebrovascular disease (CVD) and atherosclerosis in patients on dialysis.

Erythropoietin resistance in patients on continuous ambulatory peritoneal dialysis.

Anemia is one of the most serious complications in patients on dialysis. Erythropoietin improves the anemia. However, erythropoietin resistance is sometimes encountered from causes such as functional iron deficiency, secondary hyperparathyroidism, blood loss, or interaction with other drugs.

Blood pressure monitoring by cellular telephone in patients on continuous ambulatory peritoneal dialysis.

We have developed a new telemedicine system that uses a cellular telephone and Internet Web site to monitor changes of blood pressure (BP) in patients on continuous ambulatory peritoneal dialysis (CAPD). An I-converter data collection system directly transmits all data on BP and heart rate (HR) measured by a fully automatic device (HEM-705IT: Omron Life Science, Tokyo, Japan) to a cellular telephone. The cellular telephone then sends the data directly to the main server at the NTT DoCoMo data center.

Changes in the organisms of resistant peritonitis in patients on continuous ambulatory peritoneal dialysis.

Peritonitis is one of the most serious complications of continuous ambulatory peritoneal dialysis (CAPD). Approximately 20% of peritonitis infections have been reported to be resistant to initial therapy, either failing to resolve with appropriate antibiotics or relapsing within 2 weeks of antibiotic discontinuation. To investigate the current situation with regard to resistant peritonitis, we retrospectively examined the incidence and the organisms of resistant peritonitis in our unit over a period of 9 years.