WCIM 2014 SEOUL KOREA 185
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0538 Nephrology
Peritoneal Transport and Mesothelial Damage of C-Re- active Protein Transgenic Mice Undergoing Peritoneal Dialysis
PYK POON1, BCH KWAN1, HY LAN1, XR HUANG1, CC SZETO1, PKT LI1
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong S.A.R.
Background: C-reactive protein (CRP) is a mediator of systemic infl ammation. Perito- neal dialysis (PD) is known to cause peritoneal infl ammation and fi brosis. We study the degree of peritoneal infl ammation and fi brosis in CRP-transgenic (Tg) mice before and after PD treatment.
Methods: Wild-type (WT) and CRP-Tg C57 mice (all male, 10-12 weeks old) were injected intra-peritoneally with 4.25% dextrose PD solution (3ml/mouse) daily for 28 days, followed by a 4-hour peritoneal equilibration test (PET). The mice were then sac- rifi ced. Parietal peritoneum and omental tissues were collected for the assessment of infl ammation and fi brosis.
Results: After 28 days of PD, CRP-Tg mice had higher dialysate creatinine and di- alysate-to-plasma (D/P) creatinine ratio than WT mice. Parietal peritoneum of the CRP-Tg mice was more cellular than that of the WT mice. CRP-Tg mice also had high- er connective tissue growth factor (CTGF), intercellular adhesion molecule 1 (ICAM1) and tumor necrosis factor a (TNFa) RNA expressions as well as immunohistochemical staining in the parietal peritoneum than the WT mice. In addition, CRP-Tg mice had significantly more a-smooth muscle actin (aSMA) in the parietal peritoneum and omentum than WT mice.
Conclusions: CRP-Tg mice have signifi cantly more infl ammation and fi brosis than WT mice after PD treatment. Our results suggest that CRP is an important mediator of the infl ammation and fi brosis induced by PD. The implication of our results to human PD therapy needs further investigation.
PS 0539 Nephrology
High Volume Peritoneal Dialysis Versus Extended Daily Hemodialysis for Acute Kidney Injury Patients : Sys- tematic Review
Ho Sik SHIN1, Hye Yeon LEE1, Gyoung-Hoon KANG1, Ye Na KIM1, Yeon Soon JUNG1, Hark RIM1, Hyun Yul RHEW2
Department of Internal Medicine, Kosin University Gospel Hospital, Korea1, Department of Urology, Kosin University Gospel Hospital, Korea2
Background: The role of high volume peritoneal dialysis (HVPD) in the management of AKI is not well defi ned, although it remains frequently used, especially in low-resource settings. A systematic review was performed to compare high volume peritoneal dial- ysis with extended daily hemodialysis in AKI patients.
Methods: MEDLINE, Embase, and Cochrane Central were searched in October of 2013.
Eligible studies selected were randomized adult population studies on high volume peritoneal dialysis and extended daily hemodialysis in the setting of AKI. The primary outcome of interest was all-cause mortality. Summary estimates of risk diffenence were obtained using a random effects model.
Results: Of 2125 citations, 2 studies (n=263 patients) were identified. The overall methodological quality was moderate. In 2 studies (2 randomized trials), patients re- ceived high volume peritoneal dialysis (n=142, pooled mortality=61.2%) or extended daily hemodialysis (n=121, pooled mortality=58.6%). There was also no difference in mortality (risk difference, 0.02; 95% confi dence interval, -0.10 to 0.14); and, homoge- neity was signifi cant (I2= 0%, P=0.65).
Conclusions: This study showed no evidence of survival or recovery of renal function benefi t of EHD compared with HVPD
PS 0540 Nephrology
Relationship Between Onodera’s Prognostic Nutritional Index and Subpopulation Lymphocyte Counts in Hemo- dialysis and Peritoneal Dialysis Patients
Ye Na KIM1, Tae-Hun KIM1, Gyoung-Hoon KANG1, Ho Sik SHIN1, Yeon Soon JUNG1, Hark RIM1, Hyun Yul RHEW2
Department of Internal Medicine, Kosin University Gospel Hospital, Korea1, Department of Urology, Kosin University Gospel Hospital, Korea2
Background: No standard method for assessing the nutritional status in dialysis patients. In the present study, we undertook an evaluation to determine whether estimation of Onodera’s Prognostic Nutritional Index (OPNI) and lymphocyte subset counts can be helpful in diagnosis of malnutrition in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients.
Methods: We examined the OPNI and lymphocyte subset counts of 50 HD patients (55.8 ± 12.7 years; 28 men and 22 women) and 16 CAPD patients (49.8 ± 14.5 years;
10 men and 6 women). The OPNI is calculated based on the serum albumin level and total lymphocyte count and uses the following equation: OPNI = 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mL). Logistic regression analysis was per- formed for predicting malnutrition in dialysis patients.
Results: We examined the OPNI and lymphocyte subset counts of 50 HD patients (55.8
± 12.7 years; 28 men and 22 women) and 16 CAPD patients (49.8 ± 14.5 years; 10 men and 6 women). The OPNI is calculated based on the serum albumin level and total lymphocyte count and uses the following equation: OPNI = 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mL). Logistic regression analysis was performed for predicting malnutrition in dialysis patients.
Conclusions: These results suggest that OPNI and lymphocyte subset counts (especially CD 19 count) may be a signifi cant nutritional marker in HD and CAPD patients
186 32nd World Congress of Internal Medicine (October 24-28, 2014) WCIM 2014
PS 0541 Nephrology
A Comparison of Nutritional Parameters of CAPD Pa- tients with Those of Hemodialysis Patients
Jin Woo WI1, Nam Ho KIM1, Jung Hwan YOON1 Chonnam National University Hospital, Korea1
Background: Malnutrition is common and the major risk factor of mortality in pa- tients on dialysis. So far, there are limited data of nutrition of patients on dialysis.
The aim of this study is to investigate and compare nutritional parameters of CAPD patients and those of hemodialysis patients.
Methods: A total of 137 patients on dialysis from April 2009 to July 2013 were enrolled. Nutritional parameters of 66 CAPD patients and those of 71 hemodialysis patients were compared by diet analysis, anthropometry, laboratory study and ques- tionnaires.
Results: Most Anthropometric values showed no signifi cant difference except TBW.
TBW was lower in CAPD patients (p=0.026). Nutritional biomarkers were compared.
Pre-albumin was higher in CAPD patients (p=0.000). HDL, LDL and total cholesterol were higher in CAPD patients (p<0.005). In diet analysis, Total calorie (p=0.000) and Total cholesterol (p=0.012) intakes were higher in CAPD patients. Mean SGA grade was higher in CAPD patients (p=0.003).
Conclusions: Many nutritional parameters of CAPD patients were better than those of hemodialysis patients. More intensive nutritional support and diet consult may be needed in hemodialysis patients
PS 0542 Nephrology
Modifi ed Peritoneal Dialysis Catheter Insertion: Com- parison with a Conventional Method
Yong Kyu LEE1, Pil-Sung YANG2, Kyoung Sook PARK2, Kyu Hun CHOI2, Beom Seok KIM2
National Health Insurance Corp. Ilsan Hospital, Korea1, Yonsei University, College of Medicine, Severance Hospital, Korea2
Background: The conventional trocar and cannula method in peritoneal dialysis (PD) catheter insertion shows its limitation in clinical setting. The aim of this study was to compare a modifi ed method for percutaneous PD catheter insertion with the conven- tional method, and demonstrate advantages of the modifi ed method.
Methods: Patients at a single center who had percutaneous PD catheters inserted by nephrologists from January 2006 until September 2012, using either a modifi ed method (group M) or the conventional trocar and cannula method (group C), were ret- rospectively analyzed, regarding baseline characteristics, complications experienced up to 3 months after the procedure, and the suitability of the procedure for the patients.
Results: Patients at a single center who had percutaneous PD catheters inserted by nephrologists from January 2006 until September 2012, using either a modifi ed method (group M) or the conventional trocar and cannula method (group C), were ret- rospectively analyzed, regarding baseline characteristics, complications experienced up to 3 months after the procedure, and the suitability of the procedure for the patients.
Conclusions: Our modifi ed PD catheter insertion method shows its advantages in early complication rate, early complications revision rate, and the patients’ conveniences.
