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Results: 15

Continuous ambulatory peritoneal dialysis versus automated peritoneal dialysis for end‐stage renal disease

Peritoneal dialysis (PD) can be performed either manually as in continuous ambulatory peritoneal dialysis (CAPD) or using mechanical devices as in automated PD (APD). The aim of this review was to compare the effectiveness of CAPD and APD. Only three small randomised controlled trials (RCTs) (139 patients) were identified after an extensive literature search, and we found no difference between CAPD and APD for clinically important outcomes. APD may however be considered advantageous in select group of patients such as in the younger PD population and those in employment or education due to its psychosocial advantages. These outcomes were only reported in one trial. Large, long‐term RCTs are needed in this area.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Y‐set and double bag systems offer the most protection against peritonitis during continuous ambulatory peritoneal dialysis (CAPD)

People with advanced kidney disease may be treated with CAPD where a catheter is permanently inserted into the peritoneum (lining around abdominal contents) through the abdominal wall and sterile fluid is drained in and out a few times each day. The most common serious complication is infection of the peritoneum ‐ peritonitis. This may be caused by bacteria accidentally being transferred from the catheter. This review of trials compared three types of connecting systems (used to connect the bags and the catheter) and found the Y‐set and double bag exchange systems are the most effective in preventing peritonitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Tidal versus other forms of peritoneal dialysis for patients with acute kidney injury

Acute kidney injury (AKI) is characterised by a sudden decline in kidney filtration and patients with AKI have reduced (or no) urine output. AKI is clinically defined by an increase in serum creatinine and decrease in glomerular filtration rate. People with AKI need renal replacement therapy usually in the form of kidney dialysis. At present, there is no universally accepted form of dialysis for most AKI patients. Peritoneal dialysis (PD) has been favoured because it causes fewer heart and lung problems, and patients do not need anti‐clotting drugs. Tidal PD (TPD) is an automated process that fills and drains the dialysis fluid, but retains a designated proportion so the peritoneum never completely empties.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

No reduction in the incidence of peritonitis could be shown from catheter‐related interventions for peritoneal dialysis

People with advanced kidney disease may be treated with peritoneal dialysis where a catheter is permanently inserted into the peritoneum (lining around abdominal contents) through the abdominal wall and sterile fluid is drained in and out a few times each day. The most common serious complication is infection of the peritoneum ‐ peritonitis. This may be caused by bacteria accidentally being transferred from the catheter. This review of different catheter types, insertion or immobilisation techniques showed that they do not reduce the incidence of peritonitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

The nasal antibiotic prophylactic mupirocin reduces exit‐site/tunnel infection and preoperative intravenous antibiotic prophylaxis reduces early peritonitis in peritoneal dialysis

People with advanced kidney disease may be treated with peritoneal dialysis where a catheter is permanently inserted into the peritoneum (lining around abdominal contents) through the abdominal wall and sterile fluid is drained in and out a few times each day. The most common serious complication is infection of the peritoneum ‐ peritonitis. This may be caused by bacteria accidentally being transferred from the catheter. This review found that nasal mupirocin reduces exit‐site/tunnel infection but not peritonitis while preoperative intravenous antibiotic prophylaxis reduces early peritonitis but not exit‐site/tunnel infection. More large scale trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

What is the best treatment to manage peritonitis in people on peritoneal dialysis?

People with advanced kidney disease can be treated with peritoneal dialysis (PD) which involves a catheter being permanently inserted into the lining around the abdominal organs (the peritoneum) through the abdominal wall. Sterile fluid is drained in and out several times each day. The peritoneal lining enables movement of salts and toxins that accumulate when kidney function cannot maintain usual function. Wastes from the bloodstream are moved into the dialysis fluid and removed with the fluid as it is drained from the body.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Biocompatible dialysis fluids for peritoneal dialysis

Peritoneal dialysis (PD) is a form of treatment for people with advanced kidney disease to an extent where their own kidney function is inadequate to meet the body's requirements. PD is flexible, and allows for therapy to be instituted by patients at home. After initial surgical insertion of a catheter into the abdomen, patients are required to perform regular exchange of PD solution at a prescribed rate to allow clearance of toxins and fluids across the peritoneal membrane. Unfortunately, the longevity of PD is limited, which is largely due to peritoneal membrane injury that results from the use of biologically 'unfriendly' PD solutions. The 'unfriendly' characteristics of these solutions include high glucose levels, glucose breakdown products and acidity. To overcome these hurdles, biocompatible PD solutions (i.e. neutral pH, lowered levels of glucose breakdown products, use of materials alternative to glucose such as icodextrin) have been manufactured that are designed to cause less damage to the peritoneal membrane. This review of interventions testing the benefits and harms of biocompatible PD solutions identified 36 studies (2719 patients).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Methods for the drainage of fluid containing cancer cells that collect in the abdomen in women with a gynaecological cancer

Patients with advanced ovarian cancer and some patients with advanced endometrial cancer often need repeated drainage for malignant ascites. Guidelines to advise those involved in the drainage of ascites are usually produced locally and are generally not evidence‐based but mainly based on clinicians' anecdotal evidence and experience.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

There is no evidence to support routine drain use after liver resections

Use of abdominal drainage after elective liver resections is controversial. The rationale of inserting a drain in the abdomen is to prevent fluid collections in the abdomen and to detect post‐operative bleeding and bile leak. The review on five clinical trials with 465 patients could present no evidence to support drain use. However, the confidence intervals are wide, and reduced infective and chest complication rate of not draining may have been overlooked. With respect to wound infection, the likelihood of getting an infection is almost doubled if suction drain is applied, compared to no drain at all. More randomised trials are desirable as it would give further insights to the implications of the use of drains with respect to specific patient‐groups and types of operations.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Flow‐regulated versus differential pressure‐regulated shunt valves for adult patients with normal pressure hydrocephalus

Normal pressure hydrocephalus (NPH) is a condition in which the fluid around the brain is not properly absorbed, adversely affecting brain function. It is often treated using a shunt, which drains the extra fluid from the brain into the peritoneal cavity in the abdomen, where the fluid can be absorbed (a ventriculo‐peritoneal shunt). Currently about 5.5 ventriculo‐peritoneal shunt implantations are performed per 100,000 inhabitants in industrial countries per year, even though evidence supporting shunting as treatment for NPH is poor. Approximately 30% to 40% of implanted shunts fail and have to be revised during the first year. To try to reduce the number of complications, many valve and shunt system designs have been developed. These valves can be classified, according to the mechanical design, into two main groups: differential pressure valves and flow‐regulated valves. No randomised clinical trial so far has compared these two types of valve. Thus, there is no high‐quality evidence indicating that flow‐regulated and differential pressure‐regulated shunt valves differ in efficacy or complication rates.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Insufficient evidence from trials comparing CAPD (home dialysis without a machine) with hospital dialysis for people with kidney failure

When people's kidneys fail (end‐stage kidney disease), they need either a transplant or dialysis to keep performing the kidney's functions. Dialysis can involve either regular visits to hospital for time on an artificial kidney machine (haemodialysis), or home dialysis. Home dialysis (CAPD ‐ continuous ambulatory peritoneal dialysis) is a 'do it yourself' option that does not require a machine. It involves a tube permanently inserted through the abdomen to allow a fluid called dialysate to be emptied and replaced every day. The review found only one trial comparing the effects of CAPD and haemodialysis. No conclusions could be drawn.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Diuretic therapy for newborn infants with posthemorrhagic ventricular dilatation

Bleeding (hemorrhage) into the fluid‐producing cavities (ventricles) of the brain is a serious complication of premature birth. Large hemorrhages may result in fluid building up under pressure, progressively enlarging the brain and head. Current treatment approaches, including the insertion of a valve drainage system (shunt) are fraught with problems. Acetazolamide and furosemide, two drugs with diuretic action, reduce the production of fluid in the ventricles of the brain and have been proposed as safe treatments to treat dilatation of the ventricles after intraventricular hemorrhage in newborn infants. When compared with standard treatment, diuretic therapy was found not to reduce the need for shunt surgery. Diuretic drugs are neither safe nor effective in treating ventricular dilatation in infants with intraventricular hemorrhage.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Frequency of administration of erythropoiesis‐stimulating agents for the anaemia of end‐stage kidney disease in dialysis patients

Anaemia (having too few red blood cells) is a major cause of tiredness and other problems often experienced by people on dialysis. Dialysis is treatment for kidney disease using an artificial kidney machine (haemodialysis) or by exchanging fluid through a tube in the abdomen (peritoneal dialysis).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Childhood Extracranial Germ Cell Tumors Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of childhood extracranial germ cell tumors.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: November 21, 2014

Carcinoma of Unknown Primary Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of metastatic cancer that has spread from an unidentified primary tumor.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: May 2, 2014

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