I would like Table 4 of ISPD 2010 guidelines which is entitled "for CAPD patients" clarified please.– The 'continuous' column – does this suggest for a CAPD patient that one should give the LD for one exchange EVERY 24hrs, then the MD in remaining exchanges OR the LD for the first exchange, and then MD in all subsequent exchanges (ie don't give the large dose again)?– With regard to dosing antibiotics in CCPD – If giving continuous antibiotics, is it appropriate to use the Table 4 continuous column recommendation for the dosing (although it states for "CAPD patients")? If so, should you use the LD in a prolonged dwell to start, then MD in cycling exchanges, followed by then the large LD dose in day time dwell every day, OR should you just continue to use MD dose in all subsequent exchanges including the daytime dwell?
RESOLVEDChanel P answered March 31, 2011
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 I take care for a new patien who just implent pd tube for 8 days, and no DM hx,got H/T hx.on day 7,i try to flush the pd tube, the out flow is good, but when i try 1.5% 1500ml to dwell > 2hr ,i got -1000 for 3 days, after 3 days he get -3000ml inside the boday.we try apd for 3 cycles and also get (-) after dwell! he show no leakage,no hernia,no scrotum edema..symptoms,he got no constipation, no migration after kub & chest x-ray for no hydrothorax.and today we consult GS, let him back to OR again do the scope exceed the tube functional problem. and BUN,CR increas right now,hold PD ,transfer to HD!! What can i do for now to help him get good PD therapy?is it rare? or maybe the data after PET will show very H?The tube function is good!! no obstruction!!what should i do next?is anybody got the same case like this?or is there got any case report about this kind special new case?please help me!!
RESOLVEDcindy sung answered March 30, 2011
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 HELP ME PLEASE!!i have a new patient who receive pd implantation after 8 days, no complication like hernia,leakage,hydrothorax,constipation,and i try to flush tube with PD solution got good outflow,but after dwell i got -outflow.eventhough i try APD,after 3 days he get -3000ml inside the body. today he went to OR for scope check the tube function is ok!!what shold i do for next?will he be the special PET for H?Is anyone got patient like this kind of situation?what can i do for next?any paper for advice?
OPENCINDY SUNG asked March 31, 2011
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 HELP ME PLEASE!!i have a new patient who receive pd implantation after 8 days, no complication like hernia,leakage,hydrothorax,constipation,and i try to flush tube with PD solution got good outflow,but after dwell i got -outflow.eventhough i try APD,after 3 days he get -3000ml inside the body. today he went to OR for scope check the tube function is ok!!what shold i do for next?will he be the special PET for H?Is anyone got patient like this kind of situation?what can i do for next?any paper for advice?
OPENcindy asked March 31, 2011
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0 vote
 I take care for a new patien who just implent pd tube for 8 days, and no DM hx,got H/T hx.on day 7,i try to flush the pd tube, the out flow is good, but when i try 1.5% 1500ml to dwell > 2hr ,i got -1000 for 3 days, after 3 days he get -3000ml inside the boday.we try apd for 3 cycles and also get (-) after dwell! he show no leakage,no hernia,no scrotum edema..symptoms,he got no constipation, no migration after kub & chest x-ray for no hydrothorax.and today we consult GS, let him back to OR again do the scope exceed the tube functional problem. and BUN,CR increas right now,hold PD ,transfer to HD!! What can i do for now to help him get good PD therapy?is it rare? or maybe the data after PET will show very H?The tube function is good!! no obstruction!!what should i do next?is anybody got the same case like this?or is there got any case report about this kind special new case?please help me!!
RESOLVEDcindy sung asked March 31, 2011
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 I would like Table 4 of ISPD 2010 guidelines which is entitled “for CAPD patients” clarified please.– The ‘continuous’ column – does this suggest for a CAPD patient that one should give the LD for one exchange EVERY 24hrs, then the MD in remaining exchanges OR the LD for the first exchange, and then MD in all subsequent exchanges (ie don’t give the large dose again)?– With regard to dosing antibiotics in CCPD – If giving continuous antibiotics, is it appropriate to use the Table 4 continuous column recommendation for the dosing (although it states for “CAPD patients”)? If so, should you use the LD in a prolonged dwell to start, then MD in cycling exchanges, followed by then the large LD dose in day time dwell every day, OR should you just continue to use MD dose in all subsequent exchanges including the daytime dwell?
RESOLVEDChanel P asked March 30, 2011
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 I have a patient who has his pd catheter for over 1 year, but has not needed dialysis yet. The catheter was being flushed once every 2-3 weeks with 1000ml of Dianeal and after the flush heparin was instilled before capping off. The catheter functioned well until two months ago. Abdominal xray was done and the catheter migrated out of the pelvis. The catheter was surgically repositioned and it is work fine again. Is there a better way to maintain this catheter, the patient still doesnot need dialysis and not sure when dialysis will be started. The patient's creatinine has been in the 3's for over a year.
RESOLVEDLiz,S answered February 28, 2011
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 I have a patient his CAPD Catheter insertion was done before one month and after insertion first flushing was done after 3 days than 6 days but during the third flushing inflow was good but outflow was nil. after x-ray Doctor said there is a omentum rap. then patient went for cather reposion but aftetr reposion and omentum was removed the problem was still there. than doctor send him for recatherisation but after that first flushing was ok but in 2nd flushing inflow and outflow was nill catheter posion was ok in the x-ray.doctor was not able to say anyting , what could be the problem in this patient?
RESOLVEDKishor answered February 14, 2011
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 We have a 62- year- old female patient who was on PD for 7 years (polycystic renal disease) and had to remove the Tenckhoff catheter on December 2009 after a serious and non responsiveE. coli peritonitis (first episode ever!).She is on hemodialysis since then but she is not doing well. She developed refractory ascites with peritoneal fluid count with 11500 cells/mm³, 100% monocytes and sterile culture. There is no fever and no acid-fast bacilli in the peritoneal fluid.We thought about encapsulating peritoneal sclerosis and /or tuberculous peritonitis.She is on antituberculous drugs while we wait other culture results (fungi and M.tuberculosis). The CT was inconclusive for EPS. The patient has normal intestinal function but can hardily eat because of the abdominal volume(four paracentesis already).She will perform a peritoneal biopsy in a few days.Any other thoughts?
RESOLVEDMarcia, F answered February 14, 2011
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