ABSTRACT
In this report, three cases of sclerosing encapsulating peritonitis (SEP) are described; two of them were associated with pleural and/or pericardial effusions.
Subject(s)
Peritoneal Dialysis/adverse effects , Peritonitis/etiology , Adult , Fatal Outcome , Female , Humans , Intestinal Obstruction/etiology , Male , Middle Aged , Pericardial Effusion/complications , Pleural Effusion/complications , SclerosisABSTRACT
The purpose of the present study is to investigate whether Rocaltrol therapy in uremic patients undergoing dialysis treatment can improve muscle function. In 8 uramic patients (2--on CAPD, 6-on HD treatment) calcitriol (Rocaltrol, Roche) was given in the dosis at 1 mcg/day during 15 months. At the beginning of therapy and every month the following parameters were determined in serum: creatinine (Cr), calcium (Ca), phosphate (PO4) and parathyroid hormone (PTH). At the beginning and at the end of treatment the quantitative electromyography (EMG) was performed. We observed a slight increase of serum Cr during 15 months of treatment in 4 patients. Serum Ca, PO4 and PTH did not changed significantly. The EMG revealed abnormal polyphasic motor nerve unit potentials of brief durations, decrease in the amplitude and fibrillations potentials. The EMG findings did not change after Rocaltrol therapy, but all patients on physical examinations exhibited disappearance of clinical manifestations of uremic myopathy. In conclusion, our findings suggest that vit. D deficiency is one of the causes of uremic myopathy and a careful treatment with Rocaltrol can diminish muscle weakness in uremic patients.
Subject(s)
Calcitriol/therapeutic use , Muscle Weakness/drug therapy , Muscle, Skeletal/drug effects , Uremia/complications , Vitamin D Deficiency/drug therapy , Adult , Calcitriol/pharmacology , Electromyography , Female , Humans , Male , Middle Aged , Muscle Weakness/diagnosis , Muscle Weakness/etiology , Peritoneal Dialysis, Continuous Ambulatory , Uremia/therapy , Vitamin D Deficiency/etiologyABSTRACT
The purpose of the present study is to investigate whether calcitriol therapy in uremic patients undergoing dialysis treatment can improve muscle function. In 8 uremic patients [2 on continuous ambulatory peritoneal dialysis (CAPD), 6 on hemodialysis (HD) treatment], calcitriol (Calcitriol, Roche) was given in the dose of 1 microgram/day for 15 months. At the beginning of therapy and every month, the following parameters in serum were determined: creatinine (Cr), calcium (Ca), phosphate (P), and parathyroid hormone (PTH). At the beginning and at the end of treatment, quantitative electromyography (EMG) was performed. We observed a slight increase of serum Cr during 15 months of treatment in 4 patients. Serum Ca, P, and PTH did not change significantly. The EMG revealed abnormal polyphasic motor nerve unit potentials of brief durations, a decrease in the amplitude, and fibrillation potentials. The EMG findings did not change significantly after calcitriol therapy, but all patients on physical examinations exhibited the disappearance of clinical manifestations of uremic myopathy. In conclusion, our findings suggest that vitamin D deficiency is one of the causes of uremic myopathy and a careful treatment with calcitriol can diminish muscle weakness in uremic patients.
Subject(s)
Calcitriol/administration & dosage , Electromyography/drug effects , Muscle Contraction/drug effects , Peritoneal Dialysis, Continuous Ambulatory , Renal Dialysis , Uremia/therapy , Adult , Calcium/blood , Combined Modality Therapy , Creatinine/blood , Dose-Response Relationship, Drug , Drug Administration Schedule , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Muscle Contraction/physiology , Muscle, Skeletal/drug effects , Muscle, Skeletal/physiopathology , Parathyroid Hormone/blood , Phosphates/blood , Uremia/physiopathologyABSTRACT
The aim of the study was a comparative analysis of bone scans in uremic patients treated with intermittent peritoneal dialysis (IPD) or hemodialysis (HD). Bone scintigraphy was performed using technetium Tc 99m etidronate (EHDP) in 28 uremics (age 46.0 +/- 13.5 years, x +/- SD) on IPD for 3.1 +/- 3.0 months and 28 uremics (age 43.5 +/- 11.6 years) on HD for 47.3 +/- 33.9 months. Serum c terminal parathormone (cPTH) exceeded 5.3 +/- 3.3 and 6.8 +/- 3.5 times the upper normal limit of 1.4 ng/mL in IPD and HD patients, respectively. Despite significant differences in dialysis treatment duration in IPD and HD patients, an increased Tc 99m EHDP uptake in bones was shown with similar frequency, when all the groups were compared. However, in the group of patients with serum cPTH exceeding four times the upper normal limit (n = 30) or in the age group less than 45 years old (n = 26), a greater marker uptake was observed in HD patients. Significant differences (p < 0.05) were shown in the cranial vault: 33% of HD patients (n = 18) with higher cPTH and 47% of those less than 45 years old (n = 15) revealed an increased marker uptake, whereas it was not observed in any IPD patient. When scans of HD patients dialyzed less than (n = 11) and more than (n = 17) 30 months were compared, a significantly higher appearance of increased marker uptake was shown in cranial vault (41% vs 0%, p < 0.02) and in sacral bone (82% vs 36%, p < 0.02) in patients with longer dialysis. The latter group of HD patients also showed an increased marker uptake in cranial vault compared to the entire group of PD patients (41% vs 7%, p < 0.01). Our studies suggest that bone scan changes, indicating secondary hyperparathyroidism, progress significantly with prolongation of dialysis treatment, especially in patients with higher cPTH levels of younger age.
