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BACKGROUND AND AIMS Icodextrin is a soluble glucose polymer used widely as an alternative osmotic agent to glucose-only solutions in PD patients. It provides effective net peritoneal ultrafiltration (UF) and nowadays it is only licensed for once-daily dwells. However, in selected patients it has been described its use in two daily dwells (2-ICO). Our aim was to revise our center experience with icodextrin when prescribed as 2-ICO. METHOD We retrospectively analysed all patients with a 2-ICO dwell prescription in our PD unit from January 2018 until June 2021. Clinical data, indication for prescription and outcomes were collected. RESULTS CONCLUSION In selected patients, 2-ICO dwells daily may have a clinical benefit, improving UF significantly and allowing better management of fluid overload and UF failure without relevant adverse events.

BACKGROUND AND AIMS The severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) pandemic has had a massive impact in health systems worldwide, taking an important toll on dialysis patients as they are more comorbid, have higher mortality and an impaired immune system. Vaccines against SARS-Cov-2 proved to reduce mortality and hospitalization, but serological response in the dialysis population is weaker. Therefore, predictors of response would be useful to assess their level of protection and evaluate the need for further booster doses of the vaccine. METHOD RESULTS CONCLUSION In our experience, PD patients have an adequate serological response to the SARS-Cov-2 vaccines, being previous COVID exposure the main predictor of a good response. Conversely, longer duration of PD treatment was a prognostic factor of seroconversion failure. We believe this should be kept in mind to assess the need for booster vaccination doses in those patients.

BACKGROUND AND AIMS Patients with end-stage kidney disease (ESKD) are becoming older and more comorbid. We define assisted peritoneal dialysis (aPD) as any PD treatment that needs the help of another person regardless of the age of the patient and the duration of such help. Our aim was to analyse our aPD experience. METHOD RESULTS CONCLUSION aPD should be considered not only in the elder or fragile, but also in cases of variable disability regardless of patient age. It does not imply a higher complication rate or a technique failure, and careful caregiver support should be provided to avoid exhaustion and PD abandonment.

Background: Relapsing peritonitis due to the development of a biofilm in the catheter’s lumen remains an important complication of peritoneal dialysis therapy that endangers technique continuity. Taurolidine catheter lock has proven efficient reducing infection rates in permanent hemodialysis catheters based on its biocidal activity and biofilm detachment effect. Efficacy evidence on its use in peritoneal dialysis catheters is lacking. Methods: We retrospectively analyzed all relapsing peritonitis episodes from June 2018 until October 2019 in our center. Patients were identified and data were collected from our electronic renal registry and patient’s records. Results: Six patients were identified during the study period. Most patients (66.6%) were on automated peritoneal dialysis and the median duration of peritoneal dialysis before the episode of taurolidine was started was 43.66 ± 29.64 months. Mean taurolidine doses were 10 (range: 9–11) and 83.3% (five patients, with peritonitis caused by Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, and Corynebacterium propinquum) had a favorable response and microbial eradication without relapses after taurolidine treatment. Only one patient relapsed by the same organism ( Corynebacterium amycolatum) due to non-adherence to the antibiotic treatment prescribed. None of the patients experienced any relevant adverse events, with only two out of six presenting mild transient abdominal discomfort. Conclusion: We believe that peritoneal catheter taurolidine lock could be considered in cases of relapsing or refractory peritonitis, as it could prevent catheter removal and permanent switch to hemodialysis in selected cases, although literature is scarce and further studies are needed.

With aging population and chronic kidney disease burden increasing worldwide, the need for renal replacement therapy is rising and our patients are getting more complex due to comorbidities and long-standing kidney disease. Deteriorated vascular capital is a frequent feature we have to deal with these days, making even obtaining routine blood tests a hard task. We present two case reports of peritoneal dialysis patients without a peripheral vein access were a Port-a-Cath (Port-a-Cath® Deltec® Smiths Medical) was placed to sort out long-term access. Port-a-Cath manipulation was simple, safe and had no complications neither at implantation nor during its use. We believe that Port-a-Cath placement is an option to be considered when coping with end-stage venous access.