["Quality" Peritoneal Dialysis].

Evaluation of a peritoneal dialysis (PD) program in a nephrology center involve qualitative and quantitative indicators on clinical outcomes. International guidelines recommend monitoring outcomes of peritoneal catheter implantation, catheter-related infections, peritonitis and purification adequacy. However, none of these parameters can determine the organizational efficiency of a peritoneal dialysis (PD) program. It is desirable that centers with PD programs serving ≤14 patients, once capable of performing the peritoneal equilibration test, either safeguard their expertise or establish collaborations with nephrology units that have well-established PD programs.

The vascular disease of diabetic kidney disease.

The incidence of cardiovascular disease (CVD) is increased in patients with diabetic kidney disease (DKD). Aortic stiffness is a well-accepted biomarker for cardiovascular (CV) events in all stages of CKD. The worldwide prevalence of diabetes continues to grow, as does the prevalence of DKD. Insulin resistance, hyperglycaemia, hypertension and the metabolic abnormalities of type-2 diabetes are all involved in the pathogenesis of CVD. The effect of these toxins on cardiac and vascular function is amplified by the worsening of renal function and the parallel rise of uraemic toxins. In this narrative review, we analysed why arterial stiffening can be considered a vascular mediator between diabetes and cardiac dysfunction, and we discussed the strong CV and nephroprotective effects of sodium-glucose cotransporter type 2 inhibitors (SGLT2i).