How to start late-referred ESRD patients on PD urgently

When as many as half of Americans with ESRD have less than 3 months notice before needing dialysis, it's great to know that PD can safely be done as a first treatment. This avoids HD catheters, keeps working folks employed, and buys time for a fistula or transplant. This article describes patients who did very well.

Read the abstract » | (added 2011-02-24)

Tags:

Need a PD catheter? Laparoscopic placement is better

Some surgeons place PD catheters "blind" (without imaging), while others use a laparoscope to let them see inside of the peritoneum before they insert the catheter. A new study finds—not surprisingly—that it's best to see what you're doing. Laparoscopic placement had a almost an 18% better success rate and fewer revisions or replacments.

Read the abstract » | (added 2011-02-24)

Tags:

Lipid-lowering drugs save lives on PD

A new look at data from 1,053 people on PD from the USRDS has found that statins and other drugs that lower blood lipid (fat) levels seem to have a big impact on survival. Death rates from all causes or heart disease dropped by 26% and 33%, respectively.

Read the abstract » | (added 2011-02-24)

Tags:

Larger patients can safely do PD

A brand new Canadian study of 4,054 people on PD from 1994 to 2003 has found that a high body mass index (BMI > 30) was not linked with worse survival in people on PD—though a BMI of less than 18.5 was. The researchers concluded that "High BMI patients should not be discouraged from PD just because of their size."

Read the abstract » | (added 2011-02-24)

Tags:

PD fluid with amino acids may help prevent malnutrition—and improve heart health

Basing PD fluid on amino acids (AA') instead of glucose may improve nutrition on PD in the future. A new study switched 13 non-diabetic PD patients from glucose to AA-based fluid. Uptake of amino acids by the skeletal muscles was significantly better with the AA fluid (read more here). Another study of AA-based PD fluid found it less likely than glucose-based fluid to cause release of hormones (leptin and adipnectin) linked with heart problems.

Read the abstract » | (added 2011-02-24)

Tags:

Longer survival on PD with ACE-inhibitors or ARBs

Even if blood pressure is normal, taking blood pressure pills in the ACE-inhibitor or ARB class was linked with much better survival in a new study. Researchers studied 306 new PD users from 2001 to 2005. Even adjusting for age, blood pressure, and other illnesses, those who took the BP pills had a 62% lower risk of death.

Read the abstract » | (added 2011-02-24)

Tags:

Female sexual function better on PD than standard in-center HD

If you're a woman, a new study finds that a transplant is the best way to restore your sexual function to normal levels. But PD did a much better job than standard HD—and the study didn't look at daily or nocturnal HD.

Read the abstract » | (added 2011-02-24)

Tags:

Protect the peritoneal membrane to do PD longer

A new review article suggests replacing some glucose-based dialysate exchanges with icodextrin, resting the peritoneum, using bicarbonate or pyruvate as a buffer, and treating infections immediately as ways to help protect the peritoneal membrane.

Read the abstract » | (added 2011-02-24)

Tags:

C-reactive protein may help identify those at greater risk of post-peritonitis problems

People with higher CRP levels during and after peritonitis were at higher risk for relapse, a switch to HD, or death than those with lower levels, found a study in the Feb. 14 issue of Kidney International. CRP levels may be a useful screening tool.

Read the abstract » | (added 2011-02-24)

Tags:

Author suggests PD for disaster preparedness

A new article in this month's Advances in Chronic Kidney Disease suggests that PD is a good option for people whose dialysis lives are disrupted by hurricanes or other natural disasters. Home dialysis with PD, portable HD, or HD machines that do their own water treatment can help make dialyzors more self-sufficient in any emergency—from a storm to a flu epidemic. It's something to think about...

Read the abstract » | (added 2011-02-24)

Tags: