Will Zinc Supplements One Day Help Prevent Peritoneal Sclerosis?

Ironically, PD saves lives, but high-glucose PD fluid damages the peritoneum, leading to fibrosis that can make PD impossible. By activating a complex metabolic pathway, a study in rats found that supplementing with zinc helped prevent fibrosis.

Read the abstract » | (added 2019-06-13)

Tags: High glucose PD Fluid, Peritoneum, Fibrosis, Zinc

Frequency vs. Time in HD Survival

Which matters more for HD--the number of treatments per week, or the length of each treatment? A retrospective registry study from the ANZDATA database looked at survival among 16,944 non-indigenous adult patients in Australia and New Zealand from 2001 to 2015. After controlling for frequency, patients with 5+ hour long treatments had significantly better survival than those whose treatments <5 hours. However, controlling for duration, increasing frequency did not boost survival.

Read the abstract » | (added 2019-06-13)

Tags: ANZDATA, Session Frequency, Session Duration, Survival, End stage Kidney Disease

Bioimpedance Assessment of Conventional vs. Daily HD

In a small physiological study, 12 patients were switched from conventional (3x/week) to daily (6x/week) HD treatments. Baseline and monthly blood pressure, BMI, and bioimpedance measurements were gathered on participants. Among the 9 patients who completed the data collection, body composition was not altered--but fluid overload was reduced and fewer antihypertensive medications were needed.

Read the abstract » | (added 2019-06-13)

Tags: Conventional HD, Daily HD, Blood Pressure, BMI, Bioimpedance, Fluid Overload, Antihypertensive Medications

Higher Serum Albumin May Protect Residual Kidney Function in PD

In a prospective study of 104 new PD patients, having low serum albumin levels was independently associated with complete RKF loss (<100 mL/day of urine).

Read the abstract » | (added 2019-06-13)

Tags: Serum Albumin, Residual Kidney Function, Urine Volume, Peritoneal Dialysis, PD

Shared Decision-making (SDM) Boosts Uptake of PD and Living Kidney Transplants

Researchers in Taiwan found that levels of PD choice and living kidney transplantation were higher in the 71% of 310 patients (n=220) who received an SDM intervention were significantly more likely to choose PD or to obtain a living donor kidney transplant than those who did not.

Read the abstract » | (added 2019-05-15)

Tags: PD Choice, Living Kidney Transplantation, SDM Intervention

Daily HD Practices in France and Australia/New Zealand

Registry data from both regions compared all incident patients who dialyzed 5-6 sessions per week—both daytime and nocturnal—with one-to-one matching of French to Australia/New Zealand patients based on age, sex, and dialysis start year. While survival and transplant access were comparable, other intriguing differences appeared.

Read the abstract » | (added 2019-05-15)

Tags: Registry Data, Dialysis Interval, Survival, Transplant Acces

NxStage HD and Removal of Beta-2 Microglobulin

Which works best to remove B2M, High-flux standard HD, post-dilution hemodiafiltration (HDF), NxStage short daily HD, or automated PD? In a small study (N=43), HDF and NxStage HD done 6 days per week removed the most B2M. Standard HD was next, with automated PD removing the least.

Read the abstract » | (added 2019-05-15)

Tags: B2m, High flux Standard HD, Post dilution Hemodiafiltration (HDF), NxStage Short Daily HD, Automated PD

PD Fluid Overload Linked with Peritonitis from Gut Pathogens

PD patients with extra fluid in their bodies are at a significantly higher risk for peritonitis due to gut bacteria, finds a study of 138 patients. Patients in the highest third for intra-and extracellular water were at the highest risk.

Read the abstract » | (added 2019-05-15)

Tags: Body Composition, Overhydration, Peritoneal Dialysis, Peritonitis

To Reinsert a PD Catheter or Not to Reinsert: That is the Question

Among 470 PD patients in Singapore, 92 required PD catheter removal. Of these, 39% had a second PD catheter placed, while the rest switched to HD. Patients who could not continue PD were excluded from the analysis. Survival was about the same in both groups. Surprisingly, those who required catheter removal due to infection were more likely to be able to continue PD than those who required it due to catheter malfunction.

Read the abstract » | (added 2019-05-15)

Tags: PD Catheter, HD, Catheter Remova

KDIGO Controversies: Dialysis Start and Modality Choice

A January 2018 Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference addressed significant variations between countries in dialysis start, patient preparation, and modality mix. Happily, attendees supported individualized care that incorporates patient goals and preferences (within quality and safety parameters), and the need to avoid a one-size-fits-all approach.

Read the abstract » | (added 2019-05-15)

Tags: Modality, Individualized Care, Patient Goals, Patient Preferences