Journal Watch
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BMI and Survival on PD
A large study from Korea (N=80,674 PD patients) found that those in the highest group for BMI: just 25.71, had significantly higher all cause mortality.
Read the abstract » | (added 2019-06-13)
Tags: Body Mass Index, Survival, Diabetes Mellitus, Peritoneal Dialysis, Mortality
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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
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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
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Moving the PD Exit Site to Combat Infection
A 5-year retrospective cohort analysis looked at the impact of treating PD exit site and tunnel infections in 27 patients by removing the cuff and relocating the catheter under local anesthetic. After follow up ranging from 10.8 to 79.4 months, no leaks occurred, and the infections resolved in 74% of the patients. The rest had to have their catheters removed.
Read the abstract » | (added 2019-06-13)
Tags: Exit Site Relocation, Exit site Infection, Tunnel Infection, Peritoneal Dialysis Catheter, PD Catheter
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Low vs. Very Low Site PD Catheter Placement to Prevent Migration
A retrospective 5-year series of 76 patients whose PD catheter tips migrated had received either a traditional low-site insertion (N=39) or a very-low-site insertion (N=37). After 2 years of follow up, the very-low-site group had significantly better catheter and patient survival, with fewer catheter complications—and no tip migration.
Read the abstract » | (added 2019-06-13)
Tags: Catheter Dysfunction, Catheter Migration, PD Catheter, Peritoneal Dialysis Catheter, Patient Survival
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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
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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
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A Swan Song for Kt/V (It’s About Time!)
A new review of the flaws of Kt/V—including a lack of proof of concept—“leaves little room for any conclusion other than that Kt/V, as an indicator of dialysis adequacy, is obsolete.” [Editor’s Note: Now, if the authors would take on the concept of “adequate” vs. optimal therapy…]
Read the abstract » | (added 2019-05-15)
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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
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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