Journal Watch
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A Randomized, Controlled Trial of Instant Messaging for PD Patients
Among 160 PD patients, the half assigned to instant messenger had significantly higher levels of satisfaction, serum albumin, and hemoglobin—and lower levels of serum phosphorus and calcium-phosphate product than controls.
Read the abstract » | (added 2018-05-11)
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New Danish Dialysis Decision Aid
A shared decision-making tool developed and pilot tested in Denmark was well-received by 137 patients, and resulted in 80% of them choosing a home dialysis option—vs. just 23% without the tool.
Read the abstract » | (added 2018-05-11)
Tags: Patient Involvement, Dialysis Choice, Dialysis Decision Aid
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35-year Patient Survival on Home HD
A case study reports on the 35-year survival of a man with Alport’s syndrome who uses thrice-weekly conventional home HD—and still works 6-8 hours per day at age 65—despite no residual kidney function.
Read the abstract » | (added 2018-05-11)
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Low Molecular Weight Heparin as Anticoagulation for Nocturnal HD
How can the dialysis circuit be kept free of clots during slow, HD treatments done during sleep? In a small study, 12 patients who did alternate night, 8-hour treatments were randomized to nadroparin (a low molecular weight heparin) or unfractionated heparin. The dosing regimens were adapted to make them more practical for overnight use. Both were effective, but with different monitoring requirements.
Read the abstract » | (added 2018-04-12)
Tags: Anticoagulation, Home Haemodialysis, Low molecular Weight Heparin, Nadroparin, Unfractionated Heparin
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LVH Regression in the FHN Trials
Among the 243 randomized patients with biomarker data in the daily HD trial, 121 had no change, 77 got better, and 45 got worse over the course of the study. Changes in levels of collagen turnover and klotho enzyme levels seemed to predict which patients would improve; a finding that will need to be verified in another study.
Read the abstract » | (added 2018-04-12)
Tags: Copeptin, Brain Natriuretic Peptide, Cardiac Biomarkers, Frequent Hemodialysis, Klotho, Left Ventricular Hypertrophy, Markers Of Collagen Turnover
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Emergent Start PD Yet Again
Learn about the rationale and feasibility of using PD as a first dialysis option for emergent start patients instead of inserting a central venous catheter and starting HD. .
Read the abstract » | (added 2018-04-12)
Tags: End stage Renal Disease, Haemodialysis, Peritoneal Dialysis, Unplanned Start, Urgent Start
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Homocysteine as a Marker for Spontaneous Bacterial Peritonitis
A non-invasive marker for SBP could save both time and money, and in a series of 323 PD patients with ascites, the ascitic fluid was tested for homocysteine levels. Both serum and ascitic levels were elevated in the SBP group—and both levels dropped after treatment. A cutoff level was suggested. Read the abstract.
Read the abstract » | (added 2018-03-16)
Tags: Ascites, Homocysteine Levels
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Improving Incident ESRD Care with Transitional Care Units
Patients who transition onto dialysis are at high risk for morbidity and mortality—along with high costs. Transitional care units use the first 30 days of treatment for systematic onboarding that includes education and informed options choice—and may be especially helpful to those who start treatment emergently. Read the abstract.
Read the abstract » | (added 2018-03-16)
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Experiences of Self-cannulation in Men
Self-cannulation can be a barrier to home HD, and a new qualitative study examined why that is and how patient attitudes toward it changed over time. Eight male patients were interviewed, and the course of becoming a self-cannulator was described as a “process” of gaining control, building confidence, and finding a new norm. The article suggests practical techniques that can be used by clinic staff. Read the abstract
Read the abstract » | (added 2018-03-16)
Tags: Self cannulation, Techniques
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Standard Kt/V urea Targets Less Useful for Home HD
When patients do home HD more often than three times a week, do the Kt/V urea targets still predict outcomes? Not all that well, suggests a new study. Multivariate regression analysis of 109,273 standard in-center HD patients compared to 2,373 home HD patients found that while a lower Kt/V urea (<2.1) did predict higher blood pressure in both groups, it did not predict metabolic control in either group. For those on home HD, a low Kt/V did not predict hospitalization, mortality, or technique failure, though it did for in-center patients. The authors concluded that the current Kt/V urea targets “have limited utility” for home HD.
Read the abstract » | (added 2018-02-15)