Journal Watch
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Icodextrin Reduces PD Stroke Risk
Stroke risk was compared in PD patients in Taiwan who did or did not use icodextrin. Icodextrin users had a lower risk and incidence of strokes than non-users.
Read the abstract » | (added 2018-12-14)
Tags: Stroke, PD Patients, Icodexytrin
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Protein Clearance Predicts Mortality on PD
Protein clearance on PD may be a marker of peritoneal inflammation. Among 711 PD patients followed for at least one year, each 10mL/day rise in protein clearance was linked with a 10.4% increase in the risk of all-cause mortality (p=0.008). Protein clearance was linked with serum albumin and C-reactive protein levels.
Read the abstract » | (added 2018-12-14)
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Wanted: A Paradigm Shift from Urea to Sodium Removal
When nephrology icon Zyblut Twardowski talks, we listen! When dialyzors in Seattle in the 1960s got 30 hours a week of dialysis, the mortality rate was 10%. Since then, short treatments—justified by the flawed NCDS study—were driven by the equally flawed notion of Kt/V urea.
Read the abstract » | (added 2018-12-14)
Tags: Kt/V Urea, Mortality Rate, Sodium Removal, Dialysis Quality, NCDS, RCT
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Results from a Transportable Home HD Machine in Europe
A multicenter study of 129 home HD in patients using a machine with low-volume, lactate-buffered, ultrapure dialysate was done in seven clinics in four Western European countries. Patients who completed 6+ months of treatment were included. Median training time was 2.5 weeks, and more than 70% of patients were prescribed 6 sessions per week, for a mean of 15 hours per week. From baseline to month 6, elevations were observed in serum bicarbonate, serum albumin, and mean serum C-reactive protein, while mean serum potassium and number of antihypertensives dropped. Use of binders and ESAs was stable.
Read the abstract » | (added 2018-11-11)
Tags: Low flow Dialysate
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Biocompatible PD Fluids: A Systematic Review
Are neutral pH, low glucose degradation product (GDP), and icodextrin PD fluids better than standard ones? A Cochrane review of 42 studies (n=3,262 ) found that neutral pH and low GDP fluids significantly improved residual kidney function (RKF) vs. standard fluids—and more so over time, and urine volume was better preserved. Icodextrin boosted ultrafiltration without reducing RKF.
Read the abstract » | (added 2018-11-11)
Tags: Biocompatible, PD Fluid
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Brush Teeth to Avoid Peritonitis
Are neutral pH, low glucose degradation product (GDP), and icodextrin PD fluids better than standard ones? A Cochrane review of 42 studies (n=3,262 ) found that neutral pH and low GDP fluids significantly improved residual kidney function (RKF) vs. standard fluids—and more so over time, and urine volume was better preserved. Icodextrin boosted ultrafiltration without reducing RKF.
Read the abstract » | (added 2018-11-11)
Tags: Oral Hygiene, Peritonitis
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How PD and In-center HD Patients Perceive Modality Choice
The Empowering Patients on Choices for RRT (EPOCH-RRT) study looked at patients' perceptions of how they chose a dialysis option and the impact of their choice on their lives. Among 1,346 in-center HD and 614 PD patients, those on PD were more likely to report that they had enough information, understood the options, made an active choice, and were happy with it. EDITOR’S NOTE: This study did not include home HD.
Read the abstract » | (added 2018-11-11)
Tags: Dialysis Modality, ESRD
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Successful PD Catheter Quality Improvement
A clinic in China that was experiencing PD catheter dysfunction describes a CQI process that that led to several preoperative, intraoperative, and postoperative approaches that markedly reduced the problem.
Read the abstract » | (added 2018-11-11)
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Uric Acid Levels and CAPD Mortality—an Unexpected Relationship
One might think that high uric (UA) levels would be harmful to those doing CAPD. But, a retrospective analysis of 492 PD patients found that all-cause, cardiovascular, and infection-related deaths dropped as UA levels rose.
Read the abstract » | (added 2018-11-11)
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Nocturnal Home HD in Australia: a 17-year Summary
A retrospective analysis of all 109 nocturnal home HD (NHHD) patients at the Barwon Health clinic in Geelong looked at technique failure (transfer to in-center HD or PD for 60+ days, or death). Of the 112 periods of NHHD, 33 patients (30%) had technique failure after 5.2+3.6 years or died after 4.7+3.8 years. Median technique survival for the full sample was 7.8 years and median patient survival was 14.6 years.
Read the abstract » | (added 2018-11-11)
Tags: Nocturnal Home HD, Patient Survival, Positive Outcomes, Technique Survival