Journal Watch
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APD Remote Monitoring Boosts Patient Independence
An observation study of 37 automated PD patients followed by remote monitoring found that prescriptions were modified more often than when monitoring was not done—personalizing treatments better to patients’ needs—and fewer emergency visits were needed, for more efficient use of healthcare resources.
Read the abstract » | (added 2018-05-11)
Tags: Automated Peritoneal Dialysis, Remote Monitoring, Patient Independence, Prescription Of Dialysis
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Albumin Predicts Survival in Anuric PD Patients
Patients who don’t make urine have a better chance of survival on PD if their serum albumin levels are 3.6 g/dL or higher, finds a new study of 505 PD patients in Korea. Age, diabetes, ultrafiltration volume, and serum creatinine levels were other factors.
Read the abstract » | (added 2018-05-11)
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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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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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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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Nephrology Fellows Need Home HD Training & Experience
Home HD offers research and quality improvement topics for fellows, but lack of training is a barrier to patient use of this option. Fellows should attend lectures and receive at least 6-12 months of outpatient clinical exposure that includes transitioning three or more patients to home, argues a new op ed. Having a passionate home HD expert and advocate is essential, as is exposure to home HD nurses.
Read the abstract » | (added 2018-02-15)