Journal Watch
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Nephrologists’ attitudes toward intensified HD
Among German nephrologists, 44% believe there is not enough evidence in favor of intensified HD, whether or not they offer it. Respondents cited a need for more funding and more staff to support the therapy. Among the 44% who did offer the option, most reserved it for patients who were not receiving adequate treatment with conventional HD, and just 19% offered it routinely. Read the abstract.
Read the abstract » | (added 2018-07-13)
Tags: Intensified HD
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Vitamin D and Cinacalcet linked to PD survival—but not residual kidney function
In a retrospective look at 581 PD patients, use of Vitamin D and cinacalcet (which have antiinflammatory properties) were linked with 56% and 54% lower risks of death, respectively. But, neither drug slowed the loss of residual function. Read the abstract.
Read the abstract » | (added 2018-07-13)
Tags: Vitamin D, Cinacalcet, Risidual Function
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Vascular access for high-risk PD patients
Which PD patients are at risk for technique failure and should proactively have a vascular access placed for HD? A case-control study compared 72 patients who were transferred from PD to HD to 111 controls who stayed on PD, received a transplant, recovered kidney function, or passed away. Low adequacy or serum albumin, hospitalizations, and peritonitis were predictors of a transfer to HD. Read the abstract.
Read the abstract » | (added 2018-07-13)
Tags: PD, Technique, Vascular Access, HD
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Residual Kidney Function and Sleep Apnea Severity in PD
A small (n=15), exploratory study of 15 APD patients with home apnea monitors found obstructive sleep apnea in 33%, which correlated with having less residual renal function.
Read the abstract » | (added 2018-06-12)
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PKD and PD – a Metaanalysis
Among 9 studies totaling 7,197 patients—of whom 882 had polycystic kidney disease—survival was better among the PKD patients. There were no differences in peritonitis or technique survival between those who did and did not have PKD, though those with PKD did have a higher risk of hernias.
Read the abstract » | (added 2018-06-12)
Tags: PKD, PD, Metaanalysis, Polycystic Kidney Disease
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New Ideas for Incremental PD
Starting incremental PD without the exclusive focus on residual plus peritoneal clearances may ease transitions of new patients onto dialysis—and reduce our “obsession” with small moleule kinetics.
Read the abstract » | (added 2018-06-12)
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APD May Rapidly Improve Left Heart Failure
A single-center observational study of 47 CAPD patients with left-sided heart failure found that using a cycler for short-term APD improved ultrafiltration significantly in just 3 days.
Read the abstract » | (added 2018-06-12)
Tags: CAPD, Cycler, Short term APD, Ultrafiltration
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Whey Protein for PD Malnutrition
A 6-month multicenter, randomized controlled trial tested protein powder plus dietary counseling vs. counseling only for CAPD patients with low serum albumin and BMI. Significantly more of the protein powder group were able to take in enough protein, and they also had significant increases in serum urea and a normalized protein catabolic rate.
Read the abstract » | (added 2018-06-12)
Tags: Malnutrition, Peritoneal Dialysis, Protein Supplementation, Whey Protein
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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)