In-center nocturnal HD boosts lean body mass

Among 56 adults followed for a year, those who were randomly assigned to nocturnal in-center HD vs. standard treatments had higher, more stable interdialytic weights. The pattern of toxin removal suggests that the result is due to increases in lean body mass.

Read the abstract » | (added 2017-05-09)

Tags: Hemodialysis

When to start PD after catheter placement

A new randomized controlled trial included 122 new PD starts at two Queensland, Australia hospitals for 5 years. Participants were randomized to three groups, who started PD at either 1 week, 2 weeks, or 4 weeks after PD catheter placement. Leaks were higher in the 1-week group, while PD technique failure was higher in the 4-week group.

Read the abstract » | (added 2017-05-09)

Tags: Peritoneal dialysis, Catheter

How dialysis clinics can help prevent peritonitis

What can dialysis clinics do to reduce the risk of peritonitis in PD patients? In an analysis of 127 PD clinics and 5,017 new PD patients, having a nurse who specialized in PD or conducting home visits prior to the PD start had the biggest impact.

Read the abstract » | (added 2017-05-09)

Tags: Peritoneal dialysis

Why and how to change the dialysis default to PD

PD is comparable to standard HD in outcomes, but costs less, is more convenient, does a better job of preserving residual kidney function, and delivers better quality of life, argues a new editorial.

Read the abstract » | (added 2017-05-09)

Tags: Peritoneal dialysis

Short daily HD in pediatrics

Dividing 12 hours of in-center HD into 5 weekly treatments instead of 3 was feasible and beneficial to blood pressure control in adolescents in a new crossover study. However, not surprisingly, reimbursement and time demands were challenging. (Editorial note: home treatments would allow more flexibility for school.)

Read the abstract » | (added 2017-05-09)

Tags: Hemodialysis

Ultrafiltration: Speed Kills

Among 190 people on HD, those whose ultrafiltration (fluid removal) rate was higher than the median (just 6.8 mL/Kg/h) were less likely to survive than those who were at or below the median. Most participants did not have residual kidney function.

Read the abstract » | (added 2017-04-12)

Tags: Hemodialysis

In-center Nocturnal HD Beats Standard HD

An analysis of 21 published studies (n=1,165 in-center nocturnal patients and 15,865 standard in-center HD patients) found better BP, higher Hgb, and lower serum phosphate levels in those who dialyzed longer.

Read the abstract » | (added 2017-04-12)

Tags: Hemodialysis

PD vs. Standard HD for People with Cirrhosis

For cirrhotic people with kidney failure, data abstraction from the U.S. Nationwide Inpatient Study between 2005 and 2012 compared outcomes with PD and standard in-center HD. In-hospital mortality for those with ascites was significantly less with PD. In addition, PD hospital stays were shorter and costs were lower. Yet, just 1.7% of the sample was using PD.

Read the abstract » | (added 2017-04-12)

Tags: Peritoneal dialysis, Hemodialysis

Pregnancy on PD—at 42: It’s Not Impossible

While research shows that the chance for a pregnant woman on dialysis to have a healthy baby seems to be best with 36+ hours of HD per week, a 42-year old Malaysian woman had a full-term baby with no change to her CAPD prescription.

Read the abstract » | (added 2017-04-12)

Tags: Peritoneal dialysis, Hemodialysis

Striking Lack of Data on Infection Prevention in PD

A Cochrane database review of 59 randomized controlled studies revealed “striking” gaps in our knowledge about what really works to prevent infections in PD. Oral or topical antibiotics and topical disinfectants had uncertain benefits for exit site, tunnel infections, or peritonitis. Use of IV vancomycin prior to catheter placement may reduce the risk of early peritonitis. Antifungal treatments may reduce fungal peritonitis after antibiotics.

Read the abstract » | (added 2017-04-12)

Tags: Peritoneal dialysis