Journal Watch
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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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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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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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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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Year 1 Cognitive Function Better with PD than Standard In-center HD
PD came out the winner over standard in-center HD in a study of cognitive function among 96 HD and 101 PD patients who took cognitive tests at the start and end of their first year of treatment, though both groups saw some improvement.
Read the abstract » | (added 2018-02-15)
Tags: PD, HD, Cognitive Function
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Starting PD with One Daily Exchange of Icodextrin
Incremental PD can be less restrictive for patients initiating therapy. Is one daily exchange with icodextrin enough? A physiological study used a 3-pore kinetic model to assess fluid and solute removal among patients with residual function that ranged from 0 to 15 mL/min/1.73m2. All but very large patients (total body water >60L) were predicted to achieve adequate dialysis with this approach.
Read the abstract » | (added 2018-02-15)
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A New, Early Marker for Encapsulating Peritoneal Sclerosis?
Can a drop in dialysate sodium sieving during a PET forecast EPS in advance? A 20-year, controlled longitudinal cohort study found a correlation. Of 161 incident PD patients, 13 went on to develop EPS—and sodium was the best predictor.
Read the abstract » | (added 2018-02-15)
Tags: Dialysate Sodium Sieving, PET, EPS
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Avoiding Short-term HD with Lower PD Abdominal Pressure
When PD patients have hernias, leaks, surgeries, etc., they are often told that they must switch to HD temporarily—using a central venous catheter. Another approach, reducing intraabdominal pressure, may reduce the need for HD, decrease morbidity, and minimize cost.
Read the abstract » | (added 2018-02-15)
Tags: Hernias, Leaks, Surgeries, Intraabdominal Pressure
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PD and Inflammation
The moment a PD catheter is inserted or fluid is instilled in the peritoneum, a cascade of cytokines occurs. This reaction is reduced somewhat when a neutral-pH, low-GDP fluid is used, vs. a conventional one, finds a new observational study.
Read the abstract » | (added 2018-02-15)
Tags: PD Catheter, Cytokines, Low GDP Fluid
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LVAD Users – A New Group Who Can Benefit from Home HD
Patients who need a left ventricular assist device prior to heart transplant surgery may develop acute kidney injury as well. Instead of standard in-center HD, a first patient has been trained for and is successfully doing home HD while waiting.
Read the abstract » | (added 2018-02-15)
Tags: Left Ventricular Assist Device, Heart Transplant Surgery, Acute Kidney Injury