Journal Watch
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10-year Experience with Incremental PD
People who start dialysis with residual function may not need full-on, four- exchanges-per-day PD. This center reports excellent clinical experiences using incremental PD, 1-2 dwells per day, until residual function dropped (a mean of 17 months), finding no differences between an incremental and a standard PD start—and better maintenance of residual function.
Read the abstract » | (added 2016-09-14)
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Which Tidal PD Setting is Most Efficient?
A study of 5 different tidal prescriptions for automated PD (APD) were used with six low-average and six high-average transporters. There were significant differences in urea and creatinine clearance between the prescriptions.
Read the abstract » | (added 2016-09-14)
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Exploding PD Myths
Misconceptions about who will be a “good PD patient” have unnecessarily limited PD updake, increased transfers to in-center HD, and raised costs. Get the straight story!
Read the abstract » | (added 2016-09-14)
Tags: Hemodialysis
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Personal Support Workers for Home HD
Oh, Canada. The Canadians are out ahead of the US in virtually every dialysis parameter and they innovate constantly. Now, they have introduced a concept that CMS threw out with the bathwater in the 1980s—assisted home HD. A pilot project to dialyze six patients at home with personal support workers projected that costs would still be lower than for in-center HD. Phase 2 of the project includes 8 hospitals and 67 patients.
Read the abstract » | (added 2016-09-14)
Tags: Hemodialysis
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Risk Factors for Encapsulating Peritoneal Sclerosis (EPS)
In a study of 703 PD patients between 1980 and 2015 at two centers, the 44 who developed EPS were more likely to have had a history of peritonitis, which rose with the duration of time on PD. The use of biocompatible PD fluid reduced the risk.
Read the abstract » | (added 2016-09-14)
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VIPs in Dialysis Modality Choice
Whose opinion matters most to patients when it comes time to make a dialysis decision? In New Zealand, at least, it’s the nephrologist—even though respondents thought it would be predialysis nurses. In fact, a 1-point increase in nephrologist decisional power increased the rate of home therapies by 6.1%.
Read the abstract » | (added 2016-09-14)
Tags: Hemodialysis
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Silk Filter for the PD WAK
A urease silk fibroin filter has been tested with a wearable artificial kidney (WAK) for PD. In lab analysis, the filter removed more than 50% of urea from a 50 mg/dL urea solution, and 90% after 24 hours.
Read the abstract » | (added 2016-08-09)
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Weighing PD Catheter Techniques: Surgical vs. Percutaneous
Which is better for placement of a PD catheter—surgery, or use of a tiny incision and guidewire to push the tube through the skin (percutaneous). An analysis of 10 studies with 1,626 patients found no difference in 1-year catheter survival or the rate of peritonitis, tunnel/exit site infection, leaks, obstructions, bleeding, or hernias between the two techniques. But, there were fewer mechanical problems with the percutaneous approach.
Read the abstract » | (added 2016-08-09)
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Encapsulating Peritoneal Sclerosis (EPS) Incidence and Outcomes
A new Scottish registry study found that 2.8% of PD patients between 2000 and 2007 (n=1,238) developed EPS. The rate rose from 1.1% by year 1 to 3.4% at year 3, 8.8% at year 4, 9.4% at year 5, and 22.2% by year 7. The authors note that “continuing PD beyond 3 years results in an exponential rise in the risk of developing EPS and deciding whether this risk is acceptable should be made on an individual patient basis.”
Read the abstract » | (added 2016-08-09)
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Which is More Cost Effective, PD or Standard In-Center HD?
If you’ve been reading this site, you won’t be surprised to learn that yet another study has found PD to be more cost-effective than standard in-center HD. A cross-sectional analysis was done on matched pairs of incident PD and HD patients (N=4,285) in Taiwan who were followed for up to 14 years. While the quality-adjusted life expectancy was almost equal, HD costs were much higher.
Read the abstract » | (added 2016-08-09)
Tags: Hemodialysis