Journal Watch
How to prescribe intensive home HD: A guide for the nephrologist
This article describes each of the types of intensive home HD, and offers prescription guidance from experts.
Read the abstract » | (added 2014-12-09)
Tags: Home dialysis
More protein intake with nocturnal HD—but no change in body composition
Among 11 people doing nocturnal HD, protein intake increased significantly compared to matched standard in-center HD controls. But, one year later, total body mass, fat-free mass, and fat mass did not change.
Read the abstract » | (added 2014-12-09)
Cochrane database review favors home HD over standard in-center HD
Just one, small (n=9) randomized controlled trial (RCT) lasting 8 weeks could be found that looked at home HD (extended) vs. standard in-center HD in adults. But, based on this, the Cochrane Database Systematic Review was able to get a paper published. Home HD reduced 24 hour blood pressure and improved uremic symptoms. The authors recommend more RCTs.
Read the abstract » | (added 2014-12-09)
Tags: Home dialysis
Is low blood sodium as harmful in PD as it is in HD?
Hyponatremia (low blood sodium levels) raise the risk of death in people who do standard in-center HD. A prospective observational study of 441 incident PD patients found a higher mortality risk among those who did PD, too. In fact, after 3 years, the 1/3 of study participants whose sodium was lowest had a 79% higher risk of death than those whose levels were higher.
Read the abstract » | (added 2014-12-09)
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On PD, motivation matters
With the changes in the bundle, more people are being started on PD. In a study of 104 people on PD followed for 14 months, nurse ratings of home cleanliness or patients’ exchange techniques did not predict outcomes. Instead, unmotivated or depressed people were significantly more likely to have peritonitis.
Read the abstract » | (added 2014-12-09)
Tags: Peritonitis
Are portable or wearable kidney devices on the horizon?
Nanotechnology may allow for a new generation of wearable and portable devices to treat kidney failure. Some are now in large animal and human trials. A new day may be coming.
Read the abstract » | (added 2014-11-07)
Tags: Chronic kidney disease
Short-term transfer from PD to HD was not harmful
Peritonitis may require a switch to HD for a while. Does this affect patient or technique survival? No, finds an Australian study that looked at 8 years of people new to PD and matched PD-to-HD-and-back switchers to those who stayed just on PD or HD.
Read the abstract » | (added 2014-11-07)
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mTOR inhibitors may treat encapsulating peritoneal sclerosis
In a case study report, a class of drugs that includes Rapamycin (sirolimus) was used to successfully treat a 16 year old who developed EPS after a switch from PD to HD. mTOR inhibitors help keep new blood vessels from growing.
Read the abstract » | (added 2014-11-07)
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Older patients may make less informed options decisions
In a study of 99 people on dialysis in North Carolina, those who were over age 65 reported significantly less informed decision making. They were less likely to say that the doctor had explained their health problems, and more likely to feel that the doctor made a choice for them.
Read the abstract » | (added 2014-11-07)
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Biocompatible PD fluid may preserve long-term residual kidney function
A metaanalysis of 11 studies (n=1,034) found that biocompatible PD fluid did not boost residual kidney function (RKF) in the short term. But, at 12 months or more, there was a long-term preservation of RKF.
Read the abstract » | (added 2014-10-07)
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