More reasons to use PD fluid with less sugar

Using a novel index created by dividing the glucose content of PD solution by body weight, this study looked at the impact of PD fluid sugar on hemoglobin A1c, fluid overload, and inflammation (measured by interleukin (IL) 6) in 43 people on PD. Higher sugar levels were linked with worse diabetes control, more fluid overload, and higher IL-6 levels.

Read the abstract » | (added 2015-03-11)

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More Canadian patients use PD if their nephrologists place catheters

Among 3,886 people with CKD in Ontario and had a PD catheter placed, those whose nephrologists put in the catheter were 59% more likely to use PD. Even among those who did not end up doing PD, when a nephrologist placed a PD catheter, survival was 97%—vs. 73% when a radiologist put in the catheter.

Read the abstract » | (added 2015-02-10)

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Nocturnal home HD catheter sepsis rates similar to in-center

When 63 nocturnal home HD patients with catheters were matched 1:20 with standard in-center HD patients, both groups had similar rates of sepsis. The catheters lasted about the same length of time.

Read the abstract » | (added 2015-02-10)

Tags: Home dialysis

How patients and care partners feel about home HD

A review of 24 qualitative studies of home HD patients and care partners found five themes: feeling vulnerable, fear of being alone, concerns about family burden, opportunity to thrive, and appreciating medical responsiveness. Starting home HD seemed to be an especially anxious time. Acknowledging these themes and offering reassurance may help more people succeed on home HD.

Read the abstract » | (added 2015-02-10)

Tags: Home dialysis

Bioartificial kidney challenges

When Shuvo Roy is an author on a bioartificial kidney review paper, you know it is worth reading. Cell-based therapies are an approach to duplicate all of the functions of a healthy kidney, including hormone production. But, where the cells come from, organ scaffolding, and immune response remain challenges even in animals—let alone humans.

Read the abstract » | (added 2015-02-10)

Tags: Chronic kidney disease

FHN finding: Frequent and/or Nocturnal HD lowers blood pressure

In the Frequent Hemodialysis Network trials, those randomized to short daily HD had systolic BP an average of 7.7 points lower than those in the standard HD group. Diastolic BP came down an average of 3.9 points. Fewer BP meds were needed. Those who did nocturnal HD had systolic BP an average of 7.3 points lower, and diastolic an average of 4.2 points lower.

Read the abstract » | (added 2015-02-10)

Tags: Nocturnal Hemodialysis

PD training: How much is enough to reduce peritonitis risk?

In a group of 2,243 patients from Brazil, two thirds with less than 4 years of education, training time mattered. After nearly a year of follow up, those whose training was less than 1 hour per session were more likely to have peritonitis. And, those who had at least 15 hours of training had significantly less peritonitis than those who had less. Having a care partner or training multiple people did not affect the risk. But, training before the catheter was placed or at least 10 days after did help.

Read the abstract » | (added 2015-02-10)

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PD training: How much is enough to reduce peritonitis risk?

In a group of 2,243 patients from Brazil, two thirds with less than 4 years of education, training time mattered. After nearly a year of follow up, those whose training was less than 1 hour per session were more likely to have peritonitis. And, those who had at least 15 hours of training had significantly less peritonitis than those who had less. Having a care partner or training multiple people did not affect the risk. But, training before the catheter was placed or at least 10 days after did help.

Read the abstract » | (added 2015-02-10)

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Residual kidney function may drop faster with cycler PD than CAPD.

In a non-randomized Spanish study of 493 new PD users, residual kidney function (RKF) dropped faster in those who were younger, had less kidney function at the start, used PD fluid with more glucose, had higher blood pressure, or had peritonitis or heart disease. While cycler PD and CAPD rates of RKF were about the same, those who used a cycler were more likely to lose the rest of their function.

Read the abstract » | (added 2015-02-10)

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Pilot Study: Flex Dialysis Facilitates Weight Loss

Patients who need to lose weight for better health or to obtain a transplant can be stymied by the strict diet limits of standard in-center HD. In a small series (four obese and two overweight patients), combining 2-6 sessions of flex, incremental HD with a coach-assisted weight loss program led to 5.7-20 kg weight loss over 12-30 months, better metabolic markers, and high patient satisfaction.

Read the abstract » | (added 2015-01-08)

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