Glucose challenge test (GCT) detects glucose metabolism disorders in PD

When glucose-based PD fluid is used, it can be a challenge to see if there are blood sugar issues. In 20 people on PD who did not have a history of diabetes, an initial GCT detected impaired glucose tolerance in eleven and diabetes mellitus in four. About 2 years later, twelve patients had glucose metabolism disorders—but none had diabetes.

Read the abstract » | (added 2015-05-09)

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New index more accurate than Kt/V for PD “adequacy”

It’s no secret that we at Home Dialysis Central are not fans of Kt/V for HD (or the concept of “adequacy”). A new European study suggests that Kt/V is not useful for PD, either (because it does not account for protein intake), and has tested a substitute index that works better.

Read the abstract » | (added 2015-05-09)

Tags: Home dialysis

Gene therapy via nanoparticles reduces peritoneal fibrosis in mice

Gene therapies may reduce peritoneal fibrosis—a leading cause of PD failure. Delivering transforming growth factor using nanoparticles worked in a mouse study.

Read the abstract » | (added 2015-05-09)

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Ultrasound can measure peritoneal wall thickness in children

Fibrosis of the peritoneum can cause PD failure. But, peritoneal wall thickness can be measured with a painless ultrasound. The results can assess whether the peritoneum is changing over time.

Read the abstract » | (added 2015-05-09)

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Icodextrin reduces PD failure and boosts survival

In a prospective trial of 306 incident PD patients between 2007 and 2011, those who used icodextrin were significantly more likely to continue with PD and more likely to live longer than those who used standard PD fluid.

Read the abstract » | (added 2015-04-10)

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Biocompatible PD fluids are cost-effective (in capitated systems…)

In Australia, where the cost of hospitalization is of concern to the National Healthcare System, one group of PD patients was given biocompatible PD fluid, while a control group received standard PD fluid. After 2 years, the more costly biocompatible fluid created significant cost savings due to reduced peritonitis and hospital stays.

Read the abstract » | (added 2015-04-10)

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Maximum ultrafiltration rate as a measure of optimal HD

Dialysis removes both wastes and water. Yet, while we have measures for waste removal, we have no marker for water—even though, in the short run, it is more important for patient health and well-being. Dr. Agar proposes a maximum ultrafiltration rate.

Read the abstract » | (added 2015-04-10)

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Nurses may be a barrier to extended in-center HD treatments

In a UK study to assess the feasibility of recruiting patients for a trial of 6-hour HD vs. 4-hour, 56 nurses were polled about their attitudes. While 95% of national non-nurse healthcare providers felt that the longer treatments were clinically helpful, just 42% of nurses agreed. And, while 75% of the non-nurses felt that longer HD treatments were well-tolerated, only 45% of nurses thought so—while 83% of nurses were concerned about the impact of the longer treatments on scheduling shifts.

Read the abstract » | (added 2015-04-10)

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Daily HD – fewer hospital days and less dropout than PD

Compared to PD patients in the USRDS, 1,116 people who did daily home HD had significantly fewer hospital days (5.2 vs. 9.2) and were significantly less likely to switch back to standard in-center treatment (15% vs. 44%). Hospital rates for daily home HD were about the same as those for standard in-center HD in this study.

Read the abstract » | (added 2015-04-10)

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ACTIVE trial of extended dialysis described

A Clinical Trial of IntensiVE (ACTIVE) Dialysis is a randomized trial of extended (24+ hours) or standard (12-18 hours) of weekly HD for 12 months, looking at quality of life, left ventricular mass, and safety. The study has 200 participants from Australia, China, Canada, and New Zealand, meeting the planned recruitment target. The trial is registered at clinicaltrials.gov (NCT00649298).

Read the abstract » | (added 2015-04-10)

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