Journal Watch
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Education can change negative nurse attitudes toward home dialysis
In-center HD nurses tend to prefer…in-center HD. But, their negative attitudes toward home treatments can be modified, a new study shows. In Canada, a 3-hour educational session with CE credits on the benefits of home treatments, myths about patient eligibility, costs, and a testimonial video did the trick.
Read the abstract » | (added 2015-05-09)
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Home hemodialysis needs you! Special Kidney International supplement.
A special supplement of Kidney International focuses on how to implement home hemodialysis, from policies and procedures to equipment, recruitment, safety, prescription, staffing, and more—from global experts. Don't miss it!
Read the abstract » | (added 2015-05-09)
Tags: Home dialysis
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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
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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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Metanalysis of low-glucose PD fluid and residual kidney function
An analysis of six randomized controlled trials of neutral pH, low-glucose PD fluids has found that patients who used these fluids had a much slower rate of residual kidney function loss and much higher weekly Kt/Vs than those using standard PD fluids. There were no significant differences between groups in ultrafiltration, blood pressure, or all-cause mortality.
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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Biocompatible PD fluid reduces cell death due to inflammation
In time, the peritoneum (just one cell layer thick) can wear out when used for PD. A new study finds that peritoneal cells in petri dishes bathed in standard PD fluid were more likely to die due to inflammation caused by glucose. But, cells bathed in biocompatible fluids were protected from the damage. In humans, this means that the peritoneum may last longer.
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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