Journal Watch
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Peritoneal cavity model will help the study of fibrosis
Researchers have devised a model peritoneum that allows them to study the impact of PD on the cells. The model has a mesothelial layer, an endothelial layer, and a collagen membrane chamber. When used for simulated PD, various solutions had different effects on the cells—but reduced nitric oxide production seems to be a mechanism for fibrosis. This new tool may lead to new ways to prevent and treat peritoneal fibrosis.
Read the abstract » | (added 2015-09-11)
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Medihoney <i>Does</i> Equal Mupirocin for PD Infection Control
While Medihoney did not reduce overall PD infections, a substudy of the “Honeypot” trial did find positive results. Among 371 PD patients randomized to daily exit site antibacterial honey or nasal mupirocin (for staph carriers), rates of both exit site infections and peritonitis were equivalent. NOTE: Honey does not create antibiotic resistant bacteria, which is a plus.
Read the abstract » | (added 2015-08-08)
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Where Are We With Wearable Artificial Kidneys?
Sorbent and enzyme technologies are helping forward movement in the WAK world, but the long-time Achilles heel of hemodialysis—vascular access—along with anticoagulation and regulations are still challenges.
Read the abstract » | (added 2015-08-08)
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Assisted PD Not a Large Burden for Care Partners
Not everyone can do PD without assistance, so what is the cost of this help for a care partner? Not too much, finds a study of 231 PD patients (89 assisted), 72 care partners, and 39 family members of self-care patients. Family members who helped with PD had more task-oriented duties, but did not perceive any greater of a burden than those whose loved one did not need help.
Read the abstract » | (added 2015-08-08)
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Brazil APD Survival Significantly Better than CAPD
A prospective study matched each of the incident APD patients in Brazil with a CAPD patient, using 15 matching factors, and looked at mortality, technique failure, and time to first peritonitis. With 1,445 patients each in the APD and CAPD groups, the researchers found 44% higher mortality among CAPD patients, but no differences in technique failure or time to peritonitis.
Read the abstract » | (added 2015-08-08)
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High Phosphorus Levels on PD Risk Heart Vessel Calcification
Among 157 people on PD who had three or more scans for coronary artery calcification, high serum phosphorus levels were an independent risk factor for faster progression of the problem, along with age.
Read the abstract » | (added 2015-08-08)
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PD Preserves Patient Jobs Compared to Standard In-center HD
In Japan, at least (and these questions are rarely looked at in the US), a study of social functioning on PD vs. standard in-center HD found an advantage for PD. Among 179 patients (102 PD and 77 HD), the odds of becoming unemployed after treatment were 5.02 fold lower with PD.
Read the abstract » | (added 2015-08-08)
Tags: Home dialysis
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Low Molecular Weight Heparins for Nocturnal HD
A small Netherlands study of in-center nocturnal HD suggests that two divided doses may work best for low molecular weight heparins dalteparin and nadroparin. Careful dosing is needed to obtain the right level of anticoagulation and avoid overcorrection. Dalteparin required higher doses than nadroparin.
Read the abstract » | (added 2015-08-08)
Tags: Home dialysis
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Outcomes of “integrated home dialysis” (PD then home HD)
What happens to people after PD fails—and why not plan to get them home on HD? Researchers in Australia and New Zealand looked at this model using ANZDATA registry data. Those treated with PD only (n=168) had the highest risk of technique failure and death, while those who did only home HD or who transitioned from PD to home HD fared much better.
Read the abstract » | (added 2015-07-08)
Tags: Home dialysis
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Icodextrin PD fluid reduces insulin resistance in non-diabetic patients
Even without diabetes, insulin resistance can add to cardiovascular disease risk in people with CKD. A new study randomized non-diabetic adults to APD with 2.5% glucose (n=27) for the long dwell or icodextrin 7.5% (n=33). At 90 days, the icodextrin group had lower levels of insulin resistance.
Read the abstract » | (added 2015-07-08)
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