Journal Watch
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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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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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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
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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
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Urgent start PD: Better for Budgets than Urgent Start HD
A number of studies have found that urgent start PD is safe. But, does it save money, too, vs. placing a central venous catheter? Yes, finds a new study that surveyed practitioners: first 90 days costs for urgent start PD were estimated at $16,398, while for urgent start HD, the tab was $19,352.
Read the abstract » | (added 2015-01-08)
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PD Catheter Placement with Nitrous Oxide
In a series of 87 patients, placement of PD catheters was done using nitrous oxide—including removal of the omentum and any adhesions. Just five patients required conversion to general anesthesia. After a year, 97.6% of the catheters were still working, and had not required any revisions.
Read the abstract » | (added 2015-01-08)
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Should Home Dialysis Be Mandatory for Suitable Patients?
Considering improved survival, dramatically better quality of life, and reduced cost, should home dialysis be the default option?
Read the abstract » | (added 2015-01-08)
Tags: Home dialysis
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Dealing with Home HD Technology: Patients and Families
An interview study was conducted with 19 home HD patients and carers who successfully used one of five different home HD machines. Respondents believed the machines were safe—but were still scared at first, and learned through mistakes. Machines that guide patients and carers (such as with step by step instructions) and help families communicate better with professionals (such as with remote monitoring) may be helpful.
Read the abstract » | (added 2015-01-08)
Tags: Home dialysis
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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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