Journal Watch
More protein intake with nocturnal HD—but no change in body composition
Among 11 people doing nocturnal HD, protein intake increased significantly compared to matched standard in-center HD controls. But, one year later, total body mass, fat-free mass, and fat mass did not change.
Read the abstract » | (added 2014-12-09)
Emergent-start PD works!
It flat-out makes more sense for people who need dialysis emergently to do PD, if possible, than to start HD with a catheter. A new review suggests that emergent-start PD may have a higher risk of catheter problems—but not infection. On the other hand, emergent-start HD risks both catheter problems and infection. The authors conclude that emergent-start PD is a “feasible, safe, and efficient alternative.”
Read the abstract » | (added 2014-12-09)
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New PD catheter technique uses Amplatz dilators
A laparoscope paired with Amplatz dilators to form the skin tunnel was used in 100 people who needed a PD catheter. The omentum was trimmed if it was long, and adhesions were lysed when present. There were no exit site or tunnel infections with this technique, and no catheter cuff extrusions. No catheters migrated or were displaced—and 97% of the catheters were working 6 months later.
Read the abstract » | (added 2014-12-09)
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Is low blood sodium as harmful in PD as it is in HD?
Hyponatremia (low blood sodium levels) raise the risk of death in people who do standard in-center HD. A prospective observational study of 441 incident PD patients found a higher mortality risk among those who did PD, too. In fact, after 3 years, the 1/3 of study participants whose sodium was lowest had a 79% higher risk of death than those whose levels were higher.
Read the abstract » | (added 2014-12-09)
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Don’t trust glucometers on people using PD with icodextrin
Glucometer test strips can’t distinguish glucose from other sugars, like maltose. When icodextrin is used for PD in people with diabetes, standard glucometer use is risky. Blood glucose test results from glucometers can’t be trusted, and people may be given insulin they don’t need (which could cause coma or death). Three case reports show why this is the case—and the authors suggest using glucose-specific blood tests instead.
Read the abstract » | (added 2014-12-09)
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Are portable or wearable kidney devices on the horizon?
Nanotechnology may allow for a new generation of wearable and portable devices to treat kidney failure. Some are now in large animal and human trials. A new day may be coming.
Read the abstract » | (added 2014-11-07)
Tags: Chronic kidney disease
Short-term transfer from PD to HD was not harmful
Peritonitis may require a switch to HD for a while. Does this affect patient or technique survival? No, finds an Australian study that looked at 8 years of people new to PD and matched PD-to-HD-and-back switchers to those who stayed just on PD or HD.
Read the abstract » | (added 2014-11-07)
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mTOR inhibitors may treat encapsulating peritoneal sclerosis
In a case study report, a class of drugs that includes Rapamycin (sirolimus) was used to successfully treat a 16 year old who developed EPS after a switch from PD to HD. mTOR inhibitors help keep new blood vessels from growing.
Read the abstract » | (added 2014-11-07)
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Older patients may make less informed options decisions
In a study of 99 people on dialysis in North Carolina, those who were over age 65 reported significantly less informed decision making. They were less likely to say that the doctor had explained their health problems, and more likely to feel that the doctor made a choice for them.
Read the abstract » | (added 2014-11-07)
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Home therapies: Better outcomes
A review article suggests that outcomes for PD and home HD are as good—or better—than those for standard in-center HD. PD use in the US has grown after the Medicare bundle created an incentive for its use. Home therapies are effective and patient-centered treatments.
Read the abstract » | (added 2014-10-07)
Tags: Home dialysis