Journal Watch
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Calculating the dialysis dose for a wearable artificial kidney
How do you set a dialysis dose for a 24/7 continuous HD therapy? Using kinetic modeling, researchers developed theoretical doses that would be needed to achieve certain creatinine concentration targets. Interestingly, fluid intake did not affect the predicted clearances.
Read the abstract » | (added 2015-09-11)
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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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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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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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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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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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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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Are we finally nearing the end of Kt/V?
We have been vocal critics of Kt/V on Home Dialysis Central since the start—and now we are not alone. A new paper finds that Kt/V is not a good fit for short daily or long nocturnal treatments, to the point where, “urea kinetics are hardly if at all representative for those of other solutes with a deleterious effect on morbidity and mortality of uremic patients.”
Read the abstract » | (added 2015-07-08)
Tags: Nocturnal Hemodialysis