Journal Watch
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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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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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Review of Bioartificial Kidney Development
This article looks at state-of-the art efforts to duplicate kidney functions, including cell-based therapies, cell sourcing, organ scaffolding, and immune response.
Read the abstract » | (added 2015-01-08)
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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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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)
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Nocturnal HD reduces blood endotoxin levels
Endotoxin drives inflammation throughout the body. Which type of HD is most effective at reducing endotoxin in the blood? This study compared standard in-center HD (n=56) to short daily HD (n=20) and nocturnal HD (N=10). Endotoxin levels were highest when ultrafiltration rates were highest (standard in-center HD) and lowest among those doing nocturnal HD.
Read the abstract » | (added 2014-12-09)
Tags: Nocturnal Hemodialysis
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Cochrane database review favors home HD over standard in-center HD
Just one, small (n=9) randomized controlled trial (RCT) lasting 8 weeks could be found that looked at home HD (extended) vs. standard in-center HD in adults. But, based on this, the Cochrane Database Systematic Review was able to get a paper published. Home HD reduced 24 hour blood pressure and improved uremic symptoms. The authors recommend more RCTs.
Read the abstract » | (added 2014-12-09)
Tags: Home dialysis
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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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