Icodextrin metaanalysis – no impact on patient survival

Australian researchers analyzed 11 studies of icodextrin vs. glucose PD fluid (1222 patients). Icodextrin did help reduce fluid overload without harming residual kidney function. But, it did not help reduce peritonitis, technique failure, or other adverse events. And, patients who used icodextrin did not live any longer.

Read the abstract » | (added 2013-04-29)

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Patients with diabetes & renters may need extra help for home HD

Among 177 Canadian patients who started home HD training, 24 did not finish and 8 had technique failure in the first year. The strongest predictors of failure were diabetes or rented housing. These patients may need extra support to succeed.

Read the abstract » | (added 2013-04-29)

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Wearable and implantable kidney devices

The current standard in-center paradigm needs to change, say the authors of this review. Radically new approaches are needed to improve patient outcomes and quality of life. Two such approaches on the horizon are wearable and implantable devices.

Read the abstract » | (added 2013-02-27)

Tags: Chronic kidney disease

Home HD beliefs of patients and care partners in Italy

Home HD is underused in Italy. Interviews found three positive themes: flexibility/freedom, comfort in familiar surroundings, and altruistic motivation to be an example for others. Four negative themes were also found: disrupted sense of normality, family burden, housing constraints, and healthcare by "professionals", not "amateurs".

Read the abstract » | (added 2013-02-27)

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PD corrects metabolic acidosis better than standard in-center HD

Too-low bicarbonate levels are a risk factor for death. Among 110,951 standard in-center HD patients and 10,400 PD patients, bicarb levels were much lower in those on PD. Survival data suggest that it is safest to keep bicarb levels higher than 22mEq/L for all ESRD patients—on any modality.

Read the abstract » | (added 2013-02-27)

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Multidisciplinary training to reduce peritonitis in PD

Researchers in Uruguay developed a tool to assess practical PD skills. They found that one on one lessons, retraining, and group meetings for PD patients cut the peritonitis rate nearly in half.

Read the abstract » | (added 2013-02-27)

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Alert: Icodextrin PD fluid can mask hypoglycemia

A case report of an 80 year old man in the emergency room highlights the need for healthcare providers to be aware of the impact of icodextrin PD fluid on blood sugar. Handheld glucose meters can overestimate blood sugar. A lab test can verify blood sugar if symptoms of hypoglycema are present and the glucometer reading is normal.

Read the abstract » | (added 2013-02-27)

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Mortality patterns in PD & home HD differ from standard in-center HD

In the Australian dialysis database (ANZDATA), 4,298 deaths on PD and 10,338 on HD were analyzed for patterns. Patients who did PD, home HD, or in-center HD more than 3 days per week were equally likely to die on any day of the week. Not so for standard in-center HD patients: they were significantly more likely to die from heart-related reasons on Monday, after the 2-day no-treatment weekend.

Read the abstract » | (added 2013-02-27)

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New from Australia: Outcomes of extended HD (mainly done at home)

In a series of 286 people doing extended HD, 96% received their treatments at home, and 77% did them at night. Survival was 98% at 1 year, 92% at 3 years, and 83% at 5 years.

Read the abstract » | (added 2013-02-27)

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When choosing a treatment option, lifestyle is what matters to patients

A metaanalysis found 16 studies of how people with late-stage CKD choose what type of dialysis to do. Common elements included the life-or-death nature of ESRD; minimal intrusion of treatment into quality of life, autonomy, values, and sense of self; and making informed choices.

Read the abstract » | (added 2013-01-25)

Tags: Chronic kidney disease