Journal Watch
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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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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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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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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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How to prescribe intensive home HD: A guide for the nephrologist
This article describes each of the types of intensive home HD, and offers prescription guidance from experts.
Read the abstract » | (added 2014-12-09)
Tags: Home dialysis
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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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