Journal Watch
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Wearable and implantable artificial kidneys
Thrice weekly in-center HD for 4 hours or less is a paradigm that must change to improve patient outcomes. But longer and/or more frequent treatments are not practically available to the total dialysis population. Thus, radical new approaches are needed—like wearable devices or implantable ones.
Read the abstract » | (added 2013-08-22)
Tags: Chronic kidney disease
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New Vwing device helps start Buttonholes
A new, surgically implanted device used for 387 cannulations over 6 months in 9 patients was successful 94% of the time. But, standard cannulation for the other needle only worked 77% of the time. This device may help with difficult to cannulate fistulas.
Read the abstract » | (added 2013-08-22)
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Why nocturnal HD reduces sudden cardiac death
Prolonged QTc intervals between heartbeats increases the rate of sudden cardiac death in people whose kidneys work. In an ECG study, patients who did nocturnal HD had shorter QTc intervals—even if those intervals were long before dialysis and even before changes to the left ventricle.
Read the abstract » | (added 2013-08-22)
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Better Blood Sugar Control, Fewer PD Infections
No surprises here: blood sugar control matters in PD. A study that looked back at 183 PD patients found that those with poor control were more than twice as likely to have had an exit site or catheter infection as those with good control.
Read the abstract » | (added 2013-07-17)
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Itching? It May Be Due To High Calcium—Not Phosphorus
A study of 120 HD patients found high levels of serum phosphorus and parathyroid hormone (PTH) in those with and without dialysis itching (pruritus). But, the itchiest patients had significantly higher serum calcium levels.
Read the abstract » | (added 2013-07-17)
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PD Dialysate With Hydrogen May Protect Peritoneal Membranes
Over time, the peritoneum can be harmed by glucose degradation products in PD dialysate. In 6 patients, PD fluid with dissolved hydrogen significantly reduced oxidative stress vs. standard PD fluid.
Read the abstract » | (added 2013-07-17)
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Impact of frequent HD on residual kidney function
We know that PD can help residual kidney function last longer. What happens with longer and/or more frequent HD? Results from the FHN trials suggest that residual kidney function loss may be faster with these options. [Editor's note: But, if more kidney replacement therapy is given, does it matter?]
Read the abstract » | (added 2013-05-24)
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Phosphate is a blood vessel toxin
If blood phosphate levels are too high, the blood vessels can turn to stone—even in children. Heart damage from high phosphate levels can begin in pre-dialysis CKD. "Keeping serum P levels in the normal range reduces cardiovascular risk and mortality," say the authors. [Editor's note: nocturnal hemodialysis removes the most phosphate of any dialysis option.]
Read the abstract » | (added 2013-05-24)
Tags: Chronic kidney disease
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How much dialysis improves nutritional status?
Is short daily HD enough dialysis to appetite, food intake, and improve serum albumin levels? Maybe after a long time on dialysis, says a new study. But those who did nocturnal HD needed fewer binders.
Read the abstract » | (added 2013-05-24)
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More HD lowers C-reactive protein and boosts nutritional status
A study from Iran found that adding one standard HD treatment per week for 6 weeks significantly decreased C-reactive protein (a measure of inflammation), and increased serum albumin and BMI. The authors conclude that getting more HD may reduce the risk of cardiovascular events.
Read the abstract » | (added 2013-04-29)
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