Journal Watch
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Informed decision-making about dialysis options
Among 99 dialysis patients from 15 clinics in North Carolina, 67% said they felt like they had no choice about their modality, and about a third felt that the choice had already been made by their doctor.
Read the abstract » | (added 2013-08-22)
Tags: Chronic kidney disease
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Predialysis patient education boosts use of PD
In a 4-year period, 227 patients attended a CKD education program. Compared to a control group who did not attend, the educated patients were almost twice as likely to choose PD (54.3% vs. 28%).
Read the abstract » | (added 2013-08-22)
Tags: Chronic kidney disease
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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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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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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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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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Nocturnal home HD – no change in outcomes if a partner is needed
Do Canadian nocturnal home HD patients do worse if they need a partner to help them? No, says a study of 152 people, 47 who needed partners and 105 who could do their treatments unaided. Partner dependent patients were older, more likely to have diabetes, and had more comorbidities. But, there were no significant differences between groups in time to first hospitalization, technique failure, or survival.
Read the abstract » | (added 2013-04-29)
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