Journal Watch
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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
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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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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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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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Review: survival on intensive HD vs. transplant
Canadian researcher Robert Pauly reviews the literature on survival with short daily and nocturnal HD, and compares it to kidney transplant survival.
Read the abstract » | (added 2013-01-25)
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PD + C + E = reduced oxidative stress
We need oxygen to live. But, too much of a good thing can cause heart and blood vessel damage, and, if you do PD, damage your peritoneum. What can help? Among 20 people doing PD, supplements of the antioxidants vitamins C and E improved measures of oxidative stress, compared to 10 healthy volunteers who did not take the vitamins. (Ask your nephrologist if this is wise for you.)
Read the abstract » | (added 2013-01-25)
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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