Journal Watch
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Metaanalysis: Later dialysis start is better for HD
Starting dialysis at a lower GFR allows more time for access placement and options education. But the U.S. trend has been to start earlier. A new metaanalysis of 17 studies found that starting dialysis at a higher GFR was linked with a significantly higher risk of all-cause mortality—in HD, but not PD. The mortality risk was lower when GFR was calculated than when it was estimated.
Read the abstract » | (added 2012-08-16)
Tags: Chronic kidney disease
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Buttonhole needle technique causes less bleeding, pain
A small study in Thailand (21 patients') has found that stopping bleeding after removing dialysis needles takes less than half as long with the Buttonhole technique (4.19 +/- 1.66 mins) than with the rope ladder technique (9.12 +/- 2.36 mins), and causes significantly less pain.
Read the abstract » | (added 2012-08-16)
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Short daily HD reduces left ventricular mass
The Frequent Hemodialysis Network trials found significant reductions in left ventricular mass (LVM)—with greater benefit for patients whose left ventricular mass was higher than normal at the start of the study.
Read the abstract » | (added 2012-08-16)
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Short daily HD survival 13% better than than standard in-center HD
When 1,873 short daily home HD patients were matched with 9,365 standard in-center HD patients, those who did more frequent HD had a better chance of living longer.
Read the abstract » | (added 2012-08-16)
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How to do urgent-start PD
Researchers developed an urgent-start PD plan to address the needs of people who needed dialysis right away and had not chosen a treatment option. The outcomes of urgent-start PD patients were very similar to those of regular-start patients, though the urgent-start group had more minor leaks.
Read the abstract » | (added 2012-08-16)
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Mupirocin best for preventing PD exit site infections
A new double blind, controlled study of mupirocin antibiotic ointment vs. polysporin found that mupirocin came out on top. Twice as many patients who used polysporin had exit site redness and they were more likely to get fungal infections.
Read the abstract » | (added 2012-08-16)
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Pregnancy and HD: More is better (Review)
It is harder for women with ESRD to become pregnant and to carry healthy babies to term. Careful team follow up and more intensive dialysis have been shown to improve pregnancy outcomes. This article reviews fertility issues in young women with ESRD, pregnancy outcomes, and management suggestions.
Read the abstract » | (added 2012-01-26)
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Switch from standard to nocturnal in-center HD reduces left ventricular mass
Among 37 people in the UK who switched from standard in-center HD to 3x/week nocturnal in-center HD, echocardiograms showed significant drops in left ventricular mass after 12 months. This is a good sign that their hearts are healthier and they may live longer.
Read the abstract » | (added 2012-01-26)
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Antibiotic ointment reduces PD exit site infections, but not peritonitis
Researchers studied 1,270 people who used mupirocin ointment on their PD catheters, 502 used gentamycin, and 1,203 did not use an antibiotic ointment. While the ointments helped prevent exit site infections, they did not reduce the rate of peritonitis.
Read the abstract » | (added 2012-01-26)
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Arterial stiffness is equally high in PD and standard in-center HD
Arteries are supposed to be flexible. In a study of 35 people on PD and 26 doing standard HD, both groups had equally stiff arteries that were more rigid than those of the general public.
Read the abstract » | (added 2012-01-26)
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