Medihoney <i>Does</i> Equal Mupirocin for PD Infection Control

While Medihoney did not reduce overall PD infections, a substudy of the “Honeypot” trial did find positive results. Among 371 PD patients randomized to daily exit site antibacterial honey or nasal mupirocin (for staph carriers), rates of both exit site infections and peritonitis were equivalent. NOTE: Honey does not create antibiotic resistant bacteria, which is a plus.

Read the abstract » | (added 2015-08-08)

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Where Are We With Wearable Artificial Kidneys?

Sorbent and enzyme technologies are helping forward movement in the WAK world, but the long-time Achilles heel of hemodialysis—vascular access—along with anticoagulation and regulations are still challenges.

Read the abstract » | (added 2015-08-08)

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Brazil APD Survival Significantly Better than CAPD

A prospective study matched each of the incident APD patients in Brazil with a CAPD patient, using 15 matching factors, and looked at mortality, technique failure, and time to first peritonitis. With 1,445 patients each in the APD and CAPD groups, the researchers found 44% higher mortality among CAPD patients, but no differences in technique failure or time to peritonitis.

Read the abstract » | (added 2015-08-08)

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High Phosphorus Levels on PD Risk Heart Vessel Calcification

Among 157 people on PD who had three or more scans for coronary artery calcification, high serum phosphorus levels were an independent risk factor for faster progression of the problem, along with age.

Read the abstract » | (added 2015-08-08)

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Assisted PD Not a Large Burden for Care Partners

Not everyone can do PD without assistance, so what is the cost of this help for a care partner? Not too much, finds a study of 231 PD patients (89 assisted), 72 care partners, and 39 family members of self-care patients. Family members who helped with PD had more task-oriented duties, but did not perceive any greater of a burden than those whose loved one did not need help.

Read the abstract » | (added 2015-08-08)

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PD Preserves Patient Jobs Compared to Standard In-center HD

In Japan, at least (and these questions are rarely looked at in the US), a study of social functioning on PD vs. standard in-center HD found an advantage for PD. Among 179 patients (102 PD and 77 HD), the odds of becoming unemployed after treatment were 5.02 fold lower with PD.

Read the abstract » | (added 2015-08-08)

Tags: Home dialysis

Implantable microdialysis without dialysate fluid – in rats

What if we could implant an artificial kidney that did not require dialysate fluid? Researchers have developed a microdialysis system using microfluidic channels and nanoporous membranes, and tested it in rats with kidney failure. Filtrate was successfully collected with no blood leaks in the system, and the levels of creatinine in their blood was significantly reduced.

Read the abstract » | (added 2015-07-08)

Tags: Dialysis

More glucose in PD fluid makes it harder to cure peritonitis

A look back at bacterial peritonitis among 187 people on CAPD compared those whose peritoneum was exposed to more than 140 grams per day of glucose—or less. Those who used less glucose had a higher cure rate, fewer relapses, and less need for catheter removal.

Read the abstract » | (added 2015-07-08)

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Icodextrin PD fluid reduces insulin resistance in non-diabetic patients

Even without diabetes, insulin resistance can add to cardiovascular disease risk in people with CKD. A new study randomized non-diabetic adults to APD with 2.5% glucose (n=27) for the long dwell or icodextrin 7.5% (n=33). At 90 days, the icodextrin group had lower levels of insulin resistance.

Read the abstract » | (added 2015-07-08)

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Are we finally nearing the end of Kt/V?

We have been vocal critics of Kt/V on Home Dialysis Central since the start—and now we are not alone. A new paper finds that Kt/V is not a good fit for short daily or long nocturnal treatments, to the point where, “urea kinetics are hardly if at all representative for those of other solutes with a deleterious effect on morbidity and mortality of uremic patients.”

Read the abstract » | (added 2015-07-08)

Tags: Nocturnal Hemodialysis