PD training: How much is enough to reduce peritonitis risk?

In a group of 2,243 patients from Brazil, two thirds with less than 4 years of education, training time mattered. After nearly a year of follow up, those whose training was less than 1 hour per session were more likely to have peritonitis. And, those who had at least 15 hours of training had significantly less peritonitis than those who had less. Having a care partner or training multiple people did not affect the risk. But, training before the catheter was placed or at least 10 days after did help.

Read the abstract » | (added 2015-02-10)

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Residual kidney function may drop faster with cycler PD than CAPD.

In a non-randomized Spanish study of 493 new PD users, residual kidney function (RKF) dropped faster in those who were younger, had less kidney function at the start, used PD fluid with more glucose, had higher blood pressure, or had peritonitis or heart disease. While cycler PD and CAPD rates of RKF were about the same, those who used a cycler were more likely to lose the rest of their function.

Read the abstract » | (added 2015-02-10)

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More Canadian patients use PD if their nephrologists place catheters

Among 3,886 people with CKD in Ontario and had a PD catheter placed, those whose nephrologists put in the catheter were 59% more likely to use PD. Even among those who did not end up doing PD, when a nephrologist placed a PD catheter, survival was 97%—vs. 73% when a radiologist put in the catheter.

Read the abstract » | (added 2015-02-10)

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Nocturnal home HD catheter sepsis rates similar to in-center

When 63 nocturnal home HD patients with catheters were matched 1:20 with standard in-center HD patients, both groups had similar rates of sepsis. The catheters lasted about the same length of time.

Read the abstract » | (added 2015-02-10)

Tags: Home dialysis

How patients and care partners feel about home HD

A review of 24 qualitative studies of home HD patients and care partners found five themes: feeling vulnerable, fear of being alone, concerns about family burden, opportunity to thrive, and appreciating medical responsiveness. Starting home HD seemed to be an especially anxious time. Acknowledging these themes and offering reassurance may help more people succeed on home HD.

Read the abstract » | (added 2015-02-10)

Tags: Home dialysis

PD Catheter Placement with Nitrous Oxide

In a series of 87 patients, placement of PD catheters was done using nitrous oxide—including removal of the omentum and any adhesions. Just five patients required conversion to general anesthesia. After a year, 97.6% of the catheters were still working, and had not required any revisions.

Read the abstract » | (added 2015-01-08)

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Review of Bioartificial Kidney Development

This article looks at state-of-the art efforts to duplicate kidney functions, including cell-based therapies, cell sourcing, organ scaffolding, and immune response.

Read the abstract » | (added 2015-01-08)

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Pilot Study: Flex Dialysis Facilitates Weight Loss

Patients who need to lose weight for better health or to obtain a transplant can be stymied by the strict diet limits of standard in-center HD. In a small series (four obese and two overweight patients), combining 2-6 sessions of flex, incremental HD with a coach-assisted weight loss program led to 5.7-20 kg weight loss over 12-30 months, better metabolic markers, and high patient satisfaction.

Read the abstract » | (added 2015-01-08)

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Dealing with Home HD Technology: Patients and Families

An interview study was conducted with 19 home HD patients and carers who successfully used one of five different home HD machines. Respondents believed the machines were safe—but were still scared at first, and learned through mistakes. Machines that guide patients and carers (such as with step by step instructions) and help families communicate better with professionals (such as with remote monitoring) may be helpful.

Read the abstract » | (added 2015-01-08)

Tags: Home dialysis

Should Home Dialysis Be Mandatory for Suitable Patients?

Considering improved survival, dramatically better quality of life, and reduced cost, should home dialysis be the default option?

Read the abstract » | (added 2015-01-08)

Tags: Home dialysis