Utility of the 5-day Cell Count in Refractory Peritonitis

A retrospective study in Turkey analyzed 11 years of data on 135 patients with 236 episodes of refractory peritonitis. While age, gender, diabetes, prior hemodialysis, and PD duration did not reveal any significant differences, a day 5 dialysate white blood cell count higher than 1000/mm3 and hospitalization were linked width catheter loss.

Read the abstract » | (added 2024-10-15)

Tags: Refractory Peritonitis, Arteriovenous Fistula, Ark Implant, Cannulation

Mechanical Complications of PD

Learn from a review of mechanical PD complications, including leaks, hernias, dialysate flow issues, pain, and changes in breathing. Most of these happen early, due to catheter placement or dialysate filling, though late complications can also occur.

Read the abstract » | (added 2024-01-17)

Tags: Mechanical PD Complications, Catheter Placement, Dialysate Filling

Melatonin Shows Promise for Preventing Peritoneal Fibrosis

Glucose in peritoneal dialysate drives inflammation and angiogenesis, which lead to fibrosis that can cause loss of use of the membrane. A new study from China proposes that melatonin may break this cycle.

Read the abstract » | (added 2023-10-13)

Tags: Melatonin, Peritoneal Fibrosis, Glucose, GSDME, Pyroptosis

How Glucose Causes Peritoneal Fibrosis

Constant glucose exposure from PD dialysate often causes fibrosis that can make further PD impossible. High glucose causes chronic inflammation, interferes with lipid metabolism, and leads to angiogenesis and fibrosis. RAAS activation contributes to this process as well. There may be benefit to looking at the upstream pathways to see if there are ways to block fibrosis.

Read the abstract » | (added 2023-08-16)

Tags: High Glucose, PD Dialysate, Fibrosis

Portable, Wearable, and Implantable Artificial Kidneys

The need to continuously regenerate dialysate is a challenge for all portable, wearable, and implantable kidney replacement therapy options. Sorbent technology is one approach. New membrane materials can remove more uremic toxins than current ones. Combining these membranes with living kidney cells has potential as well.

Read the abstract » | (added 2023-06-14)

Tags: Dialysate, Portable, Wearable, Implantable Kidney, Kidney Replacement Therapy

Next Gen Sorbent Dialysis: Oral Sorbents with Carbon Block Columns?

Innovator Steven Ash is reimagining sorbent, as regenerating dialysate is complex. He is testing an oral sorbent to bind potassium, sodium, hydrogen, and ammonium, in animals. Carbon block columns can then bind organic and middle molecule toxins, and Ash believes the two technologies could simplify dialysis.

Read the abstract » | (added 2022-12-19)

Tags: Oral Sorbent, Uremic Toxins, Carbon Block

The Predictive Value of Early, Non-infectious PD Complications

A prospective, multicenter cohort study of 1,596 people starting PD in New Zealand from 2014 to 2018 (inclusive) looked at survival and time on PD of those who had catheter-related exit site dialysate leaks or other leaks within 30 days of PD start. Peritonitis-free survival, first PD catheter survival, and tunnel infection free survival were secondary outcomes. Among the 102 with an early complication, overall mortality, the rate of stopping PD, and first catheter failure were all higher.

Read the abstract » | (added 2022-11-16)

Tags: PD, Survival, Peritonitis free Survival, First PD Catheter Survival, Tunnel Infection Free Survival, Early Catheter related Complication

Replacing Dextrose in PD Fluid—with Steviol Glycosides?

Using glucose to remove water will scar the peritoneum over time—making PD a short-term option for most. Icodextrin (Extraneal®) is a glucose-free alternative. Now, researchers are looking at another one: steviol glycosides (SG), the compounds that make stevia taste sweet. Using artificial membranes and mice, dialysate with 1.5%, 1%, and even 0.75% SG had similar results as glucose-based fluids—with better biocompatibility.

Read the abstract » | (added 2022-09-13)

Tags: Dextrose, PD Fluid, Steviol Glycosides, Icodextrin

SARS-CoV-2 in PD Effluent

Analysis of bodily fluids from 3 SARS-CoV-2-infected PD patients found that, while viral load was quite high in nasopharyngeal swabs, none of the PD effluent tested positive, even after dialysate concentration. This suggests that the risk of virus transmission from used PD fluid may be low.

Read the abstract » | (added 2020-09-11)

Tags: COVID 19, SARS CoV 2, Peritoneal Dialysis

How Much Dialysate Should be Used for Nocturnal HD With NxStage?

Predictive modeling finds that the dialysate lactate concentration used for short daily HD may not be appropriate for nocturnal HD. Since the effect of lactate mainly depends on weekly dialysate volume, reducing from 60 to 30 liters for frequent nocturnal HD may be appropriate.

Read the abstract » | (added 2020-08-11)

Tags: Home Hemodialysis, Lactate, Acid Generation, Dialysate