Using PET Results to Screen for Encapsulating Peritoneal Sclerosis (EPS)

Identifying EPS early is vital to effectively treat this rare but devastating problem. Researchers studied whether the amount of sodium removed from the dialysate (sodium sieving) could predict EPS, in a 20-year study of 161 people. Age at PD start, duration of PD, and sodium sieving were all important predictors.

Read the abstract » | (added 2017-01-09)

Tags:

NxStage Outcomes in France and Belgium

Among 62 patients from 31 centers in France and Belgium, albumin and bicarbonate levels improved significantly, and technique survival was 75% at one year (most who stopped received transplants). Despite the low volume of dialysate, the rsearchers concluded that dialysis adequacy was acceptable.

Read the abstract » | (added 2016-12-09)

Tags: Hemodialysis

Glucose in PD Solution Affects Non-Diabetic Patients, Too

Among 640 PD patients from three countries studied for up to 6.4 years, serum glucose levels rose with age and with higher dialysate glucose. In 5.4% of the sample, the levels suggested undiagnosed diabetes.

Read the abstract » | (added 2016-06-08)

Tags:

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

VOLUME FIRST to improve outcomes in people on HD

We try to include only HOME dialysis abstracts—but when the Chief Medical Officers of most of the US dialysis clinics agree on key messages to improve care, we need to summarize their four key points. These are: (1) Normalizing extracellular fluid volume should be a primary goal of dialysis. (2) Fluid removal should be gradual and treatments should not routinely be less than 4 hours. (3) Keep dialysate sodium in the range of 134-138 mEq/L and avoid routine sodium modeling and hypertonic saline. (4) Counsel consumers to avoid salt in their diets.

Read the abstract » | (added 2014-09-05)

Tags: Home dialysis

Nocturnal in-center HD comes to Slovenia

Only a few handfuls of US clinics offer nocturnal in-center HD. Now, Slovenian researchers report their experience of switching 10 patients from "standard" (4-5 hours!) in-center treatments to thrice weekly 8-hour long nighttime ones. With almost twice as much dialysis per week, mean predialysis creatinine and urea dropped significantly, as did mean dry weight. Six of the ten were able to stop taking phosphate binders, and one more patient had a dose reduction—and phosphate was added to the dialysate for three patients. There were no major changes in predialysis blood pressure, calcium or potassium levels, mean ultrafiltration, hemoglobin, or EPO dose (Editor's note: perhaps because standard HD in Slovenia is longer, and because the nocturnal treatments were only three times per week).

Read the abstract » | (added 2013-10-02)

Tags:

Mineral balance in long HD

A metaanalysis from Canada of 21 studies concluded that keeping dialysate calcium ≥1.5 mmol/L for most patients on long/long-frequent HD prevents an increase in PTH levels and a decline in bone mineral density—without raising the risk of calcification. Adding phosphate to the dialysate for those with a low predialysis level or very low level makes sense.

Read the abstract » | (added 2013-08-22)

Tags:

PD Dialysate With Hydrogen May Protect Peritoneal Membranes

Over time, the peritoneum can be harmed by glucose degradation products in PD dialysate. In 6 patients, PD fluid with dissolved hydrogen significantly reduced oxidative stress vs. standard PD fluid.

Read the abstract » | (added 2013-07-17)

Tags:

Fleet enemas can safely be added to nocturnal HD dialysate to boost phosporus levels

Nocturnal HD removes so much phosphorus that dialyzers may need supplements. Fleet® enemas are a low-cost, easy-to-obtain source of phosphorus. The amount of added phosphorus was predictable, and the product did not add bacteria or endotoxin to the dialysate.

Read the abstract » | (added 2011-04-25)

Tags:

Long, slow HD removes more small & middle molecules than standard HD

A study that processed the same total blood and dialysate volume on two different time schedules looked at the importance of treatment time. Eleven people had a 4-hour and an 8-hour HD session, at least one week apart. Significantly more small and middle molecules were removed in the 8-hour treatments, though protein-bound solutes were not affected.

Read the abstract » | (added 2011-04-25)

Tags: