How to start late-referred ESRD patients on PD urgently

When as many as half of Americans with ESRD have less than 3 months notice before needing dialysis, it's great to know that PD can safely be done as a first treatment. This avoids HD catheters, keeps working folks employed, and buys time for a fistula or transplant. This article describes patients who did very well.

Read the abstract » | (added 2011-02-24)

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How long should PD catheters be embedded before use?

A study of 5,624 patient months found that PD catheters embedded under the skin are most likely to work if used from 48-133 days after placement—and least likely to have peritonitis if used even later: after 134 days. Using PD catheters before 47 days was linked to higher failures and more peritonitis.

Read the abstract » | (added 2011-02-24)

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Predicting blood vessel calcification in PD

In a study of 231 PD patients, those whose C-reactive protein (CRP) and interleukin-6 levels were higher had a higher risk of blood vessel calcification and heart problems than those with lower levels.

Read the abstract » | (added 2011-02-24)

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Once-a-month IV Aranesp keeps up Hgb levels on PD

It would sure be convenient to only need anemia drugs once a month—and a new study suggests that this can work for people using PD. In a study of 72 folks on PD, hemoglobins were kept in the target range with once-monthly dosing.

Read the abstract » | (added 2011-02-24)

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Biocompatible PD fluid helps adequacy

"Glucose degradation products" (GDPs) occur when sugars are caramelized as PD fluid is made. GDPs can reduce PD adequacy, and in time, harm the peritoneum. A new study of 104 PD patients who randomly received standard fluid or a pH neutral fluid with fewer GDPs found that the new fluid led to better adequacy.

Read the abstract » | (added 2011-02-24)

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Does icodextrin (extraneal) cause more peritonitis?

Doesn't look like it. A study observed icodextrin and regular, sugar-based PD fluid use in 722 people. No differences were found in the rate of peritonitis infection or so-called "sterile periotnitis" where no bacteria are found.

Read the abstract » | (added 2011-02-24)

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PD: Less cancer risk than standard HD

DNA damage that can lead to cancer can occur in kidney failure, as the buildup of toxins stresses the body. A new study looked at genetic damage in 20 people on standard in-center HD, 20 on PD matched for gender and age, and 40 controls. Cheek swabs were used to look for DNA damage. Creatinine levels, smoking, alcohol use, age, income, and length of time on dialysis were also examined. The only factor that mattered was length of time on standard HD.

Read the abstract » | (added 2011-02-24)

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Hope predicts a better adjustment to dialysis

How important is hope? A new study finds that hopeful people on dialysis were less anxious and depressed and had fewer symptoms. (We'd bet that home dialyzors are more hopeful.)

Read the abstract » | (added 2011-02-24)

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Removing adhesions improves PD catheter survival

In a series of 436 PD catheter placements using a laparoscope, Drs. Crabtree and Burchette from Kaiser Permanente reduced catheter loss from blocked flow to just 0.7% by removing adhesions—even in people with prior abdominal surgeries.

Read the abstract » | (added 2011-02-24)

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In-center HD pill burden lowers quality of life

Taking (and paying for) an average of 19 pills each day (with a strict fluid limit!) reduces health-related quality of life in people using standard in-center HD, a new study finds. Of course, every form of home treatment requires fewer pills!

Read the abstract » | (added 2011-02-24)

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