Standard PD fluids work just as well as biocompatible ones

A randomized controlled trial compared standard PD fluid to biocompatible PD fluid in 267 patients (for 7000+ dialysis months). There were no differences in PD technique survival or peritonitis between the groups.

Read the abstract » | (added 2011-08-25)

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Tweaking the PD cycler prescription can have big payoffs

Changing dwell time make a difference in how well PD works, finds a new, randomized crossover study of 19 patients. All received the same number of hours of PD using the same PD fluid prescription. But instead of doing several exchanges each with the same dwell time and volume, the researchers first used a short dwell time with a small fill volume to remove water, then a longer dwell time and larger volume to remove wastes. The change significantly improved urea, creatinine, phosphorus, water removal, and mean blood pressure. (To learn more about how to adjust a PD prescription, read our Life@Home article on the topic by Joanne Bargman: Tailoring automated PD to your life.)

Read the abstract » | (added 2011-08-25)

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Changing the treatment options paradigm: Home vs. in-center, not PD vs. HD

Traditional ESRD treatment options education divides the choice into PD vs. HD, and then looks at home HD. Drs. Thodis and Oreopoulos suggest that it makes more sense to look at home (PD and HD) vs. in-center instead.

Read the abstract » | (added 2011-07-26)

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Nocturnal HD helps people grow cells that lead to healthy new blood vessels

Growth of new blood vessels is impaired with standard in-center HD. The cells that grow blood vessels don't work as well as they should, because waste levels in the blood are still too high, even with treatment. But, nocturnal HD is another story. With the blood much cleaner, there was significantly better cell function.

Read the abstract » | (added 2011-07-26)

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Ratios of Omega-6 to Omega-3 fats may impact health in kidney disease

Western diets tend to have too much omega 6 and not enough omega 3 fatty acids. In 145 people on standard in-center HD, having too much omega 6 was linked with significantly higher inflammation.

Read the abstract » | (added 2011-07-26)

Tags: Chronic kidney disease

Dialysis removes Vitamin B6; supplements can help

A meta-analysis has found 24-56% Vitamin B6 deficiencies, a problem made worse by ESAs, some phosphate binders, and modern dialyzer membranes. B6 supplementation recommendations may need to be updated.

Read the abstract » | (added 2011-07-26)

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Blood glucose meters may overestimate blood sugar levels when Icodextrin PD fluid is used

If you use a blood sugar monitor, you need to be able to trust the results. But, they may not be accurate if you use Icodextrin PD fluid. A case report of four people with insulin-dependent diabetes found that their blood sugar monitor readings were normal—at the same time that their hospital drawn blood sugars were dangerously low.

Read the abstract » | (added 2011-07-26)

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PD is safe and efficient for urgent dialysis starts

Researchers in Germany followed 123 people who started dialysis without a prior plan (66 did PD, 54 did standard in-center HD). Those on HD had much higher infection rates and somewhat (but not significantly) lower survival.

Read the abstract » | (added 2011-07-26)

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Review: What do we know now about more-frequent HD?

Studies have shown since the 1960s that more-frequent dialysis improves outcomes. The recent Frequent Hemodialysis Network trials confirmed these findings. This article reviews the data.

Read the abstract » | (added 2011-07-26)

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With a nurse educator, more urgent-start patients choose self-care treatments

As many as half of people start dialysis with no prior plan for it. When a renal triage nurse sees these patients, the chances that they will opt for PD, home HD, or transplant was significantly higher.

Read the abstract » | (added 2011-07-26)

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