Journal Watch - 2013

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  1. Wearable and implantable kidney devices

    The current standard in-center paradigm needs to change, say the authors of this review. Radically new approaches are needed to improve patient outcomes and quality of life. Two such approaches on the horizon are wearable and implantable devices.

    Read the abstract » | (added 02/27/2013)

    Tags: Chronic Kidney Disease

  2. Home HD beliefs of patients and care partners in Italy

    Home HD is underused in Italy. Interviews found three positive themes: flexibility/freedom, comfort in familiar surroundings, and altruistic motivation to be an example for others. Four negative themes were also found: disrupted sense of normality, family burden, housing constraints, and healthcare by "professionals", not "amateurs".

    Read the abstract » | (added 02/27/2013)

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  3. Mortality patterns in PD & home HD differ from standard in-center HD

    In the Australian dialysis database (ANZDATA), 4,298 deaths on PD and 10,338 on HD were analyzed for patterns. Patients who did PD, home HD, or in-center HD more than 3 days per week were equally likely to die on any day of the week. Not so for standard in-center HD patients: they were significantly more likely to die from heart-related reasons on Monday, after the 2-day no-treatment weekend.

    Read the abstract » | (added 02/27/2013)

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  4. PD corrects metabolic acidosis better than standard in-center HD

    Too-low bicarbonate levels are a risk factor for death. Among 110,951 standard in-center HD patients and 10,400 PD patients, bicarb levels were much lower in those on PD. Survival data suggest that it is safest to keep bicarb levels higher than 22mEq/L for all ESRD patients—on any modality.

    Read the abstract » | (added 02/27/2013)

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  5. Multidisciplinary training to reduce peritonitis in PD

    Researchers in Uruguay developed a tool to assess practical PD skills. They found that one on one lessons, retraining, and group meetings for PD patients cut the peritonitis rate nearly in half.

    Read the abstract » | (added 02/27/2013)

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  6. Alert: Icodextrin PD fluid can mask hypoglycemia

    A case report of an 80 year old man in the emergency room highlights the need for healthcare providers to be aware of the impact of icodextrin PD fluid on blood sugar. Handheld glucose meters can overestimate blood sugar. A lab test can verify blood sugar if symptoms of hypoglycema are present and the glucometer reading is normal.

    Read the abstract » | (added 02/27/2013)

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  7. Review: survival on intensive HD vs. transplant

    Canadian researcher Robert Pauly reviews the literature on survival with short daily and nocturnal HD, and compares it to kidney transplant survival.

    Read the abstract » | (added 01/25/2013)

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  8. Can more fluid removal mean needing less toxin removal?

    Makers of a wearable ultrafiltration (UF; water removal) device wanted to know if daily UF could be a way to cut back on the need for dialysis toxin removal. For 4 weeks, 13 in-center patients had 4 days a week of UF plus 2 days a week of HD. Then they did 4 weeks of standard, 3x week HD. Daily UF lowered blood pressure and weight gain between treatments significantly—while Kt/V rose.

    Read the abstract » | (added 01/25/2013)

    Tags: Chronic Kidney Disease

  9. When choosing a treatment option, lifestyle is what matters to patients

    A metaanalysis found 16 studies of how people with late-stage CKD choose what type of dialysis to do. Common elements included the life-or-death nature of ESRD; minimal intrusion of treatment into quality of life, autonomy, values, and sense of self; and making informed choices.

    Read the abstract » | (added 01/25/2013)

    Tags: Chronic Kidney Disease

  10. Surgery to fix PD catheters in place is safe, effective

    PD catheters that move around in the belly can be painful and may stop working. Korean doctors compared 22 PD catheters placed by a laparoscopic technique that fixed them in place to 32 placed by open surgery. The age and sex of both groups was the same, and the fixing technique took longer to do. But, 29 months later, the fixed catheters were much less likely to move (13.6% vs. 65.6%). Both techniques had the same catheter and patient survival.

    Read the abstract » | (added 01/25/2013)

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