Journal Watch - 2014

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  1. Why it may be best to start with PD first

    Those who transfer from HD to PD have higher rates of PD technique failure and death than those who started out on PD. These results come from a new study of more than 13,000 people from Canada. In the first year, the risk of poor outcome was 50% higher among the switchers than in those who started PD in the first place.

    Read the abstract » | (added 02/06/2014)

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  2. Nocturnal HD may reduce risk factors for sudden heart death

    Sudden cardiac death is the leading cause of death on dialysis. A chart review study with ECGs has found that a year of nocturnal HD significantly improved heart function vs. standard in-center HD, even before changes to the left ventricle could be seen. More frequent nocturnal HD decreased Tpeak to Tend and QRS amplitude variation.

    Read the abstract » | (added 01/08/2014)

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  3. Extended HD improves sleep quality in China, too

    Studies find that extended HD helps people sleep better—and, per a new study, this is just as true in China as elsewhere. Forty standard HD patients were switched to in-center nocturnal HD thrice weekly for 6 months. After the switch, Kt/V rose significantly, as did BUN clearance, hemoglobin (with fewer ESAs), and albumin. Phosphorus levels dropped significantly, as did blood pressure. Sleep quality and quality of life were significantly better as well, though sleep quality started to decline again after 2 months.

    Read the abstract » | (added 01/08/2014)

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  4. Fluid overload predicts LVH in people on PD

    In a cross-sectional echocardiogram study of 31 people on PD, those with LVH had lower serum albumin levels, higher blood pressure, and more overhydration than those who did not have LVH. Overhydration (p=0.007) was the strongest predictors of LVH in multivariate analysis.

    Read the abstract » | (added 01/08/2014)

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  5. Treatment of encapsulating peritoneal sclerosis

    Science has not yet shed light on how to prevent EPS. But, this review covers treatments for the rare and devastating condition. These include steroids, tamoxifen, and the immunosuppressants sirolimus or everolimus (at transplant blood levels). Surgery may also be needed.

    Read the abstract » | (added 01/08/2014)

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  6. PD catheter fixation is helpful

    In a series of 53 patients, placing PD catheters laparoscopically and fixing the catheter in place reduced catheter migration and other complications, was faster and less invasive than open placement, and led to shorter recover times.

    Read the abstract » | (added 01/08/2014)

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  7. How does PD change muscle protein use?

    PD is the only form of dialysis that removes protein-bound solutes. But, PD also "induces a new state in muscle protein dynamics," finds a new study, decreasing protein turnover rates and reducing their efficiency. Treatments like use of amino or ketoacids, vitamin D, exercise, and myostatin antagonism for malnourished patients may help.

    Read the abstract » | (added 01/08/2014)

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