It’s (past) time to avoid 3-day interdialytic intervals

A new review paper considers the ill effects of the thrice weekly standard in-center HD schedule and finds it wanting, noting higher mortality on the day after the long gap than any other day of the week. The authors conclude that the data warrant “reexamining the issue of timing and frequency of prescribed dialysis regimens in order to improve patient outcomes.”

Read the abstract » | (added 2015-07-08)

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

More glucose in PD fluid makes it harder to cure peritonitis

A look back at bacterial peritonitis among 187 people on CAPD compared those whose peritoneum was exposed to more than 140 grams per day of glucose—or less. Those who used less glucose had a higher cure rate, fewer relapses, and less need for catheter removal.

Read the abstract » | (added 2015-07-08)

Tags:

Metaanalysis of best practices in pregnancy on dialysis

What works best to ensure a healthy baby if women on dialysis become pregnant? A systematic literature analysis found that long-hour HD has the most support, while correcting vitamin B12, folate, iron, anemia, vitamin D, and calcium levels is also important. Success rates of greater than 75% are possible.

Read the abstract » | (added 2015-06-10)

Tags:

New self-cannulation aid: Tattoo dots

In a case report of a patient who had a hard-to-feel fistula, small dots were tattooed to guide cannulation. With the permanent dots in place, the individual was able to self-cannulate and do home hemodialysis successfully.

Read the abstract » | (added 2015-06-10)

Tags:

PKD liver and kidney size may limit PD

In Japan, oversized polycystic kidneys may be treated with transcatheter arterial embolization (TAE) to cut off their blood supply and shrink them. Among two small groups of people with PKD, even those with reduced kidney volume still tended to develop hernias.

Read the abstract » | (added 2015-06-10)

Tags:

Progress toward reengineering catheters to reduce infection

Can we eliminate exit site infections by redesigning catheters? Bioengineers are working on a way to create a biological seal that would keep germs out. A new device being tested uses a removable protective membrane that slowly grows out of the body, leaving a dry groove that reduces infections—at least in goats.

Read the abstract » | (added 2015-06-10)

Tags:

Status Report: Home HD in Japan

While just 0.1% of all Japanese people on dialysis use home HD, this number has been growing quickly. Work groups of the Japanese Society for Home Hemodialysis have been set up to start a patient registry and advise on supply and wastes and the cost burden for those who self-pay. Further challenges will include recruitment, education, a business model, and more.

Read the abstract » | (added 2015-06-10)

Tags: Home dialysis

New index more accurate than Kt/V for PD “adequacy”

It’s no secret that we at Home Dialysis Central are not fans of Kt/V for HD (or the concept of “adequacy”). A new European study suggests that Kt/V is not useful for PD, either (because it does not account for protein intake), and has tested a substitute index that works better.

Read the abstract » | (added 2015-05-09)

Tags: Home dialysis

Ultrasound can measure peritoneal wall thickness in children

Fibrosis of the peritoneum can cause PD failure. But, peritoneal wall thickness can be measured with a painless ultrasound. The results can assess whether the peritoneum is changing over time.

Read the abstract » | (added 2015-05-09)

Tags: