Journal Watch - 2015

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  1. Icodextrin PD fluid reduces insulin resistance in non-diabetic patients

    Even without diabetes, insulin resistance can add to cardiovascular disease risk in people with CKD. A new study randomized non-diabetic adults to APD with 2.5% glucose (n=27) for the long dwell or icodextrin 7.5% (n=33). At 90 days, the icodextrin group had lower levels of insulin resistance.

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

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  2. Metaanalysis: PD fluid with fewer GDPs improves outcomes

    Glucose degradation products (GDPs) are known to damage the delicate peritoneum. PD fluids with neutral pH and low levels of GDPs were reviewed in a new study of 11 randomized controlled trials (n=643). While most of the studies were of poor quality, low-GDP PD fluid was better at preserving residual kidney function and urine volume for a year than standard PD fluid.

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

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  3. 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 07/08/2015)

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  4. 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 06/10/2015)

    Tags: Home Dialysis

  5. 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 06/10/2015)

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  6. 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 06/10/2015)

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  7. 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 06/10/2015)

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  8. 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 06/10/2015)

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  9. Education can change negative nurse attitudes toward home dialysis

    In-center HD nurses tend to prefer…in-center HD. But, their negative attitudes toward home treatments can be modified, a new study shows. In Canada, a 3-hour educational session with CE credits on the benefits of home treatments, myths about patient eligibility, costs, and a testimonial video did the trick.

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

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  10. Home hemodialysis needs you! Special Kidney International supplement.

    A special supplement of Kidney International focuses on how to implement home hemodialysis, from policies and procedures to equipment, recruitment, safety, prescription, staffing, and more—from global experts. Don't miss it!

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

    Tags: Home Dialysis