Journal Watch
A New Way to Correct PD Catheter Malposition and Blockage
Researchers in China developed a new, minimally invasive technique to reposition and unblock PD catheters. Tested in 16 PD patients, a surgeon made a small (3cm) incision under local anesthesia, disected the tissue, and pulled out the catheter. Adhesions were separated and a new catheter placed with forceps and stitched in place. After 6 months, all of the catheters were working.
Read the abstract » | (added 2016-07-12)
Tags:
Independence, Flexibility and Quality of Life Matter to Patients
For the PCORI-funded Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT), 180 people not yet on dialysis or using standard HD or PD were interviewed to identify the factors in their choice of a dialysis option. Independence, quality and quantity of life, and daily schedule flexibility mattered most—and 47% of those on standard HD said the choice had not been theirs. (NOTE: Ironically, the EPOCH-RRT decision aid omits home HD, an option that offers independence, quality of life, better survival, and schedule flexibility, as we have blogged here and here).
Read the abstract » | (added 2016-07-12)
Tags: Hemodialysis
Nocturnal HD Improves Nutritional Status
A metaanalysis was conducted of 9 studies with 229 patients who switched from standard to nocturnal HD. Those on nocturnal HD had significantly higher levels of serum albumin and protein and energy intake.
Read the abstract » | (added 2016-07-12)
Tags: Hemodialysis
Low Blood Magnesium Levels Risky On PD
Most magnesium in the body is not in the blood. And, very low blood levels (<1.8 mg/dL) were linked with higher rates of hospital stays and death among 10,692 people on PD. The greatest hospital risk was in patients who also had low (<3.5g/dL) serum albumin levels.
Read the abstract » | (added 2016-06-08)
Tags:
WAK Clearance of Potassium and Phosphorus in Goats
Wearable dialysis could ease fluctuations in potassium and phosphorus vs. intermittent HD. A sorbent based wearable device tested on goats found constant levels of potassium and phosphate adsorption.
Read the abstract » | (added 2016-06-08)
Outset Medical Tablo Human Factors Testing
Journal articles don’t tend to give product names, so we read between the lines to tell you that human factors testing on Outset’s Tablo home HD machine found 2.9 errors for patients—and 4.4 for nurses or technicians—out of 1,710 opportunities for error. None of the errors was safety related.
Read the abstract » | (added 2016-06-08)
Tags: Hemodialysis
Nocturnal HD Protects Bones Better Than Standard HD
Compared to 52 patients on conventional HD, 36 patients on nocturnal HD had better bone mineral density at the lumbar spine, femoral neck, and hip after one year.
Read the abstract » | (added 2016-06-08)
Tags: Hemodialysis
Glucose in PD Solution Affects Non-Diabetic Patients, Too
Among 640 PD patients from three countries studied for up to 6.4 years, serum glucose levels rose with age and with higher dialysate glucose. In 5.4% of the sample, the levels suggested undiagnosed diabetes.
Read the abstract » | (added 2016-06-08)
Tags:
More Inflammation With Standard HD Than With PD
Inflammation can lead to heart damage and poor outcomes. Two 3-month prospective studies with 228 HD and 80 PD patients measured two markers of inflammation: CRP and IL-6. In HD patients, these levels were both higher and more variable than in PD.
Read the abstract » | (added 2016-06-08)
Tags: Hemodialysis
Mechanisms of Peritoneal Membrane Fibrosis
Glucose in PD solution activates a cell protein in mice that typically prevents fibrosis when it is not activated. This pathway leads to inflammation, growth of new blood vessels, and fibrosis—so finding a way to switch it off could lead to new drugs to help prevent these problems.
Read the abstract » | (added 2016-06-08)
Tags: