Journal Watch

  1. UK Identifies Ways to Boost Use of Home HD

    Commissioners in the West Midlands, where home dialysis rates had been falling for 10 years, set a target for home dialysis uptake. Comparing this area’s seven hospitals with the rest of England for 3 years before and after the target found significant increases at the study hospitals. Use of financial penalities, adding funding for specialist staff and equipment, having visible champions, good systems for patient training, and ongoing healthcare support at home all helped. Lack of training for non-specialists, poorly developed patient education, and patients’ unmet emotional needs are ongoing challenges.

    Read the abstract » | (added 11/11/2015)

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  2. Vascular Access Technique Audits Can Reduce Home HD Access Infections

    Self-cannulation errors can lead to infections. A retrospective study of all prevalent home HD patients at the University Health Network in Canada looked at access infections between 2006 and 2013. Among the 92 patients who completed at least one vascular access audit, those with five or more errors had significantly higher infection rates. Longer duration on home HD was associated with higher error rates. Audits give nurses a chance to retrain patients and reduce future errors and infections.

    Read the abstract » | (added 11/11/2015)

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  3. Decision Support Helps Match Treatments with Preferred Lifestyles

    In Spain, 569 of 1,044 patients in 26 hospitals who had to choose a renal replacement therapy (RRT) option between September 2010 and May 2012 used a decision aid to help them decide, and 399 started treatment. Those who did use a decision aid changed their minds significantly less often and were more likely to begin the treatment they chose. There was about a 50/50 distribution of PD and standard HD, and an increase in transplant interest as well—even among those with unplanned dialysis starts. See MEI’s U.S. decision aid, My Life, My Dialysis Choice.

    Read the abstract » | (added 11/11/2015)

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  4. What Predicts Transfer to Home HD After PD Failure?

    In Australia and New Zealand, an analysis of all 10,710 patients treated with PD between 2000 and 2012 found that 2,915 transferred to HD—but just 156 started home HD. Among those who switched to home HD, more were male, obese, and had done PD longer. Older patients, those who stopped PD due to infection, who were underweight, whose ESRD was due to hypertension or diabetes, and those who were Aboriginal were less likely to go home.

    Read the abstract » | (added 11/11/2015)

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  5. Hydrogen Sulfide Reduces Peritoneal Fibrosis in Rats

    Hydrogen sulfide has helped fibrosis of the lungs, liver, kidneys, and heart. In this study, peritoneal fibrosis was induced in rats. Using hydrogen sulfide decreased inflammation and fibrosis, and improved peritoneal function, and may become a future treatment to help people.

    Read the abstract » | (added 11/11/2015)

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  6. Encapsulating Peritoneal Sclerosis Increases with Time on PD

    EPS is a devastating PD complication that can be lethal. An Italian clinic looked back at 30 years worth of data and found EPS prevalence rates of 2.8% overall among 920 patients: 0.4% for <2 years of PD, 3% at 2-4 years, 4% at 4-6 years, 6% at 6-8 years, 8% at 8-10 years, 75% by 12-14 years, and 67% for those with 14+ years of PD. Steroid treatment helped reduce mortality.

    Read the abstract » | (added 11/11/2015)

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  7. Pelvic Drainage + Catheter Removal May Aid Refractory Peritonitis

    Complications of peritonitis can go on even after PD catheter removal. A retrospective review of 46 patients with refractory peritonitis over 12-years found that the 12 who’d had pelvic drainage with closed active suction devices had an 8% future complication rate, vs. 44% in those who did not. None of the active drainage group needed further drainage or open laparotomy, while 35% of the non-drainage group did.

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  8. RCT Finds that Ginger Supplements Lower Triglycerides in People on PD

    A small (n=36), randomized, double-blind, controlled trial tested ginger supplements (1000 mg/day) vs. placebo in people on PD. After 10 weeks, serum triglycerides dropped by up to 15% from baseline in the ginger group, which may reduce cardiovascular disease risk. Total cholesterol, LDL-C, HDL-C, and Lp(a) levels did not change.

    Read the abstract » | (added 11/11/2015)

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  9. HD Membranes and Bisphenol A (BPA) Blood Levels

    BPA, an ingredient in many plastics and resins, can build up in the bodies of people with kidney failure. Studies suggest that BPA may be linked with kidney and heart damage. Compared to BPA-free polynephron dialyzers, patients dialyzed using conventional polysulfone dialyzers had higher blood levels of BPA, and higher markers of oxidative stress and inflammation.

    Read the abstract » | (added 10/15/2015)

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  10. Majority of Patients Open to Self-Care or Home HD if Trained Properly

    A survey of 250 in-center HD patients and 51 nephrologists found that 69% of patients said they were “Likely” or “Very Likely” to consider self-care HD if they received proper training on a new machine designed for patient use. Nephrologists believed patients could do many dialysis tasks, but would not be willing to—responses that did not match what the patients said. Perhaps they should ASK?!

    Read the abstract » | (added 10/15/2015)

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