Journal Watch

  1. PD Catheters: To Dress or Not to Dress?

    Which is better for preventing exit site infections, a PD catheter dressing, or leaving a healed catheter open to the air? A prospective, randomized, controlled trial in Malaysia followed 108 patients for 2 years. All were instructed to wash the exit site daily with antibacterial soap. The dressing group (n=54) used povidone iodine, mupirocin ointment, sterile gauze, and tape. The non-dressing group did not. Of the 97 patients who completed the study, the results from both groups were similar.

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

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  2. Urgent Start PD: Safe and Effective

    The first Canadian group to try urgent start PD followed 30 patients for a total of 3 years. They found no peritonitis or exit site infections in the first 4 weeks after catheter placements, three minor leaks that were managed conservatively, and four catheter migrations that were relocated without the need for surgery. The researchers concluded that urgent start PD is safe and effective for people who need to start dialysis and do not have an access.

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

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  3. Calculating the dialysis dose for a wearable artificial kidney

    How do you set a dialysis dose for a 24/7 continuous HD therapy? Using kinetic modeling, researchers developed theoretical doses that would be needed to achieve certain creatinine concentration targets. Interestingly, fluid intake did not affect the predicted clearances.

    Read the abstract » | (added 09/11/2015)

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  4. Home HD has 20% lower all-cause mortality than PD

    In a new study that matched 4,201 new home HD patients in the USRDS database to new PD patients, the risk of all-cause mortality was 20% lower with home HD. In addition, there was an 8% lower risk of hospitalization, and a 37% lower risk of technique failure.

    Read the abstract » | (added 09/11/2015)

    Tags: Home Dialysis

  5. CRP levels and abdominal CT scans can find EPS early

    A look back at CT scans and c-reactive protein levels from 30 people diagnosed with encapsulating peritoneal sclerosis has provided clues for early diagnosis. Higher than normal levels of c-reactive protein plus abnormal CT scan results found the rare complication early 78% to 87% of the time—making effective treatment more possible.

    Read the abstract » | (added 09/11/2015)

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  6. Kinetic modeling helps predict best PD prescription

    Researchers found 12 subgroups among 1,005 people on PD, based on their membrane transport and amount of body water. Using PD Adequest 2.0, patients each had a PD prescription tailored to reach a minimum adequacy target for urea and water, using glucose and icodextrin fluids. A cut-off of more or less than 2mL/min of residual kidney function was identified. Use of icodextrin simplified the regimen and reduced glucose exposure and PD fluid volumes.

    Read the abstract » | (added 09/11/2015)

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  7. Randomized controlled trial: group education aids options choice

    Among 80 people with ESRD, receiving a group education class with their support person led to significantly higher knowledge of treatment options—and more positive attitudes toward hemodialysis and living donation—than usual care. At 2 year follow up, 49 had begun renal replacement therapy, and 34 had had a transplant, of which 22 were preemptive.

    Read the abstract » | (added 09/11/2015)

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  8. Peritoneal cavity model will help the study of fibrosis

    Researchers have devised a model peritoneum that allows them to study the impact of PD on the cells. The model has a mesothelial layer, an endothelial layer, and a collagen membrane chamber. When used for simulated PD, various solutions had different effects on the cells—but reduced nitric oxide production seems to be a mechanism for fibrosis. This new tool may lead to new ways to prevent and treat peritoneal fibrosis.

    Read the abstract » | (added 09/11/2015)

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  9. Low Molecular Weight Heparins for Nocturnal HD

    A small Netherlands study of in-center nocturnal HD suggests that two divided doses may work best for low molecular weight heparins dalteparin and nadroparin. Careful dosing is needed to obtain the right level of anticoagulation and avoid overcorrection. Dalteparin required higher doses than nadroparin.

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

    Tags: Home Dialysis

  10. Where Are We With Wearable Artificial Kidneys?

    Sorbent and enzyme technologies are helping forward movement in the WAK world, but the long-time Achilles heel of hemodialysis—vascular access—along with anticoagulation and regulations are still challenges.

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

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