Journal Watch

  • New Xylitol-based PD Fluid with L-Carnitine May be More Biocompatible

    It is ironic that the glucose-based fluid that made PD possible can also harm the membrane so it stops working. A new PD fluid uses xylitol and l-carnitine to remove water instead of glucose. When tested on human cells, the new fluid kept more cells alive and reduced inflammation.

    Read the abstract » | (added 2021-01-12)

    Tags: Peritoneal Dialysis, Peritoneal Dialysis Solution

  • Will Silicone Be the Future of HD Membranes?

    Silicone nanoporous membranes (SNMs) have an average pore size of 8 nanometers. Tested with urea and creatinine, the new material was able to clear about 81% of high concentration uremic toxins in 45 minutes. This material could make more compact and portable dialysis systems possible.

    Read the abstract » | (added 2021-01-12)

    Tags: Silanization, Silicon Nanoporous

  • Chevron and Butterfly Taping Reduces Venous Needle Dislodgement in HD

    Every clinic seems to have its own preferred method of taping HD needles to prevent dislodgement. This important new study tested Chevron, Butterfly and Overlapping tape patterns in a mechanical engineering laboratory to measure the adhesive force and ability to withstand dislodgement and lateral stress.

    Read the abstract » | (added 2021-01-12)

    Tags: Dialysis, Hemodialysis

  • Yet Another Study Demonstrates the Superiority of Home HD over In-Center

    A cohort registry study matched 181 home HD patients with 413 in-center HD patients in Australia and New Zealand by age, gender, and cause of ESKD. After adjusting for BMI, smoking, race, and comorbidities, home HD had almost half the death risk of in-center HD, as well as significantly lower phosphate levels. Both groups had similar rates of transplant and graft survival 6 months after a transplant.

    Read the abstract » | (added 2021-01-12)

    Tags: Kidney Disease, Haemodialysis, Home Haemodialysis

  • Are In-center Hemodialysis Patients Interested in Self-Care?

    In-center self-care can be a bridge to home hemodialysis. A survey of 91 patients and 31 nurses revealed higher interest among the patients than the nurses (2.43+0.93 vs. 2.19+0.77). Patients also considered themselves to be capable of performing self-care tasks. Greater interest and perceived capability were linked with years of education, patient activation, disease severity, and age.

    Read the abstract » | (added 2020-12-10)

    Tags: Renal Dialysis, Self‐care, Self‐management

  • Prolonged PD Training Linked with Higher Peritonitis Risk

    A single center retrospective analysis of all PD training sessions from 2001 to 2018 (135 patients) found that the 23% whose training lasted longer than 13 sessions had a significantly higher risk of peritonitis, though technique survival was not reduced. Factors associated with prolonged PD training included older age, diabetes, and unemployment.

    Read the abstract » | (added 2020-12-10)

    Tags: Peritoneal Dialysis, Peritoneal Dialysis Learning

  • The Influence of Perceptions on PD Burnout

    A focus group study conducted with 81 PD patients and 45 care partners in Australia, Hong Kong, and the United States identified relentlessness and feeling overwhelmed by daily responsibilities as a factor in burnout. Building resilience and finding a new normal and meaning in other activities may be protective.

    Read the abstract » | (added 2020-12-10)

    Tags: Burnout; Dialysis, Peritoneal Dialysis

  • Benefits of Remote PD Monitoring

    Compared to 38 standard care PD patients, 35 who received remote monitoring (RM) for 6 months had better outcomes despite higher Charlson Comorbidity scores. The RM group lived further from the clinic or had mobility issues, but were more satisfied with their care, and they had fewer emergency room visits and nephrology-related hospitalizations.

    Read the abstract » | (added 2020-12-10)

    Tags: Quality Of Life, Remote Monitoring

  • Nephrology Fellows Not Ready for Home Dialysis

    Even nephrology fellows attending home dialysis conferences did not feel prepared to care for PD or home HD patients, finds a small study. Of 110 attendees, 76 (66%) completed a survey about their confidence with regard to management of home dialysis. Most were “moderately” confident about PD principles—though just 11% had seen a PD catheter insertion, and only 3% had initiated a patient on urgent start PD. Most had “low” confidence in their ability to manage home hemodialysis.

    Read the abstract » | (added 2020-12-10)

    Tags: Education, Home Dialysis, Nephrology Fellowship

  • Exercise May Improve Residual Kidney Function in PD

    A post-hoc study of a 12-week randomized controlled trial of home exercise for PD patients eliminated those with anuria (n=18) and analyzed 13 patients in the usual care group and 16 in the exercise group. Two RKF markers, liver-type fatty acid-binding protein (L-FABP) and the microalbumin-to-creatinine ratio, were significantly lower in the exercise group.

    Read the abstract » | (added 2020-12-10)

    Tags: Microalbumin to creatinine Ratio, Peritoneal Dialysis