Journal Watch

  1. PD Catheter Fixation Works

    Can we keep PD catheters in place? This study compared 152 people who were randomly divided into three groups. Group 1 had their PD catheters placed with traditional open surgery. Group 2 had a modified open surgery placement. Group 3 had open surgery with the PD catheter fixated to the lower abdominal wall, and a vertical tunnel. After 6 months, all of the PD catheters worked in the fixated group—a much higher rate than for Group 1. There were no significant differences in infection, bleeding, leakage, pain, hernia, or wound healing.

    Read the abstract » | (added 12/09/2016)

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  2. Urgent Start PD vs. HD

    Which option is better if someone “crashes” into dialysis? A retrospective study was done of 178 people who started dialysis urgently between January, 2013 and December, 2014. Those who started PD had far fewer complications in the first 30 days. HD patients had more bloodstream infections. Survival was about the same for both groups.

    Read the abstract » | (added 12/09/2016)

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  3. Systematic Review of Pregnancy on HD

    A new review summarizes 101 full papers and 25 abstracts and addresses the promise of successful pregnancy if enough HD is given.

    Read the abstract » | (added 11/10/2016)

    Tags: Hemodialysis

  4. The HEMO Study Returns with a New Message

    “An index only on the basis of urea does not provide a sufficient measure of dialysis adequacy,” finds yet another reanalysis of the by-now-ancient HEMO study data. Looking only at small uremic solutes—even non-urea wastes—did not predict all-cause mortality. Doing HD just three times a week made it impossible to remove enough solutes to matter.

    Read the abstract » | (added 11/10/2016)

    Tags: Hemodialysis

  5. Time Matters: HD Kt Dose , Hospitalization, and Death

    Does adding more HD benefit patients? Yes, finds a Fresenius study of 6,129 patients in Spain. There as a progressive increase in the risk of death for patients who were below the target Kt, and as Kt rose to reach and exceed the target, the risk declined, as did the risk of hospitalization. “Thus, prescribing an additional 3 L or more above the minimum Kt dose could potentially reduce mortality risk, and 9 L or more reduce hospitalization risk,” noted the authors.

    Read the abstract » | (added 11/10/2016)

    Tags: Hemodialysis

  6. Why Seniors Choose HD vs. PD

    Older people may be equally suited for PD or HD, so what guides their choice? In an interview study, PD was selected by those wanted convenience and a normal life. HD, on the other hand, was chosen by those who were afraid and wanted security. EDITOR’S NOTE: Of course patients are afraid! We need to help ease their fears before we educate them about their options.

    Read the abstract » | (added 11/10/2016)

    Tags: Hemodialysis

  7. In the Netherlands, High-Dose HD Holds Up to Cost Scrutiny

    Is high-dose HD cost-effective?  A new Dutch study finds that while conventional home HD (three treatments per week) may be the most cost-effective, since high-dose HD is twice as much treatment, "from a payer’s perspective, high dose HD should be offered as a home therapy to obtain its clinical benefits in a cost-effective manner."

    Read the abstract » | (added 10/13/2016)

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  8. US Home Dialysis Use by Racial and Ethnic Minorities

    Are African Americans about 50% less likely to do home therapies across the entire US—or are certain states less well-represented than others?  An analysis of 369,164 Medicare fee-for-service dialysis patients was analyzed by state. African American patients were the least likely to use PD in every US region except Massachusetts. Across the US, all minorities were less likely to use home HD than Caucasians, but Asians were more likely to use home HD in the Midwest.

    Read the abstract » | (added 10/13/2016)

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  9. Patient Peritonitis Perspectives

    Australian researchers conducted interviews with 29 current or past PD patients to gain insights into the prevention of peritonitis. The four themes identified were the constant need for vigilance, invading harm from infection, incapacitating lifestyle interference, and exasperation with hospitalizations. The authors concluded that education about peritonitis and lifestyle impacts of PD may be helpful.

    Read the abstract » | (added 10/13/2016)

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  10. Case Study Offers Hope for Successful EPS Treatment

    Working on the hypothesis that encapsulating peritonitis has TWO causes (a deteriorating peritoneum and inflammation), researchers tried a new treatment approach—and it worked. Combining sirolimus, a low-dose corticosteroid, and intradialytic parenteral nutrition helped a patient.

    Read the abstract » | (added 10/13/2016)

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