Journal Watch
Lack of Education Predicts Peritonitis on PD
An analysis of socioeconomic—and educational—deprivation in 233 patients who had PD catheters placed found a trend toward higher peritonitis rates in more deprived patients.
Read the abstract » | (added 2018-05-11)
Tags: Educational Deprivation, PD catheter Insertions, PD Peritonitis
A Randomized, Controlled Trial of Instant Messaging for PD Patients
Among 160 PD patients, the half assigned to instant messenger had significantly higher levels of satisfaction, serum albumin, and hemoglobin—and lower levels of serum phosphorus and calcium-phosphate product than controls.
Read the abstract » | (added 2018-05-11)
35-year Patient Survival on Home HD
A case study reports on the 35-year survival of a man with Alport’s syndrome who uses thrice-weekly conventional home HD—and still works 6-8 hours per day at age 65—despite no residual kidney function.
Read the abstract » | (added 2018-05-11)
New Danish Dialysis Decision Aid
A shared decision-making tool developed and pilot tested in Denmark was well-received by 137 patients, and resulted in 80% of them choosing a home dialysis option—vs. just 23% without the tool.
Read the abstract » | (added 2018-05-11)
Tags: Patient Involvement, Dialysis Choice, Dialysis Decision Aid
Head to Head: 8-hour Hemodialysis vs. 4-hour Hemodiafiltration
A randomized trial assigned 12 nocturnal HD patients to either two weeks of 8-hour HD or 4-hour HDF, followed by a crossover to the other option. Participants were also randomized to one of two dialyzers: a Fresenius FX80 or a Nipro Elisio. The 8-hour HD treatments removed significantly more urea and creatinine. But, the HDF removed more FGF23—and several other toxin levels were the same. The FX80 dialyzer cleared somewhat more B2M.
Read the abstract » | (added 2018-05-11)
Tags: Nocturnal HD, Extended hours Haemodialysis, Haemodiafiltration
Low Molecular Weight Heparin as Anticoagulation for Nocturnal HD
How can the dialysis circuit be kept free of clots during slow, HD treatments done during sleep? In a small study, 12 patients who did alternate night, 8-hour treatments were randomized to nadroparin (a low molecular weight heparin) or unfractionated heparin. The dosing regimens were adapted to make them more practical for overnight use. Both were effective, but with different monitoring requirements.
Read the abstract » | (added 2018-04-12)
Tags: Anticoagulation, Home Haemodialysis, Low molecular Weight Heparin, Nadroparin, Unfractionated Heparin
LVH Regression in the FHN Trials
Among the 243 randomized patients with biomarker data in the daily HD trial, 121 had no change, 77 got better, and 45 got worse over the course of the study. Changes in levels of collagen turnover and klotho enzyme levels seemed to predict which patients would improve; a finding that will need to be verified in another study.
Read the abstract » | (added 2018-04-12)
Tags: Copeptin, Brain Natriuretic Peptide, Cardiac Biomarkers, Frequent Hemodialysis, Klotho, Left Ventricular Hypertrophy, Markers Of Collagen Turnover
Emergent Start PD Yet Again
Learn about the rationale and feasibility of using PD as a first dialysis option for emergent start patients instead of inserting a central venous catheter and starting HD. .
Read the abstract » | (added 2018-04-12)
Tags: End stage Renal Disease, Haemodialysis, Peritoneal Dialysis, Unplanned Start, Urgent Start
Improving Incident ESRD Care with Transitional Care Units
Patients who transition onto dialysis are at high risk for morbidity and mortality—along with high costs. Transitional care units use the first 30 days of treatment for systematic onboarding that includes education and informed options choice—and may be especially helpful to those who start treatment emergently. Read the abstract.
Read the abstract » | (added 2018-03-16)
Experiences of Self-cannulation in Men
Self-cannulation can be a barrier to home HD, and a new qualitative study examined why that is and how patient attitudes toward it changed over time. Eight male patients were interviewed, and the course of becoming a self-cannulator was described as a “process” of gaining control, building confidence, and finding a new norm. The article suggests practical techniques that can be used by clinic staff. Read the abstract
Read the abstract » | (added 2018-03-16)
Tags: Self cannulation, Techniques