Journal Watch
Ultrafiltration: Speed Kills
Among 190 people on HD, those whose ultrafiltration (fluid removal) rate was higher than the median (just 6.8 mL/Kg/h) were less likely to survive than those who were at or below the median. Most participants did not have residual kidney function.
Read the abstract » | (added 2017-04-12)
Tags: Hemodialysis
Magnesium and Vascular Calcification in PD
In vitro and in animals, serum magnesium inhibits vascular calcification. In a study of 80 people on PD, X-ray studies of the spine found that the lower the serum magnesium levels, the higher the rate of calcification in the blood vessels. Adjusting for age, serum phosphate, serum PTH, cholesterol levels, smoking history, and diabetes did not change the results.
Read the abstract » | (added 2017-04-12)
Serum Uric Acid Levels and PD Technique Failure
Among 371 people using CAPD in Taiwan , those with higher levels of uric acid in their blood were significantly more likely to have PD technique failure and peritonitis than those with lower levels.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis
PD vs. Standard HD for People with Cirrhosis
For cirrhotic people with kidney failure, data abstraction from the U.S. Nationwide Inpatient Study between 2005 and 2012 compared outcomes with PD and standard in-center HD. In-hospital mortality for those with ascites was significantly less with PD. In addition, PD hospital stays were shorter and costs were lower. Yet, just 1.7% of the sample was using PD.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis, Hemodialysis
Frequent HD in Children
Does 5x/week in-center HD benefit children more than 3x/week treatments? A multicenter pilot followed 8 children with a median age of 16.7 years. Among the 6 patients who completed two study periods, 5 had a sustained 10% or more decrease in systolic BP or antihypertensives during the more frequent treatments. Reimbursement and time burdens are challenges.
Read the abstract » | (added 2017-04-12)
Tags: Hemodialysis
Striking Lack of Data on Infection Prevention in PD
A Cochrane database review of 59 randomized controlled studies revealed “striking” gaps in our knowledge about what really works to prevent infections in PD. Oral or topical antibiotics and topical disinfectants had uncertain benefits for exit site, tunnel infections, or peritonitis. Use of IV vancomycin prior to catheter placement may reduce the risk of early peritonitis. Antifungal treatments may reduce fungal peritonitis after antibiotics.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis
In-center Nocturnal HD Beats Standard HD
An analysis of 21 published studies (n=1,165 in-center nocturnal patients and 15,865 standard in-center HD patients) found better BP, higher Hgb, and lower serum phosphate levels in those who dialyzed longer.
Read the abstract » | (added 2017-04-12)
Tags: Hemodialysis
Pregnancy on PD—at 42: It’s Not Impossible
While research shows that the chance for a pregnant woman on dialysis to have a healthy baby seems to be best with 36+ hours of HD per week, a 42-year old Malaysian woman had a full-term baby with no change to her CAPD prescription.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis, Hemodialysis
PD and Serum Vitamin D—A Vital Link
People with no history of heart disease on PD for 3+ months were compared to age- and sex-matched healthy controls in a 24-month study of subclinical atherosclerosis. Those on PD had significantly more carotid and femoral plaques at baseline than controls. Lower levels of serum vitamin D predicted more plaque at baseline and at 24 months. The authors suggest that monitoring could help identify patients who are at higher risk.
Read the abstract » | (added 2017-03-09)
Tags: Peritoneal dialysis
Home HD: Cost-effective With Better Outcomes Than In-center
A review of the patient-centered and economic impacts of home HD that included studies between 2000 and 2016 found better quality of life, flexibility, employment potential, and survival vs. hospital HD. Minority and low-income patients still have less access than others, which compounds their already-poor health outcomes. The authors found that home HD is cost-effective and the use of this option should be increased.
Read the abstract » | (added 2017-03-09)
Tags: Hemodialysis