Low Molecular Weight Heparin Use in Nocturnal HD

Since people sleep during nocturnal HD, a form of heparin with a longer half-life is needed to keep blood from clotting. Enter low molecular weight heparin (LMWH). A study in Hong Kong* randomized 12 nocturnal HD patients to receive nadroparin or unfractioned heparin for a week—and then switch. The researchers concluded that LMWH was safe and effective, though if treatments are done each night, it is important to monitor for build up of the heparin in the blood.

Read the abstract » | (added 2017-01-09)

Tags: Hemodialysis

Early and Late Outcomes in Urgent-start PD

A single-center, matched-case control study compared 26 urgent start PD patients to 78 who started PD in the standard fashion. Urgent-start PD was linked with more catheter leaks and catheter migration. But, the rates of infection were similar, and urgent-start PD was safe.

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Peritonitis Predicts Long-term Cardiac Outcomes on PD

A large study (n=5,707) of PD patients from Brazil has found that just one bout of peritonitis boosts the risk of late cardiovascular death by 22%. Two bouts of peritonitis raised the risk by 78%, three by 181%, and four by 284%.

Read the abstract » | (added 2017-01-09)

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Using PET Results to Screen for Encapsulating Peritoneal Sclerosis (EPS)

Identifying EPS early is vital to effectively treat this rare but devastating problem. Researchers studied whether the amount of sodium removed from the dialysate (sodium sieving) could predict EPS, in a 20-year study of 161 people. Age at PD start, duration of PD, and sodium sieving were all important predictors.

Read the abstract » | (added 2017-01-09)

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PD Patient Education in Australia

Clinical PD outcomes in Australia were as much as 10-fold different from one site to another. An effort to standardize PD teaching has begun to improve PD outcomes. Of the 54 PD clinics, 70% completed an online survey about their PD teaching practices—which varied widely in the number of hours and presence of competency assessments.

Read the abstract » | (added 2017-01-09)

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Gender, PD Dose, and Anemia

Do gender and PD adequacy matter in anemia treatment, wondered researchers? Yes, as it turned out. A two-part study first included 2,180 prevalent PD patients, then followed 88 new PD patients for 3 years, recording data once a year. Regardless of adequacy, women had lower hemoglobin levels than men at every point—even with higher ESA doses.

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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 2016-12-09)

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PD vs. In-center HD for Time to Transplant (in Italy)

In the US, research has found that people who use PD receive transplants about 50% faster than those on standard in-center HD, despite comparable listing numbers. The same seems to be true in Italy. In the Province of Trento, which has increased PD use from 7 to 47%, an analysis of 279 HD and 132 PD patients found that time to transplant was about 330 days for HD and 224 for PD—a significant difference.

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

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NxStage Outcomes in France and Belgium

Among 62 patients from 31 centers in France and Belgium, albumin and bicarbonate levels improved significantly, and technique survival was 75% at one year (most who stopped received transplants). Despite the low volume of dialysate, the rsearchers concluded that dialysis adequacy was acceptable.

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

Tags: Hemodialysis

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 2016-12-09)

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