Journal Watch
Why and how to change the dialysis default to PD
PD is comparable to standard HD in outcomes, but costs less, is more convenient, does a better job of preserving residual kidney function, and delivers better quality of life, argues a new editorial.
Read the abstract » | (added 2017-05-09)
Tags: Peritoneal dialysis
In-center nocturnal HD boosts lean body mass
Among 56 adults followed for a year, those who were randomly assigned to nocturnal in-center HD vs. standard treatments had higher, more stable interdialytic weights. The pattern of toxin removal suggests that the result is due to increases in lean body mass.
Read the abstract » | (added 2017-05-09)
Tags: Hemodialysis
When to start PD after catheter placement
A new randomized controlled trial included 122 new PD starts at two Queensland, Australia hospitals for 5 years. Participants were randomized to three groups, who started PD at either 1 week, 2 weeks, or 4 weeks after PD catheter placement. Leaks were higher in the 1-week group, while PD technique failure was higher in the 4-week group.
Read the abstract » | (added 2017-05-09)
Tags: Peritoneal dialysis, Catheter
How dialysis clinics can help prevent peritonitis
What can dialysis clinics do to reduce the risk of peritonitis in PD patients? In an analysis of 127 PD clinics and 5,017 new PD patients, having a nurse who specialized in PD or conducting home visits prior to the PD start had the biggest impact.
Read the abstract » | (added 2017-05-09)
Tags: Peritoneal dialysis
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