Considering Alternative Markers for Dialysis Dose

A new review article looks at the impact of longer and/or more frequent, high-dose HD on dialysis adequacy—and inadequacy. Some uremic solutes come from nutrient intake and others don’t. For nutrient-based solutes, the authors suggest using inorganic phosphorus and protein-bound wastes as markers to develop new dose measures. For non-nutrient based middle molecules, they suggest beta-2-microglobulin measurement.

Read the abstract » | (added 2016-09-14)

Tags: Hemodialysis

VIPs in Dialysis Modality Choice

Whose opinion matters most to patients when it comes time to make a dialysis decision? In New Zealand, at least, it’s the nephrologist—even though respondents thought it would be predialysis nurses. In fact, a 1-point increase in nephrologist decisional power increased the rate of home therapies by 6.1%.

Read the abstract » | (added 2016-09-14)

Tags: Hemodialysis

Risk Factors for Encapsulating Peritoneal Sclerosis (EPS)

In a study of 703 PD patients between 1980 and 2015 at two centers, the 44 who developed EPS were more likely to have had a history of peritonitis, which rose with the duration of time on PD. The use of biocompatible PD fluid reduced the risk.

Read the abstract » | (added 2016-09-14)

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Which Tidal PD Setting is Most Efficient?

A study of 5 different tidal prescriptions for automated PD (APD) were used with six low-average and six high-average transporters. There were significant differences in urea and creatinine clearance between the prescriptions.

Read the abstract » | (added 2016-09-14)

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10-year Experience with Incremental PD

People who start dialysis with residual function may not need full-on, four- exchanges-per-day PD. This center reports excellent clinical experiences using incremental PD, 1-2 dwells per day, until residual function dropped (a mean of 17 months), finding no differences between an incremental and a standard PD start—and better maintenance of residual function.

Read the abstract » | (added 2016-09-14)

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Exploding PD Myths

Misconceptions about who will be a “good PD patient” have unnecessarily limited PD updake, increased transfers to in-center HD, and raised costs. Get the straight story!

Read the abstract » | (added 2016-09-14)

Tags: Hemodialysis

French Patients on Daily HD

Daily HD is relatively new to France—yet this study was able to include 753 patients who started on the therapy between 2003 and 2012. Two-thirds had switched to daily HD from another option. Younger patients (<64) had better survival (72.6% vs. 31%) and were more likely to receive a kidney transplant than older patients (>64).

Read the abstract » | (added 2016-08-09)

Tags: Hemodialysis

Overhydration and Mortality Risk on PD

When PD does not remove enough water, the resulting overhydration is a major risk factor for death. A study of 54 PD patients between 2008 and 2015 measured with bioimpedance technology were divided into normohydrated and overhydrated groups. Older age, low diastolic blood pressure and overhydration predicted mortality.

Read the abstract » | (added 2016-08-09)

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Silk Filter for the PD WAK

A urease silk fibroin filter has been tested with a wearable artificial kidney (WAK) for PD. In lab analysis, the filter removed more than 50% of urea from a 50 mg/dL urea solution, and 90% after 24 hours.

Read the abstract » | (added 2016-08-09)

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Fallopian Tubes and PD Catheter Problems

In women, fallopian tubes can be an unrecognized cause of PD catheter malfunction. This case report study describes five episodes of catheter malfunction in four female patients.

Read the abstract » | (added 2016-08-09)

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