PD Catheter Placement: Does Timing Matter?

Do patients who are able to wait 14 days before using a PD catheter have less peritonitis than those who use it sooner? Can they do PD longer? Do they live longer? There were no significant differences in any of these parameters, finds a new observational study of 149 patients, 80 early and 69 delayed. (NOTE: This is good news for early start PD.)

Read the abstract » | (added 2016-04-12)

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Urea Alone is Not a Good Index of Dialysis Dose

All-cause mortality in the HEMO study was not significantly related to removal of small solutes in short, intermittent, standard HD. “Failure to achieve greater reductions in solute levels may explain the failure of high Kt/V urea treatment to improve outcomes,” the authors note. (Yet another reanalysis of the HEMO study data has confirmed the obvious…)

Read the abstract » | (added 2016-04-12)

Tags: Hemodialysis

Survival on PD vs. Daily Home HD

A USRDS study matched 3,142 people starting daily home HD with 2,688 starting PD and compared survival. Those who were doing short daily HD had 12.7 deaths per 100 patient years, vs. 16.7 in the PD group.

Read the abstract » | (added 2016-04-12)

Tags: Hemodialysis

If One PD Exit Site Antibiotic is Good, Are Two Better?

In a single center study, 146 people on PD were randomized to use gentamycin cream on their exit sites (n=71) or to switch between gentamycin in odd months and mupirocin in even months (n=75). After 174 (gentamycin) or 181 patient years (alternating), the group switching between two antibiotics had significantly more peritonitis, especially gram-negative and fungal.

Read the abstract » | (added 2016-04-12)

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Loss of Kidney Function Slowed After Starting PD

In 77 new PD patients, the rate of decline of kidney function was significantly slower after they started PD than it was when they were predialysis (p<0.01).

Read the abstract » | (added 2016-04-12)

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Less Severe Itching With PD Than In-center HD

Among 380 people on PD or in-center HD, fewer on PD had uremic pruritus (itching) (28.6% vs. 38.2%). And, the itching was less severe in those who did PD, and affected less of the body. Those with higher levels of active vitamin D had less intense itching. Those with higher blood levels of phosphorus, triglycerides, and AST had more itching problems.

Read the abstract » | (added 2016-03-10)

Tags: Hemodialysis

Kidney to Kidney: 2008K@Home and NxStage System One

Among home HD patients followed for a year, there were a few differences between users of the 2008K@Home and the NxStage System One. 2008K@Home users did not do treatments as often—but their mean standardized Kt/Vs were significantly higher (2.75 vs. 1.99). System One users tended to use less EPO. Other outcomes and lab test values were largely similar.

Read the abstract » | (added 2016-03-10)

Tags: Hemodialysis

Update on Implantable and Bioengineered Kidneys

A new review focuses on two implantable innovations that may reduce the need for dialysis. An artificial kidney is a biohybrid system that will mimic renal structure and function. A bioengineered kidney will be based on native kidneys.

Read the abstract » | (added 2016-03-10)

Tags: Hemodialysis

Sleep Problems With Automated PD

Compared to people with stage 3b-5 CKD (n=89), those using a cycler for PD (n=22) had about the same, higher level of sleep problems as those on standard HD (n=75). In-home sleep measures and surveys found low levels of oxygen during sleep, and disrupted sleep cycles.

Read the abstract » | (added 2016-03-10)

Tags: Hemodialysis

CKD Case Management Boosts PD Use

A Fresenius program of renal care coordinators (RCCs) in late-stage CKD helped ease the transition onto dialysis. Compared to non-participants (693), the 738 patients with RCC case managers were more likely to start PD or have a permanent vascular access for HD, and have a serum albumin level >4.0g/dL.

Read the abstract » | (added 2016-03-10)

Tags: Hemodialysis