Journal Watch
More Inflammation With Standard HD Than With PD
Inflammation can lead to heart damage and poor outcomes. Two 3-month prospective studies with 228 HD and 80 PD patients measured two markers of inflammation: CRP and IL-6. In HD patients, these levels were both higher and more variable than in PD.
Read the abstract » | (added 2016-06-08)
Tags: Hemodialysis
Glucose in PD Solution Affects Non-Diabetic Patients, Too
Among 640 PD patients from three countries studied for up to 6.4 years, serum glucose levels rose with age and with higher dialysate glucose. In 5.4% of the sample, the levels suggested undiagnosed diabetes.
Read the abstract » | (added 2016-06-08)
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Nocturnal HD Protects Bones Better Than Standard HD
Compared to 52 patients on conventional HD, 36 patients on nocturnal HD had better bone mineral density at the lumbar spine, femoral neck, and hip after one year.
Read the abstract » | (added 2016-06-08)
Tags: Hemodialysis
Patient Costs As A Challenge For Home Dialysis Choice
Interviews with 43 home dialysis patients and 9 care partners found that fears of lost work productivity, out of pocket expenses, and socioeconomic disadvantage were challenges to choosing home dialysis. Patients weighed flexibility against training time and costs, and housing was not always suitable.
Read the abstract » | (added 2016-06-08)
Tags: Hemodialysis
WAK Clearance of Potassium and Phosphorus in Goats
Wearable dialysis could ease fluctuations in potassium and phosphorus vs. intermittent HD. A sorbent based wearable device tested on goats found constant levels of potassium and phosphate adsorption.
Read the abstract » | (added 2016-06-08)
Low Blood Magnesium Levels Risky On PD
Most magnesium in the body is not in the blood. And, very low blood levels (<1.8 mg/dL) were linked with higher rates of hospital stays and death among 10,692 people on PD. The greatest hospital risk was in patients who also had low (<3.5g/dL) serum albumin levels.
Read the abstract » | (added 2016-06-08)
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Mechanisms of Peritoneal Membrane Fibrosis
Glucose in PD solution activates a cell protein in mice that typically prevents fibrosis when it is not activated. This pathway leads to inflammation, growth of new blood vessels, and fibrosis—so finding a way to switch it off could lead to new drugs to help prevent these problems.
Read the abstract » | (added 2016-06-08)
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Metaanalysis of Patient Education and Choice of PD
An analysis of 15 studies (including one randomized controlled trial and 9 observational studies) found that patient-targeted education tripled the odds that patients would intend to use PD as a first treatment option.
Read the abstract » | (added 2016-05-12)
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Glycated Albumin More Accurate in PD than Glycated Hemoglobin
Using hemoglobin A1c levels to assess glycemic control in people with diabetes using PD is risky, because anemia causes false negative results. In a 6-month study, 20 people with diabetes using HD were matched for age, sex, and post-meal glucose levels with people with diabetes using PD. In a multiple regression analysis, glycated albumin was the only independent predictor of plasma glucose levels.
Read the abstract » | (added 2016-05-12)
Tags: Hemodialysis
Kt/V Urea Should NOT Be Used as an Adequacy Measure for PD
Since the National Cooperative Dialysis Study, PD adequacy attention has focused on urea clearance, rather than on the more important benefit of middle molecule clearance. In this opinion piece, Dr. Joanne Bargman asserts that the PD community “made a mistake” adopting urea kinetics to the peritoneal dialysis process,” an error that continues to this day despite the lack of evidence linking Kt/V to outcomes in PD patients.
Read the abstract » | (added 2016-05-12)
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