Journal Watch
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Chlorhexidine vs. Ethanol for Buttonhole AVF Disinfection
A randomized, cross-over trial compared 5mg/mL chlorhexidine in 70% ethanol vs. 70% ethanol alone in four dialysis treatments. Factors considered were arm washing, serial sampling of normal skin flora immediately before/after disinfection, and 2 and 4 hours after disinfection. Buttonhole scabs were collected and compared to each patient’s normal skin flora. Chlorhexidine was more effective than ethanol alone.
Read the abstract » | (added 2025-08-21)
Tags: Chlorhexidine, Ethanol, Skin Flora, Disinfection, AV Fistula, Buttonhole
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PD or HD: Which Has the Higher Risk of Infective Endocarditis (IE)?
In a retrospective analysis of 215,965 people with ESRD and more than a million age- and sex-matched people without it, IE incidence was lower in the PD group. For those doing HD, the IE incidence was lowest for those dialyzing with an AVF.
Read the abstract » | (added 2025-07-16)
Tags: ESRD, Infective Endocarditis, HD, PD
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U.S. PD Outcome Trends: 2009 to 2018
A USRDS analysis of data from 101,640 incident PD patients found a decrease in overall mortality from 11% (2009) to 8.4% (2018). The probability of switching to in-center HD a year after PD initiation also dropped by about 2% in patients under 75 years old.
Read the abstract » | (added 2025-07-16)
Tags: Chronic Dialysis, Incident PD , Mortality, Peritoneal Dialysis, Clinical Epidemiology
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PD Outcomes Predicted by the Triglyceride-Glucose (TyG) Index
An index based on low-cost blood tests may help predict mortality, peritonitis, and technical failure on PD. Among 354 CAPD patients stratified into TyG tertiles, the highest tertile experienced significantly higher all-cause and cardiovascular death over a median of 72 months of follow-up than the lowest tertile.
Read the abstract » | (added 2025-07-16)
Tags: PD Outcomes, Triglyceride Glucose Index, Mortality, Peritonitis, CAPD
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Impact of Embedded PD Catheters on Peritonitis and Mortality
Moncrief and Popovich pioneered a buried PD catheter technique (inexplicably abbreviated as SMAP). In a study, outcomes of 285 consecutive patients who had PD catheters implanted either directly (n=96) or via SMAP (n=189) were analyzed retrospectively. Both the risks of peritonitis and mortality were significantly lower in the SMAP group.
Read the abstract » | (added 2025-07-16)
Tags: Embedded PD Catheters, Peritonitis, Mortality, Moncrief And Popovich Technique
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Urgent-start HD (USHD) vs. Urgent-start PD (USPD): A Meta-analysis
Compiled data from seven studies and 1,338 patients found significantly fewer complications (infectious and noninfectious) and mortality with USPD than with USHD. The authors concluded that USPD patients “could potentially function as an appropriate replacement for USHD.”
Read the abstract » | (added 2025-07-16)
Tags: Urgent start HD, Urgent start PD
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In-center Hemodialysis Had the Highest Annual, Per-patient Carbon Footprint
Using comparative life cycle assessment methodology, the team identified the sources and extent of carbon emissions for all dialysis modalities. Compared to home HD (2,938 Kg CO2e), CAPD (1,969 Kg CO2e), and APD (3,339 Kg CO2e), an Australian study found significantly higher carbon impact with in-center HD (4,814 Kg CO2e).
Read the abstract » | (added 2025-07-16)
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Home HD with a B. Braun Machine
A small, retrospective study compared data from 27 patients using a B. Braun Dialog HD machine for home HD to 36 using a NxStage System One. The B. Braun had significantly higher spKt/V), standard weekly Kt/V, and urea reduction rate, despite significantly shorter treatments at higher UFRs. Of lab data, lower serum bicarbonate levels with B. Braun were the only significant difference.
Read the abstract » | (added 2025-06-11)
Tags: B. Braun Machine, Home HD, NxStage System One, Kt/V, Urea Reduction, Serum Bicarbonate Level
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U.S. Equity in Home Dialysis Choice
Why are African- and Mexican-Americans less likely to use home dialysis? Focus groups in five U.S. cities found that physician guidance was the most important factor, though African Americans wanted validation and additional modality education when ready, while Mexican American participants had more trust. Fear of sole responsibility and loss of in-center fellow patient support were barriers.
Read the abstract » | (added 2025-06-11)
Tags: African Americans, Mexican Americans, Home Dialysis, Focus Group, Physician Guidance, Modality Education
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Nocturnal HD and Myocardial Stretch
Over a 12-month period, 32 standard HD patients who chose to switch to nocturnal HD patients had significantly lower levels of a marker of volume overload/myocardial stretch (n-terminal pro-B-type natriuretic peptide) than 33 who stayed on standard HD.
Read the abstract » | (added 2025-06-11)
Tags: Nocturnal HD, Cardiovascular Biomarkers, Myocardial Stretch