Calculating the dialysis dose for a wearable artificial kidney

How do you set a dialysis dose for a 24/7 continuous HD therapy? Using kinetic modeling, researchers developed theoretical doses that would be needed to achieve certain creatinine concentration targets. Interestingly, fluid intake did not affect the predicted clearances.

Read the abstract » | (added 2015-09-11)

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Medihoney <i>Does</i> Equal Mupirocin for PD Infection Control

While Medihoney did not reduce overall PD infections, a substudy of the “Honeypot” trial did find positive results. Among 371 PD patients randomized to daily exit site antibacterial honey or nasal mupirocin (for staph carriers), rates of both exit site infections and peritonitis were equivalent. NOTE: Honey does not create antibiotic resistant bacteria, which is a plus.

Read the abstract » | (added 2015-08-08)

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High Phosphorus Levels on PD Risk Heart Vessel Calcification

Among 157 people on PD who had three or more scans for coronary artery calcification, high serum phosphorus levels were an independent risk factor for faster progression of the problem, along with age.

Read the abstract » | (added 2015-08-08)

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PD Preserves Patient Jobs Compared to Standard In-center HD

In Japan, at least (and these questions are rarely looked at in the US), a study of social functioning on PD vs. standard in-center HD found an advantage for PD. Among 179 patients (102 PD and 77 HD), the odds of becoming unemployed after treatment were 5.02 fold lower with PD.

Read the abstract » | (added 2015-08-08)

Tags: Home dialysis

Brazil APD Survival Significantly Better than CAPD

A prospective study matched each of the incident APD patients in Brazil with a CAPD patient, using 15 matching factors, and looked at mortality, technique failure, and time to first peritonitis. With 1,445 patients each in the APD and CAPD groups, the researchers found 44% higher mortality among CAPD patients, but no differences in technique failure or time to peritonitis.

Read the abstract » | (added 2015-08-08)

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Assisted PD Not a Large Burden for Care Partners

Not everyone can do PD without assistance, so what is the cost of this help for a care partner? Not too much, finds a study of 231 PD patients (89 assisted), 72 care partners, and 39 family members of self-care patients. Family members who helped with PD had more task-oriented duties, but did not perceive any greater of a burden than those whose loved one did not need help.

Read the abstract » | (added 2015-08-08)

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Where Are We With Wearable Artificial Kidneys?

Sorbent and enzyme technologies are helping forward movement in the WAK world, but the long-time Achilles heel of hemodialysis—vascular access—along with anticoagulation and regulations are still challenges.

Read the abstract » | (added 2015-08-08)

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Low Molecular Weight Heparins for Nocturnal HD

A small Netherlands study of in-center nocturnal HD suggests that two divided doses may work best for low molecular weight heparins dalteparin and nadroparin. Careful dosing is needed to obtain the right level of anticoagulation and avoid overcorrection. Dalteparin required higher doses than nadroparin.

Read the abstract » | (added 2015-08-08)

Tags: Home dialysis

Metaanalysis: PD fluid with fewer GDPs improves outcomes

Glucose degradation products (GDPs) are known to damage the delicate peritoneum. PD fluids with neutral pH and low levels of GDPs were reviewed in a new study of 11 randomized controlled trials (n=643). While most of the studies were of poor quality, low-GDP PD fluid was better at preserving residual kidney function and urine volume for a year than standard PD fluid.

Read the abstract » | (added 2015-07-08)

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Outcomes of “integrated home dialysis” (PD then home HD)

What happens to people after PD fails—and why not plan to get them home on HD? Researchers in Australia and New Zealand looked at this model using ANZDATA registry data. Those treated with PD only (n=168) had the highest risk of technique failure and death, while those who did only home HD or who transitioned from PD to home HD fared much better.

Read the abstract » | (added 2015-07-08)

Tags: Home dialysis