Kinetic modeling helps predict best PD prescription

Researchers found 12 subgroups among 1,005 people on PD, based on their membrane transport and amount of body water. Using PD Adequest 2.0, patients each had a PD prescription tailored to reach a minimum adequacy target for urea and water, using glucose and icodextrin fluids. A cut-off of more or less than 2mL/min of residual kidney function was identified. Use of icodextrin simplified the regimen and reduced glucose exposure and PD fluid volumes.

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

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CRP levels and abdominal CT scans can find EPS early

A look back at CT scans and c-reactive protein levels from 30 people diagnosed with encapsulating peritoneal sclerosis has provided clues for early diagnosis. Higher than normal levels of c-reactive protein plus abnormal CT scan results found the rare complication early 78% to 87% of the time—making effective treatment more possible.

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

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Home HD has 20% lower all-cause mortality than PD

In a new study that matched 4,201 new home HD patients in the USRDS database to new PD patients, the risk of all-cause mortality was 20% lower with home HD. In addition, there was an 8% lower risk of hospitalization, and a 37% lower risk of technique failure.

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

Tags: Home dialysis

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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Peritoneal cavity model will help the study of fibrosis

Researchers have devised a model peritoneum that allows them to study the impact of PD on the cells. The model has a mesothelial layer, an endothelial layer, and a collagen membrane chamber. When used for simulated PD, various solutions had different effects on the cells—but reduced nitric oxide production seems to be a mechanism for fibrosis. This new tool may lead to new ways to prevent and treat peritoneal fibrosis.

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

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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

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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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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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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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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