Journal Watch
PD After Loss of Residual Kidney Failure
Once residual kidney function is gone, it is vital to address fluid volume, finds a new study that followed 183 people. During the 10.5-36 months of follow up, 65% either switched to HD or died. Their inflammation rates (measured by C-reactive protein levels) were high, as were their extracellular water levels (measured by bioelectrical impedance analysis).
Read the abstract » | (added 2016-01-10)
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Using Plant-Protectant Resveratrol to Preserve the Peritoneum
Resveratrol is a phenol found in the skins of grapes and some berries that can help keep blood vessels from growing to support tumors. A new prospective, randomized, controlled, double blind study looked at its use to keep blood vessels from growing in the peritoneum, which can cause PD technique failure. Participants (n=72) were given 12 weeks of low- or high-dose resveratrol or placebo. Those who received a high dose of resveratrol had significantly better ultrafiltration.
Read the abstract » | (added 2016-01-10)
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RCT of Self-Locating PD Catheter Finds Fewer Flow Problems
Coiled or straight, Tenckhoff catheters often clog. A new small trial randomized 61 people to receive a straight Tenckhoff (n=32) or a new, self-locating Wolfram PD catheter (n=29) for urgent start PD. Seven of the Tenckhoff’s had to be swapped for Wolframs due to flow issues—but the reverse was not true.
Read the abstract » | (added 2015-12-10)
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Buttonhole Cannulation Does NOT Raise Infection Risk—at Satellite
AVF infection rates were examined among 162 patients from 1990 through 2012, which represents a changeover from rope ladder cannulation (1990-1998) to the Buttonhole technique (1998 onward). The difference in infection rates between the two techniques was not significant. Recurrence of AVF-infection was found only during time 2.
Read the abstract » | (added 2015-12-10)
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Liraglutide Has Multiple Benefits in People with Diabetes on PD
In a small study, injectable liraglutide was tested in 16 people with type 2 diabetes who use PD, 11 of whom were previously on insulin, while three used oral medications and two controlled their blood sugar using diet alone. After 12 months, glucose fluctuations were reduced, post-meal blood sugars were lower, systolic blood pressure dropped—and left ventricular mass decreased (on echocardiogram).
Read the abstract » | (added 2015-12-10)
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Gentamycin Ointment For PD Exit Sites Did Not Increase Antibiotic Resistance
A review compared 10 years PD exit-site care using oral rifampin and mupirocin ointment (n=265) with 10 years of gentamycin cream (n=179). While the demographics were largely similar apart from race, there were significantly fewer gram-negative exit site infections using gentamycin, with very low rates of gentamycin resistant infections in either period.
Read the abstract » | (added 2015-12-10)
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Home HD Has Shorter Recovery Time After Treatment Than In-Center HD
A UK study asked 288 people “how long does it take for you to recover from an HD session?” Compared to a mean of 193 minutes (3+ hours) for the 197 people dialyzing in-center, the 91 home dialyzors had a mean of 67.3 minutes (just over an hour). While conventional home HD vs. intensive home HD had similar results, those who made more urine recovered faster.
Read the abstract » | (added 2015-12-10)
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Meta-Analysis: Longer Dialysis, Better Pregnancy Outcomes
A new metaanlysis analyzed 190 papers and 25 abstracts covering 681 pregnancies in 647 women on dialysis. Meta-regression analysis found that more hours of HD per week was associated with a lower rate of preterm delivery, and that more dialysis sessions per week was associated with larger birthweight babies. Case reports suggested fewer small for gestational age babies with HD than with PD. No increased risk of birth defects was found.
Read the abstract » | (added 2015-12-10)
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Hydrogen Sulfide Reduces Peritoneal Fibrosis in Rats
Hydrogen sulfide has helped fibrosis of the lungs, liver, kidneys, and heart. In this study, peritoneal fibrosis was induced in rats. Using hydrogen sulfide decreased inflammation and fibrosis, and improved peritoneal function, and may become a future treatment to help people.
Read the abstract » | (added 2015-11-11)
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What Predicts Transfer to Home HD After PD Failure?
In Australia and New Zealand, an analysis of all 10,710 patients treated with PD between 2000 and 2012 found that 2,915 transferred to HD—but just 156 started home HD. Among those who switched to home HD, more were male, obese, and had done PD longer. Older patients, those who stopped PD due to infection, who were underweight, whose ESRD was due to hypertension or diabetes, and those who were Aboriginal were less likely to go home.
Read the abstract » | (added 2015-11-11)
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