Journal Watch
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Survival on PD is Better with Normal Magnesium Levels
A retrospective study of 253 incident PD patients followed for up to 10 years found that deaths due to cardiovascular causes (58.3%) were linked with low serum magnesium levels. Low serum albumin, and levels of triglycerides, potassium, calcium, and phosphate were also important. Those in the group with the lowest magnesium had significantly higher all-cause mortality (p<0.001).
Read the abstract » | (added 2016-04-12)
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PD Catheter Placement: Does Timing Matter?
Do patients who are able to wait 14 days before using a PD catheter have less peritonitis than those who use it sooner? Can they do PD longer? Do they live longer? There were no significant differences in any of these parameters, finds a new observational study of 149 patients, 80 early and 69 delayed. (NOTE: This is good news for early start PD.)
Read the abstract » | (added 2016-04-12)
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Urea Alone is Not a Good Index of Dialysis Dose
All-cause mortality in the HEMO study was not significantly related to removal of small solutes in short, intermittent, standard HD. “Failure to achieve greater reductions in solute levels may explain the failure of high Kt/V urea treatment to improve outcomes,” the authors note. (Yet another reanalysis of the HEMO study data has confirmed the obvious…)
Read the abstract » | (added 2016-04-12)
Tags: Hemodialysis
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Survival on PD vs. Daily Home HD
A USRDS study matched 3,142 people starting daily home HD with 2,688 starting PD and compared survival. Those who were doing short daily HD had 12.7 deaths per 100 patient years, vs. 16.7 in the PD group.
Read the abstract » | (added 2016-04-12)
Tags: Hemodialysis
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If One PD Exit Site Antibiotic is Good, Are Two Better?
In a single center study, 146 people on PD were randomized to use gentamycin cream on their exit sites (n=71) or to switch between gentamycin in odd months and mupirocin in even months (n=75). After 174 (gentamycin) or 181 patient years (alternating), the group switching between two antibiotics had significantly more peritonitis, especially gram-negative and fungal.
Read the abstract » | (added 2016-04-12)
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Milk Thistle Extract Improved Hemoglobin and Albumin in PD
Silymarin is an antioxidant. Among 50 people on PD randomly assigned to take silymarin (n=28) or a control (n=22) for 2 months, those who took the supplement three times a day had significantly higher antioxidant levels. They also had significant increases in hemoglobin and albumin levels at the p<0.05 level. (NOTE: Always inform a nephrologist of any supplement use.)
Read the abstract » | (added 2016-04-12)
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Metaanalysis: Better PD Catheter Outcomes Via Laparoscope
An analysis of five randomized trials and 11 cohort studies compared laparoscopic PD catheter placement to surgery. The laparoscopic approach had less catheter migration and the catheters lasted longer, though there was a slightly higher risk of bleeding.
Read the abstract » | (added 2016-03-10)
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CKD Case Management Boosts PD Use
A Fresenius program of renal care coordinators (RCCs) in late-stage CKD helped ease the transition onto dialysis. Compared to non-participants (693), the 738 patients with RCC case managers were more likely to start PD or have a permanent vascular access for HD, and have a serum albumin level >4.0g/dL.
Read the abstract » | (added 2016-03-10)
Tags: Hemodialysis
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ISPD Releases Free PD Teaching Syllabus
The Nursing Liaison Committee of the International Society for Peritoneal Dialysis (ISPD) has reviewed PD training programs from around the world. An expert group has developed a consensus document to help PD nurses train patients and care partners. The free curriculum is flexible, based on adult learning principles, and includes checklists.
Read the abstract » | (added 2016-03-10)
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Kidney to Kidney: 2008K@Home and NxStage System One
Among home HD patients followed for a year, there were a few differences between users of the 2008K@Home and the NxStage System One. 2008K@Home users did not do treatments as often—but their mean standardized Kt/Vs were significantly higher (2.75 vs. 1.99). System One users tended to use less EPO. Other outcomes and lab test values were largely similar.
Read the abstract » | (added 2016-03-10)
Tags: Hemodialysis