Journal Watch
Cochrane database review favors home HD over standard in-center HD
Just one, small (n=9) randomized controlled trial (RCT) lasting 8 weeks could be found that looked at home HD (extended) vs. standard in-center HD in adults. But, based on this, the Cochrane Database Systematic Review was able to get a paper published. Home HD reduced 24 hour blood pressure and improved uremic symptoms. The authors recommend more RCTs.
Read the abstract » | (added 2014-12-09)
Tags: Home dialysis
On PD, motivation matters
With the changes in the bundle, more people are being started on PD. In a study of 104 people on PD followed for 14 months, nurse ratings of home cleanliness or patients’ exchange techniques did not predict outcomes. Instead, unmotivated or depressed people were significantly more likely to have peritonitis.
Read the abstract » | (added 2014-12-09)
Tags: Peritonitis
Older patients may make less informed options decisions
In a study of 99 people on dialysis in North Carolina, those who were over age 65 reported significantly less informed decision making. They were less likely to say that the doctor had explained their health problems, and more likely to feel that the doctor made a choice for them.
Read the abstract » | (added 2014-11-07)
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Are portable or wearable kidney devices on the horizon?
Nanotechnology may allow for a new generation of wearable and portable devices to treat kidney failure. Some are now in large animal and human trials. A new day may be coming.
Read the abstract » | (added 2014-11-07)
Tags: Chronic kidney disease
Short-term transfer from PD to HD was not harmful
Peritonitis may require a switch to HD for a while. Does this affect patient or technique survival? No, finds an Australian study that looked at 8 years of people new to PD and matched PD-to-HD-and-back switchers to those who stayed just on PD or HD.
Read the abstract » | (added 2014-11-07)
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mTOR inhibitors may treat encapsulating peritoneal sclerosis
In a case study report, a class of drugs that includes Rapamycin (sirolimus) was used to successfully treat a 16 year old who developed EPS after a switch from PD to HD. mTOR inhibitors help keep new blood vessels from growing.
Read the abstract » | (added 2014-11-07)
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Nocturnal home HD boosts hemoglobin level and reduces ESA use
Every other night nocturnal home HD (NHHD) was compared to standard in-center HD in a small study. Among the 23 people using NHHD, Hemoglobin increased by about 2 g/dL after 2 years (P<0.001), while ESA dose dropped by just over 50% (P<0.001), and 26% were able to stop ESAs. Among the 25 people doing standard HD, hemoglobin levels dropped by almost 2 g/dL (P = 0.007), and ESA dosage increased (P<0.001).
Read the abstract » | (added 2014-10-07)
Biocompatible PD fluid may preserve long-term residual kidney function
A metaanalysis of 11 studies (n=1,034) found that biocompatible PD fluid did not boost residual kidney function (RKF) in the short term. But, at 12 months or more, there was a long-term preservation of RKF.
Read the abstract » | (added 2014-10-07)
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Home therapies: Better outcomes
A review article suggests that outcomes for PD and home HD are as good—or better—than those for standard in-center HD. PD use in the US has grown after the Medicare bundle created an incentive for its use. Home therapies are effective and patient-centered treatments.
Read the abstract » | (added 2014-10-07)
Tags: Home dialysis
PD catheter tunnel and exit site infections more likely with poor glycemic control—but not peritonitis
Diabetes is known to raise the risk of infection. A study that looked back at blood sugar levels of 183 people new to PD, those with poor glycemic control had almost twice as many catheter tunnel and exit site infections, and had a first infection much sooner (p = 0.004). But, there was no increase in the risk of peritonitis.
Read the abstract » | (added 2014-10-07)
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