Journal Watch
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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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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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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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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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RCT Finds that Ginger Supplements Lower Triglycerides in People on PD
A small (n=36), randomized, double-blind, controlled trial tested ginger supplements (1000 mg/day) vs. placebo in people on PD. After 10 weeks, serum triglycerides dropped by up to 15% from baseline in the ginger group, which may reduce cardiovascular disease risk. Total cholesterol, LDL-C, HDL-C, and Lp(a) levels did not change.
Read the abstract » | (added 2015-11-11)
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Encapsulating Peritoneal Sclerosis Increases with Time on PD
EPS is a devastating PD complication that can be lethal. An Italian clinic looked back at 30 years worth of data and found EPS prevalence rates of 2.8% overall among 920 patients: 0.4% for <2 years of PD, 3% at 2-4 years, 4% at 4-6 years, 6% at 6-8 years, 8% at 8-10 years, 75% by 12-14 years, and 67% for those with 14+ years of PD. Steroid treatment helped reduce mortality.
Read the abstract » | (added 2015-11-11)
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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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Decision Support Helps Match Treatments with Preferred Lifestyles
In Spain, 569 of 1,044 patients in 26 hospitals who had to choose a renal replacement therapy (RRT) option between September 2010 and May 2012 used a decision aid to help them decide, and 399 started treatment. Those who did use a decision aid changed their minds significantly less often and were more likely to begin the treatment they chose. There was about a 50/50 distribution of PD and standard HD, and an increase in transplant interest as well—even among those with unplanned dialysis starts. See MEI’s U.S. decision aid, My Life, My Dialysis Choice.
Read the abstract » | (added 2015-11-11)
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