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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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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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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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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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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UK Identifies Ways to Boost Use of Home HD
Commissioners in the West Midlands, where home dialysis rates had been falling for 10 years, set a target for home dialysis uptake. Comparing this area’s seven hospitals with the rest of England for 3 years before and after the target found significant increases at the study hospitals. Use of financial penalities, adding funding for specialist staff and equipment, having visible champions, good systems for patient training, and ongoing healthcare support at home all helped. Lack of training for non-specialists, poorly developed patient education, and patients’ unmet emotional needs are ongoing challenges.
Read the abstract » | (added 2015-11-11)
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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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Pelvic Drainage + Catheter Removal May Aid Refractory Peritonitis
Complications of peritonitis can go on even after PD catheter removal. A retrospective review of 46 patients with refractory peritonitis over 12-years found that the 12 who’d had pelvic drainage with closed active suction devices had an 8% future complication rate, vs. 44% in those who did not. None of the active drainage group needed further drainage or open laparotomy, while 35% of the non-drainage group did.
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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