Residual kidney function may drop faster with cycler PD than CAPD.

In a non-randomized Spanish study of 493 new PD users, residual kidney function (RKF) dropped faster in those who were younger, had less kidney function at the start, used PD fluid with more glucose, had higher blood pressure, or had peritonitis or heart disease. While cycler PD and CAPD rates of RKF were about the same, those who used a cycler were more likely to lose the rest of their function.

Read the abstract » | (added 2015-02-10)

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Urgent start PD: Better for Budgets than Urgent Start HD

A number of studies have found that urgent start PD is safe. But, does it save money, too, vs. placing a central venous catheter? Yes, finds a new study that surveyed practitioners: first 90 days costs for urgent start PD were estimated at $16,398, while for urgent start HD, the tab was $19,352.

Read the abstract » | (added 2015-01-08)

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Dealing with Home HD Technology: Patients and Families

An interview study was conducted with 19 home HD patients and carers who successfully used one of five different home HD machines. Respondents believed the machines were safe—but were still scared at first, and learned through mistakes. Machines that guide patients and carers (such as with step by step instructions) and help families communicate better with professionals (such as with remote monitoring) may be helpful.

Read the abstract » | (added 2015-01-08)

Tags: Home dialysis

Should Home Dialysis Be Mandatory for Suitable Patients?

Considering improved survival, dramatically better quality of life, and reduced cost, should home dialysis be the default option?

Read the abstract » | (added 2015-01-08)

Tags: Home dialysis

Review of Bioartificial Kidney Development

This article looks at state-of-the art efforts to duplicate kidney functions, including cell-based therapies, cell sourcing, organ scaffolding, and immune response.

Read the abstract » | (added 2015-01-08)

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Pilot Study: Flex Dialysis Facilitates Weight Loss

Patients who need to lose weight for better health or to obtain a transplant can be stymied by the strict diet limits of standard in-center HD. In a small series (four obese and two overweight patients), combining 2-6 sessions of flex, incremental HD with a coach-assisted weight loss program led to 5.7-20 kg weight loss over 12-30 months, better metabolic markers, and high patient satisfaction.

Read the abstract » | (added 2015-01-08)

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PD Catheter Placement with Nitrous Oxide

In a series of 87 patients, placement of PD catheters was done using nitrous oxide—including removal of the omentum and any adhesions. Just five patients required conversion to general anesthesia. After a year, 97.6% of the catheters were still working, and had not required any revisions.

Read the abstract » | (added 2015-01-08)

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Emergent-start PD works!

It flat-out makes more sense for people who need dialysis emergently to do PD, if possible, than to start HD with a catheter. A new review suggests that emergent-start PD may have a higher risk of catheter problems—but not infection. On the other hand, emergent-start HD risks both catheter problems and infection. The authors conclude that emergent-start PD is a “feasible, safe, and efficient alternative.”

Read the abstract » | (added 2014-12-09)

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New PD catheter technique uses Amplatz dilators

A laparoscope paired with Amplatz dilators to form the skin tunnel was used in 100 people who needed a PD catheter. The omentum was trimmed if it was long, and adhesions were lysed when present. There were no exit site or tunnel infections with this technique, and no catheter cuff extrusions. No catheters migrated or were displaced—and 97% of the catheters were working 6 months later.

Read the abstract » | (added 2014-12-09)

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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