Journal Watch
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Outcomes of “integrated home dialysis” (PD then home HD)
What happens to people after PD fails—and why not plan to get them home on HD? Researchers in Australia and New Zealand looked at this model using ANZDATA registry data. Those treated with PD only (n=168) had the highest risk of technique failure and death, while those who did only home HD or who transitioned from PD to home HD fared much better.
Read the abstract » | (added 2015-07-08)
Tags: Home dialysis
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Metaanalysis: PD fluid with fewer GDPs improves outcomes
Glucose degradation products (GDPs) are known to damage the delicate peritoneum. PD fluids with neutral pH and low levels of GDPs were reviewed in a new study of 11 randomized controlled trials (n=643). While most of the studies were of poor quality, low-GDP PD fluid was better at preserving residual kidney function and urine volume for a year than standard PD fluid.
Read the abstract » | (added 2015-07-08)
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New self-cannulation aid: Tattoo dots
In a case report of a patient who had a hard-to-feel fistula, small dots were tattooed to guide cannulation. With the permanent dots in place, the individual was able to self-cannulate and do home hemodialysis successfully.
Read the abstract » | (added 2015-06-10)
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Status Report: Home HD in Japan
While just 0.1% of all Japanese people on dialysis use home HD, this number has been growing quickly. Work groups of the Japanese Society for Home Hemodialysis have been set up to start a patient registry and advise on supply and wastes and the cost burden for those who self-pay. Further challenges will include recruitment, education, a business model, and more.
Read the abstract » | (added 2015-06-10)
Tags: Home dialysis
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Metaanalysis of best practices in pregnancy on dialysis
What works best to ensure a healthy baby if women on dialysis become pregnant? A systematic literature analysis found that long-hour HD has the most support, while correcting vitamin B12, folate, iron, anemia, vitamin D, and calcium levels is also important. Success rates of greater than 75% are possible.
Read the abstract » | (added 2015-06-10)
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Progress toward reengineering catheters to reduce infection
Can we eliminate exit site infections by redesigning catheters? Bioengineers are working on a way to create a biological seal that would keep germs out. A new device being tested uses a removable protective membrane that slowly grows out of the body, leaving a dry groove that reduces infections—at least in goats.
Read the abstract » | (added 2015-06-10)
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PKD liver and kidney size may limit PD
In Japan, oversized polycystic kidneys may be treated with transcatheter arterial embolization (TAE) to cut off their blood supply and shrink them. Among two small groups of people with PKD, even those with reduced kidney volume still tended to develop hernias.
Read the abstract » | (added 2015-06-10)
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Gene therapy via nanoparticles reduces peritoneal fibrosis in mice
Gene therapies may reduce peritoneal fibrosis—a leading cause of PD failure. Delivering transforming growth factor using nanoparticles worked in a mouse study.
Read the abstract » | (added 2015-05-09)
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Ultrasound can measure peritoneal wall thickness in children
Fibrosis of the peritoneum can cause PD failure. But, peritoneal wall thickness can be measured with a painless ultrasound. The results can assess whether the peritoneum is changing over time.
Read the abstract » | (added 2015-05-09)
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New index more accurate than Kt/V for PD “adequacy”
It’s no secret that we at Home Dialysis Central are not fans of Kt/V for HD (or the concept of “adequacy”). A new European study suggests that Kt/V is not useful for PD, either (because it does not account for protein intake), and has tested a substitute index that works better.
Read the abstract » | (added 2015-05-09)
Tags: Home dialysis