Journal Watch
Is low blood sodium as harmful in PD as it is in HD?
Hyponatremia (low blood sodium levels) raise the risk of death in people who do standard in-center HD. A prospective observational study of 441 incident PD patients found a higher mortality risk among those who did PD, too. In fact, after 3 years, the 1/3 of study participants whose sodium was lowest had a 79% higher risk of death than those whose levels were higher.
Read the abstract » | (added 2014-12-09)
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Nocturnal HD reduces blood endotoxin levels
Endotoxin drives inflammation throughout the body. Which type of HD is most effective at reducing endotoxin in the blood? This study compared standard in-center HD (n=56) to short daily HD (n=20) and nocturnal HD (N=10). Endotoxin levels were highest when ultrafiltration rates were highest (standard in-center HD) and lowest among those doing nocturnal HD.
Read the abstract » | (added 2014-12-09)
Tags: Nocturnal Hemodialysis
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
Don’t trust glucometers on people using PD with icodextrin
Glucometer test strips can’t distinguish glucose from other sugars, like maltose. When icodextrin is used for PD in people with diabetes, standard glucometer use is risky. Blood glucose test results from glucometers can’t be trusted, and people may be given insulin they don’t need (which could cause coma or death). Three case reports show why this is the case—and the authors suggest using glucose-specific blood tests instead.
Read the abstract » | (added 2014-12-09)
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How to prescribe intensive home HD: A guide for the nephrologist
This article describes each of the types of intensive home HD, and offers prescription guidance from experts.
Read the abstract » | (added 2014-12-09)
Tags: Home dialysis
More protein intake with nocturnal HD—but no change in body composition
Among 11 people doing nocturnal HD, protein intake increased significantly compared to matched standard in-center HD controls. But, one year later, total body mass, fat-free mass, and fat mass did not change.
Read the abstract » | (added 2014-12-09)
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
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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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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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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