U.S. barriers to home dialysis treatments

Home dialysis is underused in the U.S., and a committee of the International Society for Peritoneal Dialysis has looked at why that may be. The group organized the barriers into three groups: educational, government/regulatory, and dialysis practice, and is looking at strategies to address each.

Read the abstract » | (added 2011-09-29)

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Mucomyst does not prevent nephrogenic systemic sclerosis

A new study randomized 2,308 people at risk for kidney injury from contrast dye into two groups. One group was given acetylcysteine (Mucomyst®) by mouth, a strong antioxidant. The other group was given a placebo. Both groups had the same rate of kidney injury and need for dialysis.

Read the abstract » | (added 2011-09-29)

Tags: Chronic kidney disease

Basing dialysis dose on REAL toxins

Dialysis "adequacy" is based on removing urea—a waste that is not all that toxic. A new article points out that finding and choosing wastes that truly are toxic could change the way we measure dialysis for the better.

Read the abstract » | (added 2011-09-29)

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Using L-carnitine instead of sugar for PD fluid

Over time, sugar can harm the peritoneal membrane so it can't be used for PD. L-carnitine is a substance the body needs for energy. In a new rat study, PD fluid with L-carnitine removed as much—or more—water and wastes as sugar-based fluid. The new fluid was well tolerated and did not damage the peritoneum.

Read the abstract » | (added 2011-09-29)

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Standard PD fluids work just as well as biocompatible ones

A randomized controlled trial compared standard PD fluid to biocompatible PD fluid in 267 patients (for 7000+ dialysis months). There were no differences in PD technique survival or peritonitis between the groups.

Read the abstract » | (added 2011-08-25)

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Home HD and mortality risk in Australia and New Zealand

Researchers analyzed data from 26,016 patients in the ANZDATA registry (856,007 patient-months) to see if home HD helped people live longer. Compared to standard in-center HD, those on standard (3x/week), more-frequent, or nocturnal home HD were about twice as likely to survive.

Read the abstract » | (added 2011-08-25)

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Tweaking the PD cycler prescription can have big payoffs

Changing dwell time make a difference in how well PD works, finds a new, randomized crossover study of 19 patients. All received the same number of hours of PD using the same PD fluid prescription. But instead of doing several exchanges each with the same dwell time and volume, the researchers first used a short dwell time with a small fill volume to remove water, then a longer dwell time and larger volume to remove wastes. The change significantly improved urea, creatinine, phosphorus, water removal, and mean blood pressure. (To learn more about how to adjust a PD prescription, read our Life@Home article on the topic by Joanne Bargman: Tailoring automated PD to your life.)

Read the abstract » | (added 2011-08-25)

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Blood glucose meters may overestimate blood sugar levels when Icodextrin PD fluid is used

If you use a blood sugar monitor, you need to be able to trust the results. But, they may not be accurate if you use Icodextrin PD fluid. A case report of four people with insulin-dependent diabetes found that their blood sugar monitor readings were normal—at the same time that their hospital drawn blood sugars were dangerously low.

Read the abstract » | (added 2011-07-26)

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The frontier of regenerative medicine—what it can mean for kidney disease

While dialysis can remove wastes and excess water from the blood, it can't replace or respond to hormones like healthy kidneys do. Regenerative medicine is at the cutting edge of efforts to grow kidney cells in the lab—with the goal of one day growing new kidneys. And, that day may not be far off.

Read the abstract » | (added 2011-07-26)

Tags: Chronic kidney disease

Changing the treatment options paradigm: Home vs. in-center, not PD vs. HD

Traditional ESRD treatment options education divides the choice into PD vs. HD, and then looks at home HD. Drs. Thodis and Oreopoulos suggest that it makes more sense to look at home (PD and HD) vs. in-center instead.

Read the abstract » | (added 2011-07-26)

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