Journal Watch
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New hope for stopping peritoneal fibrosis
There are vitamin D receptors all over the body. Low levels of vitamin D have been linked with severe fibrosis. This study gave mice peritoneal fibrosis and then looked at the impact of treatment with a vitamin D analog (22-oxacalcitriol). The treatment significantly prevented fibrosis and thickening of the peritoneum.
Read the abstract » | (added 2013-04-29)
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New from Australia: Outcomes of extended HD (mainly done at home)
In a series of 286 people doing extended HD, 96% received their treatments at home, and 77% did them at night. Survival was 98% at 1 year, 92% at 3 years, and 83% at 5 years.
Read the abstract » | (added 2013-02-27)
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PD corrects metabolic acidosis better than standard in-center HD
Too-low bicarbonate levels are a risk factor for death. Among 110,951 standard in-center HD patients and 10,400 PD patients, bicarb levels were much lower in those on PD. Survival data suggest that it is safest to keep bicarb levels higher than 22mEq/L for all ESRD patients—on any modality.
Read the abstract » | (added 2013-02-27)
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Home HD beliefs of patients and care partners in Italy
Home HD is underused in Italy. Interviews found three positive themes: flexibility/freedom, comfort in familiar surroundings, and altruistic motivation to be an example for others. Four negative themes were also found: disrupted sense of normality, family burden, housing constraints, and healthcare by "professionals", not "amateurs".
Read the abstract » | (added 2013-02-27)
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Alert: Icodextrin PD fluid can mask hypoglycemia
A case report of an 80 year old man in the emergency room highlights the need for healthcare providers to be aware of the impact of icodextrin PD fluid on blood sugar. Handheld glucose meters can overestimate blood sugar. A lab test can verify blood sugar if symptoms of hypoglycema are present and the glucometer reading is normal.
Read the abstract » | (added 2013-02-27)
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Wearable and implantable kidney devices
The current standard in-center paradigm needs to change, say the authors of this review. Radically new approaches are needed to improve patient outcomes and quality of life. Two such approaches on the horizon are wearable and implantable devices.
Read the abstract » | (added 2013-02-27)
Tags: Chronic kidney disease
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Mortality patterns in PD & home HD differ from standard in-center HD
In the Australian dialysis database (ANZDATA), 4,298 deaths on PD and 10,338 on HD were analyzed for patterns. Patients who did PD, home HD, or in-center HD more than 3 days per week were equally likely to die on any day of the week. Not so for standard in-center HD patients: they were significantly more likely to die from heart-related reasons on Monday, after the 2-day no-treatment weekend.
Read the abstract » | (added 2013-02-27)
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Multidisciplinary training to reduce peritonitis in PD
Researchers in Uruguay developed a tool to assess practical PD skills. They found that one on one lessons, retraining, and group meetings for PD patients cut the peritonitis rate nearly in half.
Read the abstract » | (added 2013-02-27)
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What does glucose in PD fluid have to do with artery calcification?
Quite a bit, it appears. Among 50 people doing PD who did not have diabetes, about half had coronary artery calcification. Those who used more higher glucose PD fluids were more likely to have the problem, as were men with a history of heart disease, and those who did not get enough PD.
Read the abstract » | (added 2013-01-25)
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Surgery to fix PD catheters in place is safe, effective
PD catheters that move around in the belly can be painful and may stop working. Korean doctors compared 22 PD catheters placed by a laparoscopic technique that fixed them in place to 32 placed by open surgery. The age and sex of both groups was the same, and the fixing technique took longer to do. But, 29 months later, the fixed catheters were much less likely to move (13.6% vs. 65.6%). Both techniques had the same catheter and patient survival.
Read the abstract » | (added 2013-01-25)
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