Journal watch: CKD

Pregnancy and more dialysis

In general, pregnancy is uncommon in women with ESRD. But more dialysis seems to improve pregnancy outcomes. This review article addresses fertility issues, pregnancy, and suggestions for how to manage dialysis in pregnant women.

Implantable artificial kidney—progress

Three key bits of technology are needed to make an implantable artificial kidney possible: high efficiency membranes to remove water, a way to keep blood from clotting, and a way to mimic the selective action of kidney cells for removing wastes. Progress is occurring in each area.

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.

Patients educated about options are more likely to choose home

A new UK study surveyed 118 people with CKD who were not yet on dialysis. Those who were educated about their options were much more likely to plan for home treatment. The most important factor in their choice: fit of a treatment option with the preferred lifestyle.

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.

Ratios of Omega-6 to Omega-3 fats may impact health in kidney disease

Western diets tend to have too much omega 6 and not enough omega 3 fatty acids. In 145 people on standard in-center HD, having too much omega 6 was linked with significantly higher inflammation.

Read more | (added Jul 26, 2011)

Dialysis removes Vitamin B6; supplements can help

A meta-analysis has found 24-56% Vitamin B6 deficiencies, a problem made worse by ESAs, some phosphate binders, and modern dialyzer membranes. B6 supplementation recommendations may need to be updated.

With a nurse educator, more urgent-start patients choose self-care treatments

As many as half of people start dialysis with no prior plan for it. When a renal triage nurse sees these patients, the chances that they will opt for PD, home HD, or transplant was significantly higher.

Read more | (added Jul 26, 2011)

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 more | (added Jul 26, 2011)

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 more | (added Jul 26, 2011)

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