Home Dialysis Central
...everything you need to know about doing dialysis at home.
Journal watch
Rat study: Celexicob reduces peritoneal fibrosis
COX-2 is involved in fibrosis and the growth of new blood vessels. Is there a way to protect the peritoneal membrane using a COX-2 inhibitor so it lasts longer for PD? Perhaps one day there will be. A new study found that rats given a substance that causes fibrosis had fewer new blood vessels and milky spots, and far less fibrosis than controls.
Read more | (added Feb 24, 2011)
Better stats help prove the value of more dialysis
It's clear to us that more dialysis is more like having healthy kidneys. But the statistic used to measure the risk of death ("proportional hazards model")...didn't quite succeed. A new statistical model based on when the kidneys fail and toxins start to build up DOES find a strong relationship. In fact, each 0.1 unit increase in Kt/V improved survival by 3.5%!
Read more | (added Feb 24, 2011)
Diabetes + PD? Icodextrin-aided fluid removal and metabolic control
A randomized controlled trial of glucose PD fluid vs. icodextrin (ICO) found significant benefits. Among 59 people with diabetes on CAPD, those in the group using ICO for the long exchange were far less likely to need higher concentration fluid (9% vs. 66%). And, the ICO group needed less insulin, had lower triglycerides, and had lower A1cs.
Read more | (added Feb 24, 2011)
Wearable artificial kidney…for PD?
Dr. Claudio Ronco reports in a new article that many of the challenges of making a wearable artificial kidney could be solved if it was used for PD instead of HD.
Read more | (added Feb 24, 2011)
A honey of an idea
Some clinics help prevent peritonitis in people with PD by using an antibiotic ointment. But bacteria may become resistant. In Australia, a new randomized study of Medihoney, a honey-based wound dressing (which is FDA-approved in the US) will see whether exit site or tunnel infections or peritonitis can be reduced.
Read more | (added Feb 24, 2011)
Home FIRST—a new paradigm
Why is the least effective—and most costly—form of treatment the default choice in the U.S.? A new article asks this question, and suggests that we present treatment options in terms of home vs. in-center, rather than HD vs. PD.
Read more | (added Feb 24, 2011)
In-center HD pill burden lowers quality of life
Taking (and paying for) an average of 19 pills each day (with a strict fluid limit!) reduces health-related quality of life in people using standard in-center HD, a new study finds. Of course, every form of home treatment requires fewer pills!
Read more | (added Feb 24, 2011)
Hope predicts a better adjustment to dialysis
How important is hope? A new study finds that hopeful people on dialysis were less anxious and depressed and had fewer symptoms. (We'd bet that home dialyzors are more hopeful.)
Read more | (added Feb 24, 2011)
Removing adhesions improves PD catheter survival
In a series of 436 PD catheter placements using a laparoscope, Drs. Crabtree and Burchette from Kaiser Permanente reduced catheter loss from blocked flow to just 0.7% by removing adhesions—even in people with prior abdominal surgeries.
Read more | (added Feb 24, 2011)
New resource for intraperitoneal drug delivery
On PD, it's not hard to inject a drug into the PD bag so it goes into the peritoneum. Which drugs are safest and most effective this way? A new article tells you the scoop.
Read more | (added Feb 24, 2011)
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