Home Dialysis Central
...everything you need to know about doing dialysis at home.
Journal watch: PD
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 more | (added Apr 29, 2013)
Starting more people on PD does not cause harm
In Canada, a study looked at PD “attempt rates”: how often each nephrologist would start new patients on PD. Between the highest and lowest attempt rates, there were no differences in PD success—or survival. The authors conclude that maximizing PD start rates can save money to help more people, with no harm to patients.
Read more | (added Apr 29, 2013)
Icodextrin metaanalysis – no impact on patient survival
Australian researchers analyzed 11 studies of icodextrin vs. glucose PD fluid (1222 patients). Icodextrin did help reduce fluid overload without harming residual kidney function. But, it did not help reduce peritonitis, technique failure, or other adverse events. And, patients who used icodextrin did not live any longer.
Read more | (added Apr 29, 2013)
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 more | (added Feb 27, 2013)
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 more | (added Feb 27, 2013)
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 more | (added Feb 27, 2013)
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 more | (added Feb 27, 2013)
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 more | (added Feb 27, 2013)
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 more | (added Jan 25, 2013)
PD: Better survival than standard in-center HD
DaVita followed 23,718 patients new to dialysis for 2 years. Those who chose PD (1,358) were nine times more likely to switch treatment options and three times more likely to get a transplant than those who chose standard in-center HD. The PD patients also had 48% better survival than those who did standard in-center HD.
Read more | (added Jan 25, 2013)
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