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 more | (added Aug 25, 2011)

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 more | (added Jul 26, 2011)

Choosing PD may mean fewer access procedures for you

In a study of 369 Canadians with ESRD, 224 (61%!) chose PD, and just 145 (39%) chose HD. After an average of 1.3 years, those who chose PD had significantly fewer access procedures. PD catheters were less likely to fail than HD access.

Read more | (added Jul 26, 2011)

PD is safe and efficient for urgent dialysis starts

Researchers in Germany followed 123 people who started dialysis without a prior plan (66 did PD, 54 did standard in-center HD). Those on HD had much higher infection rates and somewhat (but not significantly) lower survival.

Read more | (added Jul 26, 2011)

Fresenius options education program boosts PD & venous access use

The 3,165 people who attended a treatment options program (TOPs) were more than 8 times more likely to choose PD than those who didn't attend—and twice as likely to get a fistula or graft if they chose HD. TOPs attendees were also more likely to survive the first 90 days of treatment.

Read more | (added Jun 21, 2011)

Better survival on home HD than PD in England and Wales

A study from the UK compared 225 people on home HD from 1997 to 2005 with age and sex matched people on PD and standard HD. Those on home HD lived significantly longer than those on PD—even when the researchers adjusted for those who received transplants or were on the wait list.

Read more | (added Jun 21, 2011)

NAC protects PD membrane from sugar damage in rats

Over time, caramelized sugars in PD fluid can scar the peritoneal membrane to the point where PD may no longer work. In a rat study, an antioxidant (N-acetylcysteine, or NAC) reduced this damage. NAC may one day prove to be a treatment for humans.

Read more | (added Jun 21, 2011)

Statin use may boost PD survival

A new study from Korea has found that taking a statin drug to lower cholesterol helped people on PD live longer—whether or not they had diabetes. The researchers suggest that larger, randomized studies are now needed.

Read more | (added Jun 21, 2011)

Early PD survival benefit comes from avoiding HD catheters

Studies have found better survival on PD than standard HD in the first 1-2 years of treatment. A new study of 40,526 people found that the main reason for this difference is that those on PD did not use central venous HD catheters.

Read more | (added Jun 21, 2011)

PD with PKD: Yes, it’s possible

A Chinese study matched 42 people with and 84 without PKD as they started PD. After 5 years, survival in both groups was the same. There was no difference in the rate of peritonitis, though the PKD group was more likely to get hernias.

Read more | (added Jun 21, 2011)

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