Home Dialysis Central
...everything you need to know about doing dialysis at home.
Journal watch: PD
PD fluid with amino acids may help prevent malnutrition—and improve heart health
Basing PD fluid on amino acids (AA) instead of glucose may improve nutrition on PD in the future. A new study switched 13 non-diabetic PD patients from glucose to AA-based fluid. Uptake of amino acids by the skeletal muscles was significantly better with the AA fluid (read more here). Another study of AA-based PD fluid found it less likely than glucose-based fluid to cause release of hormones (leptin and adipnectin) linked with heart problems.
Read more | (added Feb 24, 2011)
MYTHBUSTERS: microwaving PD fluid does NOT create glucose degradation products (GDPs)
While the belief persists that microwaving PD bags creates harmful GDPs when sugars are caramelized, the literature does not bear this out:
- A study in the ANNA Journal analyzed PD solution and found no changes, even when the fluid was superheated. The authors concluded that microwaving could be done safely.
- Very similar results were found in a study from PD International.
GDPs are a concern with PD fluid, but these are created when the fluid is manufactured, not when it is heated by the user. Of course, "hot spots" are still a concern. Anyone using a microwave to heat PD fluid should flip the bag from side to side to mix the contents well and use a thermometer strip to reduce the risk of burns.
Read more | (added Aug 22, 2011)
Once-a-month IV Aranesp keeps up Hgb levels on PD
It would sure be convenient to only need anemia drugs once a month—and a new study suggests that this can work for people using PD. In a study of 72 folks on PD, hemoglobins were kept in the target range with once-monthly dosing.
Read more | (added Feb 24, 2011)
Predicting blood vessel calcification in PD
In a study of 231 PD patients, those whose C-reactive protein (CRP) and interleukin-6 levels were higher had a higher risk of blood vessel calcification and heart problems than those with lower levels.
Read more | (added Feb 24, 2011)
Biocompatible PD fluid helps adequacy
"Glucose degradation products" (GDPs) occur when sugars are caramelized as PD fluid is made. GDPs can reduce PD adequacy, and in time, harm the peritoneum. A new study of 104 PD patients who randomly received standard fluid or a pH neutral fluid with fewer GDPs found that the new fluid led to better adequacy.
Read more | (added Feb 24, 2011)
How to start late-referred ESRD patients on PD urgently
When as many as half of Americans with ESRD have less than 3 months notice before needing dialysis, it's great to know that PD can safely be done as a first treatment. This avoids HD catheters, keeps working folks employed, and buys time for a fistula or transplant. This article describes patients who did very well.
Read more | (added Feb 24, 2011)
How long should PD catheters be embedded before use?
A study of 5,624 patient months found that PD catheters embedded under the skin are most likely to work if used from 48-133 days after placement—and least likely to have peritonitis if used even later: after 134 days. Using PD catheters before 47 days was linked to higher failures and more peritonitis.
Read more | (added Feb 24, 2011)
Need a PD catheter? Laparoscopic placement is better
Some surgeons place PD catheters "blind" (without imaging), while others use a laparoscope to let them see inside of the peritoneum before they insert the catheter. A new study finds—not surprisingly—that it's best to see what you're doing. Laparoscopic placement had a almost an 18% better success rate and fewer revisions or replacments.
Read more | (added Feb 24, 2011)
Lipid-lowering drugs save lives on PD
A new look at data from 1,053 people on PD from the USRDS has found that statins and other drugs that lower blood lipid (fat) levels seem to have a big impact on survival. Death rates from all causes or heart disease dropped by 26% and 33%, respectively.
Read more | (added Feb 24, 2011)
Larger patients can safely do PD
A brand new Canadian study of 4,054 people on PD from 1994 to 2003 has found that a high body mass index (BMI > 30) was not linked with worse survival in people on PD—though a BMI of less than 18.5 was. The researchers concluded that "High BMI patients should not be discouraged from PD just because of their size."
Read more | (added Feb 24, 2011)
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