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)

New from Australia: Outcomes of extended HD (mainly done at home)

In a series of 286 people doing extended HD, 96% received their treatments at home, and 77% did them at night. Survival was 98% at 1 year, 92% at 3 years, and 83% at 5 years.

Read more | (added Feb 27, 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)

Home HD beliefs of patients and care partners in Italy

Home HD is underused in Italy. Interviews found three positive themes: flexibility/freedom, comfort in familiar surroundings, and altruistic motivation to be an example for others. Four negative themes were also found: disrupted sense of normality, family burden, housing constraints, and healthcare by "professionals", not "amateurs".

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)

Review: survival on intensive HD vs. transplant

Canadian researcher Robert Pauly reviews the literature on survival with short daily and nocturnal HD, and compares it to kidney transplant survival.

Read more | (added Jan 25, 2013)

Can more fluid removal mean needing less toxin removal?

Makers of a wearable ultrafiltration (UF; water removal) device wanted to know if daily UF could be a way to cut back on the need for dialysis toxin removal. For 4 weeks, 13 in-center patients had 4 days a week of UF plus 2 days a week of HD. Then they did 4 weeks of standard, 3x week HD. Daily UF lowered blood pressure and weight gain between treatments significantly—while Kt/V rose.

Read more | (added Jan 25, 2013)

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