Home Dialysis Central
...everything you need to know about doing dialysis at home.
Journal watch
Surgical adhesions? PD may still be possible
Conventional wisdom says that PD is not a good choice for people who've had complex abdominal surgery or have adhesions. But a study of two groups of people—with and one without adhesions—found no significant differences in catheter success, infections, or the need for more surgery.
Read more | (added Feb 24, 2011)
Which is safer for placing a PD catheter: General or local anesthesia?
Trick question. Turns out, they're both safe! In more than 300 people followed between 1999 and 2008, there were no major complications in either group. PD catheter failure rates were similar (5% for general, 7% for local).
Read more | (added Feb 24, 2011)
On PD, higher uric acid levels predict faster loss of kidney function
Keeping as much of your kidney function as you can is a plus on PD or HD. A new study from Korea has found that people on PD whose levels of uric acid were higher had a faster decline in their kidney function. Those with higher blood pressure tended to have higher uric acid levels.
Read more | (added Feb 24, 2011)
PD catheter placement: Surgeon or nephrologist?
Does who places a PD catheter make a difference in complications or catheter survival? Not really, finds a new Greek study that looked at 152 patients who received 170 catheters. Only early leakage (easily treated) was more likely with nephrologist placement.
Read more | (added Feb 24, 2011)
Icodextrin PD fluid causes less weight gain
We're not surprised to learn that PD fluid that doesn't contain dextrose (sugar) is less likely to cause weight gain! A study of 183 PD patients found weight gains after 3 years (88% of it fat) among those using standard fluid, and significantly less weight gain in an icodextrin group.
Read more | (added Feb 24, 2011)
Mupirocin (Bactroban®) reduces staph exit site infection and peritonitis in PD
A meta-analysis of 14 studies looking at 1233 patients and 1217 controls has concluded that using an ointment with mupiricin can help prevent PD problems. Exit site infections and peritonitis—both due to staph aureus and to some other germs—were reduced by as much as 72%.
Read more | (added Aug 22, 2011)
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)
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