Journal watch

Green dialysis – reducing energy use and landfill space

Worldwide, dialysis uses an estimated 156 billion liters of water per year, 1.62 billion kilowatt hours of power, and generates 625,000 tons of plastic waste. Our own Dr. John Agar suggests ways to reduce the carbon footprint of dialysis through water conservation, solar power, and other ideas.

Read more | (added Dec 22, 2011)

HD offers better survival than PD for congestive heart failure

A study of 933 people with CHF on PD and 3468 on HD in the French dialysis registry found that for people with congestive heart failure, HD is a safer choice. The risk of death with PD was 48% higher.

Read more | (added Dec 22, 2011)

Longer life on PD with statins

A study from Korea has found that people on PD who were prescribed statin drugs (used for high cholesterol) had a 41% lower risk of death than those who were not given statins. The effect held true for people who had diabetes as well. Future randomized, controlled studies are suggested.

Read more | (added Dec 22, 2011)

Mupirocin beats polysporin triple ointment (P3) for preventing PD catheter infections

In an 18-month long randomized, controlled study, twice as many patients had redness at the PD catheter exit site and more fungal infections occurred in those using P3 than mupirocin.

Read more | (added Dec 22, 2011)

Cycler PD done longer than manual PD

Among 179 people doing CAPD and 441 using cyclers, survival and the rates of loss of residual kidney function and peritonitis were about the same. But technique survival was significantly better among those who used a cycler.

Read more | (added Dec 22, 2011)

Protein intake improves after a switch from standard to nocturnal HD

After 8 months of nocturnal HD, 15 people who switched from standard in-center HD had significantly higher protein intake. Their phosphate intake rose as well—but their serum phosphate levels did not, even without binders.

Read more | (added Nov 28, 2011)

Adsorptive column removes B2m

Too-high levels of B2m cause amyloidosis in people on dialysis, with joint and bone pain. In Japan, people dialyzed using the Lixelle S-15 adsorptive column had significantly less B2m in their blood after a year of 3x/week treatments. They were also stronger and had less joint pain.

Read more | (added Nov 28, 2011)

Alternate-night HD improves bone minerals & blood pressure

Among 63 people in Australia who switched from standard HD to alternate-night HD, bone mineral balance and blood pressure improved after 18–24 months. Left ventricular mass did not improve, but remained stable.

Read more | (added Nov 28, 2011)

Working fistula rate doubled with procedures

Are repeated fistula procedures worth it? Yes, says a new study of 294 people who had 347 fistulas made, with 736 procedures between them. While only 36.8% of fistulas were working on their own after 2 years, 77.8% were working 2 years later after procedures to fix them. (One patient had 11 interventions.)

Read more | (added Nov 28, 2011)

Urgent-start PD is feasible with a plan

In this small study, 9 people who had an urgent start for PD were compared to 9 people who started PD with more time. A standard protocol was written to support urgent start PD. After 90 days, both groups were doing equally well.

Read more | (added Nov 28, 2011)

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