Journal Watch
Cardiovascular Benefits of Benefits
A review considers the impact of nocturnal HD on cardiac remodeling, myocardial stunning, hypertension, heart rate variability, sleep apnea, coronary calcification, and endothelial dysfunction.
Read the abstract » | (added 2020-04-13)
Tags: Benefits, Cardiovascular, Home Hemodialysis, Myocardial Stunning, Nocturnal Hemodialysis, Vascular Calcification, Cardiovascular Disease
Nocturnal HD in Children
There are very few studies of the impact of intensified hemodialysis regimens (days/hours) on children. This review addresses implementation challenges.
Read the abstract » | (added 2020-03-16)
Tags: Intensified Hemodialysis, Children, Implementation Challenges
Green Nephrology: Reducing the Environmental Impact of Dialysis
Climate change and extreme weather events both increase the incidence of kidney disease and destabilize care. But, healthcare in general—and dialysis in particular—contribute substantially to greenhouse gases. Monitoring resources and reducing waste in HD can be done through reuse of RO reject water, renewable energy sources, better waste management, and slower dialysate flow rates. For PD, point-of-care dialysate will reduce the environmental impact.
Read the abstract » | (added 2020-02-19)
Tags: Environmental Change, Kidney Disease Factors, Environmental Impact Of Dialysis
Impact of a Nurse-led Protocol on PD Fluid Overload
Among PD patients divided into a group symptomatic of fluid overload (>2L; n=53) and a group that was not (n=50), a 12-week nurse-led education and motivation intervention—with hypertonic cycles for short-term relief of fluid overload—significantly reduced overhydration. Knowledge and adherence were both significantly improved as well.
Read the abstract » | (added 2020-01-09)
Impact of daily low-flow HD on potassium and lactate levels
In the NxStage FREEDOM study, 345 patients switched from standard in-center HD to daily, low-flow HD. Blood levels of potassium and lactate were analyzed during the last 3 months of standard HD and the first 3 months of daily HD. On daily HD, predialysis serum potassium decreased significantly at a dialysate potassium level of 1 mEq/L, with no change at 2 mEq/L. Predialysis serum bicarbonate level decreased significantly with dialysate lactate concentration of 40 mEq/L—but increased significanty at 45 mEq/L. Choosing the correct dialysate for the patient is important.
Read the abstract » | (added 2019-07-15)
Tags: Daily HD, Potassium, Bicarbonate, Dialysate
Moving the PD Exit Site to Combat Infection
A 5-year retrospective cohort analysis looked at the impact of treating PD exit site and tunnel infections in 27 patients by removing the cuff and relocating the catheter under local anesthetic. After follow up ranging from 10.8 to 79.4 months, no leaks occurred, and the infections resolved in 74% of the patients. The rest had to have their catheters removed.
Read the abstract » | (added 2019-06-13)
Tags: Exit Site Relocation, Exit site Infection, Tunnel Infection, Peritoneal Dialysis Catheter, PD Catheter
Impact of High Protein Diets on Residual Kidney Function in PD
Does a high-protein diet cause a faster loss of residual kidney function for PD patients? An observational study of 336 patients for at least 6 months suggests that it may.
Read the abstract » | (added 2019-01-11)
Tags: Protein Intake, Residual Kidney, Peritoneal Dialysis, PD
Blood Flow Rates and Clinically Meaningful Solute Removal
A prospective study of 17 patients looked at BFRs of 300, 350, and 450 and Kt/V urea, beta-2 microglobulin, and phosphorus when low dialysate flow rates were used. While Kt/V did increase, the impact on B2M and phosphorus were minimal.
Read the abstract » | (added 2018-08-13)
Tags: Daily Hemodialysis, Home Hemodialysis, Kt/V, Blood Flow
The Impact of AGEs on the Gut Microbiome in PD
The Impact of AGEs on the Gut Microbiome in PD Advanced glycation endpoints (AGEs) cause inflammation and are linked with heart disease. A new PLoS One paper reports on a pilot trial of 20 PD patients who routinely ate a high-AGE diet. Ten were randomized to eat as usual, while 10 had their meals AGE-restricted for a month. Gut bacteria analysis found major shifts in the experimental group that could have clinical importance.
Read the abstract » | (added 2017-10-13)
Tags: Education Issues: For Patients And Professionals, Fistulas, Grafts And Catheters (including PD)
The Impact of ESRD Treatment Modality on Sleep Quality
A metaanalysis looked at whether changing from one treatment type to another (HD, daily HD, nocturnal HD, CAPD, CCPD, or transplant) would affect sleep. Sixteen studies with 670 patients and 191 controls were examined. Restless leg syndrome resolved in 60+% of patients who switched to CCPD, intensive HD, or transplant. Sleep apnea improved with these options as well. Overall sleep quality improved as the intensity of treatment increased.
Read the abstract » | (added 2017-06-12)
Tags: What Is The Best Dialysis Option For Me, Education Issues: For Patients And Professionals