Journal Watch

« Back to Most Recent

  • What Predicts Transfer to Home HD After PD Failure?

    In Australia and New Zealand, an analysis of all 10,710 patients treated with PD between 2000 and 2012 found that 2,915 transferred to HD—but just 156 started home HD. Among those who switched to home HD, more were male, obese, and had done PD longer. Older patients, those who stopped PD due to infection, who were underweight, whose ESRD was due to hypertension or diabetes, and those who were Aboriginal were less likely to go home.

    Read the abstract » | (added 2015-11-11)

    Tags:

  • Excessive Weight Gain in Year 1 of PD Predicts Poor Outcomes

    In a PLoS One study, 148 incident PD patients were observed for a median of almost 2 years. Those who gained more than 3% of their body weight lost residual kidney function 4.17 times faster (p<0.001), and had higher blood pressure, more inflammation, and an increased rate of diabetes.

    Read the abstract » | (added 2015-10-15)

    Tags:

  • Icodextrin PD fluid reduces insulin resistance in non-diabetic patients

    Even without diabetes, insulin resistance can add to cardiovascular disease risk in people with CKD. A new study randomized non-diabetic adults to APD with 2.5% glucose (n=27) for the long dwell or icodextrin 7.5% (n=33). At 90 days, the icodextrin group had lower levels of insulin resistance.

    Read the abstract » | (added 2015-07-08)

    Tags:

  • Glucose challenge test (GCT) detects glucose metabolism disorders in PD

    When glucose-based PD fluid is used, it can be a challenge to see if there are blood sugar issues. In 20 people on PD who did not have a history of diabetes, an initial GCT detected impaired glucose tolerance in eleven and diabetes mellitus in four. About 2 years later, twelve patients had glucose metabolism disorders—but none had diabetes.

    Read the abstract » | (added 2015-05-09)

    Tags:

  • More reasons to use PD fluid with less sugar

    Using a novel index created by dividing the glucose content of PD solution by body weight, this study looked at the impact of PD fluid sugar on hemoglobin A1c, fluid overload, and inflammation (measured by interleukin (IL) 6) in 43 people on PD. Higher sugar levels were linked with worse diabetes control, more fluid overload, and higher IL-6 levels.

    Read the abstract » | (added 2015-03-11)

    Tags:

  • Don’t trust glucometers on people using PD with icodextrin

    Glucometer test strips can’t distinguish glucose from other sugars, like maltose. When icodextrin is used for PD in people with diabetes, standard glucometer use is risky. Blood glucose test results from glucometers can’t be trusted, and people may be given insulin they don’t need (which could cause coma or death). Three case reports show why this is the case—and the authors suggest using glucose-specific blood tests instead.

    Read the abstract » | (added 2014-12-09)

    Tags:

  • PD catheter tunnel and exit site infections more likely with poor glycemic control—but not peritonitis

    Diabetes is known to raise the risk of infection. A study that looked back at blood sugar levels of 183 people new to PD, those with poor glycemic control had almost twice as many catheter tunnel and exit site infections, and had a first infection much sooner (p = 0.004). But, there was no increase in the risk of peritonitis.

    Read the abstract » | (added 2014-10-07)

    Tags:

  • Inflammation in PD? Look to the gums!

    Researchers looked at gum disease in 68 people who were doing CAPD, and rated it as healthy, slight to moderate, and severe. Patients whose C-reactive protein levels (a marker of inflammation) were higher had worse gum disease and had been on PD longer. Those with heart disease and diabetes also had worse gum disease. The authors suggest that all people who use PD should have their gums checked.

    Read the abstract » | (added 2014-06-05)

    Tags:

  • An HbA1c mean glucose formula for PD

    Glucose in PD solution changes HbA1c levels. Chinese researchers compared blood sugar and HBA1c levels of 305 people on CAPD, of whom 13 had type 1 diabetes and 161 had type 2. Using linear regression, the authors identified a formula to correct HBA1c levels for PD users.

    Read the abstract » | (added 2014-04-09)

    Tags:

  • Standard HD vs. PD for risk of hip fracture

    Among the 64,124 incident ESRD patients in a Taiwan registry between 1998 and 2008, 2,587 had a hip fracture. The risk of fracture was linked with sex, age, heart disease, diabetes, epilepsy drugs, diuretics, steroids, and vitamin D use. Those on standard in-center HD had a 52% higher risk of hip fracture than those on PD (p = 0.02).

    Read the abstract » | (added 2014-03-07)

    Tags: