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 the abstract » | (added 2013-02-27)

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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 the abstract » | (added 2013-02-27)

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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 the abstract » | (added 2013-02-27)

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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 the abstract » | (added 2013-02-27)

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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 the abstract » | (added 2013-02-27)

Tags: Chronic kidney disease

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 the abstract » | (added 2013-02-27)

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PD + C + E = reduced oxidative stress

We need oxygen to live. But, too much of a good thing can cause heart and blood vessel damage, and, if you do PD, damage your peritoneum. What can help? Among 20 people doing PD, supplements of the antioxidants vitamins C and E improved measures of oxidative stress, compared to 10 healthy volunteers who did not take the vitamins. (Ask your nephrologist if this is wise for you.)

Read the abstract » | (added 2013-01-25)

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If at first you don't succeed with PD...it still costs less than in-center HD

A 4-year Canadian study has found that over a 3-year period, the cost of starting on PD and then switching to HD ($114,503) is still much less than doing standard in-center HD ($175,996). But starting and continuing PD is the lowest cost dialysis option ($58,724).

Read the abstract » | (added 2013-01-25)

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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 the abstract » | (added 2013-01-25)

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PD: Better survival than standard in-center HD

DaVita followed 23,718 patients new to dialysis for 2 years. Those who chose PD (1,358) were nine times more likely to switch treatment options and three times more likely to get a transplant than those who chose standard in-center HD. The PD patients also had 48% better survival than those who did standard in-center HD.

Read the abstract » | (added 2013-01-25)

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