Journal Watch

  • Matching home dialysis to lifestyle

    A "continuum home program concept" described in a new article would help people with kidney failure continue their lifestyles with dialysis—rather than disrupt them with treatment. The aim is for a continuous flow of services from education to treatment choice, dialysis access, and option changes when needed.

    Read the abstract » | (added 2011-02-24)

    Tags: Chronic kidney disease

  • Longer survival on PD with ACE-inhibitors or ARBs

    Even if blood pressure is normal, taking blood pressure pills in the ACE-inhibitor or ARB class was linked with much better survival in a new study. Researchers studied 306 new PD users from 2001 to 2005. Even adjusting for age, blood pressure, and other illnesses, those who took the BP pills had a 62% lower risk of death.

    Read the abstract » | (added 2011-02-24)

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  • PD fluid with amino acids may help prevent malnutrition—and improve heart health

    Basing PD fluid on amino acids (AA') instead of glucose may improve nutrition on PD in the future. A new study switched 13 non-diabetic PD patients from glucose to AA-based fluid. Uptake of amino acids by the skeletal muscles was significantly better with the AA fluid (read more here). Another study of AA-based PD fluid found it less likely than glucose-based fluid to cause release of hormones (leptin and adipnectin) linked with heart problems.

    Read the abstract » | (added 2011-02-24)

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  • Larger patients can safely do PD

    A brand new Canadian study of 4,054 people on PD from 1994 to 2003 has found that a high body mass index (BMI > 30) was not linked with worse survival in people on PD—though a BMI of less than 18.5 was. The researchers concluded that "High BMI patients should not be discouraged from PD just because of their size."

    Read the abstract » | (added 2011-02-24)

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  • Lipid-lowering drugs save lives on PD

    A new look at data from 1,053 people on PD from the USRDS has found that statins and other drugs that lower blood lipid (fat) levels seem to have a big impact on survival. Death rates from all causes or heart disease dropped by 26% and 33%, respectively.

    Read the abstract » | (added 2011-02-24)

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  • Need a PD catheter? Laparoscopic placement is better

    Some surgeons place PD catheters "blind" (without imaging), while others use a laparoscope to let them see inside of the peritoneum before they insert the catheter. A new study finds—not surprisingly—that it's best to see what you're doing. Laparoscopic placement had a almost an 18% better success rate and fewer revisions or replacments.

    Read the abstract » | (added 2011-02-24)

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  • How to start late-referred ESRD patients on PD urgently

    When as many as half of Americans with ESRD have less than 3 months notice before needing dialysis, it's great to know that PD can safely be done as a first treatment. This avoids HD catheters, keeps working folks employed, and buys time for a fistula or transplant. This article describes patients who did very well.

    Read the abstract » | (added 2011-02-24)

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  • How long should PD catheters be embedded before use?

    A study of 5,624 patient months found that PD catheters embedded under the skin are most likely to work if used from 48-133 days after placement—and least likely to have peritonitis if used even later: after 134 days. Using PD catheters before 47 days was linked to higher failures and more peritonitis.

    Read the abstract » | (added 2011-02-24)

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  • Predicting blood vessel calcification in PD

    In a study of 231 PD patients, those whose C-reactive protein (CRP) and interleukin-6 levels were higher had a higher risk of blood vessel calcification and heart problems than those with lower levels.

    Read the abstract » | (added 2011-02-24)

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  • Once-a-month IV Aranesp keeps up Hgb levels on PD

    It would sure be convenient to only need anemia drugs once a month—and a new study suggests that this can work for people using PD. In a study of 72 folks on PD, hemoglobins were kept in the target range with once-monthly dosing.

    Read the abstract » | (added 2011-02-24)

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