Journal Watch

  • Biocompatible PD fluid helps adequacy

    "Glucose degradation products" (GDPs) occur when sugars are caramelized as PD fluid is made. GDPs can reduce PD adequacy, and in time, harm the peritoneum. A new study of 104 PD patients who randomly received standard fluid or a pH neutral fluid with fewer GDPs found that the new fluid led to better adequacy.

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

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  • Does icodextrin (extraneal) cause more peritonitis?

    Doesn't look like it. A study observed icodextrin and regular, sugar-based PD fluid use in 722 people. No differences were found in the rate of peritonitis infection or so-called "sterile periotnitis" where no bacteria are found.

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

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  • PD: Less cancer risk than standard HD

    DNA damage that can lead to cancer can occur in kidney failure, as the buildup of toxins stresses the body. A new study looked at genetic damage in 20 people on standard in-center HD, 20 on PD matched for gender and age, and 40 controls. Cheek swabs were used to look for DNA damage. Creatinine levels, smoking, alcohol use, age, income, and length of time on dialysis were also examined. The only factor that mattered was length of time on standard HD.

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

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  • Hope predicts a better adjustment to dialysis

    How important is hope? A new study finds that hopeful people on dialysis were less anxious and depressed and had fewer symptoms. (We'd bet that home dialyzors are more hopeful.)

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

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  • Removing adhesions improves PD catheter survival

    In a series of 436 PD catheter placements using a laparoscope, Drs. Crabtree and Burchette from Kaiser Permanente reduced catheter loss from blocked flow to just 0.7% by removing adhesions—even in people with prior abdominal surgeries.

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

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  • In-center HD pill burden lowers quality of life

    Taking (and paying for) an average of 19 pills each day (with a strict fluid limit!) reduces health-related quality of life in people using standard in-center HD, a new study finds. Of course, every form of home treatment requires fewer pills!

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

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  • Home FIRST—a new paradigm

    Why is the least effective—and most costly—form of treatment the default choice in the U.S.? A new article asks this question, and suggests that we present treatment options in terms of home vs. in-center, rather than HD vs. PD.

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

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  • Wearable artificial kidney...for PD?

    Dr. Claudio Ronco reports in a new article that many of the challenges of making a wearable artificial kidney could be solved if it was used for PD instead of HD.

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

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  • A honey of an idea

    Some clinics help prevent peritonitis in people with PD by using an antibiotic ointment. But bacteria may become resistant. In Australia, a new randomized study of Medihoney, a honey-based wound dressing (which is FDA-approved in the US) will see whether exit site or tunnel infections or peritonitis can be reduced.

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

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  • Better stats help prove the value of more dialysis

    It's clear to us that more dialysis is more like having healthy kidneys. But the statistic used to measure the risk of death ("proportional hazards model")...didn't quite succeed. A new statistical model based on when the kidneys fail and toxins start to build up DOES find a strong relationship. In fact, each 0.1 unit increase in Kt/V improved survival by 3.5%!

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

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