Journal Watch

  1. Wanted: A Paradigm Shift from Urea to Sodium Removal

    When nephrology icon Zyblut Twardowski talks, we listen! When dialyzors in Seattle in the 1960s got 30 hours a week of dialysis, the mortality rate was 10%. Since then, short treatments—justified by the flawed NCDS study—were driven by the equally flawed notion of Kt/V urea.

    Read the abstract » | (added 12/14/2018)

    Tags: Kt/V Urea, Mortality Rate, Sodium Removal, Dialysis Quality, Ncds, Rct

  2. Protein Clearance Predicts Mortality on PD

    Protein clearance on PD may be a marker of peritoneal inflammation. Among 711 PD patients followed for at least one year, each 10mL/day rise in protein clearance was linked with a 10.4% increase in the risk of all-cause mortality (p=0.008). Protein clearance was linked with serum albumin and C-reactive protein levels.

    Read the abstract » | (added 12/14/2018)

    Tags: Protein Clearance, Peritoneal Dialysis, Mortality

  3. Icodextrin Reduces PD Stroke Risk

    Stroke risk was compared in PD patients in Taiwan who did or did not use icodextrin. Icodextrin users had a lower risk and incidence of strokes than non-users.

    Read the abstract » | (added 12/14/2018)

    Tags: Stroke, Pd Patients, Icodexytrin

  4. Medicare Reimbursement Has Driven More PD

    Changes to the Medicare Prospective Payment System (PPS) in 2011 to create financial incentives for PD have worked, finds a new analysis of 6,433 dialysis clinics before and after the change. Since 2011, 6% more clinics offered PD, and program size increased from an average of 5.7 patients to 6.9. Non-urban, chain, and larger clinics were significantly more likely to have changed their PD practices in response to the PPS change.

    Read the abstract » | (added 12/14/2018)

    Tags: Medicare, Prospective Payment System, Peritoneal Dialysis, Quality Of Life

  5. Longer-term Benefits of Early Start PD

    Do people who start PD emergently differ from those with a planned PD start? No, suggests a new study of 154 patients followed for a median of just over a year. Early vs. planned-start patients had similar ages, BMIs, genders, and rates PD drop-out due to peritonitis, catheter dysfunction, and burnout. Only diabetes and BMI >25 were independently associated with PD technique failure—but no differences were found between early and planned starts.

    Read the abstract » | (added 12/14/2018)

    Tags: Emergent Pd, Planned Pd, Early Start Pd

  6. MXene Sorbents: A Step Toward a WAK

    A sorbent tested for use in a wearable artificial kidney was able to adsorb urea with 99% efficiency in testing—twice the level removed with standard dialysate. The hemocompatible sorbent did not damage cells or reduce cell viability at the concentrations tested. A successful sorbent product will facilitate the design of a WAK. Read the abstract.

    Read the abstract » | (added 10/12/2018)

    Tags: Wearable Artificial Kidney, 2 D Materials, Urea, M Xene, Adsorption, Dialysate

  7. Metaanalysis of Nocturnal HD and Sleep Quality

    Nine studies of 286 patients found significantly less sleep apnea and better O2 saturation—but less total sleep time—after switching from conventional to nocturnal HD. Prospective pre-post studies found improved sleep quality, but randomized trials did not. Read the abstract.

    Read the abstract » | (added 10/12/2018)

    Tags: Sleep Apnea, Chd, Nhd, O2 Saturation, Nocturnal Hd, Conventional Hd, Sleep Quality

  8. Nocturnal HD vs. Transplant: Health-related Quality of Life Compared

    In a small study, transplant candidates using nocturnal HD (n=41) and transplant patients (n=31) took the KDQOL-short-form survey of health-related quality of life (HRQOL). Those with transplants had significantly higher “effects” of kidney disease scores than those on nocturnal HD. The other domains were not significant. Read the abstract.

    Read the abstract » | (added 10/12/2018)

    Tags: Transplant, Nocturnal Hd, Kdqol, Hrqol, Effects Of Kidney Disease

  9. What Makes Home HD Patients Reach for On-Call Support?

    A 4-month prospective observational study analyzed the reasons why 58 home HD patients called the on-call nurse or technician. Most calls to nurses were made for clinical issues or machine set-up or alarm questions, some of which required a technician. Most of the technician calls were for machine malfunction, set-up and alarms, or water treatment. Read the abstract.

    Read the abstract » | (added 10/12/2018)

    Tags: Home Hemodialysis, Independent Hemodialysis, Nocturnal Hemodialysis, Short Daily Hemodialysis

  10. Urgent Start PD + Diabetes

    A retrospective study compared the first 30-day outcomes and survival trends of 80 urgent start dialysis patients, 50 of whom (62.5%) did PD. Compared to those who started standard in-center HD, the dialysis-related complications were significantly lower for those on PD, and PD survival was higher as well. Read the abstract.

    Read the abstract » | (added 10/12/2018)

    Tags: Diabetes, Survival Trends, Urgent Start Dialysis, Pd, In Center Hd, Dialysis Related Complications