Journal Watch

  • The Better to See You With, My Dear

    Would you rather have a surgeon feel where a PD catheter should go—or see what s/he is doing? Researchers tried an optical puncture system on 25 patients between 2018 and 2019, while 40 patients had routine placements. Even though more of the optical patients had prior abdominal surgeries, catheter placement took less time and had a similar rate of complications.

    Read the abstract » | (added 2021-02-09)

    Tags: Peritoneal Dialysis, Catheter, Optical Puncture System

  • Low PTH Levels a Risk Factor for Peritonitis on PD

    Two hundred seventy incident PD patients over a 7-year period were divided into a low-PTH (<150 pg/mL), middle-PTH (150-300 pg/mL), and high-PTH (>300 pg/mL) groups. After follow up for 16-49 months, patients with low PTH levels had a 64% higher risk of peritonitis.

    Read the abstract » | (added 2021-02-09)

    Tags: Peritoneal Dialysis, Pd, Parathyroid Hormone

  • New Xylitol-based PD Fluid with L-Carnitine May be More Biocompatible

    It is ironic that the glucose-based fluid that made PD possible can also harm the membrane so it stops working. A new PD fluid uses xylitol and l-carnitine to remove water instead of glucose. When tested on human cells, the new fluid kept more cells alive and reduced inflammation.

    Read the abstract » | (added 2021-01-12)

    Tags: Peritoneal Dialysis, Peritoneal Dialysis Solution

  • Chevron and Butterfly Taping Reduces Venous Needle Dislodgement in HD

    Every clinic seems to have its own preferred method of taping HD needles to prevent dislodgement. This important new study tested Chevron, Butterfly and Overlapping tape patterns in a mechanical engineering laboratory to measure the adhesive force and ability to withstand dislodgement and lateral stress.

    Read the abstract » | (added 2021-01-12)

    Tags: Dialysis, Hemodialysis

  • Will Silicone Be the Future of HD Membranes?

    Silicone nanoporous membranes (SNMs) have an average pore size of 8 nanometers. Tested with urea and creatinine, the new material was able to clear about 81% of high concentration uremic toxins in 45 minutes. This material could make more compact and portable dialysis systems possible.

    Read the abstract » | (added 2021-01-12)

    Tags: Silanization, Silicon Nanoporous

  • Remote Monitoring May Reduce PD Technique Failure

    In a study looking back at 558 adult APD patients, 148 who had used remote monitoring were matched to 148 patients from the 410 who had not. The researchers found a significantly lower rate of PD technique failure in the remote-monitored group. More studies are needed.

    Read the abstract » | (added 2021-01-12)

    Tags: Technique Failure, Telemedicine.

  • Mobile Health Readiness of Home vs. In-Center Dialysis Patients

    Smartphones and other mobile devices can be used to deliver health messages. In a survey of 949 patients from 14 home and 21 in-center dialysis clinics, 81% had mobile devices to get online, and 72% used the Internet, some (18%) despite concerns about data privacy and security. Younger, non-Hispanic, and more educated patients were more likely to use mobile health, and working patients had the highest rates of proficiency. After adjustment, in-center and home patients were equally proficient with mobile health.

    Read the abstract » | (added 2021-01-12)

    Tags: Kidney Disease, Hemodialysis, Telehealth, Telemedicine

  • Yet Another Study Demonstrates the Superiority of Home HD over In-Center

    A cohort registry study matched 181 home HD patients with 413 in-center HD patients in Australia and New Zealand by age, gender, and cause of ESKD. After adjusting for BMI, smoking, race, and comorbidities, home HD had almost half the death risk of in-center HD, as well as significantly lower phosphate levels. Both groups had similar rates of transplant and graft survival 6 months after a transplant.

    Read the abstract » | (added 2021-01-12)

    Tags: Kidney Disease, Haemodialysis, Home Haemodialysis

  • Use of CMS-reimbursed CKD Education Doubles the Likelihood of Home Dialysis

    While Medicare has paid for stage 4 CKD kidney disease education (KDE) since 2010, only a tiny fraction have used it—but KDE matters, finds an analysis of 369,968 patients who started dialysis between 2010 and 2014. Just 3,469 (0.9%) had received at least one KDE session, but compared to controls matched for age, gender, ESRD Network and year of dialysis start, they were twice as likely to have started a home dialysis treatment. Concerningly, African American and Hispanic patients were significantly less likely to have received KDE services.

    Read the abstract » | (added 2020-12-10)

    Tags: Home Dialysis, Kidney Disease Education, Peritoneal Dialysis

  • Nephrology Fellows Not Ready for Home Dialysis

    Even nephrology fellows attending home dialysis conferences did not feel prepared to care for PD or home HD patients, finds a small study. Of 110 attendees, 76 (66%) completed a survey about their confidence with regard to management of home dialysis. Most were “moderately” confident about PD principles—though just 11% had seen a PD catheter insertion, and only 3% had initiated a patient on urgent start PD. Most had “low” confidence in their ability to manage home hemodialysis.

    Read the abstract » | (added 2020-12-10)

    Tags: Education, Home Dialysis, Nephrology Fellowship