Journal Watch
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Survival on PD beats standard in-center HD hands down
Studies done with data from the early 1990s found better survival on standard in-center HD than PD. But a new study pairing 6,337 PD patients who started treatment in 2003 with standard HD patients found just the opposite. Survival was significantly better with PD—especially for those under 65, and those who did not have heart disease or diabetes.
Read the abstract » | (added 02/24/2011)
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Extended catheters make PD possible for more people
For those who can't have an abdominal PD catheter, an "extended" (i.e., presternal) catheter that can exit in the chest can make PD work. A new study found 1, 2, and 3-year catheter success rates that were slightly lower than standard PD catheters.
Read the abstract » | (added 02/24/2011)
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Surgical adhesions? PD may still be possible
Conventional wisdom says that PD is not a good choice for people who've had complex abdominal surgery or have adhesions. But a study of two groups of people—with and one without adhesions—found no significant differences in catheter success, infections, or the need for more surgery.
Read the abstract » | (added 02/24/2011)
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On PD, higher uric acid levels predict faster loss of kidney function
Keeping as much of your kidney function as you can is a plus on PD or HD. A new study from Korea has found that people on PD whose levels of uric acid were higher had a faster decline in their kidney function. Those with higher blood pressure tended to have higher uric acid levels.
Read the abstract » | (added 02/24/2011)
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Which is safer for placing a PD catheter: General or local anesthesia?
Trick question. Turns out, they're both safe! In more than 300 people followed between 1999 and 2008, there were no major complications in either group. PD catheter failure rates were similar (5% for general, 7% for local).
Read the abstract » | (added 02/24/2011)
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Icodextrin PD fluid causes less weight gain
We're not surprised to learn that PD fluid that doesn't contain dextrose (sugar) is less likely to cause weight gain! A study of 183 PD patients found weight gains after 3 years (88% of it fat) among those using standard fluid, and significantly less weight gain in an icodextrin group.
Read the abstract » | (added 02/24/2011)
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PD catheter placement: Surgeon or nephrologist?
Does who places a PD catheter make a difference in complications or catheter survival? Not really, finds a new Greek study that looked at 152 patients who received 170 catheters. Only early leakage (easily treated) was more likely with nephrologist placement.
Read the abstract » | (added 02/24/2011)
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Mupirocin (Bactroban®) reduces staph exit site infection and peritonitis in PD
A meta-analysis of 14 studies looking at 1233 patients and 1217 controls has concluded that using an ointment with mupiricin can help prevent PD problems. Exit site infections and peritonitis—both due to staph aureus and to some other germs—were reduced by as much as 72%.
Read the abstract » | (added 02/24/2011)
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Rat study: Celexicob reduces peritoneal fibrosis
COX-2 is involved in fibrosis and the growth of new blood vessels. Is there a way to protect the peritoneal membrane using a COX-2 inhibitor so it lasts longer for PD? Perhaps one day there will be. A new study found that rats given a substance that causes fibrosis had fewer new blood vessels and milky spots, and far less fibrosis than controls.
Read the abstract » | (added 02/24/2011)
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Diabetes + PD? Icodextrin-aided fluid removal and metabolic control
A randomized controlled trial of glucose PD fluid vs. icodextrin (ICO) found significant benefits. Among 59 people with diabetes on CAPD, those in the group using ICO for the long exchange were far less likely to need higher concentration fluid (9% vs. 66%). And, the ICO group needed less insulin, had lower triglycerides, and had lower A1cs.
Read the abstract » | (added 02/24/2011)
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