More glucose in PD fluid makes it harder to cure peritonitis

A look back at bacterial peritonitis among 187 people on CAPD compared those whose peritoneum was exposed to more than 140 grams per day of glucose—or less. Those who used less glucose had a higher cure rate, fewer relapses, and less need for catheter removal.

Read the abstract » | (added 2015-07-08)

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Metaanalysis: PD fluid with fewer GDPs improves outcomes

Glucose degradation products (GDPs) are known to damage the delicate peritoneum. PD fluids with neutral pH and low levels of GDPs were reviewed in a new study of 11 randomized controlled trials (n=643). While most of the studies were of poor quality, low-GDP PD fluid was better at preserving residual kidney function and urine volume for a year than standard PD fluid.

Read the abstract » | (added 2015-07-08)

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Icodextrin PD fluid reduces insulin resistance in non-diabetic patients

Even without diabetes, insulin resistance can add to cardiovascular disease risk in people with CKD. A new study randomized non-diabetic adults to APD with 2.5% glucose (n=27) for the long dwell or icodextrin 7.5% (n=33). At 90 days, the icodextrin group had lower levels of insulin resistance.

Read the abstract » | (added 2015-07-08)

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Outcomes of “integrated home dialysis” (PD then home HD)

What happens to people after PD fails—and why not plan to get them home on HD? Researchers in Australia and New Zealand looked at this model using ANZDATA registry data. Those treated with PD only (n=168) had the highest risk of technique failure and death, while those who did only home HD or who transitioned from PD to home HD fared much better.

Read the abstract » | (added 2015-07-08)

Tags: Home dialysis

Implantable microdialysis without dialysate fluid – in rats

What if we could implant an artificial kidney that did not require dialysate fluid? Researchers have developed a microdialysis system using microfluidic channels and nanoporous membranes, and tested it in rats with kidney failure. Filtrate was successfully collected with no blood leaks in the system, and the levels of creatinine in their blood was significantly reduced.

Read the abstract » | (added 2015-07-08)

Tags: Dialysis

Metaanalysis of best practices in pregnancy on dialysis

What works best to ensure a healthy baby if women on dialysis become pregnant? A systematic literature analysis found that long-hour HD has the most support, while correcting vitamin B12, folate, iron, anemia, vitamin D, and calcium levels is also important. Success rates of greater than 75% are possible.

Read the abstract » | (added 2015-06-10)

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PKD liver and kidney size may limit PD

In Japan, oversized polycystic kidneys may be treated with transcatheter arterial embolization (TAE) to cut off their blood supply and shrink them. Among two small groups of people with PKD, even those with reduced kidney volume still tended to develop hernias.

Read the abstract » | (added 2015-06-10)

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New self-cannulation aid: Tattoo dots

In a case report of a patient who had a hard-to-feel fistula, small dots were tattooed to guide cannulation. With the permanent dots in place, the individual was able to self-cannulate and do home hemodialysis successfully.

Read the abstract » | (added 2015-06-10)

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Progress toward reengineering catheters to reduce infection

Can we eliminate exit site infections by redesigning catheters? Bioengineers are working on a way to create a biological seal that would keep germs out. A new device being tested uses a removable protective membrane that slowly grows out of the body, leaving a dry groove that reduces infections—at least in goats.

Read the abstract » | (added 2015-06-10)

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Status Report: Home HD in Japan

While just 0.1% of all Japanese people on dialysis use home HD, this number has been growing quickly. Work groups of the Japanese Society for Home Hemodialysis have been set up to start a patient registry and advise on supply and wastes and the cost burden for those who self-pay. Further challenges will include recruitment, education, a business model, and more.

Read the abstract » | (added 2015-06-10)

Tags: Home dialysis