Journal Watch

  • New hope for stopping peritoneal fibrosis

    There are vitamin D receptors all over the body. Low levels of vitamin D have been linked with severe fibrosis. This study gave mice peritoneal fibrosis and then looked at the impact of treatment with a vitamin D analog (22-oxacalcitriol). The treatment significantly prevented fibrosis and thickening of the peritoneum.

    Read the abstract » | (added 2013-04-29)

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  • More HD lowers C-reactive protein and boosts nutritional status

    A study from Iran found that adding one standard HD treatment per week for 6 weeks significantly decreased C-reactive protein (a measure of inflammation), and increased serum albumin and BMI. The authors conclude that getting more HD may reduce the risk of cardiovascular events.

    Read the abstract » | (added 2013-04-29)

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  • Swedish patients who do home HD first have excellent survival

    In Sweden, 128 patients who chose home HD as their first treatment and were under age 60 had 10-year survival of 75%, 20-year survival of 47%, and 30-year survival of 23%. For patients in this age group, getting a transplant did not further improve survival.

    Read the abstract » | (added 2013-04-29)

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  • Icodextrin metaanalysis – no impact on patient survival

    Australian researchers analyzed 11 studies of icodextrin vs. glucose PD fluid (1222 patients). Icodextrin did help reduce fluid overload without harming residual kidney function. But, it did not help reduce peritonitis, technique failure, or other adverse events. And, patients who used icodextrin did not live any longer.

    Read the abstract » | (added 2013-04-29)

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  • Patients with diabetes & renters may need extra help for home HD

    Among 177 Canadian patients who started home HD training, 24 did not finish and 8 had technique failure in the first year. The strongest predictors of failure were diabetes or rented housing. These patients may need extra support to succeed.

    Read the abstract » | (added 2013-04-29)

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  • Wearable and implantable kidney devices

    The current standard in-center paradigm needs to change, say the authors of this review. Radically new approaches are needed to improve patient outcomes and quality of life. Two such approaches on the horizon are wearable and implantable devices.

    Read the abstract » | (added 2013-02-27)

    Tags: Chronic kidney disease

  • Home HD beliefs of patients and care partners in Italy

    Home HD is underused in Italy. Interviews found three positive themes: flexibility/freedom, comfort in familiar surroundings, and altruistic motivation to be an example for others. Four negative themes were also found: disrupted sense of normality, family burden, housing constraints, and healthcare by "professionals", not "amateurs".

    Read the abstract » | (added 2013-02-27)

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  • PD corrects metabolic acidosis better than standard in-center HD

    Too-low bicarbonate levels are a risk factor for death. Among 110,951 standard in-center HD patients and 10,400 PD patients, bicarb levels were much lower in those on PD. Survival data suggest that it is safest to keep bicarb levels higher than 22mEq/L for all ESRD patients—on any modality.

    Read the abstract » | (added 2013-02-27)

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  • Multidisciplinary training to reduce peritonitis in PD

    Researchers in Uruguay developed a tool to assess practical PD skills. They found that one on one lessons, retraining, and group meetings for PD patients cut the peritonitis rate nearly in half.

    Read the abstract » | (added 2013-02-27)

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  • Alert: Icodextrin PD fluid can mask hypoglycemia

    A case report of an 80 year old man in the emergency room highlights the need for healthcare providers to be aware of the impact of icodextrin PD fluid on blood sugar. Handheld glucose meters can overestimate blood sugar. A lab test can verify blood sugar if symptoms of hypoglycema are present and the glucometer reading is normal.

    Read the abstract » | (added 2013-02-27)

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