Journal Watch
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Home HD may be a good fit for obese patients
An Australian clinic has successfully trained 23 obese people (BMI >30) to do home HD between 2001 and 2009. Patients stayed on the treatment for an average of 43.7 months.
Read the abstract » | (added 2012-10-25)
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Mathematical modeling shows long, slow HD is better
Dropping the blood flow rate from 350 mL/min to 175 mL/min and dialyzing for 8 hours instead of 4 removes significantly more wastes—especially beta2 microglobulin, which causes amyloidosis.
Read the abstract » | (added 2012-10-25)
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Long-term effects of daily HD on vascular access
Does more frequent use of a vascular access create problems for those who do short daily HD? A new 4-year prospective, randomized study of 77 people says NO. Patients did six 3-hour HD sessions per week (n=26) or three 4-hour sessions (n=51). There were fewer access procedures in the daily group (543.2 per 1000 patient years, vs. 400.8), though this difference was not significant. There was also no difference in time to first access revision or access failure.
Read the abstract » | (added 2012-10-25)
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Chest ultrasound finds some lung congestion in asymptomatic PD patients
Italian researchers did chest ultrasounds on 88 PD patients. Just under half had moderate to severe lung congestion—even though 57% had no shortness of breath, and only 27% had foot swelling.
Read the abstract » | (added 2012-10-25)
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How to overcome barriers and set up a successful home HD program
Want to establish a home HD program, but don't know how to overcome the barriers? Look no further. This review article by giants in the field will help you get started.
Read the abstract » | (added 2012-10-25)
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A "self-locating" PD catheter
The Di Paolo self-locating PD catheter was tested in 20 patients in Italy. The researchers found no infections, and only 0.8% dislocated catheters—vs. 12% for Tenkhoff PD catheters.
Read the abstract » | (added 2012-09-25)
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Longer or more-frequent HD normalizes mortality patterns
It has long been known that those on PD have an equal chance of dying on any day of the week—while standard in-center HD are much more likely to die on a Monday (or Tuesday with Tue-Thu-Sat treatments). A new study looking at 14,636 Australian registry deaths found that those who got more than 3 standard in-center treatments per week or did home HD were no more likely to die on a Monday (or Tuesday) than any other day.
Read the abstract » | (added 2012-09-25)
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Are infections requiring hospitalization more common with PD or standard HD?
A study in Canada paired 910 people on PD with people on HD, matched by age, race, smoking, BMI, comorbid conditions, and lab data. After 2 years, researchers found that those on PD were more likely to be in the hospital for peritonitis—but less likely to have sepsis or pneumonia than those on standard HD.
Read the abstract » | (added 2012-09-25)
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Reasons why patients prefer more HD
An in-depth, interview study of 10 short daily or nocturnal HD patients in Canada found four main reasons why they liked their choice. 1) They felt better physically and mentally. 2) They felt more in control of their time. 3) They didn't feel "sick" and were more able to work. 4) They had the support they needed to succeed.
Read the abstract » | (added 2012-09-25)
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PD in older patients
This study from Ireland looked at 148 people over age 50 who started PD between 1998 and 2008. The mean age was 63; most were over 70. The researchers found no difference in survival or technique survival by age, though older people did need a longer hospital stay to get started on PD.
Read the abstract » | (added 2012-08-16)
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