Journal Watch

  • Matching home dialysis to lifestyle

    A "continuum home program concept" described in a new article would help people with kidney failure continue their lifestyles with dialysis—rather than disrupt them with treatment. The aim is for a continuous flow of services from education to treatment choice, dialysis access, and option changes when needed.

    Read the abstract » | (added 2011-02-24)

    Tags: Chronic kidney disease

  • MYTHBUSTERS: microwaving PD fluid does NOT create glucose degradation products (GDPs)

    While the belief persists that microwaving PD bags creates harmful GDPs when sugars are caramelized, the literature does not bear this out:

    GDPs are a concern with PD fluid, but these are created when the fluid is manufactured, not when it is heated by the user. Of course, "hot spots" are still a concern. Anyone using a microwave to heat PD fluid should flip the bag from side to side to mix the contents well and use a thermometer strip to reduce the risk of burns.

    Read the abstract » | (added 2011-02-24)

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  • Does dialysis time matter? YES!

    Perhaps if in-center folks got more HD, they would see that they feel better—and think about home. Per Drs. Lacson and Lazarus from Fresenius, "Compelling rationale and recent outcome data support use of longer Td [dialysis time]...Until such time that results from prospective randomized trials are available, we believe that physicians should prescribe and exert all efforts to convince thrice-weekly hemodialysis patients to accept 4 h as minimum Td."

    Read the abstract » | (added 2011-02-24)

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  • PD doesn't zap your heart

    "Myocardial stunning" occurs in HD due to brief periods of not enough blood flow to the heart muscle. Over time, as this happens over and over, it can cause heart damage. In a small study (just 10 people') looking at heart muscles, PD exchanges did not reduce blood flow to the heart—so, no stunning occurred.

    Read the abstract » | (added 2011-02-24)

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  • Fungal peritonitis (FP)? Take catheter out sooner rather than later

    FP is a rare but serious problem on PD—and it can be lethal. A new study of 94 cases found that survival was nearly 3 times better when the infected catheter was removed within 24 hours of diagnosis.

    Read the abstract » | (added 2011-02-24)

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  • Future of the artificial kidney

    Learn the latest on futuristic dialysis with wearable and miniaturized devices!

    Read the abstract » | (added 2011-02-24)

    Tags: Chronic kidney disease

  • Naturally higher red blood cell counts do NOT reduce survival

    It never made sense to us that a "normal" hemoglobin level would somehow become harmful in kidney failure. And, in fact, it's not the Hgb itself that causes harm. A new DOPPS study of 545 people on dialysis whose Hgbs were normal without ESA drugs found no difference in survival.

    Read the abstract » | (added 2011-02-24)

    Tags: Chronic kidney disease

  • Buttonholes made easier with BioHole™ device

    A polycarbonate peg placed in the needle track after dialysis can form buttonholes more quickly and accurately than using cannulation alone. The BioHole peg may help more people use the buttonhole technique—so they can take their treatments home.

    Read the abstract » | (added 2011-02-24)

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  • Electrolyte management with more-frequent HD

    How do you adjust short daily or nocturnal HD treatments to keep electrolytes in balance? This abstract isn't all that helpful—but you may want to get hold of the whole article.

    Read the abstract » | (added 2011-02-24)

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  • Better CKD care saves lives

    People who met targets for access, hemoglobin, and blood protein levels before starting dialysis were far more likely to survive the first year, finds a new study of 192,307 patients. But just 2% met all three goals—even when they'd been seeing a nephrologist for a year.

    Read the abstract » | (added 2011-02-24)

    Tags: Chronic kidney disease