Journal Watch

  • 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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  • 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 2011-02-24)

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  • 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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  • Female sexual function better on PD than standard in-center HD

    If you're a woman, a new study finds that a transplant is the best way to restore your sexual function to normal levels. But PD did a much better job than standard HD—and the study didn't look at daily or nocturnal HD.

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

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  • PKD is not a barrier to successful PD

    In a study that compared 56 people with polycystic kidney disease on PD to 56 non-diabetic people with small kidneys on PD, there were no differences between the two groups after 37 months.

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

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  • Need an MRI? Ask for NAC + bicarb

    MRI contrast dye can damage kidneys. A new meta-analysis (study of studies) has found that two approaches are better than one in preventing this damage. N-acetylcystein (NAC, or Mucomyst®) plus bicarbonate-based IV fluid reduced the risk of damage by 35%. The authors say this combo treatment should be used for all high-risk patients—including those with CKD.

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

    Tags: Chronic kidney disease

  • Need high doses of EPO? Might want to check for CMV

    A new study from the Netherlands has found that people who have ESRD and have been exposed to the cytomegalovirus (CMV) have immune changes. With fewer working T-cells, they can't respond as well to anemia drugs.

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

    Tags: Chronic kidney disease

  • CKD education saves lives

    A new study from Taiwan found that people who got CKD education were about 3 times less likely to need dialysis during the study period (about a year), and more than 5 times more likely to live than a control group that did not receive the education.

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

    Tags: Chronic kidney disease

  • Slow the rate of CKD with baking soda?

    A small UK pilot study found that a group of people with CKD who were randomly assigned to take a tablet of sodium bicarbonate each day had kidney function that fell 2/3 more slowly than controls. The baking soda group was less likely to need dialysis. More research is needed—and a doctor should supervise any medication use in CKD. But this is promising, and more studies may prove the benefit.

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

    Tags: Chronic kidney disease

  • If you have CKD, EAT!

    We know that malnutrition in people on dialysis is a killer. Turns out that the same holds true with earlier stages of chronic kidney disease (CKD). A new study found that people with CKD who had lower levels of protein (albumin) in their blood were 70% more likely to die.

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

    Tags: Chronic kidney disease