Journal Watch - Dialysate

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  1. First European Patients Using Nocturnal Home HD with Low-flow Dialysate

    A retrospective analysis looked at 21 patients using low-flow dialysate for nocturnal home HD and followed for a minimum of 12 months. Participants had a mean dialysis duration of 28 hours per week; most used alternate nights and 50-60 L of dialysate per session. Use of phosphate binders and blood pressure medications was significantly reduced, and no patient safety events were reported.

    Read the abstract » | (added 01/09/2020)

    Tags: Low Flow Dialysate, Nocturnal Home Hd, Phosphate Binders, Blood Pressure Medication

  2. Impact of daily low-flow HD on potassium and lactate levels

    In the NxStage FREEDOM study, 345 patients switched from standard in-center HD to daily, low-flow HD. Blood levels of potassium and lactate were analyzed during the last 3 months of standard HD and the first 3 months of daily HD. On daily HD, predialysis serum potassium decreased significantly at a dialysate potassium level of 1 mEq/L, with no change at 2 mEq/L. Predialysis serum bicarbonate level decreased significantly with dialysate lactate concentration of 40 mEq/L—but increased significanty at 45 mEq/L. Choosing the correct dialysate for the patient is important.

    Read the abstract » | (added 07/15/2019)

    Tags: Daily Hd, Potassium, Bicarbonate, Dialysate

  3. MXene Sorbents: A Step Toward a WAK

    A sorbent tested for use in a wearable artificial kidney was able to adsorb urea with 99% efficiency in testing—twice the level removed with standard dialysate. The hemocompatible sorbent did not damage cells or reduce cell viability at the concentrations tested. A successful sorbent product will facilitate the design of a WAK. Read the abstract.

    Read the abstract » | (added 10/12/2018)

    Tags: Wearable Artificial Kidney, 2 D Materials, Urea, M Xene, Adsorption, Dialysate

  4. Peritonitis Symptoms in Older vs. Younger People

    A single center study compared the time to first episode of peritonitis treated successfully with antibiotics in PD patients >65 (n=79)compared to those who were younger (n=168). Of 377 peritonitis episodes, 126 were in the older group and 251 in the younger group. Older patients were less likely to have fever or cloudy dialysate as symptoms than younger patients, but rates of transfer to hemodialysis, relapse, hospitalization, and mortality were similar. Read the abstract.

    Read the abstract » | (added 10/12/2018)

    Tags: Peritonitis, Outcomes Of Peritonitis, Elderly Pd, Patient Pd

  5. Blood Flow Rates and Clinically Meaningful Solute Removal

    A prospective study of 17 patients looked at BFRs of 300, 350, and 450 and Kt/V urea, beta-2 microglobulin, and phosphorus when low dialysate flow rates were used. While Kt/V did increase, the impact on B2M and phosphorus were minimal.

    Read the abstract » | (added 08/13/2018)

    Tags: Daily Hemodialysis, Home Hemodialysis, Kt/V, Blood Flow

  6. Color of Used PD Dialysate Gives Diagnostic Clues

    A review article proposes a differential diagnosis of various conditions based on a change in the color of PD effluent from clear to red, orange, cloudy, milky white, green, yellow, purple or black.

    Read the abstract » | (added 08/13/2018)

    Tags: Bloody Effluent, Chyloperitoneum, Peritoneal Dialysis, Peritonitis, Rhabdomyolysis

  7. A New, Early Marker for Encapsulating Peritoneal Sclerosis?

    Can a drop in dialysate sodium sieving during a PET forecast EPS in advance? A 20-year, controlled longitudinal cohort study found a correlation. Of 161 incident PD patients, 13 went on to develop EPS—and sodium was the best predictor.

    Read the abstract » | (added 02/15/2018)

    Tags: Dialysate Sodium Sieving, Pet, Eps

  8. Urgent-start PD in Brazil

    In a prospective study, 51 patients who needed dialysis urgently began peritoneal dialysis instead of hemodialysis. Even with high-volume dialysate used less than 72 hours after catheter placement (on alternate days in the dialysis clinic), the option was feasible and safe. Read the abstract.

    Read the abstract » | (added 11/13/2017)

    Tags: Acute Peritoneal Dialysis, Unplanned Peritoneal Dialysis, Urgent Start Dialysis, Urgent Start Peritoneal Dialysis

  9. Bone Mineral Balance in Short Daily HD: A Cautionary Tale

    A new case report suggests that bone mineral balance may need extra attention for those doing short daily HD. A patient who had multiple fractures and bone pain severe enough to require a wheelchair for more than a year was found on biopsy to have osteomalacia, likely due to chronically low levels of serum phosphorus and calcium. Increasing these minerals in the dialysate enabled the patient to leave the wheelchair and walk pain-free.

    Read the abstract » | (added 09/15/2017)

    Tags: Education Issues: For Patients And Professionals

  10. Using PET Results to Screen for Encapsulating Peritoneal Sclerosis (EPS)

    Identifying EPS early is vital to effectively treat this rare but devastating problem. Researchers studied whether the amount of sodium removed from the dialysate (sodium sieving) could predict EPS, in a 20-year study of 161 people. Age at PD start, duration of PD, and sodium sieving were all important predictors.

    Read the abstract » | (added 01/09/2017)