Journal Watch

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  • SARS-CoV-2 in PD Effluent

    Analysis of bodily fluids from 3 SARS-CoV-2-infected PD patients found that, while viral load was quite high in nasopharyngeal swabs, none of the PD effluent tested positive, even after dialysate concentration. This suggests that the risk of virus transmission from used PD fluid may be low.

    Read the abstract » | (added 2020-09-11)

    Tags: COVID 19, SARS CoV 2, Peritoneal Dialysis

  • How Much Dialysate Should be Used for Nocturnal HD With NxStage?

    Predictive modeling finds that the dialysate lactate concentration used for short daily HD may not be appropriate for nocturnal HD. Since the effect of lactate mainly depends on weekly dialysate volume, reducing from 60 to 30 liters for frequent nocturnal HD may be appropriate.

    Read the abstract » | (added 2020-08-11)

    Tags: Home Hemodialysis, Lactate, Acid Generation, Dialysate

  • Peritonitis with Diarrhea Could be C-diff

    Cloudy PD dialysate can signal infectious peritonitis from a variety of causes—including C-diff. But, use of cephalosporins could worsen a C-diff infection. A new article presents two case histories of C-diff peritonitis and suggests reexamining the traditional empiric treatment of peritonitis when diarrhea is present.

    Read the abstract » | (added 2020-03-16)

    Tags: PD Dialysate, Infectious Peritonitis, C diff, Cephalosporins, Empiric Treatment, Diarrhea

  • Green Nephrology: Reducing the Environmental Impact of Dialysis

    Climate change and extreme weather events both increase the incidence of kidney disease and destabilize care. But, healthcare in general—and dialysis in particular—contribute substantially to greenhouse gases. Monitoring resources and reducing waste in HD can be done through reuse of RO reject water, renewable energy sources, better waste management, and slower dialysate flow rates. For PD, point-of-care dialysate will reduce the environmental impact.

    Read the abstract » | (added 2020-02-19)

    Tags: Environmental Change, Kidney Disease Factors, Environmental Impact Of Dialysis

  • 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 2020-01-09)

    Tags: Low flow Dialysate, Nocturnal Home HD, Phosphate Binders, Blood Pressure Medication

  • 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 2019-07-15)

    Tags: Daily HD, Potassium, Bicarbonate, Dialysate

  • 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 2018-10-12)

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

  • 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 2018-10-12)

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

  • 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 2018-08-13)

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

  • 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 2018-08-13)

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