Journal Watch - Impact

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  1. Impact of a Nurse-led Protocol on PD Fluid Overload

    Among PD patients divided into a group symptomatic of fluid overload (>2L; n=53) and a group that was not (n=50), a 12-week nurse-led education and motivation intervention—with hypertonic cycles for short-term relief of fluid overload—significantly reduced overhydration. Knowledge and adherence were both significantly improved as well.

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

    Tags: Fluid Overload, Hypertonic Cycles, Over Hydration

  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. Moving the PD Exit Site to Combat Infection

    A 5-year retrospective cohort analysis looked at the impact of treating PD exit site and tunnel infections in 27 patients by removing the cuff and relocating the catheter under local anesthetic. After follow up ranging from 10.8 to 79.4 months, no leaks occurred, and the infections resolved in 74% of the patients. The rest had to have their catheters removed.

    Read the abstract » | (added 06/13/2019)

    Tags: Exit Site Relocation, Exit Site Infection, Tunnel Infection, Peritoneal Dialysis Catheter, Pd Catheter

  4. Impact of High Protein Diets on Residual Kidney Function in PD

    Does a high-protein diet cause a faster loss of residual kidney function for PD patients? An observational study of 336 patients for at least 6 months suggests that it may.

    Read the abstract » | (added 01/11/2019)

    Tags: Protein Intake, Residual Kidney, Peritoneal Dialysis, 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. The Impact of AGEs on the Gut Microbiome in PD

    The Impact of AGEs on the Gut Microbiome in PD Advanced glycation endpoints (AGEs) cause inflammation and are linked with heart disease. A new PLoS One paper reports on a pilot trial of 20 PD patients who routinely ate a high-AGE diet. Ten were randomized to eat as usual, while 10 had their meals AGE-restricted for a month. Gut bacteria analysis found major shifts in the experimental group that could have clinical importance.

    Read the abstract » | (added 10/13/2017)

    Tags: Education Issues: For Patients And Professionals, Fistulas, Grafts And Catheters (Including Pd)

  7. The Impact of ESRD Treatment Modality on Sleep Quality

    A metaanalysis looked at whether changing from one treatment type to another (HD, daily HD, nocturnal HD, CAPD, CCPD, or transplant) would affect sleep. Sixteen studies with 670 patients and 191 controls were examined. Restless leg syndrome resolved in 60+% of patients who switched to CCPD, intensive HD, or transplant. Sleep apnea improved with these options as well. Overall sleep quality improved as the intensity of treatment increased.

    Read the abstract » | (added 06/12/2017)

    Tags: What Is The Best Dialysis Option For Me, Education Issues: For Patients And Professionals

  8. How dialysis clinics can help prevent peritonitis

    What can dialysis clinics do to reduce the risk of peritonitis in PD patients? In an analysis of 127 PD clinics and 5,017 new PD patients, having a nurse who specialized in PD or conducting home visits prior to the PD start had the biggest impact.

    Read the abstract » | (added 05/09/2017)

    Tags: Peritoneal Dialysis

  9. Home HD: Cost-effective With Better Outcomes Than In-center

    A review of the patient-centered and economic impacts of home HD that included studies between 2000 and 2016 found better quality of life, flexibility, employment potential, and survival vs. hospital HD. Minority and low-income patients still have less access than others, which compounds their already-poor health outcomes. The authors found that home HD is cost-effective and the use of this option should be increased.

    Read the abstract » | (added 03/09/2017)

    Tags: Hemodialysis

  10. The Impact of Telehealth on PD Satisfaction

    Per quarterly surveys completed by 200 people on PD, a system of telemedicine that included remote monitoring of blood pressure, weight, and glucose, and had educational videos boosted satisfaction with the option. Participants felt more autonomy and confidence in their health care, as well, and were less frustrated. Nearly half watched at least one video.

    Read the abstract » | (added 03/09/2017)

    Tags: Peritoneal Dialysis