Journal Watch - Metabolic
Will Zinc Supplements One Day Help Prevent Peritoneal Sclerosis?
Ironically, PD saves lives, but high-glucose PD fluid damages the peritoneum, leading to fibrosis that can make PD impossible. By activating a complex metabolic pathway, a study in rats found that supplementing with zinc helped prevent fibrosis.
Read the abstract » | (added 06/13/2019)
Standard Kt/V urea Targets Less Useful for Home HD
When patients do home HD more often than three times a week, do the Kt/V urea targets still predict outcomes? Not all that well, suggests a new study. Multivariate regression analysis of 109,273 standard in-center HD patients compared to 2,373 home HD patients found that while a lower Kt/V urea (<2.1) did predict higher blood pressure in both groups, it did not predict metabolic control in either group. For those on home HD, a low Kt/V did not predict hospitalization, mortality, or technique failure, though it did for in-center patients. The authors concluded that the current Kt/V urea targets “have limited utility” for home HD.
Read the abstract » | (added 02/15/2018)
Pilot Study: Flex Dialysis Facilitates Weight Loss
Patients who need to lose weight for better health or to obtain a transplant can be stymied by the strict diet limits of standard in-center HD. In a small series (four obese and two overweight patients), combining 2-6 sessions of flex, incremental HD with a coach-assisted weight loss program led to 5.7-20 kg weight loss over 12-30 months, better metabolic markers, and high patient satisfaction.
Read the abstract » | (added 01/08/2015)
All about icodextrin – in one place
A new review explains why and how to use icodextrin appropriately and avoid adverse events. Learn about the hemodynamic, metabolic, and idiopathic effects of this glucose-sparing PD fluid so you can prescribe it with confidence.
Read the abstract » | (added 07/07/2014)
PD corrects metabolic acidosis better than standard in-center HD
Too-low bicarbonate levels are a risk factor for death. Among 110,951 standard in-center HD patients and 10,400 PD patients, bicarb levels were much lower in those on PD. Survival data suggest that it is safest to keep bicarb levels higher than 22mEq/L for all ESRD patients—on any modality.
Read the abstract » | (added 02/27/2013)
Biocompatible PD solution preserves residual kidney function
Researchers in Korea looked at the long-term impact of using Fresenius Balance® (FB) fluid vs. standard PD fluid. After 24 months, the GFR of patients using FB was twice that of those using standard fluid. Patients using FB also had better correction of metabolic acidosis, and higher levels of cancer fighting antigens.
Read the abstract » | (added 11/27/2012)
Diabetes + PD? Icodextrin-aided fluid removal and metabolic control
A randomized controlled trial of glucose PD fluid vs. icodextrin (ICO) found significant benefits. Among 59 people with diabetes on CAPD, those in the group using ICO for the long exchange were far less likely to need higher concentration fluid (9% vs. 66%). And, the ICO group needed less insulin, had lower triglycerides, and had lower A1cs.
Read the abstract » | (added 02/24/2011)