Journal Watch

  1. How to prescribe intensive home HD: A guide for the nephrologist

    This article describes each of the types of intensive home HD, and offers prescription guidance from experts.

    Read the abstract » | (added 12/09/2014)

    Tags: Home Dialysis, Hemodialysis

  2. More protein intake with nocturnal HD—but no change in body composition

    Among 11 people doing nocturnal HD, protein intake increased significantly compared to matched standard in-center HD controls. But, one year later, total body mass, fat-free mass, and fat mass did not change.

    Read the abstract » | (added 12/09/2014)

    Tags: Nocturnal Hemodialysis, In Center Hemodialysis

  3. Nocturnal HD reduces blood endotoxin levels

    Endotoxin drives inflammation throughout the body. Which type of HD is most effective at reducing endotoxin in the blood? This study compared standard in-center HD (n=56) to short daily HD (n=20) and nocturnal HD (N=10). Endotoxin levels were highest when ultrafiltration rates were highest (standard in-center HD) and lowest among those doing nocturnal HD.

    Read the abstract » | (added 12/09/2014)

    Tags: Nocturnal Hemodialysis, Hemodialysis

  4. Cochrane database review favors home HD over standard in-center HD

    Just one, small (n=9) randomized controlled trial (RCT) lasting 8 weeks could be found that looked at home HD (extended) vs. standard in-center HD in adults. But, based on this, the Cochrane Database Systematic Review was able to get a paper published. Home HD reduced 24 hour blood pressure and improved uremic symptoms. The authors recommend more RCTs.

    Read the abstract » | (added 12/09/2014)

    Tags: Home Dialysis, Hemodialysis

  5. Is low blood sodium as harmful in PD as it is in HD?

    Hyponatremia (low blood sodium levels) raise the risk of death in people who do standard in-center HD. A prospective observational study of 441 incident PD patients found a higher mortality risk among those who did PD, too. In fact, after 3 years, the 1/3 of study participants whose sodium was lowest had a 79% higher risk of death than those whose levels were higher.

    Read the abstract » | (added 12/09/2014)

    Tags: Peritoneal Dialysis, Hemodialysis

  6. On PD, motivation matters

    With the changes in the bundle, more people are being started on PD. In a study of 104 people on PD followed for 14 months, nurse ratings of home cleanliness or patients’ exchange techniques did not predict outcomes. Instead, unmotivated or depressed people were significantly more likely to have peritonitis.

    Read the abstract » | (added 12/09/2014)

    Tags: Peritonitis, Peritoneal Dialysis

  7. Don’t trust glucometers on people using PD with icodextrin

    Glucometer test strips can’t distinguish glucose from other sugars, like maltose. When icodextrin is used for PD in people with diabetes, standard glucometer use is risky. Blood glucose test results from glucometers can’t be trusted, and people may be given insulin they don’t need (which could cause coma or death). Three case reports show why this is the case—and the authors suggest using glucose-specific blood tests instead.

    Read the abstract » | (added 12/09/2014)

    Tags: Peritoneal Dialysis

  8. New PD catheter technique uses Amplatz dilators

    A laparoscope paired with Amplatz dilators to form the skin tunnel was used in 100 people who needed a PD catheter. The omentum was trimmed if it was long, and adhesions were lysed when present. There were no exit site or tunnel infections with this technique, and no catheter cuff extrusions. No catheters migrated or were displaced—and 97% of the catheters were working 6 months later.

    Read the abstract » | (added 12/09/2014)

    Tags: Peritoneal Dialysis

  9. Emergent-start PD works!

    It flat-out makes more sense for people who need dialysis emergently to do PD, if possible, than to start HD with a catheter. A new review suggests that emergent-start PD may have a higher risk of catheter problems—but not infection. On the other hand, emergent-start HD risks both catheter problems and infection. The authors conclude that emergent-start PD is a “feasible, safe, and efficient alternative.”

    Read the abstract » | (added 12/09/2014)

    Tags: Peritoneal Dialysis, Hemodialysis

  10. Are portable or wearable kidney devices on the horizon?

    Nanotechnology may allow for a new generation of wearable and portable devices to treat kidney failure. Some are now in large animal and human trials. A new day may be coming.

    Read the abstract » | (added 11/07/2014)

    Tags: Chronic Kidney Disease