Journal Watch

  1. Implantable microdialysis without dialysate fluid – in rats

    What if we could implant an artificial kidney that did not require dialysate fluid? Researchers have developed a microdialysis system using microfluidic channels and nanoporous membranes, and tested it in rats with kidney failure. Filtrate was successfully collected with no blood leaks in the system, and the levels of creatinine in their blood was significantly reduced.

    Read the abstract » | (added 07/08/2015)

    Tags: Dialysis

  2. It’s (past) time to avoid 3-day interdialytic intervals

    A new review paper considers the ill effects of the thrice weekly standard in-center HD schedule and finds it wanting, noting higher mortality on the day after the long gap than any other day of the week. The authors conclude that the data warrant “reexamining the issue of timing and frequency of prescribed dialysis regimens in order to improve patient outcomes.”

    Read the abstract » | (added 07/08/2015)

    Tags: Hemodialysis

  3. Are we finally nearing the end of Kt/V?

    We have been vocal critics of Kt/V on Home Dialysis Central since the start—and now we are not alone. A new paper finds that Kt/V is not a good fit for short daily or long nocturnal treatments, to the point where, “urea kinetics are hardly if at all representative for those of other solutes with a deleterious effect on morbidity and mortality of uremic patients.”

    Read the abstract » | (added 07/08/2015)

    Tags: Nocturnal Hemodialysis, Hemodialysis

  4. Outcomes of “integrated home dialysis” (PD then home HD)

    What happens to people after PD fails—and why not plan to get them home on HD? Researchers in Australia and New Zealand looked at this model using ANZDATA registry data. Those treated with PD only (n=168) had the highest risk of technique failure and death, while those who did only home HD or who transitioned from PD to home HD fared much better.

    Read the abstract » | (added 07/08/2015)

    Tags: Peritoneal Dialysis, Home Dialysis, Hemodialysis

  5. Icodextrin PD fluid reduces insulin resistance in non-diabetic patients

    Even without diabetes, insulin resistance can add to cardiovascular disease risk in people with CKD. A new study randomized non-diabetic adults to APD with 2.5% glucose (n=27) for the long dwell or icodextrin 7.5% (n=33). At 90 days, the icodextrin group had lower levels of insulin resistance.

    Read the abstract » | (added 07/08/2015)

    Tags: Peritoneal Dialysis

  6. Metaanalysis: PD fluid with fewer GDPs improves outcomes

    Glucose degradation products (GDPs) are known to damage the delicate peritoneum. PD fluids with neutral pH and low levels of GDPs were reviewed in a new study of 11 randomized controlled trials (n=643). While most of the studies were of poor quality, low-GDP PD fluid was better at preserving residual kidney function and urine volume for a year than standard PD fluid.

    Read the abstract » | (added 07/08/2015)

    Tags: Peritoneal Dialysis

  7. More glucose in PD fluid makes it harder to cure peritonitis

    A look back at bacterial peritonitis among 187 people on CAPD compared those whose peritoneum was exposed to more than 140 grams per day of glucose—or less. Those who used less glucose had a higher cure rate, fewer relapses, and less need for catheter removal.

    Read the abstract » | (added 07/08/2015)

    Tags: Peritoneal Dialysis

  8. Status Report: Home HD in Japan

    While just 0.1% of all Japanese people on dialysis use home HD, this number has been growing quickly. Work groups of the Japanese Society for Home Hemodialysis have been set up to start a patient registry and advise on supply and wastes and the cost burden for those who self-pay. Further challenges will include recruitment, education, a business model, and more.

    Read the abstract » | (added 06/10/2015)

    Tags: Home Dialysis, Hemodialysis

  9. Metaanalysis of best practices in pregnancy on dialysis

    What works best to ensure a healthy baby if women on dialysis become pregnant? A systematic literature analysis found that long-hour HD has the most support, while correcting vitamin B12, folate, iron, anemia, vitamin D, and calcium levels is also important. Success rates of greater than 75% are possible.

    Read the abstract » | (added 06/10/2015)

    Tags: Hemodialysis

  10. Progress toward reengineering catheters to reduce infection

    Can we eliminate exit site infections by redesigning catheters? Bioengineers are working on a way to create a biological seal that would keep germs out. A new device being tested uses a removable protective membrane that slowly grows out of the body, leaving a dry groove that reduces infections—at least in goats.

    Read the abstract » | (added 06/10/2015)

    Tags: Peritoneal Dialysis