Journal Watch
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Left Atrial Remodeling Not Found After 1 Year of Nocturnal HD
While left ventricular mass has been shown to regress with intensive HD, the same does not seem to hold true for the left atrium, nor did the ejection fraction improve, finds a new study of 37 patients switched from conventional HD. Read the abstract.
Read the abstract » | (added 09/10/2018)
Tags: Cardiac Mri, End Stage Renal Disease, Hemodialysis, Left Atrium
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Nocturnal HD is Underused
A new review suggests that the improved outcomes associated with more hours of HD in-center or at home mean that these options should be used more. Read the abstract.
Read the abstract » | (added 09/10/2018)
Tags: Quality Of Life, Hd, Extended Hours, Improved Outcomes, Nocturnal Dialysis
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Biocompatible PD Solutions Maintain Membranes Longer
Independently of inflammation, biocompatible PD solutions helped 71 patients keep a steady level of solute transport over 7.5 years, compared to 295 patients who used standard solutions. Read the abstract.
Read the abstract » | (added 09/10/2018)
Tags: Peritoneal Dialysis, Peritonitis, Icodextrin, Peritoneal Membrane, Dialysis Solutions, Glucans, Glucose, Il6 Protein, Human, Inflammation, Interleukin 6, Peritoneal Fibrosis, Peritoneum, Creatinine, Hospitalization
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PD Catheter Outcomes in Low vs. High-Volume Centers
Not surprisingly, patients whose PD catheters were placed at high-volume centers (in Japan) had fewer adverse events, needed feer blood transfusions, and had shorter hospital stays than those from low-volume centers. Read the abstract.
Read the abstract » | (added 09/10/2018)
Tags: Pd, Catheter, Hospital Volume
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Gender and Malnutrition in PD
Do hypoalbumineumia, overhydration, inflammation, and cardiovascular risk affect men and women on PD differently? A small study (N=26 men and 28 women) with comparable BMI found more fluid overload, inflammation, and heart risk in women with low serum albumin than in men. Read the abstract.
Read the abstract » | (added 09/10/2018)
Tags: Gender, Malnutrition, Cardiovascular Risk, Hypoalbuminemia, Inflammation, Overhydration, Peritoneal Dialysis
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5-year study: Predialysis PD Education Saves Lives on PD
Among 398 patients who started PD from 2007-2016, 169 had received predialysis education. After 5 years, this group had a significantly lower rate of peritonitis, a longer median time to a first peritonitis episode, and less risk of death from peritonitis than patients who did not get CKD education. Read the abstract.
Read the abstract » | (added 09/10/2018)
Tags: Pd, Predialysis, Peritonitis, Mortality, Ckd Education
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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
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Driving Home Dialysis Takes More Than Money
Are financial incentives enough to change nephrologist practice to favor home therapies? Only a little, finds a comprehensive literature review and an international workshop. Other levers, such as the framework of funding for clinics, nephrologist belief in home treatments, and direct costs to patients (e.g., utilities) may play a role as well.
Read the abstract » | (added 08/13/2018)
Tags: Home Dialysis, Financial Incentives, Nephrologist Practice
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Home HD After PD Failure May Lead to More Transplants, Lower Mortality
Since PD failure can lead to hospitalization and death in those who switch to standard in-center HD (ICHD), would outcomes improve with home HD? A new analysis found 521 patients in the USRDS data who made the change. Compared to matched ICHD patients, the chance of transplant was nearly double (21% vs. 10.6%), while survival of home HD patients was 89.1% at 1 year and 80.5% at 2 years.
Read the abstract » | (added 08/13/2018)
Tags: Pd Technique Failure, Ichd, Transplant, Home Hd, Lower Mortality
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Regional Variation in PD Infection Prevention
A PDOPPS analysis of surveys from medical directors caring for more than 11,000 patients from 170 clinics in seven countries (Australia, New Zealand, Canada, Thailand, Japan, the UK, and the US) found variation from 63% to 100% in use of antibiotic prophylaxis for PD exit sites, with mupirocin used most often.
Read the abstract » | (added 08/13/2018)
Tags: Peritoneal Dialysis Related Infections, Peritoneal Dialysis, Infections, Peritoneal Dialysis Outcomes