Tag: PD (Page 9 of 48)

My Dialysis Team Meeting took place as scheduled this morning. We had a meeting that did not resolve my low Albumin reading from my latest lab. Recall that it dropped from 3.6 to 3.1 and an acceptable reading is over 4. We discussed six ways from Sunday what may have changed in my life and/or lifestyle to merit this change with no conclusions. As often happens in medicine, we’re now going to wait and see what my labs are as a result of my next scheduled lab on 9/6/2024. I will be doing an adequacy test at that time also so there will be a lot on the table.

One unique aspect of the meeting was that my dietician provided me with a 32 oz bottle of LiquaCel to try out as a protein supplement. My nephrologist also approved my use of protein powder to improve my protein intake. I’ve included a PR-type video below from the company that makes LiquaCel to familiarize readers with their products.

One of the many little nagging things that plague me as a result of kidney failure is bad breath. I do all the right things having to do with my teeth and mouth. I have my teeth cleaned three times a year and see the dentist like clockwork. I floss and brush every night without fail. Still, my wife informs me constantly that I have bad breath and to go brush my teeth. This leads to me wonder what the correlation is between being on peritoneal dialysis and bad breath. I quizzed Perxiplity about this with the following results:

There is a correlation between peritoneal dialysis (PD) and bad breath, also known as halitosis, in patients with end-stage renal disease (ESRD). Studies have shown that high blood urea nitrogen (BUN) levels and low salivary flow rates are associated with halitosis. Peritoneal dialysis can help decrease the level of halitosis by reducing BUN levels and increasing salivary flow rates over time[1][3][5].

Chronic renal failure, which leads to a buildup of waste in the blood (uremia), can result in halitosis. This condition is often described as having an ammonia-like odor, and it is one of the non-oral causes of bad breath in patients with kidney disease[4][5]. Additionally, oral health issues such as dry mouth and changes in taste are common in patients undergoing peritoneal dialysis, particularly those with diabetes[2].

Overall, while peritoneal dialysis can help reduce halitosis, the presence of bad breath may still occur due to underlying renal issues or other oral health conditions.

Citations:
[1] https://pubmed.ncbi.nlm.nih.gov/20338971/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525369/
[3] https://journals.sagepub.com/doi/10.3747/pdi.2009.00089
[4] https://southgablesdental.com/what-your-kidneys-and-bad-breath-have-in-common/
[5] https://www.ejgm.co.uk/download/comparison-of-systemic-oral-malodor-in-patients-undergoing-hemodialysis-and-peritoneal-dialysis-7176.pdf

Of interest to all of us on PD, is today’s topic, “What’s the hottest and most recent topic in peritoneal dialysis?” I turned to Perplexity with this topic as a prompt with the following results. Read on to stay up-to-date:

The hottest and most recent topics in peritoneal dialysis (PD) focus on several key areas of research and clinical practice:

1. Peritoneal Membrane Biology and Physiology: Understanding the biology and physiology of the peritoneal membrane is crucial for improving PD outcomes. This includes studying how the membrane functions and changes over time with PD treatment[1].
2. Metabolic Disturbances: Researchers are examining metabolic disturbances that occur in patients undergoing PD, which can affect overall health and treatment efficacy[1].
3. COVID-19 Impact: The pandemic has influenced PD practices and outcomes, prompting studies on how COVID-19 affects PD patients and their treatment[1].
4. Infections Related to PD: Peritoneal dialysis-related infections, such as peritonitis, remain a significant concern. Research is ongoing to better understand and prevent these infections[1][2].
5. Technological Advancements: The use of physiological modeling and artificial intelligence in PD is an emerging area, aimed at enhancing treatment personalization and improving patient outcomes[1].
6. Volume Management: Evaluating and managing the volume status of PD patients is a current research hotspot, which is essential for optimizing treatment and preventing complications[4].
7. Patient Outcomes and Trends: Studies have shown improvements in patient survival rates and reductions in peritonitis rates over time, indicating advancements in PD care and infrastructure[2].

These topics represent the forefront of research and development in peritoneal dialysis, aiming to improve patient care and treatment outcomes.

Citations:
[1] https://www.frontiersin.org/research-topics/20156/peritoneal-dialysis-recent-advances-and-state-of-the-art
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476299/
[3] https://journals.lww.com/cjasn/fulltext/2019/12000/trends_in_peritoneal_dialysis_use_in_the_united.14.aspx
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11001717/
[5] https://www.kidney.org/kidney-topics/taking-care-your-peritoneal-dialysis-pd-catheter

esterday I blogged about my Albumin lab result being in the toilet. From my July 2024 labs, my Cholesterol was at 218 where the goal is less than 200. For the same labs, my Triglycerides were 191 where the goal is less than 150. As a side, my Creatinine for the current lab was 8.20 which maps to an eGFR of 6 which is par for the course for someone on dialysis.

So here’s the deal as I see it. My wife and are are concentrating on bringing Albumin up with diet. The diet to do this also tends to reduce Cholesterol and Triglycerides resulting in a win-win combination. We are going to start working more salmon, tofu, smear case, and such foods into our diet.

I have a meeting with my dialysis team this coming Friday during which I’m certain I will first, get raked over the coals, and second, receive firm guidance as to what steps to take. Stand by for action.

TYhe lead graphic is from Poe’s FLUX-dev bot with Prompt: Picture of Popeye standing by for action on a sailing ship.

The phrase “in deep kimchi” is a humorous expression in the US military slang meaning to be in serious trouble. Why am I in deep trouble you ask? Looking at one of my recent lab results, you may notice that my Albumin dropped from 3.6 to 3.1, a full 0.5. You may now further ask, so what? That’s what this blog is about.

The form of protein found in your blood is called albumin. You can think of albumin as your body’s mail carrier – it delivers nutrients, vitamins, minerals, and energy you get from food to the rest of your body. It also helps the fluid you drink to stay in your cells and blood vessels, and it helps fight infection. Dialysis removes some of the albumin in your blood which is why people on dialysis need to have a protein source at every meal and sometimes with snacks.

With this background, I asked several questions of Perplexity which are included in the following dialog. Read on for more info on this complex subject. The bottom line is that lower Albumin levels lead to a higher probability of death. Got your attention now?

In peritoneal dialysis (PD) patients, serum albumin levels below specific thresholds indicate increased mortality risk. A baseline serum albumin level below 3.0 g/dL is associated with a more than threefold higher risk of all-cause, cardiovascular, and infection-related mortality compared to levels between 4.00-4.19 g/dL[1]. Additionally, PD patients with serum albumin levels below 3.8 g/dL also face an increased mortality risk[1]. Maintaining serum albumin levels above these thresholds is crucial for reducing mortality risk in PD patients.

Citations:
[1] https://pubmed.ncbi.nlm.nih.gov/21601335/
[2] https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-019-1433-8
[3] https://www.sciencedirect.com/science/article/abs/pii/S0272638611007293
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159826/
[5] https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.917603/full

To raise albumin levels in peritoneal dialysis patients, a diet rich in high-quality protein is essential. Recommended protein sources include lean meats like chicken and fish, eggs, and dairy products such as cottage cheese and Greek yogurt[1][4][5]. It’s important to avoid processed meats due to their high sodium and phosphorus content[1][4]. Additionally, incorporating protein-rich foods like tofu and protein supplements can be beneficial[4]. Consulting with a dietitian can help tailor a diet plan that meets individual needs while maintaining kidney health[1][5].

Citations:
[1] https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/peritoneal-dialysis/eating-nutrition
[2] https://www.jrnjournal.org/article/S1051-2276%2803%2900035-9/fulltext
[3] https://advancingdialysis.org/peritoneal-dialysis/nutritional-status-concerns-for-peritoneal-dialysis-patients/
[4] https://www.davita.com/diet-nutrition/articles/advice/15-kidney-friendly-protein-foods-for-keeping-albumin-up
[5] https://www.kidney.org/atoz/content/nutripd

To increase albumin levels in peritoneal dialysis patients, incorporating high-quality protein foods into the diet is essential. Recommended foods include:

• Lean meats: Turkey or lean beef burgers provide high-quality protein and iron.
• Chicken: Fresh chicken offers significant protein without excess sodium or phosphorus.
• Fish: Options like salmon, mackerel, and rainbow trout are excellent protein sources.
• Eggs: Deviled eggs and egg whites are easy protein-rich snacks.
• Dairy: Greek yogurt and cottage cheese are good protein sources with lower potassium.
• Tofu: A versatile protein alternative for meat, poultry, and fish[3].

Citations:
[1] https://www.jrnjournal.org/article/S1051-2276%2803%2900035-9/fulltext
[2] https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.760394/full
[3] https://www.davita.com/diet-nutrition/articles/advice/15-kidney-friendly-protein-foods-for-keeping-albumin-up
[4] https://go.gale.com/ps/i.do?aty=open-web-entry&id=GALE%7CA123327278&issn=1526744X&it=r&linkaccess=abs&p=AONE&sid=googleScholar&sw=w&userGroupName=anon~e37d0809&v=2.1
[5] https://health.clevelandclinic.org/the-best-diet-for-parkinsons-disease

Since I am on Peritoneal Dialysis, it is of interest to me as I have a background in strategic management to delve into what’s going on in the industry per se. To accomplish this I quizzed Perplexity with the following prompt and results: Prompt: “What’s the latest in research or to market in the world of peritoneal dialysis?”

1. Market Growth and Trends:

• The global peritoneal dialysis market was valued at USD 4.52 billion in 2022 and is expected to grow at a compound annual growth rate (CAGR) of 5.86% from 2022 to 2030, reaching approximately USD 7.13 billion by 2030[1]. The growth is driven by factors such as increasing healthcare expenditure, the rising incidence of renal disorders, and the benefits of peritoneal dialysis over hemodialysis, including lower costs and greater patient mobility[1].
• The Asia Pacific region has emerged as the largest market for peritoneal dialysis, with significant contributions from countries such as China and India[1][5].

1. Technological Advancements:

• Technological advancements in devices, particularly automated peritoneal dialysis (APD), are anticipated to drive market growth. The device sector is expected to expand rapidly due to rising demand for APD[2].
• Baxter International introduced Sharesource Analytics 1.0, an eHealth solution for managing peritoneal dialysis patients at home, which provides comprehensive treatment information to healthcare providers[3].

1. Market Segmentation and Key Players:

• The peritoneal dialysis solution segment currently dominates the market, as solutions are essential for fluid exchange during dialysis[2].
• Key players in the market include Fresenius Medical Care, Baxter International, and Medtronic, among others. These companies are focusing on product launches, innovations, mergers, and partnerships to enhance their market position[2][4].

1. Challenges and Opportunities:

• Despite the growth, challenges such as the lack of skilled professionals, stringent regulatory policies, and technical failures in peritoneal dialysis remain[1].
• Growth opportunities include increasing awareness of chronic kidney disease (CKD), government initiatives, and the development of independent dialysis facilities[2][4].

Overall, the peritoneal dialysis market is experiencing robust growth due to technological advancements and increasing demand for home-based treatments, although it faces challenges related to regulatory and technical issues.

The lead graphic was produced using the FLUX Rev bot of Poe with the Prompt: “Picture of Popeye looking at spreadsheets and charts and pondering the future of the peritoneal dialysis market”

Citations:
[1] https://www.thebrainyinsights.com/report/peritoneal-dialysis-market-13236
[2] https://www.skyquestt.com/report/peritoneal-dialysis-market
[3] https://www.polarismarketresearch.com/industry-analysis/hemodialysis-and-peritoneal-dialysis-market
[4] https://www.grandviewresearch.com/industry-analysis/hemodialysis-peritoneal-dialysis-market
[5] https://www.fortunebusinessinsights.com/industry-reports/peritoneal-dialysis-market-100089
[6] https://finance.yahoo.com/news/global-hemodialysis-peritoneal-dialysis-research-145700826.html?_guc_consent_skip=1721779028
[7] https://www.linkedin.com/pulse/peritoneal-dialysis-market-share-2032-mlmff
[8] https://www.linkedin.com/pulse/peritoneal-dialysis-market-detailed-analysis-current-2welf

My life on peritoneal dialysis continues to roll along nicely. Yesterday was more or less a day off for me. My wife and I traveled to a city about 25 miles north of us named Weatherford, TX to shop for items to put into two thank you basked for the kindness shown to us by our neighbors. One basket is for the couple who helped us lay sod on our former iris bed; the other is for our next-door neighbors who continue to drop off the most delicious food you have ever tasted just because they can. The same second neighbor also informed me that we have a broken sprinkler head along our property line. I checked it out and he’s right. I’ll fix it later today.

Speaking of today, at 0900 I have labs at Fresenius which will take a couple of hours counting travel time. I am not expecting anything out of the ordinary as I explained in the previous blog, my biometrics are currently locked in with good numbers. BTW, my weight this AM was again 141.0, in the grove.

From time to time I cite that I have used Perplexity or Poe to assist in writing this blog. Yesterday I received notification from Poe that they have made available a state-of-the-art bot to make pictures named Flux. There are three versions and two of them are free. I used Flux-dev with the Prompt: “Picture of Popeye eating spinach” for the lead graphic. Pretty cool.

After over a week of being on reduced dwell times for my evening PD treatment, I’m very happy to report that to date, I have felt no indication that it is not working as it should. I feel good when I wake up – earlier now – and more or less put in a full day of outside activities, mostly working in our yard.

Yesterday our two “weeders” arrived as promised and made fast work out of cleaning out our last bed, the one by the single garage. They raked, blew, and took away all the debris, all of this in approaching 100-degree F heat. You got to hand it to the Hispanics in North Texas. They are more than willing to work and can stand the heat that would put a more mortal man on their knees. Out of this bed, we got approximately four 64-gallon plastic bags of stuff that they hauled off.

On another subject, for the last nine days, my morning weight has been 141.0 except for two days when it was 142.0. I suspect on those two days I forgot to do a static drain but did on the others. The point is, I have been using only 1.5% solution and my weight is hanging in there which is what we want.

I haven’t been taking ANY blood pressure medication for a couple of months and these morning readings are also right in there. My readings have ranged from 141/76 to 121/74, with the vast majority in the 120s/70s. I’d say we have a handle on this also. Likewise, my morning, fasting glucose has mostly been in the 90s and 100 to 109 after taking an evening insulin shot of 9 units so I’m very pleased with this also.

The bottom line, at least from a definitive biometric viewpoint, I am hanging in there very well. Hope my readers are also.

Yesterday at 10 AM I visited our local CVS pharm and received my second Shingles shot. So that’s completed. Later in the afternoon I played with their APP and found that I was able to download in PDF format my vaccination records with them dating back to 2014 which I did. I then send this PDF to both my dialysis nurse and GP to bring my records up to date. BTW, I always send my GP our monthly PD lab results also to keep him up-to-date. He is, after all, an important member of my overall health team. We can forget this in our drive to achieve normalcy through dialysis.

Come Thursday I have a lab visit with my temp dialysis nurse. My regular dialysis nurse has August off due to the repair of a rupture. Let’s hope she is doing well.

And if that wasn’t enough, our stock account is down over $20,000 for the day. Enough to make you want to cry in your beer!