Journal Watch - Peritoneal Dialysis
Safety Study of the PD Automated Wearable Artificial Kidney
In the AWAK pilot study, 15 participants used up to nine sessions over 72 hours and were then followed for one month. There were no serious adverse events, but 60% of participants had abdominal pain and 47% reported bloating. Median body weights were not significantly different before and after the study. Device enhancements will address ultrafiltration and pain.
Read the abstract » | (added 2021-06-15)
Tags: Wearable Kidney, Artificial Kidney, Chronic Kidney Disease, Peritoneal Dialysis
How the Ontario Renal Network (ORN) has been trying to grow home dialysis
ORN started efforts to increase home dialysis use in Ontario in 2012, using a new funding formula based on modality, mandatory informatics, home dialysis coordinator and assisted PD funding, support for urgent start PD, targets for home dialysis rates, a network of clinics committed to home therapies, and frequent leadership meetings. Did they succeed?
Read the abstract » | (added 2021-05-14)
Tags: Home Dialysis, Home Haemodialysis, Peritoneal Dialysis, Hd, Pd
Measure needed for life participation in PD
A literature review and metaanalysis of 301 studies identified 42 measures to assess life participation, but most were used in just one study or were not specific to PD. The authors conclude that a new measure is needed.
Read the abstract » | (added 2021-05-14)
Tags: Life Participation, Peritoneal Dialysis, Pd
U.S. nephrology fellows’ perceptions of their home dialysis training
To grow home therapies, we must have clinicians who are trained in PD and home HD. A survey of 110 nephrology trainees suggests that we are not there yet. Of the 76 respondents, most were moderately confident about PD principles—but not urgent start PD or catheter insertion. Confidence around home HD was low.
Read the abstract » | (added 2021-05-14)
Tags: Home Dialysis, Hd, Home Hemodialysis, Hdd, Peritoneal Dialysis, Pd
Home Dialysis Care Experience instrument
A new patient-reported experience measure for PD and home HD has been developed, based on a structured literature review, focus groups, interviews, and then cognitive testing. The 26-item measure covers 16 domains in six areas: communication and patient education, care team concern and helpfulness, care team proficiency, patient-centered care, care coordination, and personalized care.
Read the abstract » | (added 2021-04-16)
Tags: Hemodialysis, Hd, Peritoneal Dialysis, Pd
Missed Opportunities to Help Patients to Home Dialysis
Even strong home dialysis programs do not always successfully get everyone who is interested in a home therapy to go home. In British Columbia, of the 1,845 patients who started dialysis between 2015 and 2017, 34% started on their preferred home therapy—while 8.9% did not, and 8.4% had remained undecided and started in-center. A significant factor was that those who chose and started a home treatment had more home therapy-specific (vs. “general modality orientation”) education
Read the abstract » | (added 2021-03-09)
Tags: Home Hemodialysis, Peritoneal Dialysis, Pd
Outcomes and Costs of Assisted PD
As many as half of those who could use PD need assistance to do so, and many countries outside the U.S. offer this. A narrative review found no differences in quality of life, hospitalization, or mortality between PD and in-center HD patients after adjusting for age and frailty. Nurse assistance may result in better technique survival than family assistance. Assisted PD was still significantly less costly than in-center HD in Canada and Western Europe.
Read the abstract » | (added 2021-03-09)
Tags: Assisted Peritoneal Dialysis, Barriers, Cost, Hemodialysis, Peritoneal Dialysis, Pd
Use of CMS-reimbursed CKD Education Doubles the Likelihood of Home Dialysis
While Medicare has paid for stage 4 CKD kidney disease education (KDE) since 2010, only a tiny fraction have used it—but KDE matters, finds an analysis of 369,968 patients who started dialysis between 2010 and 2014. Just 3,469 (0.9%) had received at least one KDE session, but compared to controls matched for age, gender, ESRD Network and year of dialysis start, they were twice as likely to have started a home dialysis treatment. Concerningly, African American and Hispanic patients were significantly less likely to have received KDE services.
Read the abstract » | (added 2020-12-10)
Tags: Home Dialysis, Kidney Disease Education, Peritoneal Dialysis
Exercise May Improve Residual Kidney Function in PD
A post-hoc study of a 12-week randomized controlled trial of home exercise for PD patients eliminated those with anuria (n=18) and analyzed 13 patients in the usual care group and 16 in the exercise group. Two RKF markers, liver-type fatty acid-binding protein (L-FABP) and the microalbumin-to-creatinine ratio, were significantly lower in the exercise group.
Read the abstract » | (added 2020-12-10)
The Influence of Perceptions on PD Burnout
A focus group study conducted with 81 PD patients and 45 care partners in Australia, Hong Kong, and the United States identified relentlessness and feeling overwhelmed by daily responsibilities as a factor in burnout. Building resilience and finding a new normal and meaning in other activities may be protective.
Read the abstract » | (added 2020-12-10)