Journal Watch - PD
Transplant Survival Better After PD Than Standard In-center HD
Is there an advantage to PD over standard in-center HD for transplant graft survival? YES, suggests a 15-year retrospective study of 2,277 transplant recipients. Those who did PD prior to transplant were 34.5% more likely to survive, and had less frequent rejection. Living donor kidneys did best among patients who received transplants before starting dialysis—or did PD.
Read the abstract » | (added 2019-11-16)
Tags: Kidney Transplant, Modality, PD, HD, Hemodialysis, Peritoneal Dialysis
Is PD a Good Option for Patients with Liver Cirrhosis?
A study matched patients with cirrhosis who did PD, patients with cirrhosis who did HD, and non-cirrhosis patients on PD by age, sex, catheter placement date, and diabetes status. PD technique failure and all-cause mortality were similar between patients with and without cirrhosis.
Read the abstract » | (added 2019-10-14)
PD and Swimming
Australian nurses in 39 PD clinics conducted phone surveys. While only 77% of the clinics advocated swimming, nearly all had patients who did swim, mainly in sea water or a private pool. Covering the exit site and catheter with a waterproof dressing or ostomy bag was recommended, along with routine exit-site care. Several infections were linked with swimming.
Read the abstract » | (added 2019-10-14)
Tags: PD, Swimming, Exit Site, Waterproof, Infections
Sudden Cardiac Death (SCD) in PD vs. HD
A Korean registry analysis of 132,083 dialysis patients between 1985 and 2017 found that SCD caused 19.6% of the 34,632 deaths. Even after adjusting for age and significant comorbidities, HD was independently associated with SCD, as was diabetes.
Read the abstract » | (added 2019-10-14)
Tags: SCD, Sudden Cardiac Death, PD, HD
PD Outcomes under the Medicare Expanded Dialysis Prospective Payment System
A Medicare change in 2011 may have increased the likelihood that clinics would expand PD to a broader population. Did this affect outcomes? A prospective cohort study compared 10,585 patients who started PD before payment reform, 7,832 interim patients, and 18,742 during the reform period. With similar demographics, more patients were treated in clinics with less PD experience—and these clinics had higher PD discontinuation rates. But, PD discontinuation fell overall, and mortality risk was stable.
Read the abstract » | (added 2019-10-14)
Tags: Expanded Dialysis Prospective Payment System, PD, Medicare
RCT: Which Works Best, Straight or Coiled PD Catheters?
A metaanalysis recently found that straight catheters were better, and an RCT of 308 CAPD patients randomly assigned to receive a straight (n=153) or coiled (n=155) catheter corroborates that finding. After a mean follow-up of 21 months, straight PD catheters caused almost 9 times less dysfunction or drainage failure (0.7% vs. 5.8%) with less pain than coiled catheters. Both catheters had a similar risk of peritonitis.
Read the abstract » | (added 2019-09-11)
Tags: Catheter, Randomized Controlled Trial (RCT), PD, CAPD
PD: Better Quality of Life than In-Center HD for 2 Years
Among 989 patients starting PD or in-center HD, health-related quality of life (HRQOL) was measured at 3, 12, and 24 months after dialysis start. PD patients scored higher all along on several key dimensions than HD patients—and this effect lasted up to 2 years. Both PD and HD patients had about the same amount of decline in HRQOL over 2 years.
Read the abstract » | (added 2019-08-14)
Tags: HRQOL, PD, In center HD, Quality Of Life
Half of PD patients may develop a new glucose disorder
A metaanalysis of nine studies with a total of 13,879 PD patients found that 8% had new-onset diabetes, 15% developed impaired glucose tolerance, and 32% had newly abnormal fasting blood sugar levels. No differences were found by ethnicity. The authors concluded that PD patients should receive glucose tolerance tests.
Read the abstract » | (added 2019-07-15)
Tags: PD, Diabetes, Glucose Tolerance, Blood Sugar Levels, Glucose Tolerance Test
Higher Serum Albumin May Protect Residual Kidney Function in PD
In a prospective study of 104 new PD patients, having low serum albumin levels was independently associated with complete RKF loss (<100 mL/day of urine).
Read the abstract » | (added 2019-06-13)
Tags: Serum Albumin, Residual Kidney Function, Urine Volume, Peritoneal Dialysis, PD
Longitudinal Experience with Remote PD Monitoring
Patients whose PD was monitored remotely had almost twice the number of APD prescription changes--and significantly fewer nighttime alarms and less need for in-person visits than control subjects, saving both time and money.
Read the abstract » | (added 2019-02-14)
Tags: PD, Remote Monitoring, APD, Nighttime Alarm, In person Visit