Journal Watch - Peritoneal Dialysis
Medicare Reimbursement Has Driven More PD
Changes to the Medicare Prospective Payment System (PPS) in 2011 to create financial incentives for PD have worked, finds a new analysis of 6,433 dialysis clinics before and after the change. Since 2011, 6% more clinics offered PD, and program size increased from an average of 5.7 patients to 6.9. Non-urban, chain, and larger clinics were significantly more likely to have changed their PD practices in response to the PPS change.
Read the abstract » | (added 2018-12-14)
Tags: Medicare, Prospective Payment System, Peritoneal Dialysis, Quality Of Life
Metaanalysis of PD for Kidney Failure due to PKD
Polycystic kidneys may displace room for PD fluid, so can PD be a viable treatment option? A metaanalysis of 12 studies and more than 17,000 patients found…maybe. PD outcomes were about the same for those with PKD as with other primary kidney diseases, and some can do PD. More research is needed to determine who is suitable. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Dialysis Adequacy, PD associated Complications, Peritoneal Dialysis, Polycystic Kidney Disease
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 2018-09-10)
Tags: Dialysis Solutions, Glucans, Glucose, IL6 Protein, Human, Inflammation, Interleukin 6, Peritoneal Fibrosis, Peritoneum, Peritonitis, Creatinine, Hospitalization, Icodextrin, Peritoneal Dialysis, Peritoneal Membrane
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 2018-09-10)
Tags: Gender, Malnutrition, Cardiovascular Risk, Hypoalbuminemia, Inflammation, Overhydration, Peritoneal Dialysis
New Model Could Help Screen PD Patients for CeVD Risk
A new risk score could predict how likely new PD patients are to develop cerebrovascular disease down the road. The strongest predictors of CeVD were blood pressure, total cholesterol, and serum phosphate and sodium levels.
Read the abstract » | (added 2018-08-13)
Tags: Cerebrovascular Diseases, Mortality, Peritoneal Dialysis, Risk Prediction
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 2018-08-13)
Tags: Peritoneal Dialysis related Infections, Peritoneal Dialysis, Infections, Peritoneal Dialysis Outcomes
PD vs. In-Center HD for Stroke Risk
A systematic review of 15 cohort studies totaling nearly 1.3M ESRD patients concludes that PD had a significantly lower (16%) risk of hemorrhagic stroke, though the risks of other types of strokes were comparable.
Read the abstract » | (added 2018-08-13)
Tags: Dialysis, Hemodialysis, Meta analysis, Peritoneal Dialysis, Stroke
Color of Used PD Dialysate Gives Diagnostic Clues
A review article proposes a differential diagnosis of various conditions based on a change in the color of PD effluent from clear to red, orange, cloudy, milky white, green, yellow, purple or black.
Read the abstract » | (added 2018-08-13)
Tags: Bloody Effluent, Chyloperitoneum, Peritoneal Dialysis, Peritonitis, Rhabdomyolysis
New Ideas for Incremental PD
Starting incremental PD without the exclusive focus on residual plus peritoneal clearances may ease transitions of new patients onto dialysis—and reduce our “obsession” with small moleule kinetics.
Read the abstract » | (added 2018-06-12)
Residual Kidney Function and Sleep Apnea Severity in PD
A small (n=15), exploratory study of 15 APD patients with home apnea monitors found obstructive sleep apnea in 33%, which correlated with having less residual renal function.
Read the abstract » | (added 2018-06-12)