Journal Watch - PD
PD vs. HD for Women’s Sexual Function (But, Would Intensive HD be Better?)
Women (n=200) with non-dialysis CKD, HD, CAPD, and controls who completed the Female Sexual Function Index (FSFI) were analyzed by treatment group. The control group had the highest FSFI mean scores. The point means between PD and standard HD were nearly identical, except for sexual satisfaction, which favored CAPD (p<0.05). NOTE: Intensive HD was not compared in this study—but may prove to be helpful.
Read the abstract » | (added 2024-09-12)
Tags: PD, HD, Female Sexual Function Index, FSFI
Fat Mass May Protect Bones and Muscles on PD
Among 359 PD patients, 25% had osteoporosis, 32% had sarcopenia, 15% had osteosarcopenia, with considerable overlap between these conditions. Using body composition monitoring, fat tissue index (FTI) and lean tissue index (LTI) were measured. Low FTI—but not normal or high FTI—was linked with all three conditions, even after adjusting for age and BMI.
Read the abstract » | (added 2024-09-12)
Tags: PD, Osteoporosis, Sarcopenia, Osteosarcopenia, Fat Mass, Fat Tissue Index, FTI, Lean Tissue Index, LTI
Which is Safer: Urgent Start HD or Urgent Start PD?
Analysis of data from 9 studies (941 PD and 779 HD patients) revealed that the risk of all-cause mortality, dialysis-related infections, and mechanical complications were higher in patients who started HD urgently than in those who started PD urgently.
Read the abstract » | (added 2024-07-12)
Tags: PD, HD, All cause Mortality, Dialysis related Infections, Mechanical Complications, Urgent start
Cardiovascular Outcomes Compared in PD vs. Home HD
Data from almost 69,000 patients in the USRDS who started PD or home HD to assess for rates of hospitalizations due to incident cardiovascular events (acute coronary syndrome, heart failure, stroke). While the unadjusted rate of cardiovascular events was higher in home HD than PD patients, the adjusted rates were lower for stroke and acute coronary syndrome. There was no difference in heart failure risk, but home HD was linked with a 22% lower adjusted risk of cardiovascular death.
Read the abstract » | (added 2024-02-07)
Tags: USRDS, PD, Home HD, Hospitalization Rate, Incident Cardiovascular Events
The PD Surprise Question Predicts Transfer to HD
An observational study of 1,275 PD patients in 35 programs asking the RN and treating nephrologist, “Would you be surprised if this patient transferred to HD in the next 6 months?” identified 15% as high risk. After 6 months, the transfer to HD rate was nearly four times higher in the high risk group than the low risk group.
Read the abstract » | (added 2023-12-15)
Tags: PD, Home Dialysis, Peritoneal Dialysis, Surprise Question
Steady Glucose Concentration in PD and Sodium Removal
In a small pilot study (n=8), two fast-average and six fast transporters used a standard 4-hour CAPD dwell as a control, and three 5-hour steady-concentration treatments using the Carry Life® UF device following an overnight icodextrin fill as the intervention. UF rates were significantly higher with the steady glucose concentration treatments, as were sodium removal and glucose UF efficiency.
Read the abstract » | (added 2023-11-15)
Tags: PD, Glucose Concentration, Sodium Removal
Exercise and Quality of Life on PD
In a cross sectional study of 339 PD patients, 81.7% exercised a median of 5 hours per week, mainly slow walking. Those who exercised had better quality of life. Older age, female sex, higher BMI, and pain were independently associated with lower exercise capacity.
Read the abstract » | (added 2023-10-13)
Tags: PD, Exercise, Quality Of Life
Outcomes with PD to HHD Compared to Direct HHD
Analysis of data from all patients who started PD or HHD in the first 90 days of kidney replacement therapy in Canada matched PD+HHD patients (n=163) 1:1 to incident HHD patients (n=711). Interestingly, while hospitalization risk was similar, clinical outcomes were better in the PD+HHD group.
Read the abstract » | (added 2023-09-13)
Tags: PD, HHD, Kidney Replacement Therapy, Clinical Outcomes
Systemic Immune-Inflammation Index (SII) and Mortality on PD
Among 1,419 PD patients from 2007 to 2019, SII was calculated as platelet count x neutrophil count/lymphocyte count. During a median 42 month follow up, 321 patients died, 171 of cardiovascular disease. Each 1 standard deviation increase in the SII was associated with a 20.2% rise in all-cause mortality and 28% in cardiovascular-specific mortality.
Read the abstract » | (added 2023-09-13)
ISPD Proposes to Remove PD Toxin Clearance Targets
New ISPD Guidelines suggest that the focus of PD should be patient well-being—not lab values. This change would allow more people to do PD, and focusing on relieving uremic symptoms could help determine which solutes really do matter to quality of life.
Read the abstract » | (added 2023-08-16)
Tags: PD, Patient Well being, Lab Values, Uremic Symptoms, Quality Of Life