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  • Complications in Planned vs. Unplanned Peritoneal Dialysis Starts

    A metaanalysis of 14 papers totalling 2,401 PD patients looked at the outcomes and safety of unplanned PD starts within 7 days of catheter placement vs. 7-14 days. Early-start PD was linked with more leaks, omental wrap, and—for CAPD—catheter malposition. There were no significant differences in infectious complications, but the risk of transition to HD and mortality were higher. More studies are needed.

    Read the abstract » | (added 2020-11-12)

    Tags: End Stage Kidney Disease, Peritoneal Dialysis, PD

  • Survival Benefit of More HD Hours is Not Sustained After a Switch Back to Standard

    In the ACTIVE Dialysis trial, 200 standard HD patients were randomized to receive usual care (median of 12 hours of HD/week) or extended hours (median of 24 hours of HD/week) for 12 months, with follow up through 60 months. After the 12 months, intervention group participants were switched back to usual care. At 5 years, there was no difference between the groups in all-cause mortality.

    Read the abstract » | (added 2020-10-12)

    Tags: Dialysis, End stage Kidney Disease

  • Aspergillus Peritonitis Review

    Compared to other fungal peritonitis, colonization with aspergillus is more dangerous, and identification is still a challenge. Among 55 cases reported in the literature between 1968 and 2019, the mortality rate was 38.3%, 85.5% had to have their PD catheter removed, and 81.8% of patients had to switch to HD.

    Read the abstract » | (added 2020-09-11)

    Tags: Aspergillus, Mortality, Peritoneal Dialysis, Peritonitis

  • PD and Bone Mineral Disorders vs. HD

    Body composition, nutritional status, DEXA, and bone mineral disease (BMD) biomarkers were assessed at baseline and one year in 242 ESRD patients starting either PD (n=138) or HD (n=104). Among HD patients, BMD decreased significantly—but not in PD patients. Preservation of BMD was associated with significantly lower all-cause mortality, with cortical bone preservation more predictive than trabecular bone preservation.

    Read the abstract » | (added 2020-09-11)

    Tags: End stage Renal Disease, Bone Mineral Density, Dialysis

  • Comorbidities—but not Peritonitis—drove Mortality on PD

    Among 242 Turkish PD patients followed for up to 9 years, age over 65, diabetes, cancer, and heart failure were independent risk factors for death, but surprisingly peritonitis was not.

    Read the abstract » | (added 2020-02-19)

    Tags: Peritoneal Dialysis, Mortality, Patient Survival, Peritonitis, Technique Survival

  • European Patients Live Longer with Extended HD Treatments

    Compared to standard in-center HD, patients from eight European countries who dialyzed for 6+ hours thrice weekly lived longer. Of 142,460 patients, 1,338 did extended HD. Compared to in-center HD (13.5/100 person-years), crude mortality for extended HD (6.0/100 person-years) was significantly better. Overall, those treated with extended treatments were 73% more likely to have survived.

    Read the abstract » | (added 2019-12-10)

    Tags: Survival, Extended hours Hemodialysis, Haemodialysis, ERA EDTA Registry

  • In-center Nocturnal HD: Fewer Complications than PD in Patients with PKD

    An analysis that matched PDK patients who did conventional HD (26) or PD (26) to in-center nocturnal HD (NHD; 13) found no significant difference in mortality—but after a median follow up of 5.5 years, NHD had significantly fewer complications than PD—and higher serum albumin levels as well.

    Read the abstract » | (added 2019-12-10)

    Tags: Polycystic Kidney Disease, Conventional Dialysis, In center Nocturnal HD, Nocturnal Hemodialysis, Mortality

  • Is PD Unwise for Patients with Lupus Nephritis?

    A small study found 92.4% (1 year), 84.7% (3 year) and 67.6% (5 year) patient survival among 28 non-diabetic lupus patients doing PD—compared to 100% (1 year), 93.5% (3 year), and 82.9% (5 year) among 56 controls. While the lupus was not directly associated with mortality, it was a risk factor for PD technique failure, infection, and hospitalizations.

    Read the abstract » | (added 2019-11-16)

    Tags: Patient Survival, Lupus, PD, Mortality, Technique Failure, Infection, Hospitalization

  • 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)

    Tags: PD, Cirrhosis

  • 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