Journal Watch
Most Cost Effective Dialysis Options: Metaanalysis
An analysis of 16 economic studies from both high- and low-income countries determined that home dialysis options are less costly and offer comparable—or better—health outcomes than in-center HD. Quality of life concerns were rarely investigated, however.
Read the abstract » | (added 2019-02-14)
Tags: Economic Studies, HD, Cost, Dialysis Options, Health Outcomes
Low-volume Tidal PD for Urgent Starts
A randomized, prospective trial was done to see if tidal PD (TPD) would improve outcomes among 27 urgent start PD patients, vs. 22 who did low-volume intermittent PD. After follow up for up to 2 years, the TPD group did have significantly fewer catheter complications. Both options had about the same technique survival.
Read the abstract » | (added 2019-01-11)
Tags: Automated Peritoneal Dialysis, Tidal Peritoneal Dialysis, Intermittent Peritoneal Dialysis, Complications
Urgent Start PD + Diabetes
A retrospective study compared the first 30-day outcomes and survival trends of 80 urgent start dialysis patients, 50 of whom (62.5%) did PD. Compared to those who started standard in-center HD, the dialysis-related complications were significantly lower for those on PD, and PD survival was higher as well. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Diabetes, Survival Trends, Urgent Start Dialysis, PD, In center HD, Dialysis related Complications
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
Nocturnal HD is Underused
A new review suggests that the improved outcomes associated with more hours of HD in-center or at home mean that these options should be used more. Read the abstract.
Read the abstract » | (added 2018-09-10)
Tags: Extended Hours, Improved Outcomes, HD, Nocturnal Dialysis, Quality Of Life
PD Catheter Outcomes in Low vs. High-Volume Centers
Not surprisingly, patients whose PD catheters were placed at high-volume centers (in Japan) had fewer adverse events, needed feer blood transfusions, and had shorter hospital stays than those from low-volume centers. Read the abstract.
Read the abstract » | (added 2018-09-10)
Tags: PD, Catheter, Hospital volume
Home HD After PD Failure May Lead to More Transplants, Lower Mortality
Since PD failure can lead to hospitalization and death in those who switch to standard in-center HD (ICHD), would outcomes improve with home HD? A new analysis found 521 patients in the USRDS data who made the change. Compared to matched ICHD patients, the chance of transplant was nearly double (21% vs. 10.6%), while survival of home HD patients was 89.1% at 1 year and 80.5% at 2 years.
Read the abstract » | (added 2018-08-13)
Tags: PD Technique Failure, ICHD, Transplant, Home HD, Lower Mortality
High Peritoneal Transport and Long-term PD Outcomes
Among 470 patients who did PD for up to 10 years in Hong Kong, the peritoneal transport rate was able to differentiate survivors. After the first few years of PD, having high peritoneal transport became a significant risk factor for mortality.
Read the abstract » | (added 2018-05-11)
Standard Kt/V urea Targets Less Useful for Home HD
When patients do home HD more often than three times a week, do the Kt/V urea targets still predict outcomes? Not all that well, suggests a new study. Multivariate regression analysis of 109,273 standard in-center HD patients compared to 2,373 home HD patients found that while a lower Kt/V urea (<2.1) did predict higher blood pressure in both groups, it did not predict metabolic control in either group. For those on home HD, a low Kt/V did not predict hospitalization, mortality, or technique failure, though it did for in-center patients. The authors concluded that the current Kt/V urea targets “have limited utility” for home HD.
Read the abstract » | (added 2018-02-15)
Barriers to Intensive HD in Pediatrics
Why don’t more people choose intensive hemodialysis? Responses to a survey by 134 of the 221 pediatric dialysis centers in the International Pediatric Dialysis Network found that more than 2/3 were aware of evidence supporting the benefits of intensive HD and half believed it produced the best outcomes (just 2% favored conventional HD). Key barriers included lack of funding and staff, with lack of expertise and motivation as minor factors. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Children, Financial Barriers, Home Dialysis, Intensified Hemodialysis, Nocturnal Hemodialysis