Why and how to change the dialysis default to PD

PD is comparable to standard HD in outcomes, but costs less, is more convenient, does a better job of preserving residual kidney function, and delivers better quality of life, argues a new editorial.

Read the abstract » | (added 2017-05-09)

Tags: Peritoneal dialysis

PD vs. Standard HD for People with Cirrhosis

For cirrhotic people with kidney failure, data abstraction from the U.S. Nationwide Inpatient Study between 2005 and 2012 compared outcomes with PD and standard in-center HD. In-hospital mortality for those with ascites was significantly less with PD. In addition, PD hospital stays were shorter and costs were lower. Yet, just 1.7% of the sample was using PD.

Read the abstract » | (added 2017-04-12)

Tags: Peritoneal dialysis, Hemodialysis

Home HD: Cost-effective With Better Outcomes Than In-center

A review of the patient-centered and economic impacts of home HD that included studies between 2000 and 2016 found better quality of life, flexibility, employment potential, and survival vs. hospital HD. Minority and low-income patients still have less access than others, which compounds their already-poor health outcomes. The authors found that home HD is cost-effective and the use of this option should be increased.

Read the abstract » | (added 2017-03-09)

Tags: Hemodialysis

And, Again: More HD Improves Quality of Life

Data from the Frequent Hemodialysis Network (FHN) trials found that those who were randomized to frequent or nocturnal HD reported outcomes that included better results on a “feeling thermometer,” better general health, and shorter recovery time than for standard in-center HD.

Read the abstract » | (added 2017-03-09)

Tags: Hemodialysis

Early and Late Outcomes in Urgent-start PD

A single-center, matched-case control study compared 26 urgent start PD patients to 78 who started PD in the standard fashion. Urgent-start PD was linked with more catheter leaks and catheter migration. But, the rates of infection were similar, and urgent-start PD was safe.

Read the abstract » | (added 2017-01-09)

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PD Patient Education in Australia

Clinical PD outcomes in Australia were as much as 10-fold different from one site to another. An effort to standardize PD teaching has begun to improve PD outcomes. Of the 54 PD clinics, 70% completed an online survey about their PD teaching practices—which varied widely in the number of hours and presence of competency assessments.

Read the abstract » | (added 2017-01-09)

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Peritonitis Predicts Long-term Cardiac Outcomes on PD

A large study (n=5,707) of PD patients from Brazil has found that just one bout of peritonitis boosts the risk of late cardiovascular death by 22%. Two bouts of peritonitis raised the risk by 78%, three by 181%, and four by 284%.

Read the abstract » | (added 2017-01-09)

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NxStage Outcomes in France and Belgium

Among 62 patients from 31 centers in France and Belgium, albumin and bicarbonate levels improved significantly, and technique survival was 75% at one year (most who stopped received transplants). Despite the low volume of dialysate, the rsearchers concluded that dialysis adequacy was acceptable.

Read the abstract » | (added 2016-12-09)

Tags: Hemodialysis

Encapsulating Peritoneal Sclerosis (EPS) Incidence and Outcomes

A new Scottish registry study found that 2.8% of PD patients between 2000 and 2007 (n=1,238) developed EPS. The rate rose from 1.1% by year 1 to 3.4% at year 3, 8.8% at year 4, 9.4% at year 5, and 22.2% by year 7. The authors note that “continuing PD beyond 3 years results in an exponential rise in the risk of developing EPS and deciding whether this risk is acceptable should be made on an individual patient basis.”

Read the abstract » | (added 2016-08-09)

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More Inflammation With Standard HD Than With PD

Inflammation can lead to heart damage and poor outcomes. Two 3-month prospective studies with 228 HD and 80 PD patients measured two markers of inflammation: CRP and IL-6. In HD patients, these levels were both higher and more variable than in PD.

Read the abstract » | (added 2016-06-08)

Tags: Hemodialysis