Journal Watch

In-center Hemodialysis Had the Highest Annual, Per-patient Carbon Footprint

Using comparative life cycle assessment methodology, the team identified the sources and extent of carbon emissions for all dialysis modalities. Compared to home HD (2,938 Kg CO2e), CAPD (1,969 Kg CO2e), and APD (3,339 Kg CO2e), an Australian study found significantly higher carbon impact with in-center HD (4,814 Kg CO2e).

Read the abstract » | (added 2025-07-16)

Tags: In center Hemodialysis, Carbon Footprint, Modalities

Impact of Embedded PD Catheters on Peritonitis and Mortality

Moncrief and Popovich pioneered a buried PD catheter technique (inexplicably abbreviated as SMAP). In a study, outcomes of 285 consecutive patients who had PD catheters implanted either directly (n=96) or via SMAP (n=189) were analyzed retrospectively. Both the risks of peritonitis and mortality were significantly lower in the SMAP group.

Read the abstract » | (added 2025-07-16)

Tags: Embedded PD Catheters, Peritonitis, Mortality, Moncrief And Popovich Technique

Impact of Hurricane Helene on the PD Supply Chain

Hurricane damage to Baxter’s North Cove plant—which produces 60% of U.S. IV solutions—significantly disrupted patients’ ability to start or even continue PD. This analysis highlights healthcare vulnerabilities due to climate change.

Read the abstract » | (added 2025-04-23)

Tags: Hurricane, Emergency Planning, PD Supply

The Impact of Rural Outreach in West Virginia on Home Dialysis

Of 22,408 WV patients who started dialysis between 1965 and 2020, 13% overall started with a home modality—but this figure was 18% in counties that had a rural outreach kidney care clinic.

Read the abstract » | (added 2025-03-13)

Tags: Dialysis, Home Modality, Rural Outreach

Home Dialysis in Finland

Prevalence of home dialysis has dropped in the past decade in Finland, despite its better survival compared to in-center HD. Semi-structured surveys for nephrologists, nephrology nurses, and patient associations endeavored to understand why. Nursing shortages and patient comorbidities received wide agreement as barriers, and clinicians believed that starting in-center reduces the odds of switching to home treatments later. For patients, financial burdens and impact on care partners were critical, as was “bringing hospitals home” or living in small spaces.

Read the abstract » | (added 2025-03-13)

Tags: Home Dialysis, Survival, Modality, Barriers

Impact of Extended HD with a Liberalized Diet on Protein Energy Wasting

An 8-year longitudinal study assessed BMI and creatinine generation rate for 402 patients who started extended-hours HD (>18 hours/week). Over time, treatment sessions got longer (70% received >21 hours/week). Participants maintained their BMIs and % creatinine generation over time, and the 5-year survival rate was 85%.

Read the abstract » | (added 2025-02-14)

Tags: Extended hours Hemodialysis, Liberalized Diet, Longitudinal Study, Protein energy Wasting

Psychosocial Concerns May Impact Minority Uptake of PD

Analysis of qualitative interview data from 113 patients in Bronx, NY who completed dialysis modality education found gaps in the areas of support for the emotional trauma of an ESKD diagnosis and lack of a program to reduce anxiety about PD responsibilities, along with failure to address structural barriers to PD.

Read the abstract » | (added 2025-02-14)

Tags: Qualitative Interview Data, Dialysis Modality Education, Patient Support, Emotional Trauma, ESKD

Advancing American Kidney Health Initiative Did Not Impact Public Awareness

In 2019, the AAKHI aimed to increase the use of home dialysis. Analysis of U.S. Google Trends data from 2013 to 2021 for home dialysis terms found an increase in searches when the AAKHI was first announced, followed by flat or declining searches. The authors concluded that the AAKHI did not impact public information-seeking and targeted education initiatives may be needed.

Read the abstract » | (added 2025-01-13)

Tags: Advancing American Kidney Health Initiative, AAKHI , Public Awareness

Impact of PD Exchange Volume/Day on Outcomes

A DOPPS cohort study in Japan divided patients into two groups by daily PD dialysate volume (<4L/day; n=98 or >4L/day; n=244). Despite demographic differences between the groups, there were no significant differences in transfers to HD, mortality, hospitalization, peritonitis, or patient-reported outcomes based on volume—thus less volume may be more cost effective.

Read the abstract » | (added 2024-12-11)

Tags: Dialysate Volume, Peritoneal Dialysis Outcomes, Mortality, Patient reported Outcomes

Do Ketoanalogue (KA) Supplements Preserve Residual Kidney Function in PD?

A 1-year, six center, randomized, double-blind trial investigated the impact of KA supplements on RKF in 153 CAPD patients vs. placebo. For patients with early PD initiation, the KA group had a significantly lower decline in RKF. No differences were found in RKF decline in those with late PD starts or in PD adequacy, peritoneal function, nutritional status, or quality of life scores between groups.