How dialysis clinics can help prevent peritonitis

What can dialysis clinics do to reduce the risk of peritonitis in PD patients? In an analysis of 127 PD clinics and 5,017 new PD patients, having a nurse who specialized in PD or conducting home visits prior to the PD start had the biggest impact.

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

Tags: Peritoneal dialysis

The Impact of Telehealth on PD Satisfaction

Per quarterly surveys completed by 200 people on PD, a system of telemedicine that included remote monitoring of blood pressure, weight, and glucose, and had educational videos boosted satisfaction with the option. Participants felt more autonomy and confidence in their health care, as well, and were less frustrated. Nearly half watched at least one video.

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

Tags: Peritoneal dialysis

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

Patient Peritonitis Perspectives

Australian researchers conducted interviews with 29 current or past PD patients to gain insights into the prevention of peritonitis. The four themes identified were the constant need for vigilance, invading harm from infection, incapacitating lifestyle interference, and exasperation with hospitalizations. The authors concluded that education about peritonitis and lifestyle impacts of PD may be helpful.

Read the abstract » | (added 2016-10-13)

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Considering Alternative Markers for Dialysis Dose

A new review article looks at the impact of longer and/or more frequent, high-dose HD on dialysis adequacy—and inadequacy. Some uremic solutes come from nutrient intake and others don’t. For nutrient-based solutes, the authors suggest using inorganic phosphorus and protein-bound wastes as markers to develop new dose measures. For non-nutrient based middle molecules, they suggest beta-2-microglobulin measurement.

Read the abstract » | (added 2016-09-14)

Tags: Hemodialysis

Peritoneal cavity model will help the study of fibrosis

Researchers have devised a model peritoneum that allows them to study the impact of PD on the cells. The model has a mesothelial layer, an endothelial layer, and a collagen membrane chamber. When used for simulated PD, various solutions had different effects on the cells—but reduced nitric oxide production seems to be a mechanism for fibrosis. This new tool may lead to new ways to prevent and treat peritoneal fibrosis.

Read the abstract » | (added 2015-09-11)

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Nurses may be a barrier to extended in-center HD treatments

In a UK study to assess the feasibility of recruiting patients for a trial of 6-hour HD vs. 4-hour, 56 nurses were polled about their attitudes. While 95% of national non-nurse healthcare providers felt that the longer treatments were clinically helpful, just 42% of nurses agreed. And, while 75% of the non-nurses felt that longer HD treatments were well-tolerated, only 45% of nurses thought so—while 83% of nurses were concerned about the impact of the longer treatments on scheduling shifts.

Read the abstract » | (added 2015-04-10)

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More reasons to use PD fluid with less sugar

Using a novel index created by dividing the glucose content of PD solution by body weight, this study looked at the impact of PD fluid sugar on hemoglobin A1c, fluid overload, and inflammation (measured by interleukin (IL) 6) in 43 people on PD. Higher sugar levels were linked with worse diabetes control, more fluid overload, and higher IL-6 levels.

Read the abstract » | (added 2015-03-11)

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US dialysis education in this study was a FAIL—especially for seniors

In a study of 99 US dialysis consumers, education about options was poor regardless of age—but was far worse in those over age 65. Significantly fewer older people said the doctor explained the cause of their kidney failure, the impact dialysis would have on their daily lives, or the life-long need for dialysis, and most felt that the choice of treatment was made by the doctor.

Read the abstract » | (added 2014-03-07)

Tags: Chronic kidney disease

Urgent-start PD: A how-to guide

Many nephrologists would choose PD for themselves. But few patients start on it, in part because ESRD may be found so late that dialysis is imminent. If only PD starts could be as done as easily as HD catheter placements... As it turns out, PD can be started on an urgent basis, and this approach is starting to pick up speed. This article reviews the literature, ways to overcome challenges, and the possible impact of changing the paradigm away from a default of standard in-center HD.

Read the abstract » | (added 2013-12-10)

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