Journal Watch
Value of Remote Monitoring of PD
A cluster-randomized trial assigned 21 hospitals with automated PD (APD) programs to either do remote monitored (RM-APD; 10 hospitals) or conventional APD (11 hospitals) for 398 adult patients initiating PD. In the conventional APD group, all-cause mortality, cardiovascular deaths, and hospitalizations were significantly higher, as were PD dropouts and adverse events and hospitalizations related to cardiovascular disease, fluid overload, or poor PD adequacy.
Read the abstract » | (added 2024-09-12)
Tags: Automated PD, APD, All cause Mortality, Cardiovascular Deaths, Hospitalizations, Cardiovascular Disease, Fluid Overload, PD Adequacy
Which is Safer: Urgent Start HD or Urgent Start PD?
Analysis of data from 9 studies (941 PD and 779 HD patients) revealed that the risk of all-cause mortality, dialysis-related infections, and mechanical complications were higher in patients who started HD urgently than in those who started PD urgently.
Read the abstract » | (added 2024-07-12)
Tags: PD, HD, All cause Mortality, Dialysis related Infections, Mechanical Complications, Urgent start
Management of PD Anemia in Japan
Should people who use PD have the same hemoglobin (hb) targets as those who do HD? Researchers analyzed registry data of 4,875 patients 18 or older who were doing PD at the end of 2012 and compared their hb levels with mortality for the 1,586 who died. In a U-shaped curve, hb levels < 9.0 and > 13.0 were significantly associated with death. In those who had a history of cardiovascular disease, hb levels > 12.0 were significantly associated with death.
Read the abstract » | (added 2024-06-14)
Home HD, Self-cannulation, and Survival
An observational study of all home HD patients at a single center from 2001 to 2020 examined treatment survival and mortality. Among 77 self-cannulating patients dialyzing for a median of 18 hours per week, there were 11 deaths, largely cardiovascular, and 19 technique failures after 100 months, largely due to vascular access issues.
Read the abstract » | (added 2024-06-14)
Tags: Home HD, Self Cannulation, Treatment Survival, Mortality, Cardiovascular, Technique Failure, Vascular Access
Mineral Bone Disease (MBD) and Survival on PD
A P-DOPPS study analyzed MBD data from more than 12,000 patients from eight countries. The results revealed a U-shaped curve for the relationship between PTH and mortality, with the lowest risk at PTH levels of 300-599 pg/mL. Serum calcium levels higher than 9.6 mg/dL were associated with a 20% increase in mortality as well. Major country variations in MBD treatment were identified.
Read the abstract » | (added 2024-04-12)
Tags: Mineral Bone Disease, MBD, PTH, Mortality, Serum Calcium Levels, PD
Meta-analysis of Urgent Start vs. Conventional Start PD
Analysis of data from 27 studies found comparable post-procedure infections, peritonitis, and exit site infections, technique survival, and transfer to HD for urgent and conventional start PD. Urgent start PD had a signficantly higher risk of mechanical complications such as leaks, and significantly higher mortality rates.
Read the abstract » | (added 2024-03-15)
Tags: Chronic Kidney Disease, Meta analysis, Peritoneal Dialysis
Urgent-start PD vs. Urgent-start HD: Meta-analysis
Analysis of data from nine studies looking at all-cause mortality found a rate of 0.173 for urgent-start PD vs. .214 for urgent-start HD. Those who started PD urgently had lower risks of infection-related death, bacteremia, and other complications, though rates of cardiovascular and cancer mortality were similar.
Read the abstract » | (added 2024-01-17)
Tags: All cause Mortality, Urgent start PD, Urgent start HD, Infection related Death, Bacteremia
Surprising Impact of First Dialysis Modality on Survival in Patients with Diabetes
A retrospective cohort study of 739 patients from 2010 to 2018 (inclusive) used propensity score matching to compare mortality between standard HD and PD in China, matching 125 PD patients with HD patients. No significant differences were found—except in those with diabetes, who had significantly better survival with PD.
Read the abstract » | (added 2023-11-15)
Tags: Modality, Survival, Diabetes, Propensity Score Matching
Rate of Residual Kidney Function Decline and Mortality in PD
When 497 PD patients were divided into two groups based on RRF decline value, those in the fast-decline group had significantly higher rates of all-cause and cardiovascular mortality. In fact, each 0.1mL/min/1.73m2 per month drop in RRF in the first year of PD predicted a 19% higher risk of all-cause mortality and a 20% higher risk of cardiovascular mortality.
Read the abstract » | (added 2023-11-15)
Tags: Rate Of Residual Kidney Function Decline, All cause Mortality, Cardiovascular Mortality
Longer Survival with Extended Home HD
A study in Turkey compared 348 patients doing extended home HD (418 minutes) matched with 1,047 doing standard in-center HD (242 minutes) and followed both groups for about 55 months. The extended home HD patients had an all-cause mortality rate of 3.76 per 100 patient years—vs. 6.27 for the in-center HD patients; a significant 40% reduction.
Read the abstract » | (added 2023-10-13)