CAPD vs. APD: Meta-analysis Sheds No New Light

A Cochrane Kidney and Transplant Register of Studies update identified two new randomized controlled trials (n=131) to include, one with 6-month follow-up and one with 24-month follow-up. Both studies had mostly low risk of bias. Conclusions about differences in CAPD and APD outcomes for death, hospitalizations, peritonitis, modality change, residual kidney function, health-related quality of life, overhydration, blood pressure, and a host of other outcomes were all based on low to very low certainty evidence.

Read the abstract » | (added 2024-10-15)

Tags: CAPD, APD, Modality Outcomes

Shared Decision-making (SDM) in ESKD Modality Choice and Outcomes

Among 554 patients studied, 22.2% (123) participated in SDM to choose an ESKD treatment. Survival was significantly higher in the SDM group (p = 0.001).

Read the abstract » | (added 2024-08-16)

Tags: Renal Replacement Therapy, Shared Decision Making, Modality, Dialysis Therapy

Personalized PD Prescriptions

Urea alone is not able to assess dialysis adequacy. Rather than a focus on removing a single toxin, a more holistic, person-centered approach is emerging to improve well-being and minimize treatment burden—based on clinical outcomes and patient experiences of care. This approach requires close collaboration between patients and care teams and eliciting patient goals, priorities, and preferences. This paper reviews the evidence for a patient-centered approach to PD.

Read the abstract » | (added 2024-06-14)

Tags: Urea, Dialysis Adequacy, Treatment Burden, Patient centered Care, PD

Does Social Deprivation Impact PD Outcomes?

A French registry (REIN) study examined data from 1,581 adult PD patients during the 18 months from January 1, 2017 to June 30, 2018, with observation completed in December, 2020. More than a quarter (418; 26.5%) were in Quintile 5 of the European Deprivation Index; the most deprived patients. Social deprivation was not associated with death or a composite event of death or transfer to HD.

Read the abstract » | (added 2024-05-09)

Tags: Social Deprivation, PD Outcomes, European Deprivation Index

Impact of Prior Abdominal Procedures on Peritoneal Dialysis Catheter Outcomes: Findings From the North American Peritoneal Dialysis Catheter Registry

A history of prior abdominal procedures may influence the likelihood of referral for peritoneal dialysis (PD) catheter insertion. To guide clinical decision making in this population, this study examined the association between prior abdominal procedures and outcomes in patients undergoing PD catheter insertion.

Read the abstract » | (added 2024-03-15)

Tags: Dialysis, PD, PD Catheter Outcomes, End Stage Kidney Disease, Peritoneal Dialysis, Prior Abdominal Surgery

The effect of urgent-start peritoneal dialysis and urgent-start hemodialysis on clinical outcomes in patients with chronic kidney disease: an updated systematic review and meta-analysis

Recently, urgent-start peritoneal dialysis (PD) has been suggested in place of urgent-start hemodialysis (HD) in cases of chronic kidney disease (CKD). However, the comparative effectiveness of these methods is still unclear. This study compared the outcomes of urgent-start PD and urgent-start HD in CKD patients.

Read the abstract » | (added 2024-03-15)

Tags: Dialysis related Complications, Hemodialysis, Kidney Disease, Mechanical Complications, Mortality, Peritoneal Dialysis, Renal Replacement Therapy

Cardiovascular Outcomes Compared in PD vs. Home HD

Data from almost 69,000 patients in the USRDS who started PD or home HD to assess for rates of hospitalizations due to incident cardiovascular events (acute coronary syndrome, heart failure, stroke). While the unadjusted rate of cardiovascular events was higher in home HD than PD patients, the adjusted rates were lower for stroke and acute coronary syndrome. There was no difference in heart failure risk, but home HD was linked with a 22% lower adjusted risk of cardiovascular death.

Read the abstract » | (added 2024-02-07)

Tags: USRDS, PD, Home HD, Hospitalization Rate, Incident Cardiovascular Events

Incremental PD and Patient Outcomes: Registry Data

Between 2007 and 2017, incremental PD use increased by 2.7% in the ANZDATA database. Most (67%) used the approach for one year or less. After controlling for patient and center variables, starting PD with incremental treatments reduced peritonitis risk and transfers to in-center HD, with no increase in mortality.

Read the abstract » | (added 2023-09-13)

Tags: Incremental PD, Incremental Treatments, Peritonitis, Mortality Rate

Outcomes with PD to HHD Compared to Direct HHD

Analysis of data from all patients who started PD or HHD in the first 90 days of kidney replacement therapy in Canada matched PD+HHD patients (n=163) 1:1 to incident HHD patients (n=711). Interestingly, while hospitalization risk was similar, clinical outcomes were better in the PD+HHD group.

Read the abstract » | (added 2023-09-13)

Tags: PD, HHD, Kidney Replacement Therapy, Clinical Outcomes

Meta-analysis of Quality of Life by ESRD Treatment Modality

Analysis of 111 papers with more than 50,000 patients compared transplant, PD, home HD, and in-center HD for health-related quality of life outcomes. The rankings? Transplant, PD, home HD, in-center HD.

Read the abstract » | (added 2023-08-16)

Tags: Quality Of Life, ESRD, Treatment Modality