Journal Watch
Icodextrin Reduces PD Stroke Risk
Stroke risk was compared in PD patients in Taiwan who did or did not use icodextrin. Icodextrin users had a lower risk and incidence of strokes than non-users.
Read the abstract » | (added 2018-12-14)
Tags: Stroke, PD Patients, Icodexytrin
Medicare Reimbursement Has Driven More PD
Changes to the Medicare Prospective Payment System (PPS) in 2011 to create financial incentives for PD have worked, finds a new analysis of 6,433 dialysis clinics before and after the change. Since 2011, 6% more clinics offered PD, and program size increased from an average of 5.7 patients to 6.9. Non-urban, chain, and larger clinics were significantly more likely to have changed their PD practices in response to the PPS change.
Read the abstract » | (added 2018-12-14)
Tags: Medicare, Prospective Payment System, Peritoneal Dialysis, Quality Of Life
Protein Clearance Predicts Mortality on PD
Protein clearance on PD may be a marker of peritoneal inflammation. Among 711 PD patients followed for at least one year, each 10mL/day rise in protein clearance was linked with a 10.4% increase in the risk of all-cause mortality (p=0.008). Protein clearance was linked with serum albumin and C-reactive protein levels.
Read the abstract » | (added 2018-12-14)
Wanted: A Paradigm Shift from Urea to Sodium Removal
When nephrology icon Zyblut Twardowski talks, we listen! When dialyzors in Seattle in the 1960s got 30 hours a week of dialysis, the mortality rate was 10%. Since then, short treatments—justified by the flawed NCDS study—were driven by the equally flawed notion of Kt/V urea.
Read the abstract » | (added 2018-12-14)
Tags: Kt/V Urea, Mortality Rate, Sodium Removal, Dialysis Quality, NCDS, RCT
Longer-term Benefits of Early Start PD
Do people who start PD emergently differ from those with a planned PD start? No, suggests a new study of 154 patients followed for a median of just over a year. Early vs. planned-start patients had similar ages, BMIs, genders, and rates PD drop-out due to peritonitis, catheter dysfunction, and burnout. Only diabetes and BMI >25 were independently associated with PD technique failure—but no differences were found between early and planned starts.
Read the abstract » | (added 2018-12-14)
Tags: Emergent PD, Planned PD, Early Start PD
Peritonitis Symptoms in Older vs. Younger People
A single center study compared the time to first episode of peritonitis treated successfully with antibiotics in PD patients >65 (n=79)compared to those who were younger (n=168). Of 377 peritonitis episodes, 126 were in the older group and 251 in the younger group. Older patients were less likely to have fever or cloudy dialysate as symptoms than younger patients, but rates of transfer to hemodialysis, relapse, hospitalization, and mortality were similar. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Peritonitis, Outcomes Of Peritonitis, Elderly PD, Patient PD
PD and Dialysis Patient Employment
In a Swedish study, 4,734 working-age (20-60 years old) patients who survived at least one year on in-center HD or PD were compared. Patients using PD had a 4% increased probability of employment over in-center HD—as well as a 6% lower disability pension and higher work income. Read the abstract
Read the abstract » | (added 2018-10-12)
Tags: PD, HD, Employment, Disability Pension, Work Income
Nocturnal HD vs. Transplant: Health-related Quality of Life Compared
In a small study, transplant candidates using nocturnal HD (n=41) and transplant patients (n=31) took the KDQOL-short-form survey of health-related quality of life (HRQOL). Those with transplants had significantly higher “effects” of kidney disease scores than those on nocturnal HD. The other domains were not significant. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Transplant, Nocturnal HD, Kdqol, HRQOL, Effects Of Kidney Disease
Metaanalysis of Nocturnal HD and Sleep Quality
Nine studies of 286 patients found significantly less sleep apnea and better O2 saturation—but less total sleep time—after switching from conventional to nocturnal HD. Prospective pre-post studies found improved sleep quality, but randomized trials did not. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Sleep Apnea, CHD, NHD, O2 Saturation, Nocturnal HD, Conventional HD, Sleep Quality
Urgent Start PD + Diabetes
A retrospective study compared the first 30-day outcomes and survival trends of 80 urgent start dialysis patients, 50 of whom (62.5%) did PD. Compared to those who started standard in-center HD, the dialysis-related complications were significantly lower for those on PD, and PD survival was higher as well. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Diabetes, Survival Trends, Urgent Start Dialysis, PD, In center HD, Dialysis related Complications