Journal Watch
Safety of Bedside PD Catheter Placement During COVID-19
Urgent-start PD is being used to address acute kidney injury due to COVID-19. A New York hospital successfully placed 14 PD catheters bedside to minimize use of critical hospital resources. The catheter did not work in one patient, who required HD. Another had bleeding stopped with compression and withholding of anticoagulants. The remaining 12 worked at follow up (3-18 days), with long-term follow-up suggested.
Read the abstract » | (added 2020-06-10)
Does Extended Hour HD Helps Survival After Returning to Standard HD?
In an analysis of data from the ACTIVE Dialysis Trial, 200 standard HD patients were randomly assigned to 12 or 24 hours of treatment per week for a year, with follow up at 24, 36, and 60 months after a return to 12 hours of treatment per week. Long-term survival was not improved.
Read the abstract » | (added 2020-06-10)
Tags: Mortality, End Stage Kidney Disease, Hemodialysis, Randomized Controlled Trial
Physical Activity and Survival in PD
Among 79 PD patients, fat and muscle mass, strength, and physical performance were not different between patients who were alive 2 years later and those who were not. However, the odds of death were 7.4 times higher in those whose level of physical activity was below the group’s median.
Read the abstract » | (added 2020-05-12)
Bioimpedance-measured Fluid Overload and Short Daily HD Survival
In 297 patients switched from thrice-weekly to 5-6 sessions per week of in-center short daily HD (SDHD), predialysis hydration was measured at initiation of SDHD and 6 and 18 months later using bioimpedance. Compared to patients whose predialysis fluid overload (FO) was <15% of extracellular volume (ECV), those whose FO was >15% of ECV had no survival difference by 6 months. However, at 18 months, those with an FO <15% had 91% survival, while those whose FO was >15% had just 72% survival (p = 0.0006), and remained significant after adjustment for demographic, clinical, and laboratory variables.
Read the abstract » | (added 2020-05-12)
Tags: Bioimpedance; Dialysis; Fluid Overload, Hd, Demographic
Universal AVF Back-up for PD Patients Reduces HD Catheter Use
Should an arteriovenous fistula always be placed as a PD back-up for new patients? A retrospective study of two hospitals examined this question. Hospital RAH (n=142) did universal AVF back-up at PD start. Hospital PAH (n=232) did selective AVF back-up for “high risk” patients only. Yet, the transfer-to-HD rate at RAH was about half that of RAH (23% vs. 43%)—as was the HD catheter usage rate (33% vs. 65%; p<0.001), despite a population at RAH that was more likely to be older, Caucasian, and have diabetes.
Read the abstract » | (added 2020-05-12)
Are PD eHealth Initiatives Ready for Prime Time?
A review of 15 studies (n=1,334) of use of telemedicine and eHealth to support PD self-management found bias and low-quality evidence that made a metaanalysis impossible. While no adverse effects of eHealth interventions were reported, effectiveness was mixed. Better quality evidence is needed.
Read the abstract » | (added 2020-05-12)
Tags: Digital Health, EHealth, Peritoneal Dialysis, Evidence
PD Catheter Placement Outcomes: Urgent- vs. Elective-start
After analyzing 13 years of data comparing urgent-start (n=29) and elective-start (n=211) PD, the only significant difference between the mostly-comparable groups was a higher incidence of catheter leaks. Complication and catheter removal rates at 3 and 12 months were similar, as were days to first complication and 12-month patient survival. Catheter placement technique did not affect the outcomes.
Read the abstract » | (added 2020-05-12)
How to Prevent and Manage COVID-19 in PD Patients
A comprehensive set of recommendations from China suggest reinforcing hygiene education, avoiding fear, and encourage patients to stay home—deferring clinic visits or using virtual ones when possible. When clinic or hospital visits are necessary, safety steps are described in detail. Covid-19 positive patients must be quarantined. Download the article.
Read the abstract » | (added 2020-05-12)
Tags: Https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198185/pdf/main.pdf
Cardiovascular Benefits of Benefits
A review considers the impact of nocturnal HD on cardiac remodeling, myocardial stunning, hypertension, heart rate variability, sleep apnea, coronary calcification, and endothelial dysfunction.
Read the abstract » | (added 2020-04-13)
Tags: Benefits, Cardiovascular, Home Hemodialysis, Myocardial Stunning, Nocturnal Hemodialysis, Vascular Calcification, Cardiovascular Disease
Impact of Assisted PD
A retrospective look at 1,576 incident patients at one clinic between 2002 and 2017 examined the effects of offering assisted PD on the rates and cumulative incidence of PD starts. Those who used assisted PD tended to be older. Use of the program significantly increased the rate of PD initiation, but there was a fall in usage over time.
Read the abstract » | (added 2020-04-13)
Tags: Renal Replacement Therapy, Assisted Peritoneal Dialysis