Journal Watch
PD After Transplant Failure
We know that PD helps preserve residual kidney function longer: will this work after a failed transplant, too? An 8-year chart review study found no difference between technique survival, peritonitis-free survival, and residual urine in patients with transplant failure who returned to PD (n=18) vs. those who started PD for other reasons (n=163).
Read the abstract » | (added 2021-09-14)
Tags: PD, Residual Kidney Function, Failed Transplant, Technique Survival, Diuresis
Urgent Start PD: Better Survival, Fewer Complications than Urgent Start HD
A metaanalysis pooling data from seven studies found that urgent start PD was linked with significantly better survival than urgent start HD, though infectious complications were comparable. Urgent start PD had significantly less risk of mechanical complications as well.
Read the abstract » | (added 2021-09-14)
Tags: Urgent start Peritoneal Dialysis, Survival, Urgent Start HD, Mechanical Complications, Infectious Complications
Residual Kidney Function and Incremental PD
A retrospective cohort study was done of 96 incident PD patients (54 on incremental PD; 42 on standard PD). The incremental PD patients had lower exchange volumes, less glucose load—and longer peritonitis-free survival.
Read the abstract » | (added 2021-09-14)
Tags: PD, Incremental Dialysis, Peritonitis, Residual Kidney Function, Technique Survival
Poorer Survival for Those Who Switch from Home to In-center HD
Among 19,306 people who started HD in the ANZDATA registry from 2005 to 2015 and were treated for more than 90 days, those who started home HD and then went to in-center HD had significantly higher mortality than those who stayed at home. The reasons for this are not yet known.
Read the abstract » | (added 2021-08-12)
Tags: HD, Home HD, In center HD, Mortality, Home Hemodialysis Treatment Failure
Healthcare System Change Increased PD and Home HD in Australia
A lean-thinking framework and commitment of top leadership to change the system of care were used in a “Home before Hospital” approach to increase use of home therapies. Multidisciplinary Pathway, Outreach, and Hybrid working groups were established, and goals were set. A target of >30% for PD and home HD was achieved in 2 years, 35% within 3 years—and was still being maintained at 8 years.
Read the abstract » | (added 2021-08-12)
Tags: Peritoneal Dialysis, PD, Home Haemodialysis
Encapsulating Peritoneal Sclerosis Linked to Vasculopathy
EPS is a rare but devastating complication of PD. Tissue samples from 223 people with EPS who had surgery to remove adhesions were analyzed under a microscope. In the 174 samples that could be evaluated, the individuals who had used conventional PD fluid had more severe vasculopathy and longer PD durations than those who used pH neutral PD fluid.
Read the abstract » | (added 2021-08-12)
Outcomes of Incremental PD
A retrospective cohort study looked at 175 PD patients followed for about 2 years. Starting PD with a lower vs. higher dose was associated with better survival.
Read the abstract » | (added 2021-08-12)
Tags: Peritoneal Dialysis , PD, End stage Kidney Disease, Dialysate Volume, Survival
Feel Low on PD? Could be Vitamin D
In a study of 50 people on PD, those with vitamin D deficiency (< 20ng/mL) did more poorly than those with adequate vitamin D levels on all subscales of the KDQOL-36 survey to measure health-related quality of life. High blood pressure was also a factor in higher kidney disease burden.
Read the abstract » | (added 2021-08-12)
Tags: Serum Vitamin D Levels, Health related Quality Of Life, Peritoneal Dialysis
PD Adequacy and Itching
Among 80 people on CAPD, blood levels of the pain marker “substance P” and total urea clearance both independently predicted itching. Inadequate PD seems to be a reason for people using PD to itch.
Read the abstract » | (added 2021-07-12)
Tags: Pruritus , Peritoneal Dialysis, CAPD, Substance P, Total Urea Clearance, Itching, PD
Roxadustat for Anemia in PD
The anemia drug was tested in 129 people on PD randomized to roxadustat or other ESAs for 24 weeks. The roxadustat group had a 96% response rate (vs. 92%), lower hepcidin levels and higher TIBC. Total cholesterol and LDL dropped more with roxadustat, independently of C-reactive protein. Mean average hemoglobin on roxadustat were 11.5 g/dL (vs. 11.2). There were some common adverse events.
Read the abstract » | (added 2021-07-12)
Tags: Prolyl Hydroxylase Inhibitor, Erythropoiesis, Iron Metabolism, Anemia