Impact of Telemedicine on PD Technique Survival

Can telemedicine (TM) help people stay on PD longer? A prospective study conducted in 27 hospitals in China since 2016 enrolled 7,539 patients. Compared to matched patients in the non-TM group (60.9%), those in the TM group (39.1%) had significantly lower risks of severe fluid overload, inadequate solute clearance, non-infectious catheter complications, transfer to HD, and death.

Read the abstract » | (added 2022-09-13)

Tags: Telemedicine, PD, Technique Survival, Fluid Overload, Inadequate Solute Clearance, Non infectious Catheter Complications

HD Dose and Patient Survival: More is Better

Even using spKt/V—a flawed measure that considers only urea—a study of 558 standard HD patients from 2015 to 2020, of whom 214 died, found that a higher dose of dialysis reduced the risk of all-cause mortality by 33%.

Read the abstract » | (added 2022-09-13)

Tags: HD Dose, Dialysis Dose, Patient Survival, All cause Mortality

Healthcare System Factors in Home Modality Choice

A Midwest interview study was conducted with 40 people, half doing standard in-center HD. Access to and engagement in healthcare prior to nephrology care and after dialysis start had an impact on patients’ awareness of their CKD, its progression, and dialysis options—and most had been passive during decision-making. Level of fatigue, treatment schedule, and access problems affected satisfaction.

Read the abstract » | (added 2022-08-11)

Tags: Standard In center HD, CKD Progression, Dialysis Options, Shared Decision making

Late CKD Options Education Affects PD Selection

Analysis of data from 355 people at one center found that those who received CKD options education while their eGFRs were higher were more likely to choose PD. Other factors such as gender, poverty, or living alone were not associated with PD choice.

Read the abstract » | (added 2022-08-11)

Tags: CKD Options, RRT Education Timing, Patient Education PD, Peritoneal Dialysis, Dialysis Choice

Too-high OR Too-low LDL Cholesterol and Survival on PD

A retrospective study in China looked at data from 3,565 people starting PD from 2005 to 2020. Both higher and lower levels of LDL-C were linked with higher all-cause and cardiovascular mortality. Malnutrition and low LDL-C was especially risky.

Read the abstract » | (added 2022-08-11)

Tags: PD, LDL C, Cardiovascular Mortality, All cause Mortality, Malnutrition

Meta-analysis: Buttonhole vs. Rope Ladder Cannulation

Buttonhole cannulation with blunt needles can make home hemodialysis more appealing. A new systematic review and meta-analysis of 15 well-designed studies found that Buttonhole cannulation significantly reduced aneurysms, stenosis, blood clots, and bruising—with no difference in infection.

Read the abstract » | (added 2022-08-11)

Tags: Buttonhole Cannulation, Blunt Needles, Rope ladder Cannulation, Arteriovenous Fistula Puncture Techniques

Safety and Efficacy of Wearable PD

The automated wearable artificial kidney (AWAK) uses sorbent technology. In a pilot study done in Singapore, patients used the AWAK for 72 hours and were followed up for a month. Among the 15 patients who took part, the AWAK had to be altered to fix blocked flows, but no serious adverse events occurred. Abdominal pain (60%) and bloating (47%) were reported.

Read the abstract » | (added 2022-07-13)

Tags: Peritoneal Dialysis, Automated Wearable Artificial Kidney, AWAK, Sorbent Technology

Rapid Differentiation of PD Peritonitis Causes

Eosinophilic vs. microbial peritonitis requires different treatment, but cultures take days—and still may not find the cause. A center used effluent microscopy—slides of gram-stained PD fluid under a microscope—to determine if microbes were present and if so, which types. Among 250 people between 2007 and 2017, there were 155 at-risk cases of peritonitis, hemacolor staining was key to differentiating the cause and guiding treatment.

Read the abstract » | (added 2022-07-13)

Tags: Eosinophilic, Microbial, Peritonitis, Effluent Microscopy, Hemacolor Staining

Structured CKD Education More Than Tripled Uptake of Home Therapies

In a matched retrospective cohort study, 2,398 CKD patients who attended a single 90-minute education program were pair-matched with others who did not. Compared to controls, those who attended the session were significantly more likely to be doing home dialysis (38.5% vs. 12.6%) and to be using a permanent access (57.9% vs. 33.8%). Hospitalization rates were 38% lower as well, and education-attendees had lower first-year mortality.

Read the abstract » | (added 2022-07-13)

Tags: CKD, Education Program, Home Dialysis, Permanent Access, Hospitalization Rates, First year Mortality

Frequent HD Shortens Recovery Time—Even in Nursing Homes

In a study of 2,309 people receiving 14 hours of more frequent HD in skilled nursing facilities (SNFs), 92% reported recovery time of 2 hours or less. Those who received five treatments per week or had systolic blood pressure of 160-179 prior to treatment had greater odds of rapid recovery.

Read the abstract » | (added 2022-07-13)

Tags: ESRD, Home Hemodialysis, More Frequent Dialysis, Mortality, Nursing Home, Post dialysis Recovery Time