Journal Watch
The Impact of Patient Empowerment on PD Self-management
A controlled trial investigated use of a problem-based learning (PBL) model to empower people on PD to self-manage. Among 94 participants, 47 patients were randomized to PBL learning, while the control group got usual care. PBL participants were divided into five study groups that each had six lessons. After 9-11.5 months, the PBL group had significantly more basic PD knowledge, higher self-management scores, better quality of life, increased satisfaction, and less depression and anxiety.
Read the abstract » | (added 2023-04-19)
Tags: Problem based Learning Model, PBL, Self management, PD Knowledge, Quality Of Life, Depression, Anxiety
Factors Linked with Time to First Peritonitis on PD
In a 5-year, 57 clinic, prospective randomized controlled trial in Europe, 33% of 671 participants had a bout of peritonitis. The factors independently linked with time to first peritonitis included older age, higher number of PD bags, low serum albumin, and higher body weight.
Read the abstract » | (added 2023-04-19)
Tags: Peritonitis, Age, PD Bags, Serum Albumin, Body Weight
Nephrologist Attitudes Toward Home Therapies Drive Practice
A survey of 327 nephrologists assessed their knowledge, attitudes, and practice around the choices for renal replacement therapy. Attitudes toward PD, HD, and transplant were independently linked to participants’ consideration of these options for patients.
Read the abstract » | (added 2023-04-19)
Tags: Nephrologists Modality Knowledge, Modality Bias, Choices For Renal Replacement Therapy, Modality Choice, Patient Education, Shared Decision making
How Kidney Patients Define Health
Among people with kidney failure who used three or more treatment options, “health” was linked to the ability to take part in meaningful activities and maintain life balance. Social and treatment environments that supported autonomy also helped people to consider themselves healthy.
Read the abstract » | (added 2023-04-19)
Tags: CKD, Treatment Options, Health, Treatment Experience, Shared Decision making
Serum Phosphorus and Survival on PD
Data from 5,847 PD patients between 2014-2017 from seven countries in the PDOPPS study found that compared to an optimal range of 3.5-4.5mg/dL, the hazard ratio (HR) for all-cause mortality was 19% higher when phosphorus was 5.5-6.5 and 53% higher when phosphorus was greater than 6.5. When 6 months of data were examined, the linkage was even stronger.
Read the abstract » | (added 2023-02-13)
Tags: PD, Serum Phosphorus, PDOPPS, Hazard Ratio, All cause Mortality
KDIGO Home Dialysis Controversies Conference
The report from the May, 2021 KDIGO conference on increasing use of PD and home HD has been released. Attendees agreed that shared decision-making was ideal, everyone should have access to home therapies, and alignment of policies and resources must occur to make these goals happen.
Read the abstract » | (added 2023-02-13)
Tags: Modality, Treatment Satisfaction, KDIGO, Shared Decision making
44 Years of Home HD Technique Survival in Valencia, Spain
In Valencia, 13.4% of patients on dialysis were using home HD in 2018. Researchers compared home HD data from two eras: “ancient” (1976-2000) and “modern” (2001-2020). Interestingly, 1- and 2-year patient survival were superior in the modern era (87.3% vs. 83.7% for 1-year; 83% vs. 77.4% for 2-year)—but 5-year survival was better in the ancient era (61% vs. 47.8%), as patients aged. Technique survival was better at every point in the modern era.
Read the abstract » | (added 2023-02-13)
Do More Hours of HD Benefit Older Patients, Too?
Analysis of ANZDATA registry data of patients who started dialysis at age 65 and older from 2005 to 2015 say YES—hours of HD do matter to survival. Among 8,224 people, those whose HD sessions were 5 hours or longer had an 81% reduction in the hazard risk of death vs. those who only got 4-4.5 hour treatments (p < .001).
Read the abstract » | (added 2023-02-13)
Tags: HD, ANZDATA, HD Hours, Session Length, Survival Rate
5-year Assisted PD Program Outcomes
Not everyone can do solo PD—or has a partner. In BC, Canada, a pilot staff-assisted PD program began in 2016. Analysis of 5 years of data from 322 patients found growth to 11.2% of the total PD population, with a median time of 13.6 months on PD. More than 1/3 were able to use the service until they died.
Read the abstract » | (added 2023-02-13)
Video-based vs. Traditional PD Training: Which is Better
PD could be expanded more quickly if training did not have to be done one-on-one in person. In Italy, Videodialysis has been used since 2016 for remote patient and care partner training, after an initial home visit. In a small series (46 trainings; 21 at home and 25 by video), the video technique was found to be as effective as traditional training with fewer home visits.
Read the abstract » | (added 2023-01-10)
Tags: PD Training, Videodialysis, Home Visits, Telemedicine