Meta-analysis of Urgent Start vs. Conventional Start PD

Analysis of data from 27 studies found comparable post-procedure infections, peritonitis, and exit site infections, technique survival, and transfer to HD for urgent and conventional start PD. Urgent start PD had a signficantly higher risk of mechanical complications such as leaks, and significantly higher mortality rates.

Read the abstract » | (added 2024-03-15)

Tags: Chronic Kidney Disease, Meta analysis, Peritoneal Dialysis

Impact of the START Project on PD in Canada

In Alberta, Canada, the Starting dialysis on Time, at home, on the Right Therapy (START) project enrolled 1,962 consecutive adult ESKD patients who started dialysis between April 1, 2015 and March 31, 2018 with the aim of increasing the proportion of patients who do PD within 6 months of dialysis start. At baseline, 27% of incident patients tarted PD. Immediately after implementation, there was a 5.4% increase in the use of PD. No changes were found in rates of hospitalization, death, or probability of switching to HD.

Read the abstract » | (added 2024-03-15)

Tags: Haemodialysis, Peritoneal Dialysis, Quality Improvement

A New, Miniaturized Ultrafiltration System

Collaboration between cardiologists and nephrologists may be key to developing a treatment that can help heart and kidney patients. This article describes extracorporeal ultrafiltration and steps in development of Artificial Diuresis (AD1), a new miniaturized system for ultrafiltration.

Read the abstract » | (added 2024-02-07)

Tags: Artificial Diuresis, Extracorporeal Ultrafiltration, Fluid Overload, Heart Failure, Miniaturization, Portable, Wearable

A Home Dialysis Primer for Internists

A new primer developed for clinicians in primary care aims to explain PD and home HD.

Read the abstract » | (added 2024-02-07)

Tags: Home Dialysis Primer, PD, Home HD

Finally: A Patient Reported Experience Measure for Home Dialysis

The Home Dialysis Care Experience survey is a new 26-item experience measure with one composite scale and two global rating scores, derived from 1,372 patients who use PD or home HD at 30 U.S. clinics. The measure was tested for floor and ceiling effects and test-retest reliability. Of the group, 495 patients completed at least one survey.

Read the abstract » | (added 2024-02-07)

Tags: Home Dialysis Care Experience Survey, Patient Reported Experience Measure

Short Daily HD, Muscle Strength, and Bone Health

A cross-sectional study compared a variety of parameters between 86 conventional HD patients and 92 short daily HD patients. The short daily HD patients had significantly higher serum albumin levels, Kt/V, and bone mineral density, required significantly fewer ESAs, and had lower phosphorus, inflammation, and PTH levels than conventional HD patients. Short daily HD patients also had significantly higher scores on the 6-minute walking test, stronger hand grips, lower fasting blood sugars, and higher hemoglobin levels.

Read the abstract » | (added 2024-02-07)

Tags: Bone Mineral Density, Conventional Haemodialysis, End stage Kidney Disease, Inflammation, Muscle Function, Short daily Haemodialysis

Update on Pregnancy in Home Dialysis Patients

For women with CKD, pregnancy may be a goal, but their fertility window is limited and they may not have time to wait for a transplant. Pregnancy rates on dialysis are low, and the pregnancies are high risk—but this may be changing. Intensive HD that improve fertility and live birth rates, with longer gestation and higher birth weights are another option for women on dialysis who want children. Learn principles and practical management of dialysis pregnancies, as well as patient experiences.

Read the abstract » | (added 2024-02-07)

Tags: Pregnancy, Dialysis Pregnancies, Home Dialysis, Fertility, Live Birth Rates

Cardiovascular Outcomes Compared in PD vs. Home HD

Data from almost 69,000 patients in the USRDS who started PD or home HD to assess for rates of hospitalizations due to incident cardiovascular events (acute coronary syndrome, heart failure, stroke). While the unadjusted rate of cardiovascular events was higher in home HD than PD patients, the adjusted rates were lower for stroke and acute coronary syndrome. There was no difference in heart failure risk, but home HD was linked with a 22% lower adjusted risk of cardiovascular death.

Read the abstract » | (added 2024-02-07)

Tags: USRDS, PD, Home HD, Hospitalization Rate, Incident Cardiovascular Events

Among Prediabetic Patients, PD Nearly Tripled the Risk of New Onset Diabetes vs. HS

A retrospective cohort study was done of 1426 non-diabetic end-stage renal disease (ESRD) patients who started PD or in-center HD. Over a 12 year period, 23% of the patients developed NODM. Among patients with prediabetes, those on PD had a 2.93 times higher risk of NODM than those on HD (p <0.001).

Read the abstract » | (added 2024-01-17)

Tags: ESRD, PD, In center HD, NODM, New Onset Diabetes Mellitus

Non-mechanical Complications of PD

Learn from a review of non-mechanical PD complications, including oddly-colored PD effluent, encapsulating peritoneal sclerosis, and metabolic changes.

Read the abstract » | (added 2024-01-17)

Tags: Non mechanical PD Complications, Oddly colored PD Effluent, Encapsulating Peritoneal Sclerosis, Metabolic Changes