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

The Impact of Abdominal Adhesions on PD

A total of 758 people getting laparoscopic PD catheter placement in Canada; 27% with adhesions, were enrolled in a study of PD catheter complications. Among the adhesion group, 17% had catheter complications such as abdominal pain or flow restriction, vs. 10% in the group without adhesions. Yet, the majority did not have complications, even with adhesions.

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

Tags: Intra abdominal Adhesions, Peritoneal Dialysis, Catheter Complications, Laparoscopic PD Catheter Placement

Mechanical Complications of PD

Learn from a review of mechanical PD complications, including leaks, hernias, dialysate flow issues, pain, and changes in breathing. Most of these happen early, due to catheter placement or dialysate filling, though late complications can also occur.

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

Tags: Mechanical PD Complications, Catheter Placement, Dialysate Filling

Urgent-start PD vs. Urgent-start HD: Meta-analysis

Analysis of data from nine studies looking at all-cause mortality found a rate of 0.173 for urgent-start PD vs. .214 for urgent-start HD. Those who started PD urgently had lower risks of infection-related death, bacteremia, and other complications, though rates of cardiovascular and cancer mortality were similar.

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

Tags: All cause Mortality, Urgent start PD, Urgent start HD, Infection related Death, Bacteremia

Progression of Brain Atrophy in PD vs. HD

A follow-up study of brain atrophy progression followed 73 PD and 34 HD patients who had brain MRIs, including 42 PD and 25 HD patients who had a second brain MRI. Brain grey matter volume measurement demonstrated faster progression of brain atrophy in PD than in HD, independent of potential confounders.

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

Tags: Brain Atrophy, PD, HD

How Sugar Harms the Peritoneum and Causes Fibrosis

HOW does sugar harm the peritoneum? An RNA sequencing study looked at peritoneal endothelial cell (EC) function in mice and human ESRD cells in the presence or absence of glucose. In mice, glucose increased EC proliferation, permeability, and inflammation. Blocking glucose caused a therapeutic benefit. Human cells reacted in a similar way.

Read the abstract » | (added 2023-12-15)

Tags: Sugar, Glucose, Peritoneum, RNA Sequencing, Endothelial Cell Function

Lessons from Almost 15,000 PD Catheter Placements

Of the various PD catheter placement techniques, laparoscopy had higher 6-month mechanical complications, exit site infections, revision, and removal rates, while fluoroscopy had higher rates of sepsis and death. Open surgery had higher rates of catheter displacement.

Read the abstract » | (added 2023-12-15)

Tags: PD Catheter Placement Technique, Laparoscopy, Mechanical Complications, Exit Site Infections, Revision, Removal Rates, Fluoroscopy, Sepsis, Death

Dietary Protein Intake and Survival on PD

Among 668 stable PD patients followed for up to 13 years, quarterly 3-day dietary records were collected for 2 ½ years. Dietary protein intake greater than 0.8 g/Kg/day improved long-term survival.

Read the abstract » | (added 2023-12-15)

Tags: Dietary Protein, Survival, PD

A Home Dialysis Primer for Internists

Since PD and home HD are increasing in use due to their clinical and practical advantages, clinicians need to understand these treatments. A new primer in the Annual Review of Medicine will help them do just that.

Read the abstract » | (added 2023-12-15)

Tags: Home Dialysis, HD, PD, Home Dialysis Primer