Value of an Integrated Home Dialysis Model in the United Kingdom: A Cost-Effectiveness Analysis

This study aimed to determine the lifetime cost-effectiveness of increasing home hemodialysis as a treatment option for patients experiencing peritoneal dialysis technique failure compared with the current standard of care.

Read the abstract » | (added 2023-07-17)

Tags: Cost effective, Home Hemodialysis, Treatment Option, Peritoneal Dialysis Technique Failure

Paradoxical Finding in PD Peritonitis

The common wisdom is that larger patients are at greater risk for PD-associated peritonitis (PDAP). But, a new single-center study of 483 peritonitis episodes in 285 patients suggests that the opposite may be true. A lower value of body surface area was an independent risk factor for peritonitis episodes. (p=0.015).

Read the abstract » | (added 2023-07-17)

Tags: Body Surface Area, PDAP, Metabolism, Nutrition, PD, Peritoneal Dialysis, Peritonitis

GI Outcomes in PD Trials

A meta-analysis of 61 trials looking at patient-reported GI outcomes of PD mainly found nausea (43% of trials), diarrhea (43%), constipation (34%), abdominal pain (31%) and PD peritonitis (40%). But, only 19% of the available trials reported GI outcomes at all.

Read the abstract » | (added 2023-07-17)

Tags: GI Outcomes, PD, Nausea, Diarrhea, Constipation, Abdominal Pain, Peritonitis

Home Dialyzor Telehealth Preferences

A small study (n=34) that included surveys and 21 interviews found that 70% of home dialysis patients preferred face-to-face home visits, while 68% had previously had telehealth visits. Knowledge of telehealth was the main perceived barrier, while convenience and flexibility were the main benefits. Non-English speaking patients were at a disadvantage for telehealth.

Read the abstract » | (added 2023-07-17)

Tags: Home Dialysis, Home Visits, Telehealth

PD vs. Home HD for Severe Infections

In a Finnish study of 536 patients using home dialysis, the risk of a severe infection (C-reactive protein of 100mg/L or higher) in year 1 of CAPD was 35%, APD was 25% and home HD was 11%. Over a 5-year period, compared to home HD, the hazard ratio of severe infection for APD was 2.2 and for CAPD, 2.8. PD peritonitis accounted for the difference.

Read the abstract » | (added 2023-07-17)

Tags: Home Dialysis, Severe Infection, C reactive Protein, CAPD, APD, HD, Home HD, PD Peritonitis

Does Incremental PD Preserve Residual Kidney Function?

Analysis of data from 154 patients in the randomized, controlled balANZ trial did not find a difference in the slope of ultrafiltration volume decline between full dose and incremental PD.

Read the abstract » | (added 2023-06-14)

Tags: Incremental PD, Residual Kidney Function, Ultrafiltration Volume

Portable, Wearable, and Implantable Artificial Kidneys

The need to continuously regenerate dialysate is a challenge for all portable, wearable, and implantable kidney replacement therapy options. Sorbent technology is one approach. New membrane materials can remove more uremic toxins than current ones. Combining these membranes with living kidney cells has potential as well.

Read the abstract » | (added 2023-06-14)

Tags: Dialysate, Portable, Wearable, Implantable Kidney, Kidney Replacement Therapy

Daily HD and Cardiovascular Risk factors

In a 4-year study of 26 people using daily hemodialysis and 51 matched controls doing standard hemodiaysis, the daily treatments significantly improved blood pressure, calcium-phosphorus product, and hemoglobin levels. There was also a non-significant trend toward lower left ventricular mass index.

Read the abstract » | (added 2023-06-14)

Tags: Daily HD, Cardiovascular Risk Factors, Blood Pressure, Calcium phosphorus Product, Hemoglobin Levels

2023 ISPD Catheter Infection Recommendations

The updated recommendations have new definitions and classifications of exit site infection and tunnel infection, and new targets.

Read the abstract » | (added 2023-06-14)

Tags: Catheter, Infection, Exit Site Infection, Tunnel Infection, Antibiotic Treatment

Pathophysiology of Encapsulating Peritoneal Sclerosis (EPS)

EPS is a rare but often fatal complication of PD. Biopsy findings from Japan suggest that EPS is not sclerosis, but formation of a neo-membrane in response to a peritoneal injury.

Read the abstract » | (added 2023-06-14)

Tags: EPS, Sclerosis, Neo membrane