Journal Watch
Home Dialysis Associated with Higher Patient Activation
Increased patient activation is linked with better health outcomes. Among 182 people starting dialysis who took the Patient Activation Measure (PAM) survey at month 1 and month 4, those who did home dialysis tended to have higher PAM scores than those who did in-center treatments.
Read the abstract » | (added 2022-07-13)
Tags: Patient Activation, Health Outcomes, Dialysis, Patient Activation Measure, PAM, Home Dialysis
Prospective Cohort Study of Urgent-start APD
Can automated PD be used for urgent-start dialysis? A study from China enrolled 68 people who needed to start treatment urgently and did either APD (52.9%) or HD. After following for an average of 20.1 months, the APD group had “significantly fewer short-term dialysis-related complications,” and lower hospital costs. Both groups had similar technique survival, infection rates, and patient survival.
Read the abstract » | (added 2022-07-13)
Tags: Automated Peritoneal Dialysis, Cost effectiveness, End stage Renal Disease, Esrd, Urgent start
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
Fatigue at PD Start Linked with Higher Mortality
A PLOS One study compared 4,285 incident PD patients who completed a KDQOL-SF vitality scale from Brazil (1,388) and the U.S. (2,897) from 2004 to 2011. Lower vitality scores after 90 days of PD were linked with a higher risk of mortality in both countries
Read the abstract » | (added 2022-07-13)
Tags: Fatigue, Incident Peritoneal Dialysis, Vitality, Mortality
Spiritual Well-being and PD Outcomes
The Peritoneal Dialysis Outcomes and Practice Patterns (PDOPPS) study has looked at whether spiritual well-being (SWB) affects PD outcomes, using a survey of SWB and SF-12 results. Among 529 people on PD who completed the surveys, 70% had moderate or higher SWB scores, which were positively correlated with higher physical and mental functioning and burden of kidney disease scores, and linked with less likelihood of depression.
Read the abstract » | (added 2022-07-13)
Tags: Peritoneal Dialysis Outcomes, PDOPPS, Spiritual Well being, SWB
Surprise Supplement Reduced Risk of Peritonitis on PD
Does correction of hypokalemia with potassium supplementation impact peritonitis rates? Yes, finds a new randomized controlled trial of 167 PD patients with hypokalemia from six clinics. Compared to conventional potassium management, use of a protocol aimed at maintaining potassium levels at 4-5mEq/L significantly extended time to first peritonitis.
Read the abstract » | (added 2022-06-10)
Some WILL Choose More Intensive HD—If They Learn the Benefits
In the UK, a new study of 183 in-center HD patients finds that 60+% would consider doing 4 treatments per week or 4.5 hours per treatment. Information about longer survival, better quality of life, and fewer fluid limits and access complications were all significantly linked with choosing longer and/or more frequent treatments.
Read the abstract » | (added 2022-06-10)
Home HD Patients Grasp Fluid Management Better than In-Center Ones
Compared to 839 people on in-center HD in the UK from six clinics, 99 receiving home HD had significantly more knowledge about fluid management and signs and symptoms of fluid overload. They also felt more in control and reported better adherence—though knowledge gaps remained.
Read the abstract » | (added 2022-06-10)
Tags: In center HD, Home HD, Fluid Management, Fluid Overload, Ckd Education
In Which Countries Do People Stay on PD Longer?
The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) analyzed time on PD among 218 randomly chosen clinics and 7,121 patients in seven countries including the U.S. Median time on PD ranged from 1.7 years in the UK to 3.2 years in Japan and Thailand. PD mortality risk was higher in Thailand and the U.S., and infection was the leading cause of transfers to HD.
Read the abstract » | (added 2022-06-10)
Tags: Peritoneal Dialysis Outcomes And Practice Patterns Study, PDOPPS, PD, Mortality, Hemodialysis Transfer, Kidney Transplantation
Risk of Left Ventricular Hypertrophy Tied to Fluid Overload on PD
A single hospital had 226 enrolled PD patients between late 2018 and January 2021. Using bioimpedance analysis and cardiac color Doppler ultrasound, patients were divided into an LVF and a non-LVF group, and into a normal volume and overhydration group. Of participants, 125 (55.3%) had LVH. Overhydration and low hemoglobin levels were independent risk factors for LVH.
Read the abstract » | (added 2022-06-10)
Tags: PD, LVH, Overhydration, Volume Loads