Wound Vac Use Helpful for 7 Days After PD Catheter Placement

A new PD catheter is surrounded by an open wound. Among 30 people who had PD catheters placed, half were randomly assigned to receive negative pressure wound therapy (wound vac) for 7 days. The other half received conventional dressings. The exit site scores were significantly better in the wound vac group, and their exit sites remained significantly better for the next 6 months, though peritonitis rates were the same.

Read the abstract » | (added 2022-01-14)

Tags: PD Catheter, Catheter Exit site Care, Infection, Wound Vac

Can Urgent PD Starts Use Incremental PD?

In a retrospective study of 169 people who began PD, 111 started with incremental PD, while the remaining 58 began full-dose PD. Both groups were similar at the start. After 1 year, the full-dose group was on a higher PD prescription and had significantly higher PD adequacy numbers. Residual kidney function, blood pressure, anemia, and bone mineral correction were similar in both groups.

Read the abstract » | (added 2022-01-14)

Tags: Incremental PD, Full dose PD, PD Prescription, PD Adequacy, Urgent start Peritoneal Dialysis, Residual Kidney Function

Simplified Half Percutaneous PD Catheter Placement Technique

Use of a simple modified metal trocar was safe and effective in a series of 280 consecutive PD patients followed for 3 years. Taking an average of less than 30 minutes, the new technique was technically successful 99.3% of the time initially, with mechanical complications occurring in 10% during the follow-up period; most commonly catheter malfunction, and 32 episodes of peritonitis (10.4%). By the end of the study, 83.9% lived and still had their initial catheters.

Read the abstract » | (added 2021-12-16)

Tags: PD, Peritoneal Dialysis, Catheter, Half percutaneous Technique

Clinically-focused Shared Decision-making Does NOT Improve Home Dialysis Uptake

A qualitative interview study with 95 people in Wales found that generic, clinically-focused shared decision-making was not able to overcome denial, lack of symptoms, and health systems issues to increase use of home dialysis. Unmet and unrecognized family needs and untranslated medical knowledge were additional challenges. The “simplest” option seemed to be standard hemodialysis.

Read the abstract » | (added 2021-12-16)

Tags: Clinically focused Shared Decision making, Home Dialysis Uptake, Pre dialysis

Home HD Core Curriculum 2021

AJKD has released a new edition of this manual, which covers benefits, pitfalls and challenges of starting and growing a home HD program, home HD equipment, prescriptions, and medical management.

Read the abstract » | (added 2021-12-16)

Tags: Home Hemodialysis, HHD, Home HD Program, Patient Choice

Oral Hygiene and Nutritional Status on PD

Clean teeth mattered for nutritional status and hand grip strength in a small study (n=41) of people on PD. Inflamed gums can cause tooth loss and limit what people can eat. Those with dirty to very dirty teeth had poorer nutrition than those with clean or slightly dirty teeth, and their hand grips were weaker. Those with dirty teeth also had more GI symptoms and a higher risk of malnutrition.

Read the abstract » | (added 2021-12-16)

Tags: PD, Tooth Loss, Malnutrition, Gingivitis, Periodontitis

Platelet-to-Albumin Ratio Predicts PD Technique Success and Survival

Dividing patients’ absolute platelet counts by their serum albumin levels creates a protein-to-albumin ratio (PAR) that predicts PD outcomes, finds a new study of 405 people over a median of 2 years. Patients with lower PAR levels had higher rates of PD success and better survival.

Read the abstract » | (added 2021-12-16)

Tags: Platelet to albumin Ratio, Technique Failure, Mortality, Peritoneal Dialysis

Standard vs. Incremental PD Start: 12-year Retrospective Study

When people start PD with some residual function, is it beneficial not to begin with a full PD prescription? A study looked back at 12 years of people who started PD, 232 standard and 71 intermittent (iPD; 2-3 manual exchanges per day). Those who did iPD had higher residual kidney function than those on standard PD. For people with diabetes, iPD was linked with a survival advantage as well.

Read the abstract » | (added 2021-12-16)

Tags: PD, Residual Function, Intermittent PD, IPD, Diabetes

New Clinical Practice Guidelines for Exercise on PD

The International Society for Peritoneal Dialysis and the Global Renal Exercise Network have teamed up to grade and review the literature and clinical experience to help people on PD stay physically active safely. With sparse quality evidence available, the new guidelines are largely opinion based, and cover timing of exercise relative to PD (i.e., empty or full); impact of exercise on mental health, weight, frailty, etc.; exercise nutrition, and potential adverse PD outcomes.

Read the abstract » | (added 2021-11-12)

Tags: Peritoneal Dialysis, Exercise, Physical Activity, PD Outcomes

Italians Improve on Daily Home HD

As in the U.S., the Italian Ministry of Health has home dialysis as a primary objective. In a 2-year study of seven people switched to six times per week daily home HD, significant improvements began to appear almost immediately. After 3-6 months, bone mineral balance and blood pressure were better, PTH levels and use of phosphate binders dropped, and the participants needed less rhEPO.

Read the abstract » | (added 2021-11-12)

Tags: Home Dialysis, Daily Home HD, RhEPO, Mineral Balance, Blood Pressure, PTH Levels