Meta-analysis: Buttonhole vs. Rope Ladder Cannulation

Buttonhole cannulation with blunt needles can make home hemodialysis more appealing. A new systematic review and meta-analysis of 15 well-designed studies found that Buttonhole cannulation significantly reduced aneurysms, stenosis, blood clots, and bruising—with no difference in infection.

Read the abstract » | (added 2022-08-11)

Tags: Buttonhole Cannulation, Blunt Needles, Rope ladder Cannulation, Arteriovenous Fistula Puncture Techniques

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

Frequent HD Shortens Recovery Time—Even in Nursing Homes

In a study of 2,309 people receiving 14 hours of more frequent HD in skilled nursing facilities (SNFs), 92% reported recovery time of 2 hours or less. Those who received five treatments per week or had systolic blood pressure of 160-179 prior to treatment had greater odds of rapid recovery.

Read the abstract » | (added 2022-07-13)

Tags: ESRD, Home Hemodialysis, More Frequent Dialysis, Mortality, Nursing Home, Post dialysis Recovery Time

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

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

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

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

Structured CKD Education More Than Tripled Uptake of Home Therapies

In a matched retrospective cohort study, 2,398 CKD patients who attended a single 90-minute education program were pair-matched with others who did not. Compared to controls, those who attended the session were significantly more likely to be doing home dialysis (38.5% vs. 12.6%) and to be using a permanent access (57.9% vs. 33.8%). Hospitalization rates were 38% lower as well, and education-attendees had lower first-year mortality.

Read the abstract » | (added 2022-07-13)

Tags: CKD, Education Program, Home Dialysis, Permanent Access, Hospitalization Rates, First year Mortality

Safety and Efficacy of Wearable PD

The automated wearable artificial kidney (AWAK) uses sorbent technology. In a pilot study done in Singapore, patients used the AWAK for 72 hours and were followed up for a month. Among the 15 patients who took part, the AWAK had to be altered to fix blocked flows, but no serious adverse events occurred. Abdominal pain (60%) and bloating (47%) were reported.

Read the abstract » | (added 2022-07-13)

Tags: Peritoneal Dialysis, Automated Wearable Artificial Kidney, AWAK, Sorbent Technology

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