Journal Watch
Which Modality is Better Between Transplants: PD or HD?
Among 776 people in a registry who received a second kidney transplant, 656 did standard in-center hemodialysis (HD) between transplants, 72 did PD, and 48 went immediately to a second transplant. Those who did PD or went directly to a second transplant had better adjusted survival than those on HD.
Read the abstract » | (added 2022-11-16)
The Predictive Value of Early, Non-infectious PD Complications
A prospective, multicenter cohort study of 1,596 people starting PD in New Zealand from 2014 to 2018 (inclusive) looked at survival and time on PD of those who had catheter-related exit site dialysate leaks or other leaks within 30 days of PD start. Peritonitis-free survival, first PD catheter survival, and tunnel infection free survival were secondary outcomes. Among the 102 with an early complication, overall mortality, the rate of stopping PD, and first catheter failure were all higher.
Read the abstract » | (added 2022-11-16)
Tags: PD, Survival, Peritonitis free Survival, First PD Catheter Survival, Tunnel Infection Free Survival, Early Catheter related Complication
A New PET Resource
How and why are peritoneal equilibrium tests (PETs) done? What are the various iterations? What can be learned from the results? Find out in this new review.
Read the abstract » | (added 2022-11-16)
Tags: Peritoneal Equilibrium Tests, PETs
Better COVID Survival with PD and Home HD
Among 1,336 people whose kidneys failed between March, 2020 and January, 2021, 13.12% (n=178) contracted COVID-19. Of these, most (n=139) did standard in-center HD, and 33 (3.87%) died. On PD, 39 people developed COVID, and 1 (0.81%) died. On home HD, there were zero cases of COVID and no deaths. Five transplant patients developed COVID, with a mortality rate of 1.47%.
Read the abstract » | (added 2022-10-17)
Tags: Covid, Standard In center HD, PD, Mortality, Home HD, Home Hd And Covid, Transplant
Remote vs. In-person PD Training: Which is Better?
It’s a tie, finds a small, retrospective Italian study comparing 21 in-home, in-person PD trainings from 2014 through 2016 to 25 video-based training from 2016 through 2018. After a home visit, PD training done by telemedicine. Actually, there were 5 episodes of peritonitis in the home training group—and 0 in the telemedicine group. And, 2-year technique survival with in-person training was 56.3%—while for telemedicine training, it was 76.9%.
Read the abstract » | (added 2022-10-17)
Tags: Remote Training, PD Training, Telemedicine
The Varied Uses of Assisted PD in Spain
In a retrospective look from 1997 through 2020, a Spanish clinic identified four groups who used assisted PD at some point. Group 1 was totally dependent at PD start, group 2 was self-care and then became totally dependent, group 3 needed short-term PD help, and group 4, the controls, remained on self-care. Of those who required assistance, 73% did so during follow up, not initially. Up to 44% of autonomous patients became dependent for various reasons over time, including loss of a care partner. Assisted PD—even when paying care partners—was less costly than switching to standard HD.
Read the abstract » | (added 2022-10-17)
Tags: Assisted PD, Dependency
Savings from Incremental PD
In a stud of 147 people who did incremental PD from 2009 through 2021, 11.9% transitioned to full-dose PD. Peritoneal glucose exposure was reduced by multiple kilos per year, and costs, plastic waste, and water use were also lower, as was time to manage PD.
Read the abstract » | (added 2022-10-17)
Tags: Healthcare Cost, Cost Analysis, Incremental PD, Full dose PD, Peritoneal Glucose Exposure
PD: Sweat it Out to Reduce Fluid Overload
In a small study, 4 people on PD used a portable sauna bath daily for 10 days, at 30 minutes a day and a temperature of 45°C. Most (51) of the 54 sauna sessions were well-tolerated; two people reported dizziness and one person with advanced diabetic neuropathy received a second degree skin burn. Body water loss and blood pressure improved significantly from the control period. Larger studies are needed.
Read the abstract » | (added 2022-10-17)
Tags: Diaphoresis, Fluid Overload, Sauna Bath, Sweat
Replacing Dextrose in PD Fluid—with Steviol Glycosides?
Using glucose to remove water will scar the peritoneum over time—making PD a short-term option for most. Icodextrin (Extraneal®) is a glucose-free alternative. Now, researchers are looking at another one: steviol glycosides (SG), the compounds that make stevia taste sweet. Using artificial membranes and mice, dialysate with 1.5%, 1%, and even 0.75% SG had similar results as glucose-based fluids—with better biocompatibility.
Read the abstract » | (added 2022-09-13)
Tags: Dextrose, PD Fluid, Steviol Glycosides, Icodextrin
Safety of Exercise for Those Who Do PD
A review of 25 studies of exercise in PD found only minor adverse events, mainly short-term muscle or joint pain or fatigue. There were no serious adverse events or signs of harm.
Read the abstract » | (added 2022-09-13)
Tags: PD, Peritoneal Dialysis, Exercise, Benefits, Adverse Events