Journal Watch
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
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
Minority of UK Dialyzors Would Choose Standard HD Schedule
Given the choice of 12 different scheduling options, just 38% of 183 people doing standard in-center HD would always choose to keep doing what they were doing. Of the remainder, after being informed of the survival and quality of life benefits of more dialysis, 27.1% would choose longer treatments thrice weekly, and 34.4% would choose four 4-hour treatments per week.
Read the abstract » | (added 2021-11-12)
Tags: In center HD, More Frequent Hemodialysis, Longer Treatments
Health-related Quality of Life Better on PD than Standard HD in Morocco City
Compared to 71 people using standard HD, 20 doing PD had significantly better physical and mental component scores and staff encouragement, and significantly lower burden of kidney disease scores.
Read the abstract » | (added 2021-11-12)
Tags: Standard HD, PD, Component Scores, Burden Of Kidney Disease Scores
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
Some Antihypertensive Meds Reduce GI Bleeds in PD
GI bleeding is more likely in people with CKD. A study of 734 people on PD were followed to see if use of an ACE-inhitor or angiotensin receptor blocker (ARB) would reduce the incidence. After an 8-year follow-up, those who were taking these meds had a significantly lower rate of GI bleeding.
Read the abstract » | (added 2021-11-12)
Tags: GI Bleeding, CKD, PD, ACE inhitor, Angiotensin Receptor Blocker
Local Anesthetic for PD Catheter Placement
A study of 27 people tested the feasibility of using mepivacaine 1% (which lasts longer than lidocaine) plus sedation with Remifentanil for PD catheter placement. None of the 27 needed to convert to general anesthesia, and all of the catheters worked with no leakage.
Read the abstract » | (added 2021-11-12)
Tags: PD Catheter, Mepivacaine, Remifentanil
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
Lower salt diet and residual kidney function on PD
Sixty-two people on PD were divided into three groups by salt intake (<6 grams/day, 6-8 grams/day, and>8 grams/day). One year later, those with the highest salt intake had the fastest decline in residual kidney function.
Read the abstract » | (added 2021-10-13)
Tags: PD, Salt Intake, Residual Kidney Function
Home HD Core Curriculum, 2021
COVID-19 and policy changes have revived interest in home HD, so nephrologists need to better understand the therapy. This article focuses on factors in successful training and retention, including benefits, pitfalls, challenges, new equipment, prescriptions, and more.
Read the abstract » | (added 2021-10-13)