HD Dose and Patient Survival: More is Better

Even using spKt/V—a flawed measure that considers only urea—a study of 558 standard HD patients from 2015 to 2020, of whom 214 died, found that a higher dose of dialysis reduced the risk of all-cause mortality by 33%.

Read the abstract » | (added 2022-09-13)

Tags: HD Dose, Dialysis Dose, Patient Survival, All cause Mortality

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

Late CKD Options Education Affects PD Selection

Analysis of data from 355 people at one center found that those who received CKD options education while their eGFRs were higher were more likely to choose PD. Other factors such as gender, poverty, or living alone were not associated with PD choice.

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

Tags: CKD Options, RRT Education Timing, Patient Education PD, Peritoneal Dialysis, Dialysis Choice

Healthcare System Factors in Home Modality Choice

A Midwest interview study was conducted with 40 people, half doing standard in-center HD. Access to and engagement in healthcare prior to nephrology care and after dialysis start had an impact on patients’ awareness of their CKD, its progression, and dialysis options—and most had been passive during decision-making. Level of fatigue, treatment schedule, and access problems affected satisfaction.

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

Tags: Standard In center HD, CKD Progression, Dialysis Options, Shared Decision making

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

Too-high OR Too-low LDL Cholesterol and Survival on PD

A retrospective study in China looked at data from 3,565 people starting PD from 2005 to 2020. Both higher and lower levels of LDL-C were linked with higher all-cause and cardiovascular mortality. Malnutrition and low LDL-C was especially risky.

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

Tags: PD, LDL C, Cardiovascular Mortality, All cause Mortality, Malnutrition

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

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

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