Advancing American Kidney Health Initiative Did Not Impact Public Awareness

In 2019, the AAKHI aimed to increase the use of home dialysis. Analysis of U.S. Google Trends data from 2013 to 2021 for home dialysis terms found an increase in searches when the AAKHI was first announced, followed by flat or declining searches. The authors concluded that the AAKHI did not impact public information-seeking and targeted education initiatives may be needed.

Read the abstract » | (added 2025-01-13)

Tags: Advancing American Kidney Health Initiative, AAKHI , Public Awareness

Organizational Culture and Home Dialysis Uptake

An ethnographic study of dialysis clinic culture was conducted at four clinics in England with average or high rates of home dialysis and maximal geographic, ethnic, and socioeconomic diversity. Three themes identified were encouraging the patient voice and providing individualized support, ensuring home dialysis access (minimalizing eligibility assumptions), and achieving sustained change based on benefits for patients.

Read the abstract » | (added 2025-01-13)

Tags: Dialysis Clinic Culture, Home Dialysis Access, Patient Benefits

Do Ketoanalogue (KA) Supplements Preserve Residual Kidney Function in PD?

A 1-year, six center, randomized, double-blind trial investigated the impact of KA supplements on RKF in 153 CAPD patients vs. placebo. For patients with early PD initiation, the KA group had a significantly lower decline in RKF. No differences were found in RKF decline in those with late PD starts or in PD adequacy, peritoneal function, nutritional status, or quality of life scores between groups.

Read the abstract » | (added 2024-12-11)

Tags: KA Supplements, Residual Kidney Function, CAPD, Ketoanalogues

Impact of PD Exchange Volume/Day on Outcomes

A DOPPS cohort study in Japan divided patients into two groups by daily PD dialysate volume (<4L/day; n=98 or >4L/day; n=244). Despite demographic differences between the groups, there were no significant differences in transfers to HD, mortality, hospitalization, peritonitis, or patient-reported outcomes based on volume—thus less volume may be more cost effective.

Read the abstract » | (added 2024-12-11)

Tags: Dialysate Volume, Peritoneal Dialysis Outcomes, Mortality, Patient reported Outcomes

Long-term PD vs. HD on Left Ventricular Function

In a small echocardiogram study of long-term dialysis patients (mean of 125.1+35.2 months), 24 CAPD patients and 23 HD patients were assessed for LV function, LVH, and LV geometry. Left ventricle dysfunction, LVH, and deterioration in LV geometry were significantly worse in the PD group.

Read the abstract » | (added 2024-12-11)

Tags: Echocardiogram, LVH, Left Ventricular Hypertrophy, Left Ventricle Dysfunction, CAPD, HD

Early Icodextrin (ICO) Use Reduced PD-associated Peritonitis Risk

A group of 82 patients who did PD between 2011 and 2020 were divided into a group (n=21) who received ICO at PD initiation and a group (n=61) who received it later or not at all. Patients were followed until they stopped PD, died, or 3 years passed. PD-associated peritonitis and tunnel infection-free survival rates were significantly better with early ICO use.

Read the abstract » | (added 2024-12-11)

Tags: PD, ICO, Early Icodextrin, Peritonitis, Tunnel Infection free Survival Rates

Unphysiology is Back and Affects the Heart in Standard HD

It’s been quite a while since “unphysiology” appeared in a journal article title. The authors note that the intermittent nature of in-center HD causes significant upward and downward fluctuations that affect fluid status, add to hemodynamic instability, and increase cardiovascular risk. More frequent HD modalities, on the other hand, can reduce left ventricular hypertrophy, improve BP control, and possibly boost survival, and PD is more continuous and gentle.

Read the abstract » | (added 2024-11-21)

Tags: Unphysiology, In center HD, Fluid Status, Hemodynamic Instability, Cardiovascular Risk, HD, PD

Staying Infection-free with PD and Home HD

While home treatments tend to be better treatments, infection is still a risk—and prevention a necessity. Education and inclusion of infection-prevention in training are important, as are managing modifiable risk factors, such as constipation, gastric acid blockers, and hypokalemia in PD. For home HD, reducing CVC use and duration and using the rope ladder technique for cannulation can reduce risk.

Read the abstract » | (added 2024-11-21)

Tags: Infection prevention, Modifiable Risk Factors, PD, HHD, Central Venous Catheters, CVC

An Integrated Home Approach: PD to Home HD

Even in Canada, it is rare (2-6%) that patients who stop PD transfer to home HD. A new review article shares data and describes an integrated home dialysis model that covers patient identification, timely transition planning, and challenges.

Read the abstract » | (added 2024-11-21)

Tags: PD Transfer To Home HD, Transition, Integrated Home Dialysis Model

Stepwise PD Starts vs. Conventional PD Starts—Which is Better?

Stepwise Initiation of PD (SIPD) is an approach that uses a gradual introduction to PD (perhaps like incremental PD in the U.S.?). In a retrospective look at 39 SIPD patients vs. 78 conventional PD (CPD) starts during a 13-year period matched for age and sex, early complications and PD catheter survival were similar between groups. But, late complications were significantly lower in the SIPD group. The authors believe SIPD may aid tissue healing and reduce biofilms, which may reduce infections. As always, more studies are needed…

Read the abstract » | (added 2024-11-21)

Tags: Stepwise Initiation Of PD, Incremental PD, Late Complications, Infection, Tissue Healing, Biofilms