Journal Watch
Funding U.S. Dialysis Innovation: The Role of TPNIES
CMS is expanding reimbursement to encourage use of home treatments under the transitional add-on payment for new and innovative equipment and supplies (TPNIES). An up to 26% reimbursement to clinics requires machines to be eligible under the substantial clinical improvement (SCI) criteria—but these have not been adapted for home dialysis and may not be suitable.
Read the abstract » | (added 2021-06-15)
Tags: Home Dialysis, Transitional Add on Payment For New And Innovative Equipment And Supplies, TPNIES
Home vs. In-center HD Outcomes from a Matched Cohort
After adjusting for BMI, smoking, race, and comorbidities, home HD came out ahead of in-center HD when 181 home HD patients were matched to 413 using in-center HD. With home HD, the risk of death was significantly less, and phosphate levels were significantly lower. There were no major differences in transplant rates, graft survival, hemoglobin, calcium, or PTH levels.
Read the abstract » | (added 2021-06-15)
Tags: Dialysis Modality; End stage Kidney Disease; Haemodialysis, Hemodialysis, Home Haemodialysis, Home Hemodialysis, Mortality
In-center Nocturnal HD Improves Quality of Life vs. Standard In-center HD
A small prospective cohort study of standard in-center HD patients (n=36) who switched to in-center nocturnal HD compared baseline health-related quality of life to levels 12 months later. Among the 24 who completed the study and permitted follow up, the mental component score increased by 7.1 points, and improvements were seen in several domains.
Read the abstract » | (added 2021-06-15)
Tags: In center Nocturnal Hemodialysis, Health related Quality Of Life, End stage Renal Disease, KDQOL 36
Safety Study of the PD Automated Wearable Artificial Kidney
In the AWAK pilot study, 15 participants used up to nine sessions over 72 hours and were then followed for one month. There were no serious adverse events, but 60% of participants had abdominal pain and 47% reported bloating. Median body weights were not significantly different before and after the study. Device enhancements will address ultrafiltration and pain.
Read the abstract » | (added 2021-06-15)
Tags: Wearable Kidney, Artificial Kidney, Chronic Kidney Disease, Peritoneal Dialysis
PD vs. Standard In-Center HD for Stroke Risk: A 14-year Study
Of 7,916 ESRD patients with atrial fibrillation between 2001 and 2013, data from 363 PD and 5,302 HD patients were analyzed. At 1 year, 3 years, and 5 years, the participants who used PD had significantly lower risks for outcomes including stroke, major bleeding, and intracranial hemorrhage than those using HD.
Read the abstract » | (added 2021-06-15)
Tags: ESRD, End Stage Renal Disease, Atrial Fibrillation, Peritoneal Dialysis, Hemodialysis, Patient Outcomes
PDOPPS Findings of Factors Important to Peritonitis Outcomes
The Peritoneal Dialysis Outcomes and Practice Patterns Study analyzed factors in the outcomes variations among 1,631 peritonitis episodes in 1,190 patients in seven countries. About 2/3 of the bouts were successfully cured, which was more likely with Gram-positive organisms, automated PD, and use of icodextrin (facility level), aminoglycosides, and ciprofloxacin vs. ceftazidime for Gram-negative organisms.
Read the abstract » | (added 2021-06-15)
Tags: Peritoneal Dialysis, Peritonitis, Peritoneal Dialysis And Outcomes Practice Patterns Study
PD vs. standard HD for health-related quality of life, and employment
A DOPPS study analyzed data from 7,771 standard in-center HD and PD patients in six countries. Those from Japan had the highest physical functioning and employment rates—with PD better than HD. The U.S. had the highest mental functioning and lowest employment rates. During one year, physical and mental function did not change much.
Read the abstract » | (added 2021-05-14)
Tags: Kidney Disease, Employment, DOPPS
Measure needed for life participation in PD
A literature review and metaanalysis of 301 studies identified 42 measures to assess life participation, but most were used in just one study or were not specific to PD. The authors conclude that a new measure is needed.
Read the abstract » | (added 2021-05-14)
Tags: Life Participation, Peritoneal Dialysis, Pd
How the Ontario Renal Network (ORN) has been trying to grow home dialysis
ORN started efforts to increase home dialysis use in Ontario in 2012, using a new funding formula based on modality, mandatory informatics, home dialysis coordinator and assisted PD funding, support for urgent start PD, targets for home dialysis rates, a network of clinics committed to home therapies, and frequent leadership meetings. Did they succeed?
Read the abstract » | (added 2021-05-14)
Tags: Home Dialysis, Home Haemodialysis, Peritoneal Dialysis, Hd, Pd
The impact of low magnesium levels on heart disease deaths on PD
Hypomagnesemia is linked with all-cause mortality in HD—but, what about PD? A study classed 1,004 blood tests from PD patients measuring magnesium into one of three groups: <0.7 mmol/L, 0.7-1.2 mmol/L, and >1.2 mmol/L. Those in the lowest magnesium group did have a higher risk of death from both heart and non-heart causes.
Read the abstract » | (added 2021-05-14)