Journal Watch
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Disparities in Access to PD
Per logistic regression of USRDS data from 2009 to 2019, the incident PD population more than doubled, with increases in PD use by seniors. There was a 5% increase in PD use by Hispanic people, but no difference in other races. Urban PD use also increased by 5%, and 7% for those in socioeconomically disadvantaged areas.
Read the abstract » | (added 2023-08-16)
Tags: Incident PD, PD Access, Disparity, PD Demographics
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How Glucose Causes Peritoneal Fibrosis
Constant glucose exposure from PD dialysate often causes fibrosis that can make further PD impossible. High glucose causes chronic inflammation, interferes with lipid metabolism, and leads to angiogenesis and fibrosis. RAAS activation contributes to this process as well. There may be benefit to looking at the upstream pathways to see if there are ways to block fibrosis.
Read the abstract » | (added 2023-08-16)
Tags: High Glucose, PD Dialysate, Fibrosis
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Skilled Nursing Facility “Home” Dialysis Improves Rehabilitation
Rehab therapies take time—and so does going off-site for in-center dialysis. Offering more frequent dialysis (MFD) at SNFs saves time. Does it improve PT participation? Yes, finds a new retrospective EMR review study. Compared to 562 in-center HD rehab patients, 92 people who received MFD in their SNF had higher PT participation rates (equivalent to almost 13,000 non-ESRD rehab patients), even though they had significantly more comorbidities.
Read the abstract » | (added 2023-08-16)
Tags: Rehabilitation Therapies, Skilled Nursing Facility, MFD, SNF, PT Participation, Comorbidities
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ISPD Proposes to Remove PD Toxin Clearance Targets
New ISPD Guidelines suggest that the focus of PD should be patient well-being—not lab values. This change would allow more people to do PD, and focusing on relieving uremic symptoms could help determine which solutes really do matter to quality of life.
Read the abstract » | (added 2023-08-16)
Tags: PD, Patient Well being, Lab Values, Uremic Symptoms, Quality Of Life
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Value of an Integrated Home Dialysis Model in the United Kingdom: A Cost-Effectiveness Analysis
This study aimed to determine the lifetime cost-effectiveness of increasing home hemodialysis as a treatment option for patients experiencing peritoneal dialysis technique failure compared with the current standard of care.
Read the abstract » | (added 2023-07-17)
Tags: Cost effective, Home Hemodialysis, Treatment Option, Peritoneal Dialysis Technique Failure
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Paradoxical Finding in PD Peritonitis
The common wisdom is that larger patients are at greater risk for PD-associated peritonitis (PDAP). But, a new single-center study of 483 peritonitis episodes in 285 patients suggests that the opposite may be true. A lower value of body surface area was an independent risk factor for peritonitis episodes. (p=0.015).
Read the abstract » | (added 2023-07-17)
Tags: Body Surface Area, PDAP, Metabolism, Nutrition, PD, Peritoneal Dialysis, Peritonitis
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GI Outcomes in PD Trials
A meta-analysis of 61 trials looking at patient-reported GI outcomes of PD mainly found nausea (43% of trials), diarrhea (43%), constipation (34%), abdominal pain (31%) and PD peritonitis (40%). But, only 19% of the available trials reported GI outcomes at all.
Read the abstract » | (added 2023-07-17)
Tags: GI Outcomes, PD, Nausea, Diarrhea, Constipation, Abdominal Pain, Peritonitis
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Home Dialyzor Telehealth Preferences
A small study (n=34) that included surveys and 21 interviews found that 70% of home dialysis patients preferred face-to-face home visits, while 68% had previously had telehealth visits. Knowledge of telehealth was the main perceived barrier, while convenience and flexibility were the main benefits. Non-English speaking patients were at a disadvantage for telehealth.
Read the abstract » | (added 2023-07-17)
Tags: Home Dialysis, Home Visits, Telehealth
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PD vs. Home HD for Severe Infections
In a Finnish study of 536 patients using home dialysis, the risk of a severe infection (C-reactive protein of 100mg/L or higher) in year 1 of CAPD was 35%, APD was 25% and home HD was 11%. Over a 5-year period, compared to home HD, the hazard ratio of severe infection for APD was 2.2 and for CAPD, 2.8. PD peritonitis accounted for the difference.
Read the abstract » | (added 2023-07-17)
Tags: Home Dialysis, Severe Infection, C reactive Protein, CAPD, APD, HD, Home HD, PD Peritonitis
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Hope Matters in PD
Among 134 patients receiving PD in Hong Kong, those who were working, had a higher income, and were using a cycler for PD had higher hope scores, and there were correlations with age and social support. Higher hope scores were linked with better mental well-being and less severe depression.
Read the abstract » | (added 2023-06-14)
Tags: PD, PD Cycler, Work, Hope Score, Social Support, Mental Well being, Depression