Journal Watch
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
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
U.S. nephrology fellows’ perceptions of their home dialysis training
To grow home therapies, we must have clinicians who are trained in PD and home HD. A survey of 110 nephrology trainees suggests that we are not there yet. Of the 76 respondents, most were moderately confident about PD principles—but not urgent start PD or catheter insertion. Confidence around home HD was low.
Read the abstract » | (added 2021-05-14)
Tags: Home Dialysis, Hd, Home Hemodialysis, Hdd, Peritoneal Dialysis, 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)
Metaanalysis: Weighted PD Catheters are Better
Analysis of data from 20 RCTs and 18 observational studies found no differences between double-cuff vs. single-cuff, swan-neck vs. straight-neck, and coiled-tip vs. straight tip PD catheters. Weighted PD catheters, on the other hand, were linked with significantly lower rates of tunnel infection, migration, drainage failure, cuff extrusion, and complication-related removal.
Read the abstract » | (added 2021-04-16)
Tags: Self locating Catheter, Coiled Catheter, Tenckhoff Catheter
Impact of Exercise on Bone Mineral Density in PD
Does exercise improve bone density in PD patients as it does in those who use HD? No, finds a small new pilot study of 53 people on PD who were randomly assigned to home exercise (n = 26) or usual care (n = 27). While home exercise significantly improved results on the 30 second sit-to-stand test, 6-minute walk test, and physical activity level, it did not change lumbar spine or hip DEXA results.
Read the abstract » | (added 2021-04-16)
Patients Who Want Autonomy More Likely to Choose PD
A national survey had 630 HD and PD patients respond to a survey about internal locus of control (ILOC) and an interest in treatment responsibility (ITR). The responding PD patients were younger and had significantly more desire both for control in general and interest in treatment responsibility in particular.
Read the abstract » | (added 2021-04-16)
Tags: Peritoneal Dialysis, Pd, Hemodialysis, Hd, Decision making
Home Dialysis Care Experience instrument
A new patient-reported experience measure for PD and home HD has been developed, based on a structured literature review, focus groups, interviews, and then cognitive testing. The 26-item measure covers 16 domains in six areas: communication and patient education, care team concern and helpfulness, care team proficiency, patient-centered care, care coordination, and personalized care.
Read the abstract » | (added 2021-04-16)
Tags: Hemodialysis, Hd, Peritoneal Dialysis, Pd
Better Technique Survival with Assisted PD
A study of 384 PD patients in China compared the outcomes of 274 who did self-care PD with 110 who had assisted PD. Older age, diabetes, low residual kidney function and low serum albumin predicted higher mortality, as did assisted PD, since this group had more comorbidities. Technique failure was also significantly lower in the assisted PD group.
Read the abstract » | (added 2021-04-16)