Journal Watch
Can Urgent PD Starts Use Incremental PD?
In a retrospective study of 169 people who began PD, 111 started with incremental PD, while the remaining 58 began full-dose PD. Both groups were similar at the start. After 1 year, the full-dose group was on a higher PD prescription and had significantly higher PD adequacy numbers. Residual kidney function, blood pressure, anemia, and bone mineral correction were similar in both groups.
Read the abstract » | (added 2022-01-14)
Tags: Incremental PD, Full dose PD, PD Prescription, PD Adequacy, Urgent start Peritoneal Dialysis, Residual Kidney Function
Cost of the Quanta SC+ in the UK
In the United Kingdom, in-center hemodialysis costs more than £36,350 per year, which includes patient transport. Annual costs for use of the SC+ were estimated to be less: £26,642 for thrice weekly HD as home self-care, £30,235 for standard in-center HD; and £29,866 for 5x/weekly HD as home self-care.
Read the abstract » | (added 2022-01-14)
Tags: Quanta SC+, Hemodialysis Costs
Plastic vs. Metal Hemodialysis Needles: An International Nurse Survey
Plastic HD needles help prevent infiltration and hematomas, especially in elbow-located, new, or fragile fistulae—yet most countries continue to use cheaper metal needles. A nurse survey found strong resistance to plastic cannulae among respondents. Reduction in adverse access events may reduce costs, staff time, and patient distress.
Read the abstract » | (added 2022-01-14)
Tags: Plastic HD Needles, Plastic Cannulae, Infiltration, Hematomas
Incremental PD with Residual Kidney Function: Safe and Effective
Compared to 42 people who started full-dose PD, 54 who began incremental PD between 2015 and 2019 tended to be female, not have diabetes, and have more residual kidney function. PD technique survival, peritonitis, and hospitalization were about the same for both groups.
Read the abstract » | (added 2022-01-14)
Tags: Incremental PD, Residual Kidney Function, Full dose PD, Technique Survival
PD and Home HD in the U.S. vs. Canada
PD and home HD offer well-documented advantages and lower total costs in high-income countries. Both have seen growth in the US during the last decade, driven by payment changes and COVID-19—but US numbers still lag behind Canada and other countries.
Read the abstract » | (added 2022-01-14)
Tags: Peritoneal Dialysis, PD, Home Haemodialysis, HHD
Wound Vac Use Helpful for 7 Days After PD Catheter Placement
A new PD catheter is surrounded by an open wound. Among 30 people who had PD catheters placed, half were randomly assigned to receive negative pressure wound therapy (wound vac) for 7 days. The other half received conventional dressings. The exit site scores were significantly better in the wound vac group, and their exit sites remained significantly better for the next 6 months, though peritonitis rates were the same.
Read the abstract » | (added 2022-01-14)
Tags: PD Catheter, Catheter Exit site Care, Infection, Wound Vac
Home HD Core Curriculum 2021
AJKD has released a new edition of this manual, which covers benefits, pitfalls and challenges of starting and growing a home HD program, home HD equipment, prescriptions, and medical management.
Read the abstract » | (added 2021-12-16)
Tags: Home Hemodialysis, HHD, Home HD Program, Patient Choice
Clinically-focused Shared Decision-making Does NOT Improve Home Dialysis Uptake
A qualitative interview study with 95 people in Wales found that generic, clinically-focused shared decision-making was not able to overcome denial, lack of symptoms, and health systems issues to increase use of home dialysis. Unmet and unrecognized family needs and untranslated medical knowledge were additional challenges. The “simplest” option seemed to be standard hemodialysis.
Read the abstract » | (added 2021-12-16)
Tags: Clinically focused Shared Decision making, Home Dialysis Uptake, Pre dialysis
Oral Hygiene and Nutritional Status on PD
Clean teeth mattered for nutritional status and hand grip strength in a small study (n=41) of people on PD. Inflamed gums can cause tooth loss and limit what people can eat. Those with dirty to very dirty teeth had poorer nutrition than those with clean or slightly dirty teeth, and their hand grips were weaker. Those with dirty teeth also had more GI symptoms and a higher risk of malnutrition.
Read the abstract » | (added 2021-12-16)
Tags: PD, Tooth Loss, Malnutrition, Gingivitis, Periodontitis
Simplified Half Percutaneous PD Catheter Placement Technique
Use of a simple modified metal trocar was safe and effective in a series of 280 consecutive PD patients followed for 3 years. Taking an average of less than 30 minutes, the new technique was technically successful 99.3% of the time initially, with mechanical complications occurring in 10% during the follow-up period; most commonly catheter malfunction, and 32 episodes of peritonitis (10.4%). By the end of the study, 83.9% lived and still had their initial catheters.
Read the abstract » | (added 2021-12-16)
Tags: PD, Peritoneal Dialysis, Catheter, Half percutaneous Technique