Journal Watch

  1. Home HD: Cost-effective With Better Outcomes Than In-center

    A review of the patient-centered and economic impacts of home HD that included studies between 2000 and 2016 found better quality of life, flexibility, employment potential, and survival vs. hospital HD. Minority and low-income patients still have less access than others, which compounds their already-poor health outcomes. The authors found that home HD is cost-effective and the use of this option should be increased.

    Read the abstract » | (added 03/09/2017)

    Tags: Hemodialysis

  2. PD and Serum Vitamin D—A Vital Link

    People with no history of heart disease on PD for 3+ months were compared to age- and sex-matched healthy controls in a 24-month study of subclinical atherosclerosis. Those on PD had significantly more carotid and femoral plaques at baseline than controls. Lower levels of serum vitamin D predicted more plaque at baseline and at 24 months. The authors suggest that monitoring could help identify patients who are at higher risk.

    Read the abstract » | (added 03/09/2017)

    Tags: Peritoneal Dialysis

  3. The Impact of Telehealth on PD Satisfaction

    Per quarterly surveys completed by 200 people on PD, a system of telemedicine that included remote monitoring of blood pressure, weight, and glucose, and had educational videos boosted satisfaction with the option. Participants felt more autonomy and confidence in their health care, as well, and were less frustrated. Nearly half watched at least one video.

    Read the abstract » | (added 03/09/2017)

    Tags: Peritoneal Dialysis

  4. Does Frequent HD Boost Quality of Life? NO

    A new Canadian study randomized 200 patients to standard in-center HD (12-15 hours/wk; maximum of 18 hours) or extended HD (>24 hours/wk) for a year. Extended HD reduced phosphate and potassium levels and boosted Hgb, and patients took fewer BP meds and phosphate binders. However, health-related quality of life scores did not differ significantly between the groups.

    Read the abstract » | (added 02/08/2017)

    Tags: Hemodialysis

  5. Does Frequent HD Boost Quality of Life? YES

    As with nearly every other study, a new paper from the Frequent Hemodialysis Network trial looked at HRQOL among patients randomized to conventional vs. 6x/week HD (N=245) or 6x/week nocturnal vs. conventional home HD (N=87). After one year, patients who dialyzed more often had higher HRQOL than those on standard HD—and shorter recovery after each treatment.

    Read the abstract » | (added 02/08/2017)

    Tags: Hemodialysis

  6. Medicare Payment for Daily Home HD Varies Geographically

    According to Medicare claims data for in-center HD and home HD from 2009-2012, there were persistent variations in the home HD treatment claims paid by different Medicare contractors. Fortunately, these differences did not seem to affect whether clinics offered home HD.

    Read the abstract » | (added 02/08/2017)

    Tags: Hemodialysis

  7. A New Approach for Treating Peritonitis in Patients Over Age 50

    Researchers tried a new, 3-step “Mero-PerRest” protocol when patients over age 50 developed peritonitis due to enteric (gut) microorganisms. 1). Temporary “peritoneal rest” with the catheter in place. 2). IV meropenem. 3). Meropenum as a catheter lock. Compared to 203 bouts of peritonitis treated with usual care, 217 bouts treated with the new protocol had a higher primary cure rate (90% vs. 65.3%), better PD survival (90% vs. 64.9%), and similar patient survival.

    Read the abstract » | (added 02/08/2017)

    Tags: Peritoneal Dialysis

  8. More Hospital Readmissions with PD Than In-Center HD

    Those on PD have fewer routine clinic visits than those on standard in-center HD. This may help explain why a 10-year study of hospital discharges among 28,026 dialyzors in Canada found that 30-day readmission rates in PD patients were higher (7.1) than for matched patients doing standard in-center HD (6.0). Better care transitions may help.

    Read the abstract » | (added 02/08/2017)

    Tags: Peritoneal Dialysis, Hemodialysis

  9. Heart Disease? PD is a Good Option

    In a single clinic study, 112 new patients starting PD with or without heart disease were followed for 5 years. More people with heart disease had diabetes (53.3% vs. 31.7%), and they tended to be older. But, there were no differences between groups in hospital admissions, peritonitis, or PD technique failure.

    Read the abstract » | (added 02/08/2017)

    Tags: Peritoneal Dialysis

  10. Autonomy is Key to Choice of PD

    French researchers interviewed 150 patients who began dialysis between 2010 and 2014 from four clinics, and their nephrologists, to see what factors influence the choice of PD. Of those who could do PD or HD, 46.7% preferred PD. The main reason for this preference was having or wanting to have autonomy.

    Read the abstract » | (added 02/08/2017)

    Tags: Peritoneal Dialysis