Journal Watch
Simultaneous Hernia Repair and PD Catheter Placement
Taking care of two surgeries at once saves a procedure, recovery time, and costs. Among 123 patients who had catheters placed at a single center over a 4-year period, 23 (19%) had hernias. Across the 23, 27 procedures were done combining hernia repair with PD catheter placement. None of the hernias recurred, and there were no early surgical site infections. Five of the patients developed new hernias at other sites, but after a median of about 3 years, 96% of the catheters were still working.
Read the abstract » | (added 2019-12-10)
Tablo HD Machine Safe and Effective at Home and In-center
Safety and efficacy human trials of the easy-to-use Tablo were conducted with 28 participants who received 4 treatments per week in-center and then at home for a total of 21 weeks. Home adherence (99%) was slightly better than in-center (96%), with average prescribed—and delivered—treatments of 3.4 hours, and an average weekly standard Kt/Vurea of 2.8 in both settings. Adverse events were not related to the Tablo, and alarm resolution time was 8 seconds in-center and 5 seconds at home.
Read the abstract » | (added 2019-11-16)
Antibiotics Before Colonoscopy May Reduce Peritonitis Risk in PD Patients
In a retrospective study of 236 CAPD patients who had colonoscopies, 9 developed peritonitis within a week of the procedure. No patient who received prophylactic antibiotics developed peritonitis. Randomized controlled trials are recommended.
Read the abstract » | (added 2019-11-16)
Tags: CAPD, Colonoscopy, Peritonitis, Prophylactic Antibiotics, Polypectomy, Endoscopic Mucosal Resection
Is PD Unwise for Patients with Lupus Nephritis?
A small study found 92.4% (1 year), 84.7% (3 year) and 67.6% (5 year) patient survival among 28 non-diabetic lupus patients doing PD—compared to 100% (1 year), 93.5% (3 year), and 82.9% (5 year) among 56 controls. While the lupus was not directly associated with mortality, it was a risk factor for PD technique failure, infection, and hospitalizations.
Read the abstract » | (added 2019-11-16)
Tags: Patient Survival, Lupus, PD, Mortality, Technique Failure, Infection, Hospitalization
Home Dialysis “Virtual Ward” Addresses Gaps in Care Transitions
Following hospital discharge, a procedure, antibiotics, or completion of home training, 2 weeks of telephonic follow-up was provided to 193 PD or home HD patients as a “home dialysis virtual ward” (HDVW). The HDVW identified a median of 1 care gap per patient, with newer patients at higher risk of gaps. Patients were highly satisfied with the HDVW.
Read the abstract » | (added 2019-11-16)
Tags: Home Dialysis, Home Dialysis Virtual Ward, HDVW, Care Gap
A Post-op Surgical Girdle for Pain and Catheter Tunnel Infections in Urgent Start PD
Urgent start PD can be associated with pain and tunnel infections. In a study of 85 consecutive PD catheter placements, a surgical girdle was used from days 1-3 while patients were supine. Among the 23 patients who completed pain surveys, the girdle helped significantly. Tunnel infections were reduced as well.
Read the abstract » | (added 2019-11-16)
Tags: Urgent Start PD, Pain, Tunnel Infection, PD Catheter, Surgical Girdle
Transplant Survival Better After PD Than Standard In-center HD
Is there an advantage to PD over standard in-center HD for transplant graft survival? YES, suggests a 15-year retrospective study of 2,277 transplant recipients. Those who did PD prior to transplant were 34.5% more likely to survive, and had less frequent rejection. Living donor kidneys did best among patients who received transplants before starting dialysis—or did PD.
Read the abstract » | (added 2019-11-16)
Tags: Kidney Transplant, Modality, PD, HD, Hemodialysis, Peritoneal Dialysis
PD vs. Standard In-center HD for Quality of Life
A 24-month observational study compared 45 standard HD and 30 PD patients, and assessed their quality of life, cognitive function, and depression at study start and every 12 months. Over the 24 months, PD patients had significant improvement in physical and social well-being—while HD patients stayed the same. Cognitive function held steady in PD patients—but declined in HD patients. Depression increased among those on standard HD—but not those on PD.
Read the abstract » | (added 2019-11-16)
Tags: Peritoneal Dialysis, Hemodialysis, Cognitive Function, Emotional Distress, Quality Of Life
Proton Pump Inhibitors Increase Peritonitis Risk in PD
In a single-center, 36-month retrospective look at 230 Japanese PD patients, those who took PPIs were 72% more likely to develop peritonitis than those who did not.
Read the abstract » | (added 2019-11-16)
Tags: PD, PPIs, Peritonitis, Proton Pump Inhibitors
PD Outcomes under the Medicare Expanded Dialysis Prospective Payment System
A Medicare change in 2011 may have increased the likelihood that clinics would expand PD to a broader population. Did this affect outcomes? A prospective cohort study compared 10,585 patients who started PD before payment reform, 7,832 interim patients, and 18,742 during the reform period. With similar demographics, more patients were treated in clinics with less PD experience—and these clinics had higher PD discontinuation rates. But, PD discontinuation fell overall, and mortality risk was stable.
Read the abstract » | (added 2019-10-14)
Tags: Expanded Dialysis Prospective Payment System, PD, Medicare