Journal Watch
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Roxadustat for Anemia in PD
The anemia drug was tested in 129 people on PD randomized to roxadustat or other ESAs for 24 weeks. The roxadustat group had a 96% response rate (vs. 92%), lower hepcidin levels and higher TIBC. Total cholesterol and LDL dropped more with roxadustat, independently of C-reactive protein. Mean average hemoglobin on roxadustat were 11.5 g/dL (vs. 11.2). There were some common adverse events.
Read the abstract » | (added 2021-07-12)
Tags: Prolyl Hydroxylase Inhibitor, Erythropoiesis, Iron Metabolism, Anemia
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Home vs. In-center HD Outcomes from a Matched Cohort
After adjusting for BMI, smoking, race, and comorbidities, home HD came out ahead of in-center HD when 181 home HD patients were matched to 413 using in-center HD. With home HD, the risk of death was significantly less, and phosphate levels were significantly lower. There were no major differences in transplant rates, graft survival, hemoglobin, calcium, or PTH levels.
Read the abstract » | (added 2021-06-15)
Tags: Dialysis Modality; End stage Kidney Disease; Haemodialysis, Hemodialysis, Home Haemodialysis, Home Hemodialysis, Mortality
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Funding U.S. Dialysis Innovation: The Role of TPNIES
CMS is expanding reimbursement to encourage use of home treatments under the transitional add-on payment for new and innovative equipment and supplies (TPNIES). An up to 26% reimbursement to clinics requires machines to be eligible under the substantial clinical improvement (SCI) criteria—but these have not been adapted for home dialysis and may not be suitable.
Read the abstract » | (added 2021-06-15)
Tags: Home Dialysis, Transitional Add on Payment For New And Innovative Equipment And Supplies, TPNIES
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In-center Nocturnal HD Improves Quality of Life vs. Standard In-center HD
A small prospective cohort study of standard in-center HD patients (n=36) who switched to in-center nocturnal HD compared baseline health-related quality of life to levels 12 months later. Among the 24 who completed the study and permitted follow up, the mental component score increased by 7.1 points, and improvements were seen in several domains.
Read the abstract » | (added 2021-06-15)
Tags: In center Nocturnal Hemodialysis, Health related Quality Of Life, End stage Renal Disease, KDQOL 36
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PDOPPS Findings of Factors Important to Peritonitis Outcomes
The Peritoneal Dialysis Outcomes and Practice Patterns Study analyzed factors in the outcomes variations among 1,631 peritonitis episodes in 1,190 patients in seven countries. About 2/3 of the bouts were successfully cured, which was more likely with Gram-positive organisms, automated PD, and use of icodextrin (facility level), aminoglycosides, and ciprofloxacin vs. ceftazidime for Gram-negative organisms.
Read the abstract » | (added 2021-06-15)
Tags: Peritoneal Dialysis, Peritonitis, Peritoneal Dialysis And Outcomes Practice Patterns Study
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PD vs. Standard In-Center HD for Stroke Risk: A 14-year Study
Of 7,916 ESRD patients with atrial fibrillation between 2001 and 2013, data from 363 PD and 5,302 HD patients were analyzed. At 1 year, 3 years, and 5 years, the participants who used PD had significantly lower risks for outcomes including stroke, major bleeding, and intracranial hemorrhage than those using HD.
Read the abstract » | (added 2021-06-15)
Tags: ESRD, End Stage Renal Disease, Atrial Fibrillation, Peritoneal Dialysis, Hemodialysis, Patient Outcomes
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Safety Study of the PD Automated Wearable Artificial Kidney
In the AWAK pilot study, 15 participants used up to nine sessions over 72 hours and were then followed for one month. There were no serious adverse events, but 60% of participants had abdominal pain and 47% reported bloating. Median body weights were not significantly different before and after the study. Device enhancements will address ultrafiltration and pain.
Read the abstract » | (added 2021-06-15)
Tags: Wearable Kidney, Artificial Kidney, Chronic Kidney Disease, Peritoneal Dialysis
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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
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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
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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