Journal Watch
Moving the PD Exit Site to Combat Infection
A 5-year retrospective cohort analysis looked at the impact of treating PD exit site and tunnel infections in 27 patients by removing the cuff and relocating the catheter under local anesthetic. After follow up ranging from 10.8 to 79.4 months, no leaks occurred, and the infections resolved in 74% of the patients. The rest had to have their catheters removed.
Read the abstract » | (added 2019-06-13)
Tags: Exit Site Relocation, Exit site Infection, Tunnel Infection, Peritoneal Dialysis Catheter, PD Catheter
Low vs. Very Low Site PD Catheter Placement to Prevent Migration
A retrospective 5-year series of 76 patients whose PD catheter tips migrated had received either a traditional low-site insertion (N=39) or a very-low-site insertion (N=37). After 2 years of follow up, the very-low-site group had significantly better catheter and patient survival, with fewer catheter complications—and no tip migration.
Read the abstract » | (added 2019-06-13)
Tags: Catheter Dysfunction, Catheter Migration, PD Catheter, Peritoneal Dialysis Catheter, Patient Survival
Higher Serum Albumin May Protect Residual Kidney Function in PD
In a prospective study of 104 new PD patients, having low serum albumin levels was independently associated with complete RKF loss (<100 mL/day of urine).
Read the abstract » | (added 2019-06-13)
Tags: Serum Albumin, Residual Kidney Function, Urine Volume, Peritoneal Dialysis, PD
BMI and Survival on PD
A large study from Korea (N=80,674 PD patients) found that those in the highest group for BMI: just 25.71, had significantly higher all cause mortality.
Read the abstract » | (added 2019-06-13)
Tags: Body Mass Index, Survival, Diabetes Mellitus, Peritoneal Dialysis, Mortality
Will Zinc Supplements One Day Help Prevent Peritoneal Sclerosis?
Ironically, PD saves lives, but high-glucose PD fluid damages the peritoneum, leading to fibrosis that can make PD impossible. By activating a complex metabolic pathway, a study in rats found that supplementing with zinc helped prevent fibrosis.
Read the abstract » | (added 2019-06-13)
Tags: High glucose PD Fluid, Peritoneum, Fibrosis, Zinc
Shared Decision-making (SDM) Boosts Uptake of PD and Living Kidney Transplants
Researchers in Taiwan found that levels of PD choice and living kidney transplantation were higher in the 71% of 310 patients (n=220) who received an SDM intervention were significantly more likely to choose PD or to obtain a living donor kidney transplant than those who did not.
Read the abstract » | (added 2019-05-15)
Tags: PD Choice, Living Kidney Transplantation, SDM Intervention
PD Fluid Overload Linked with Peritonitis from Gut Pathogens
PD patients with extra fluid in their bodies are at a significantly higher risk for peritonitis due to gut bacteria, finds a study of 138 patients. Patients in the highest third for intra-and extracellular water were at the highest risk.
Read the abstract » | (added 2019-05-15)
Tags: Body Composition, Overhydration, Peritoneal Dialysis, Peritonitis
Daily HD Practices in France and Australia/New Zealand
Registry data from both regions compared all incident patients who dialyzed 5-6 sessions per week—both daytime and nocturnal—with one-to-one matching of French to Australia/New Zealand patients based on age, sex, and dialysis start year. While survival and transplant access were comparable, other intriguing differences appeared.
Read the abstract » | (added 2019-05-15)
Tags: Registry Data, Dialysis Interval, Survival, Transplant Acces
NxStage HD and Removal of Beta-2 Microglobulin
Which works best to remove B2M, High-flux standard HD, post-dilution hemodiafiltration (HDF), NxStage short daily HD, or automated PD? In a small study (N=43), HDF and NxStage HD done 6 days per week removed the most B2M. Standard HD was next, with automated PD removing the least.
Read the abstract » | (added 2019-05-15)
Tags: B2m, High flux Standard HD, Post dilution Hemodiafiltration (HDF), NxStage Short Daily HD, Automated PD
A Swan Song for Kt/V (It’s About Time!)
A new review of the flaws of Kt/V—including a lack of proof of concept—“leaves little room for any conclusion other than that Kt/V, as an indicator of dialysis adequacy, is obsolete.” [Editor’s Note: Now, if the authors would take on the concept of “adequate” vs. optimal therapy…]
Read the abstract » | (added 2019-05-15)