Half of PD patients may develop a new glucose disorder

A metaanalysis of nine studies with a total of 13,879 PD patients found that 8% had new-onset diabetes, 15% developed impaired glucose tolerance, and 32% had newly abnormal fasting blood sugar levels. No differences were found by ethnicity. The authors concluded that PD patients should receive glucose tolerance tests.

Read the abstract » | (added 2019-07-15)

Tags: PD, Diabetes, Glucose Tolerance, Blood Sugar Levels, Glucose Tolerance Test

How longer HD treatments affect bone minerals

The ACTIVE study randomized 200 people to do 24+ hours of HD per week vs. standard (<18 hours per week) HD. Long HD treatments reduced serum phosphate levels, but did not change PTH or serum calcium. In a second analysis of the data, those who did longer HD needed fewer phosphate binders as well.

Read the abstract » | (added 2019-07-15)

Tags: HD Duration, Long Hd Treatment, Serum Phospate, Mineral Metabolism, Phosphate Binders

Frequency vs. Time in HD Survival

Which matters more for HD--the number of treatments per week, or the length of each treatment? A retrospective registry study from the ANZDATA database looked at survival among 16,944 non-indigenous adult patients in Australia and New Zealand from 2001 to 2015. After controlling for frequency, patients with 5+ hour long treatments had significantly better survival than those whose treatments <5 hours. However, controlling for duration, increasing frequency did not boost survival.

Read the abstract » | (added 2019-06-13)

Tags: ANZDATA, Session Frequency, Session Duration, Survival, End stage Kidney Disease

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

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

Bioimpedance Assessment of Conventional vs. Daily HD

In a small physiological study, 12 patients were switched from conventional (3x/week) to daily (6x/week) HD treatments. Baseline and monthly blood pressure, BMI, and bioimpedance measurements were gathered on participants. Among the 9 patients who completed the data collection, body composition was not altered--but fluid overload was reduced and fewer antihypertensive medications were needed.

Read the abstract » | (added 2019-06-13)

Tags: Conventional HD, Daily HD, Blood Pressure, BMI, Bioimpedance, Fluid Overload, Antihypertensive Medications

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

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

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

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