Journal Watch
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Which Form of PD Has a Higher Risk of Peritonitis?
If you guessed CAPD because there are more exchanges to perform, you are correct, finds a study that matched 106 APD to 106 CAPD patients and followed them for 3 years. During the study period, there were 64 cases of peritonitis, and the risk was 30% higher among those who did CAPD.
Read the abstract » | (added 2020-11-12)
Tags: PD, Peritoneal Dialysis, CAPD
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Survival Benefit of More HD Hours is Not Sustained After a Switch Back to Standard
In the ACTIVE Dialysis trial, 200 standard HD patients were randomized to receive usual care (median of 12 hours of HD/week) or extended hours (median of 24 hours of HD/week) for 12 months, with follow up through 60 months. After the 12 months, intervention group participants were switched back to usual care. At 5 years, there was no difference between the groups in all-cause mortality.
Read the abstract » | (added 2020-10-12)
Tags: Dialysis, End stage Kidney Disease
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Pilot: Chlorhexidine-impregnated Sponge Dressings to Prevent Exit Site Infections
In a single-center study, 50 incident PD patients were taught to use a weekly chlorhexidine dressing on their exit sites, and followed for a year. While 12% developed contact dermatitis, 73% found the dressings acceptable. Episodes per patient year of exit-site/tunnel infections and peritonitis were 0.09 and 0.07, respectively, while 1-year technique and patient survival rates were 86% and 96%, respectively.
Read the abstract » | (added 2020-10-12)
Tags: Chlorhexidine Dressing, Exit site Infection, Peritoneal Dialysis
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24-hour Dietary Recall Less Accurate for Protein Intake Assessment in PD
Among 50 PD patients, use of protein nitrogen appearance (PNA) revealed levels of protein that ranged from 48.27-67.74 grams per day; median 55.75—while 24-hour dietary estimated the levels at 45.28-87.40; median 61.43 g/day. The authors suggest that proportionality bias may have influenced the results.
Read the abstract » | (added 2020-10-12)
Tags: Dialysis Initiation, Dialysate, Peritoneal Dialysis, PD
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Physical Activity May Reduce Bone Density in PD
In a paradoxical finding, 13 women and 21 men on PD who were sedentary had higher BMD than those who were moderately or vigorously physically active. Other aspects of body composition and biochemistry, such as creatinine clearance and triglyceride levels were linked with higher levels of physical activity.
Read the abstract » | (added 2020-10-12)
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Converting In-center HD Patients to Home: the Importance of Belief
A small, cross-sectional study (n=44) interviewed patients who were and were not considering home HD. Only 68% of patients said they’d heard about the benefits of home HD. The cohort who were willing to consider it were significantly more likely to believe that self-care and home HD would improve their quality of life, particularly travel, better health outcomes, and the comfort of being at home.
Read the abstract » | (added 2020-09-11)
Tags: Home Hemodialysis, Hemodialysis, Homedialysis, HD
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PD and Bone Mineral Disorders vs. HD
Body composition, nutritional status, DEXA, and bone mineral disease (BMD) biomarkers were assessed at baseline and one year in 242 ESRD patients starting either PD (n=138) or HD (n=104). Among HD patients, BMD decreased significantly—but not in PD patients. Preservation of BMD was associated with significantly lower all-cause mortality, with cortical bone preservation more predictive than trabecular bone preservation.
Read the abstract » | (added 2020-09-11)
Tags: End stage Renal Disease, Bone Mineral Density, Dialysis
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Impact of Depression on PD Patient and Technique Survival
Among 275 patients who had done CAPD for at least 3 months, 31.3% tested as having depressive symptoms. Long-term patient and technique survival were significantly poorer in this group, even adjusting for cofounders.
Read the abstract » | (added 2020-09-11)
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Aspergillus Peritonitis Review
Compared to other fungal peritonitis, colonization with aspergillus is more dangerous, and identification is still a challenge. Among 55 cases reported in the literature between 1968 and 2019, the mortality rate was 38.3%, 85.5% had to have their PD catheter removed, and 81.8% of patients had to switch to HD.
Read the abstract » | (added 2020-09-11)
Tags: Aspergillus, Mortality, Peritoneal Dialysis, Peritonitis
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Benefits of PD Remote Monitoring
A retrospective study compared two groups of APD patients, one that received remote monitoring (n=38) and one that received routine care (n=35). PD dropout and fluid status were similar between the two groups. But, the remote monitoring group had fewer ER and hospital visits related to kidney disease, especially among those with more comorbidities. Patients also preferred remote monitoring, and were more satisified with their care.
Read the abstract » | (added 2020-09-11)
Tags: Clinical Outcomes, Quality Of Life, Remote Monitoring, Telemedicine