Journal Watch

  • Cognitive Impairment Predicts PD Peritonitis

    A prospective cohort study assigned 458 PD patients to a cognitively impaired (CI) or non-CI group based on results of mental state testing. The groups were not otherwise significantly different. Over 31.4 (median) months, 94 patients had first-time peritonitis, and short-term memory losses were independently linked with a higher risk.

    Read the abstract » | (added 2019-04-11)

    Tags: Cognitive Impairment, Mental State, Peritonitis

  • Operationalizing Telehealth for Home Dialysis

    In January, 2019, Medicare rules for telehealth changed to permit the home as an originating site for home dialysis patients. ESCOs can take advantage of waivers to obtain payment for a monthly comprehensive telehealth visit with a home patient after the first 3 months of therapy—with no geographic restrictions. Technical, regulatory, and operational challenges are discussed in this article.

    Read the abstract » | (added 2019-04-11)

    Tags: Maintenance Dialysis Therapy, Telehealth Services, Legislation, Regulatory Requirements, Remote Monitoring

  • Home HD - Significantly Better Survival and Transplant Rate

    A Swedish matched cohort study compared the long-term survival of 152 home HD patients with those doing PD (n=456) or standard in-center HD (n=608). Median survival for home HD was significantly better (18.5 years) than PD (15.0) and in-center HD (11.9). Home HD patients were also significantly more likely to have received a transplant.

    Read the abstract » | (added 2019-03-12)

    Tags: Survival, Home Hemodialysis, Institutional Hemodialysis, Peritoneal Dialysis

  • Clues to Home HD Retention

    Why do people drop out of home HD? A new interview study of 15 current and 10 former patients sheds some light. The study identified five themes, each with a positive and a negative aspect: degree of independence, support, technical aspects, home environment, and attitudes and expectations.

    Read the abstract » | (added 2019-03-12)

    Tags: HHD, Modality, Discontinuation

  • HOW do AGE’s Cause Peritoneal Fibrosis?

    For years, researchers have known that the advanced glycation endpoints (AGEs) that form when sugar-based PD fluid is made harm the membrane. But, we didn’t know why. Human cell modeling finds that AGEs cause outer layer peritoneal cells (epithelial) to become connective tissue cells (mesenchymal).

    Read the abstract » | (added 2019-03-12)

    Tags: AGEs, Mesothelial, Epithelial, STAT3

  • Longer HD Treatments Do Not Make Up for the 2-day “Killer Gap”

    For 20 years, the kidney community has known that death on HD is significantly higher on the day after the 2-day “killer gap.” An analysis of 250+ minutes vs. <200 minutes HD treatments found that even 4.5 hour long treatments thrice weekly did not make the gap less lethal.

    Read the abstract » | (added 2019-03-12)

    Tags: Treatment time, Interdialytic Interval, Hospitalization, Mortality

  • Urgent-start PD Catheter Placement - Surgical vs. Percutaneous

    PD catheter placement does NOT have to be limited to just minimally-invasive percutaneous procedures, suggests a literature review. But, minimizing intraperitoneal pressure for the first 2 weeks IS important.

    Read the abstract » | (added 2019-02-14)

    Tags: PD, Catheter, Urgent start, Complications

  • Longitudinal Experience with Remote PD Monitoring

    Patients whose PD was monitored remotely had almost twice the number of APD prescription changes--and significantly fewer nighttime alarms and less need for in-person visits than control subjects, saving both time and money.

    Read the abstract » | (added 2019-02-14)

    Tags: PD, Remote Monitoring, APD, Nighttime Alarm, In person Visit

  • Most Cost Effective Dialysis Options: Metaanalysis

    An analysis of 16 economic studies from both high- and low-income countries determined that home dialysis options are less costly and offer comparable—or better—health outcomes than in-center HD. Quality of life concerns were rarely investigated, however.

    Read the abstract » | (added 2019-02-14)

    Tags: Economic Studies, HD, Cost, Dialysis Options, Health Outcomes

  • Fewer Hip Fractures with PD than Standard In-Center HD: Metaanalysis

    Analysis of five cohort studies totalling more than 1.2 million ESRD patients found that those doing HD had a 61% higher risk of hip fracture than those doing PD.

    Read the abstract » | (added 2019-02-14)

    Tags: Hip Fractures, PD, In center HD