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

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

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

Lower Dementia Risk with PD than Standard In-Center HD: Metaanalysis

An analysis of 15 studies concludes that PD is associated with a lower risk of cognitive decline and dementia than HD--but calls for well-conducted prospective studies.

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

Tags: Dementia, PD, In center HD, Cognitive Functions

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

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

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

To Screen or Not to Screen PD Patients for Bacteria: That is the Question

Does the ISPD guideline for routine use of mupirocin ointment at PD exit sites risk creating mupirocin-resistant organisms? No, finds a surveillance study of 1,175 swabs from 240 patients.

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

Tags: Mupirocin, PD, Catheter, Peritonitis, Pseudomonas, Hygiene

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