Gender and Malnutrition in PD

Do hypoalbumineumia, overhydration, inflammation, and cardiovascular risk affect men and women on PD differently? A small study (N=26 men and 28 women) with comparable BMI found more fluid overload, inflammation, and heart risk in women with low serum albumin than in men. Read the abstract.

Read the abstract » | (added 2018-09-10)

Tags: Gender, Malnutrition, Cardiovascular Risk, Hypoalbuminemia, Inflammation, Overhydration, Peritoneal Dialysis

Biocompatible PD Solutions Maintain Membranes Longer

Independently of inflammation, biocompatible PD solutions helped 71 patients keep a steady level of solute transport over 7.5 years, compared to 295 patients who used standard solutions. Read the abstract.

Read the abstract » | (added 2018-09-10)

Tags: Dialysis Solutions, Glucans, Glucose, IL6 Protein, Human, Inflammation, Interleukin 6, Peritoneal Fibrosis, Peritoneum, Peritonitis, Creatinine, Hospitalization, Icodextrin, Peritoneal Dialysis, Peritoneal Membrane

5-year study: Predialysis PD Education Saves Lives on PD

Among 398 patients who started PD from 2007-2016, 169 had received predialysis education. After 5 years, this group had a significantly lower rate of peritonitis, a longer median time to a first peritonitis episode, and less risk of death from peritonitis than patients who did not get CKD education. Read the abstract.

Read the abstract » | (added 2018-09-10)

Tags: PD, Predialysis, Peritonitis, Mortality, CKD Education

Home HD After PD Failure May Lead to More Transplants, Lower Mortality

Since PD failure can lead to hospitalization and death in those who switch to standard in-center HD (ICHD), would outcomes improve with home HD? A new analysis found 521 patients in the USRDS data who made the change. Compared to matched ICHD patients, the chance of transplant was nearly double (21% vs. 10.6%), while survival of home HD patients was 89.1% at 1 year and 80.5% at 2 years.

Read the abstract » | (added 2018-08-13)

Tags: PD Technique Failure, ICHD, Transplant, Home HD, Lower Mortality

Driving Home Dialysis Takes More Than Money

Are financial incentives enough to change nephrologist practice to favor home therapies? Only a little, finds a comprehensive literature review and an international workshop. Other levers, such as the framework of funding for clinics, nephrologist belief in home treatments, and direct costs to patients (e.g., utilities) may play a role as well.

Read the abstract » | (added 2018-08-13)

Tags: Home Dialysis, Financial Incentives, Nephrologist Practice

The Secrets to Boosting Home Therapy Choice in Sweden

What factors make a choice PD or home HD more likely? A survey of Swedish patients found that receiving high quality, comprehensive predialysis information from three or more sources made a difference. Younger patients and men living with a spouse were also more likely to choose home, while those who lived close to a clinic were less likely. Once in-center, patients believed social interaction at the clinic influenced their choice.

Read the abstract » | (added 2018-08-13)

Tags: Dialysis Modality

PD vs. In-Center HD for Stroke Risk

A systematic review of 15 cohort studies totaling nearly 1.3M ESRD patients concludes that PD had a significantly lower (16%) risk of hemorrhagic stroke, though the risks of other types of strokes were comparable.

Read the abstract » | (added 2018-08-13)

Tags: Dialysis, Hemodialysis, Meta analysis, Peritoneal Dialysis, Stroke

Blood Flow Rates and Clinically Meaningful Solute Removal

A prospective study of 17 patients looked at BFRs of 300, 350, and 450 and Kt/V urea, beta-2 microglobulin, and phosphorus when low dialysate flow rates were used. While Kt/V did increase, the impact on B2M and phosphorus were minimal.

Read the abstract » | (added 2018-08-13)

Tags: Daily Hemodialysis, Home Hemodialysis, Kt/V, Blood Flow

Regional Variation in PD Infection Prevention

A PDOPPS analysis of surveys from medical directors caring for more than 11,000 patients from 170 clinics in seven countries (Australia, New Zealand, Canada, Thailand, Japan, the UK, and the US) found variation from 63% to 100% in use of antibiotic prophylaxis for PD exit sites, with mupirocin used most often.

Read the abstract » | (added 2018-08-13)

Tags: Peritoneal Dialysis related Infections, Peritoneal Dialysis, Infections, Peritoneal Dialysis Outcomes

Color of Used PD Dialysate Gives Diagnostic Clues

A review article proposes a differential diagnosis of various conditions based on a change in the color of PD effluent from clear to red, orange, cloudy, milky white, green, yellow, purple or black.

Read the abstract » | (added 2018-08-13)

Tags: Bloody Effluent, Chyloperitoneum, Peritoneal Dialysis, Peritonitis, Rhabdomyolysis