Journal Watch
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Patient and Clinic Factors Driving Home Dialysis in Australia/New Zealand
Among 54,773 patients in 76 centers in the ANZDATA registry, an overall 45% (0-87%) were using some form of home dialysis. Males, people of color, and patients who were older, had comorbidities, experienced late nephrology referral, lived remotely, or were obese had lower uptake of home therapies. Smaller centers, those with shorter hours, and clinics who had fewer patients with permanent access had lower uptake as well.
Read the abstract » | (added 2020-02-19)
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Survival with PD vs. Home HD and When to Go Home
Using a national cohort of 1,993 patients transitioning to home HD and 16,514 to PD between 2007 to 2011, 1,195 home HD were matched to 1,195 using propensity scores and adjusting for demographics, comorbidities, dialysis duration, and BMI. Those on home HD had significantly better survival (9.6 vs. 12.9 deaths per 100 patient-years; p<0.001). However, when patients switched to PD within the first 12 months of starting dialysis, survival was comparable between PD and home HD: patients who transitioned after 12 months had an 83% higher risk of death.
Read the abstract » | (added 2020-02-19)
Tags: Home HD, PD, Comorbidities, Dialysis Duration, BMI, Survival
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Comorbidities—but not Peritonitis—drove Mortality on PD
Among 242 Turkish PD patients followed for up to 9 years, age over 65, diabetes, cancer, and heart failure were independent risk factors for death, but surprisingly peritonitis was not.
Read the abstract » | (added 2020-02-19)
Tags: Peritoneal Dialysis, Mortality, Patient Survival, Peritonitis, Technique Survival
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PD Glucose Absorption and Lipid Profiles
Lipid status was assessed at baseline and 12 month in 143 CAPD patients, 2/3 of whom used a daytime icodextrin exchange. No associations were found between glucose absorption, lipid profiles, or changes in serum lipids.
Read the abstract » | (added 2020-02-19)
Tags: Peritoneal Dialysis, Cholesterol, Glucose, Triglycerides
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Exercise in PD Patients and Residual Renal Function
After a 12-week home-based exercise program was completed, researchers analyzed residual renal function among 13 patients who received usual care and 16 who had been in the exercise intervention group. Urinary liver-type fatty acid-binding protein and microalbumin-to-creatinine ratios were significantly lower in the exercise group, suggesting a possible benefit.
Read the abstract » | (added 2020-02-19)
Tags: Exercise, Renal Outcome, Residual Renal Function, Peritoneal Dialysis
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Diabetes and the Risk of Peritonitis on PD
In contrast to earlier reports, a single-center study of PD patients between 1980 and 2012 (by era: 1980-’93, 1994-’04, 2005-12) found that while PD-associated peritonitis was higher among patients with diabetes in the earlier two eras, there were no differences in recent years.
Read the abstract » | (added 2020-01-09)
Tags: PD, Peritonitis, Diabetes
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A Novel Surgical Technique for Urgent Start PD
Placing a PD catheter with a double purse-string around the inner cuff was safe and feasible for urgent start PD, finds a study of 135 catheter insertions between 2011 and 2018. Double-cuffed straight Tenckhoff catheters were implanted surgically or semi-surgically using the double purse-string technique, and the incidence of leakages, dislocations, peritonitis, and exit-site infection were low. There were no bleeding events, bowel perforations, or hernia formations.
Read the abstract » | (added 2020-01-09)
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Low-dose IV Iron Sucrose for Treatment of Anemia in PD
A small study (n=18) of IV iron sucrose (200mg loading dose followed by 100mg monthly for 5 consecutive months) found reductions in ESA dosing for 5 patients and discontinuation in one, with no reported side effects.
Read the abstract » | (added 2020-01-09)
Tags: IV Iron Sucrose, Anemia, ESA Dosing
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Impact of a Nurse-led Protocol on PD Fluid Overload
Among PD patients divided into a group symptomatic of fluid overload (>2L; n=53) and a group that was not (n=50), a 12-week nurse-led education and motivation intervention—with hypertonic cycles for short-term relief of fluid overload—significantly reduced overhydration. Knowledge and adherence were both significantly improved as well.
Read the abstract » | (added 2020-01-09)
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PD vs. In-center HD for Sudden Cardiac Death
A Korean registry study of 132,083 PD and in-center HD patients followed between 1985 and 2017 analyzed 34,532 deaths. Sudden cardiac death (SCD) was responsible for 19.6% of deaths on PD and 22.2% of deaths on in-center HD. Even after adjusting for age and comorbidities, the risk of SCD was higher with HD.
Read the abstract » | (added 2020-01-09)
Tags: PD, In center HD, Sudden Cardiac Death