Metaanalysis of PD for Kidney Failure due to PKD

Polycystic kidneys may displace room for PD fluid, so can PD be a viable treatment option? A metaanalysis of 12 studies and more than 17,000 patients found…maybe. PD outcomes were about the same for those with PKD as with other primary kidney diseases, and some can do PD. More research is needed to determine who is suitable. Read the abstract.

Read the abstract » | (added 2018-10-12)

Tags: Dialysis Adequacy, PD associated Complications, Peritoneal Dialysis, Polycystic Kidney Disease

Nocturnal HD is Underused

A new review suggests that the improved outcomes associated with more hours of HD in-center or at home mean that these options should be used more. Read the abstract.

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

Tags: Extended Hours, Improved Outcomes, HD, Nocturnal Dialysis, Quality Of Life

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

PD Catheter Outcomes in Low vs. High-Volume Centers

Not surprisingly, patients whose PD catheters were placed at high-volume centers (in Japan) had fewer adverse events, needed feer blood transfusions, and had shorter hospital stays than those from low-volume centers. Read the abstract.

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

Tags: PD, Catheter, Hospital volume

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

Left Atrial Remodeling Not Found After 1 Year of Nocturnal HD

While left ventricular mass has been shown to regress with intensive HD, the same does not seem to hold true for the left atrium, nor did the ejection fraction improve, finds a new study of 37 patients switched from conventional HD. Read the abstract.

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

Tags: Cardiac MRI, End stage Renal Disease, Hemodialysis, Left Atrium

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

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

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