Journal Watch
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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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Home HD: Hospitalizations and Technique Survival
In a Swedish registry study, patients initiating PD (n=456), home HD (n=152), and in-center HD (IHD; n=608) were matched by age, sex, comorbidity, and start date. Patients using home HD had significantly lower hospital admissions and days than those doing PD or IHD (1.7, 12 days vs. 2.8, 20 days and 2.2, 14 days respectively). Home HD patients also had significantly fewer admissions for cardiovascular diagnoses or infectious disease, as well as significantly longer technique survival.
Read the abstract » | (added 2020-01-09)
Tags: PD, Home HD, In center HD, Hospital Admissions, Cardiovascular Diagnosis, Infectious Disease, Technique Survival
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First European Patients Using Nocturnal Home HD with Low-flow Dialysate
A retrospective analysis looked at 21 patients using low-flow dialysate for nocturnal home HD and followed for a minimum of 12 months. Participants had a mean dialysis duration of 28 hours per week; most used alternate nights and 50-60 L of dialysate per session. Use of phosphate binders and blood pressure medications was significantly reduced, and no patient safety events were reported.
Read the abstract » | (added 2020-01-09)
Tags: Low flow Dialysate, Nocturnal Home HD, Phosphate Binders, Blood Pressure Medication
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Higher Serum Phosphorus Predicts More Residual Function Loss—in Men Only
A retrospective analysis of 1,245 CAPD patients followed for up to 11 years divided participants into tertiles based on their baseline serum phosphorus levels. One third of patients lost residual renal function (RRF) during the study, and those with the highest baseline phosphorus levels had a 51% higher risk of RRF loss than those in tertiles 1 and 2 combined. The risk of RRF loss was significantly higher for men.
Read the abstract » | (added 2019-12-10)
Tags: Serum Phosphorus, Renal Function Loss, Gender, Peritoneal Dialysis
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PD—Controlling Volume to Reach Normal Hydration Protects the Heart
Reanalysis of data from a multicenter, prospective, randomized controlled trial looked at fluid control in PD in 151 patients followed for a year. While most (120) reached normal hydration levels as measured by bioimpedance analysis, those who did not had significantly higher left atrial diameter—and a lower left ventricular ejection fraction at the end of the study.
Read the abstract » | (added 2019-12-10)
Tags: Fluid Management, Cardiovascular Risk, PD, Peritoneal Dialysis, Bioimpedance Spectroscopy
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In-center Nocturnal HD: Fewer Complications than PD in Patients with PKD
An analysis that matched PDK patients who did conventional HD (26) or PD (26) to in-center nocturnal HD (NHD; 13) found no significant difference in mortality—but after a median follow up of 5.5 years, NHD had significantly fewer complications than PD—and higher serum albumin levels as well.
Read the abstract » | (added 2019-12-10)
Tags: Polycystic Kidney Disease, Conventional Dialysis, In center Nocturnal HD, Nocturnal Hemodialysis, Mortality
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Simultaneous Hernia Repair and PD Catheter Placement
Taking care of two surgeries at once saves a procedure, recovery time, and costs. Among 123 patients who had catheters placed at a single center over a 4-year period, 23 (19%) had hernias. Across the 23, 27 procedures were done combining hernia repair with PD catheter placement. None of the hernias recurred, and there were no early surgical site infections. Five of the patients developed new hernias at other sites, but after a median of about 3 years, 96% of the catheters were still working.
Read the abstract » | (added 2019-12-10)
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European Patients Live Longer with Extended HD Treatments
Compared to standard in-center HD, patients from eight European countries who dialyzed for 6+ hours thrice weekly lived longer. Of 142,460 patients, 1,338 did extended HD. Compared to in-center HD (13.5/100 person-years), crude mortality for extended HD (6.0/100 person-years) was significantly better. Overall, those treated with extended treatments were 73% more likely to have survived.
Read the abstract » | (added 2019-12-10)
Tags: Survival, Extended hours Hemodialysis, Haemodialysis, ERA EDTA Registry
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Transplant Survival Better After PD Than Standard In-center HD
Is there an advantage to PD over standard in-center HD for transplant graft survival? YES, suggests a 15-year retrospective study of 2,277 transplant recipients. Those who did PD prior to transplant were 34.5% more likely to survive, and had less frequent rejection. Living donor kidneys did best among patients who received transplants before starting dialysis—or did PD.
Read the abstract » | (added 2019-11-16)
Tags: Kidney Transplant, Modality, PD, HD, Hemodialysis, Peritoneal Dialysis
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Proton Pump Inhibitors Increase Peritonitis Risk in PD
In a single-center, 36-month retrospective look at 230 Japanese PD patients, those who took PPIs were 72% more likely to develop peritonitis than those who did not.
Read the abstract » | (added 2019-11-16)
Tags: PD, PPIs, Peritonitis, Proton Pump Inhibitors