Journal Watch
Urgent-start PD in Brazil
In a prospective study, 51 patients who needed dialysis urgently began peritoneal dialysis instead of hemodialysis. Even with high-volume dialysate used less than 72 hours after catheter placement (on alternate days in the dialysis clinic), the option was feasible and safe. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Acute Peritoneal Dialysis, Unplanned Peritoneal Dialysis, Urgent start Dialysis, Urgent start Peritoneal Dialysis
Barriers to Intensive HD in Pediatrics
Why don’t more people choose intensive hemodialysis? Responses to a survey by 134 of the 221 pediatric dialysis centers in the International Pediatric Dialysis Network found that more than 2/3 were aware of evidence supporting the benefits of intensive HD and half believed it produced the best outcomes (just 2% favored conventional HD). Key barriers included lack of funding and staff, with lack of expertise and motivation as minor factors. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Children, Financial Barriers, Home Dialysis, Intensified Hemodialysis, Nocturnal Hemodialysis
Nocturnal Home HD Boosts Patient Employment Compared to PD
A year-long study comparing 20 alternate-night nocturnal home hemodialysis patients to matched 81 CAPD patients in Hong Kong found 80% employment among the nocturnal HD patients (who were 5 years younger) and just 33.3% among PD patients. The nocturnal patients also used fewer phosphate binders. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Chinese, Nocturnal Hemodialysis, Employment Rate, Incident, Peritoneal Dialysis
The Impact of AGEs on the Gut Microbiome in PD
The Impact of AGEs on the Gut Microbiome in PD Advanced glycation endpoints (AGEs) cause inflammation and are linked with heart disease. A new PLoS One paper reports on a pilot trial of 20 PD patients who routinely ate a high-AGE diet. Ten were randomized to eat as usual, while 10 had their meals AGE-restricted for a month. Gut bacteria analysis found major shifts in the experimental group that could have clinical importance.
Read the abstract » | (added 2017-10-13)
Tags: Education Issues: For Patients And Professionals, Fistulas, Grafts And Catheters (including PD)
More CMS Incentives Needed to Boost Home Dialysis
More CMS Incentives Needed to Boost Home Dialysis Have changes in the ESRD Prospective Payment System (“bundle”) designed to increase the use of home dialysis been successful? A new analysis of USRDS data from 2006 to 2013 found that bundling injectable medications and paying for home training did move the needle a bit—but not enough. Compared to patients with other insurance who had a 4.1% increase in home dialysis during this period, Medicare beneficiaries had a non-significant 5.8% rise.
Read the abstract » | (added 2017-10-13)
Tags: Education Issues: For Patients And Professionals, Choosing The Right Path Through ‘The System’
Views of Patients vs. MDs Re: Important Dialysis Outcomes
An international 3-round Delphi survey that started with 202 patients and care partners and 979 renal professionals aimed to generate a consensus-based prioritized list of core outcomes for HD trials. Not surprisingly, patient/care partner priorities differed dramatically from those of professionals: patients largely valued quality of life outcomes, while professionals focused on clinical ones.
Read the abstract » | (added 2017-10-13)
Tags: What Is The Best Dialysis Option For Me, Making Dialysis Better
Why Do Patients Think PD is Underused?
A survey of 920 HD patients in Saudi Arabia found that lack of appropriate counseling and education by nephrologists was an important reason why they did not choose PD.
Read the abstract » | (added 2017-10-12)
Obesity and PD Catheter Function
It is a common belief that obesity is a contraindication to PD—but a new study of 231 patients who were demographically similar except for weight found otherwise. Compared to normal weight patients, those who were overweight or obese had no signficant differences in catheter dysfunction or complications—regardless of the placement technique used.
Read the abstract » | (added 2017-10-12)
Tags: Education Issues: For Patients And Professionals, Fistulas, Grafts And Catheters (including PD)
Bone Mineral Balance in Short Daily HD: A Cautionary Tale
A new case report suggests that bone mineral balance may need extra attention for those doing short daily HD. A patient who had multiple fractures and bone pain severe enough to require a wheelchair for more than a year was found on biopsy to have osteomalacia, likely due to chronically low levels of serum phosphorus and calcium. Increasing these minerals in the dialysate enabled the patient to leave the wheelchair and walk pain-free.
Read the abstract » | (added 2017-09-15)
Canadian Home Dialysis by Race: Access vs. Outcomes
Unlike the US, Canada’s universal healthcare system does not limit access to home dialysis by racial minorities. However, compared to whites, Asians, blacks, and some others had better survival on PD, while Aboriginals had poorer survival. No survival differences were found among home HD patients based on race—but event numbers were lower.
Read the abstract » | (added 2017-09-15)
Tags: Choosing The Right Path Through ‘The System’ Education Issues: For Patients And Professionals