Patients Prefer Home Therapies

Researchers from New Zealand asked 143 CKD patients expected to need dialysis within a year about their preferences. Patients significantly preferred home treatments, due to flexible schedule, better well-being, and longer survival—and were even willing to pay as much as $400 per month out-of-pocket for extra nursing support. Read the abstract.

Read the abstract » | (added 2017-11-13)

Tags: Confidence Intervals, Health Expenditures, Humans, Life Expectancy, Odds Ratio, Patient Preference, Adult, Choice Behavior

Which PD Exit Site Dressing is Better?

Is an occlusive dressing better to reduce exit site or tunnel infections? A semi-occlusive one? It made no difference, found a new analysis of 2,460 incident PD patients. Read the abstract.

Read the abstract » | (added 2017-11-13)

Tags: Chronic Kidney Disease, Dressing, Nursing, Peritoneal Dialysis

Iron-based Binder Safe and Effective in PD

A study conducted with 84 PD patients compared sucroferric oxyhydroxide (n=56) to sevelamer (n=28). After a year, both groups had serum phosphate levels within the target range. The iron-based binder required fewer pills per day and resulted in fewer adverse events. Read the abstract.

Read the abstract » | (added 2017-11-13)

Tags: Chronic Kidney Disease, Hemodialysis, Peritoneal Dialysis; Phosphate Binder, Sevelamer Carbonate, Sucroferric Oxyhydroxide

Colonoscopy Antibiotic Protocols in PD

A study comparing 46 PD patients who received prophylactic antibiotics prior to colonoscopy to 47 patients who did not found no difference in the risk of peritonitis between groups, even when polyps were removed during the procedure. Patients with diabetes did benefit from antibiotics, however. Read the abstract.

Read the abstract » | (added 2017-11-13)

Tags: Peritoneal Dialysis, Prophylactic Antibiotics, Colonoscopy

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