A Home Dialysis Primer for Internists

Since PD and home HD are increasing in use due to their clinical and practical advantages, clinicians need to understand these treatments. A new primer in the Annual Review of Medicine will help them do just that.

Read the abstract » | (added 2023-12-15)

Tags: Home Dialysis, HD, PD, Home Dialysis Primer

Should We Drop PD “Adequacy” as a Measure?

New ISPD guidelines suggest that patient well-being should be the goal of the PD prescription, not target urea or creatinine clearances. Identification of solutes that cause uremic symptoms could help devise ways to limit their accumulation.

Read the abstract » | (added 2023-12-15)

Tags: ISPD Guidelines, Patient Well being, PD Prescription, Uremic Symptoms

Lessons from Almost 15,000 PD Catheter Placements

Of the various PD catheter placement techniques, laparoscopy had higher 6-month mechanical complications, exit site infections, revision, and removal rates, while fluoroscopy had higher rates of sepsis and death. Open surgery had higher rates of catheter displacement.

Read the abstract » | (added 2023-12-15)

Tags: PD Catheter Placement Technique, Laparoscopy, Mechanical Complications, Exit Site Infections, Revision, Removal Rates, Fluoroscopy, Sepsis, Death

Dietary Protein Intake and Survival on PD

Among 668 stable PD patients followed for up to 13 years, quarterly 3-day dietary records were collected for 2 ½ years. Dietary protein intake greater than 0.8 g/Kg/day improved long-term survival.

Read the abstract » | (added 2023-12-15)

Tags: Dietary Protein, Survival, PD

The PD Surprise Question Predicts Transfer to HD

An observational study of 1,275 PD patients in 35 programs asking the RN and treating nephrologist, “Would you be surprised if this patient transferred to HD in the next 6 months?” identified 15% as high risk. After 6 months, the transfer to HD rate was nearly four times higher in the high risk group than the low risk group.

Read the abstract » | (added 2023-12-15)

Tags: PD, Home Dialysis, Peritoneal Dialysis, Surprise Question

Rate of Residual Kidney Function Decline and Mortality in PD

When 497 PD patients were divided into two groups based on RRF decline value, those in the fast-decline group had significantly higher rates of all-cause and cardiovascular mortality. In fact, each 0.1mL/min/1.73m2 per month drop in RRF in the first year of PD predicted a 19% higher risk of all-cause mortality and a 20% higher risk of cardiovascular mortality.

Read the abstract » | (added 2023-11-15)

Tags: Rate Of Residual Kidney Function Decline, All cause Mortality, Cardiovascular Mortality

Home Dialysis and Psychological Health

An interview study of 36 people on PD (n=13) or home HD (n=7) and care partners identified four themes and subthemes, including isolation and disconnection, importance of support systems, burden of distress, and seeking mental health support.

Read the abstract » | (added 2023-11-15)

Tags: Isolation, Support Systems, Distress, Mental Health Support

Assisted PD in Europe

Not every PD patient can perform solo treatments—or has a care partner to help. Some European countries are offering assisted PD in the home, often temporarily, using a variety of PD prescriptions and care provided by private care agencies or nursing home staff. Tailoring the prescription to residual kidney function reduces PD burden and aids technique survival.

Read the abstract » | (added 2023-11-15)

Tags: Assisted PD

Surprising Impact of First Dialysis Modality on Survival in Patients with Diabetes

A retrospective cohort study of 739 patients from 2010 to 2018 (inclusive) used propensity score matching to compare mortality between standard HD and PD in China, matching 125 PD patients with HD patients. No significant differences were found—except in those with diabetes, who had significantly better survival with PD.

Read the abstract » | (added 2023-11-15)

Tags: Modality, Survival, Diabetes, Propensity Score Matching

Hope, Quality of Life, and Psychoscial Distress in PD

Are people on PD hopeful? A study from China surveyed 134 people on PD, assessing their level of hope. Working patients with higher income using APD had higher hope scores, and hope correlated significantly with both age and social support. Higher hope scores were linked with better mental well-being and less severe depression.

Read the abstract » | (added 2023-11-15)

Tags: Hope, Quality Of Life, Psychoscial Distress In PD, Income, APD, Depression