Which is More Cost Effective, PD or Standard In-Center HD?

If you’ve been reading this site, you won’t be surprised to learn that yet another study has found PD to be more cost-effective than standard in-center HD. A cross-sectional analysis was done on matched pairs of incident PD and HD patients (N=4,285) in Taiwan who were followed for up to 14 years. While the quality-adjusted life expectancy was almost equal, HD costs were much higher.

Read the abstract » | (added 2016-08-09)

Tags: Hemodialysis

Encapsulating Peritoneal Sclerosis (EPS) Incidence and Outcomes

A new Scottish registry study found that 2.8% of PD patients between 2000 and 2007 (n=1,238) developed EPS. The rate rose from 1.1% by year 1 to 3.4% at year 3, 8.8% at year 4, 9.4% at year 5, and 22.2% by year 7. The authors note that “continuing PD beyond 3 years results in an exponential rise in the risk of developing EPS and deciding whether this risk is acceptable should be made on an individual patient basis.”

Read the abstract » | (added 2016-08-09)

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Weighing PD Catheter Techniques: Surgical vs. Percutaneous

Which is better for placement of a PD catheter—surgery, or use of a tiny incision and guidewire to push the tube through the skin (percutaneous). An analysis of 10 studies with 1,626 patients found no difference in 1-year catheter survival or the rate of peritonitis, tunnel/exit site infection, leaks, obstructions, bleeding, or hernias between the two techniques. But, there were fewer mechanical problems with the percutaneous approach.

Read the abstract » | (added 2016-08-09)

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French Patients on Daily HD

Daily HD is relatively new to France—yet this study was able to include 753 patients who started on the therapy between 2003 and 2012. Two-thirds had switched to daily HD from another option. Younger patients (<64) had better survival (72.6% vs. 31%) and were more likely to receive a kidney transplant than older patients (>64).

Read the abstract » | (added 2016-08-09)

Tags: Hemodialysis

Overhydration and Mortality Risk on PD

When PD does not remove enough water, the resulting overhydration is a major risk factor for death. A study of 54 PD patients between 2008 and 2015 measured with bioimpedance technology were divided into normohydrated and overhydrated groups. Older age, low diastolic blood pressure and overhydration predicted mortality.

Read the abstract » | (added 2016-08-09)

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Silk Filter for the PD WAK

A urease silk fibroin filter has been tested with a wearable artificial kidney (WAK) for PD. In lab analysis, the filter removed more than 50% of urea from a 50 mg/dL urea solution, and 90% after 24 hours.

Read the abstract » | (added 2016-08-09)

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Fallopian Tubes and PD Catheter Problems

In women, fallopian tubes can be an unrecognized cause of PD catheter malfunction. This case report study describes five episodes of catheter malfunction in four female patients.

Read the abstract » | (added 2016-08-09)

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PD or In-Center HD: Which is Better for Transplant?

An analysis of 12 studies found that doing PD before a transplant had significanlty less delayed graft function than those who did standard in-center HD. While on dialysis, PD had better 5-year survival than standard HD, too. There were no differences in the rates of acute rejection or transplant survival. Watch a Video Journal Club of this study on 'Cappuccino with Claudio Ronco'

Read the abstract » | (added 2016-07-12)

Tags: Hemodialysis

PD Survival and Serum Sodium – Not What You Might Think

In an analysis of 4,687 people on PD between 2007 and 2011, those whose serum sodium levels were <140 mEq/L had a higher death rate than those with higher levels. Further studies are needed to see if correcting the sodium levels helps people live longer on PD.

Read the abstract » | (added 2016-07-12)

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Nocturnal HD Improves Nutritional Status

A metaanalysis was conducted of 9 studies with 229 patients who switched from standard to nocturnal HD. Those on nocturnal HD had significantly higher levels of serum albumin and protein and energy intake.

Read the abstract » | (added 2016-07-12)

Tags: Hemodialysis