Journal Watch

  1. 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 08/09/2016)

    Tags: Hemodialysis

  2. 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 08/09/2016)

    Tags:

  3. 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 08/09/2016)

    Tags:

  4. 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 07/12/2016)

    Tags: Hemodialysis

  5. Independence, Flexibility and Quality of Life Matter to Patients

    For the PCORI-funded Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT), 180 people not yet on dialysis or using standard HD or PD were interviewed to identify the factors in their choice of a dialysis option. Independence, quality and quantity of life, and daily schedule flexibility mattered most—and 47% of those on standard HD said the choice had not been theirs. (NOTE: Ironically, the EPOCH-RRT decision aid omits home HD, an option that offers independence, quality of life, better survival, and schedule flexibility, as we have blogged here and here).

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

    Tags: Hemodialysis

  6. For HD Survival, Home Beats In-Center

    An observational study looked back at 41 incident patients starting home HD and matched them to patients starting in-center HD by sex, age, comorbidity, and start date. Mean survival on home HD was 17.3 years, vs. 13 years in-center. Home HD patients also had significantly lower phosphate levels and did not require blood pressure medications.

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

    Tags: Hemodialysis

  7. A New Way to Correct PD Catheter Malposition and Blockage

    Researchers in China developed a new, minimally invasive technique to reposition and unblock PD catheters. Tested in 16 PD patients, a surgeon made a small (3cm) incision under local anesthesia, disected the tissue, and pulled out the catheter. Adhesions were separated and a new catheter placed with forceps and stitched in place. After 6 months, all of the catheters were working.

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

    Tags:

  8. 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 07/12/2016)

    Tags:

  9. 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 07/12/2016)

    Tags: Hemodialysis

  10. Outset Medical Tablo Human Factors Testing

    Journal articles don’t tend to give product names, so we read between the lines to tell you that human factors testing on Outset’s Tablo home HD machine found 2.9 errors for patients—and 4.4 for nurses or technicians—out of 1,710 opportunities for error. None of the errors was safety related.

    Read the abstract » | (added 06/08/2016)

    Tags: Hemodialysis