Journal Watch
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Striking Lack of Data on Infection Prevention in PD
A Cochrane database review of 59 randomized controlled studies revealed “striking” gaps in our knowledge about what really works to prevent infections in PD. Oral or topical antibiotics and topical disinfectants had uncertain benefits for exit site, tunnel infections, or peritonitis. Use of IV vancomycin prior to catheter placement may reduce the risk of early peritonitis. Antifungal treatments may reduce fungal peritonitis after antibiotics.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis
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Pregnancy on PD—at 42: It’s Not Impossible
While research shows that the chance for a pregnant woman on dialysis to have a healthy baby seems to be best with 36+ hours of HD per week, a 42-year old Malaysian woman had a full-term baby with no change to her CAPD prescription.
Read the abstract » | (added 2017-04-12)
Tags: Peritoneal dialysis, Hemodialysis
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The Impact of Telehealth on PD Satisfaction
Per quarterly surveys completed by 200 people on PD, a system of telemedicine that included remote monitoring of blood pressure, weight, and glucose, and had educational videos boosted satisfaction with the option. Participants felt more autonomy and confidence in their health care, as well, and were less frustrated. Nearly half watched at least one video.
Read the abstract » | (added 2017-03-09)
Tags: Peritoneal dialysis
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Results of a Metaanalysis of Nocturnal vs. Standard HD
Researchers who looked at 28 studies of 22,508 patients found a mixed bag: comparable side effects and mortality between nocturnal and standard HD, less hospitalization with standard HD—but better heart health and physical quality of life with nocturnal HD, with fewer blood pressure medicines needed.
Read the abstract » | (added 2017-03-09)
Tags: Hemodialysis
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And, Again: More HD Improves Quality of Life
Data from the Frequent Hemodialysis Network (FHN) trials found that those who were randomized to frequent or nocturnal HD reported outcomes that included better results on a “feeling thermometer,” better general health, and shorter recovery time than for standard in-center HD.
Read the abstract » | (added 2017-03-09)
Tags: Hemodialysis
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Home HD: Cost-effective With Better Outcomes Than In-center
A review of the patient-centered and economic impacts of home HD that included studies between 2000 and 2016 found better quality of life, flexibility, employment potential, and survival vs. hospital HD. Minority and low-income patients still have less access than others, which compounds their already-poor health outcomes. The authors found that home HD is cost-effective and the use of this option should be increased.
Read the abstract » | (added 2017-03-09)
Tags: Hemodialysis
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PD and Serum Vitamin D—A Vital Link
People with no history of heart disease on PD for 3+ months were compared to age- and sex-matched healthy controls in a 24-month study of subclinical atherosclerosis. Those on PD had significantly more carotid and femoral plaques at baseline than controls. Lower levels of serum vitamin D predicted more plaque at baseline and at 24 months. The authors suggest that monitoring could help identify patients who are at higher risk.
Read the abstract » | (added 2017-03-09)
Tags: Peritoneal dialysis
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Medicare Payment for Daily Home HD Varies Geographically
According to Medicare claims data for in-center HD and home HD from 2009-2012, there were persistent variations in the home HD treatment claims paid by different Medicare contractors. Fortunately, these differences did not seem to affect whether clinics offered home HD.
Read the abstract » | (added 2017-02-08)
Tags: Hemodialysis
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A New Approach for Treating Peritonitis in Patients Over Age 50
Researchers tried a new, 3-step “Mero-PerRest” protocol when patients over age 50 developed peritonitis due to enteric (gut) microorganisms. 1). Temporary “peritoneal rest” with the catheter in place. 2). IV meropenem. 3). Meropenum as a catheter lock. Compared to 203 bouts of peritonitis treated with usual care, 217 bouts treated with the new protocol had a higher primary cure rate (90% vs. 65.3%), better PD survival (90% vs. 64.9%), and similar patient survival.
Read the abstract » | (added 2017-02-08)
Tags: Peritoneal dialysis
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Autonomy is Key to Choice of PD
French researchers interviewed 150 patients who began dialysis between 2010 and 2014 from four clinics, and their nephrologists, to see what factors influence the choice of PD. Of those who could do PD or HD, 46.7% preferred PD. The main reason for this preference was having or wanting to have autonomy.
Read the abstract » | (added 2017-02-08)
Tags: Peritoneal dialysis