Journal Watch
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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
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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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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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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
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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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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
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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
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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 2016-07-12)
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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 2016-07-12)
Tags: Hemodialysis
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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 2016-07-12)
Tags: Hemodialysis