Journal Watch
Risk Factors for Cognitive Impairment in Peritoneal Dialysis
A retrospective analysis of 268 CAPD patients from January 2020 to September 2023. categorized participants into a cognitively impaired (CI; 58.2%) and a cognitively normal (CN) group. Logistic regression analysis identified male gender, older age, lower educational attainment, hypercholesterolemia, and elevated high-sensitivity C-reactive protein levels as independent risk factors for CI in CAPD patients (P < .05), while dialysis duration and residual renal function were protective against CI (P < .05).
Read the abstract » | (added 2024-08-16)
Tags: CAPD, Cognitive Impairment, Logistic Regression Analysis, Risk Factors
Virtual Reality (VR) Training for PD
Does all PD training have to be done face-to-face by a nurse, or is there a role for technology? VR-based training (stay•safe MyTraining) by Fresenius with a headset and hand controls was investigated in an interview study of seven nurses using the system with 2-5 patients each. The system was efficient, well-accepted, and improved the learning experience for patients, though it did not replace the need to handle PD materials and did not provide emotional or motivational support.
Read the abstract » | (added 2024-08-16)
Tags: PD Training, VR Training, Learning Experience, Patient Education
Shared Decision-making (SDM) in ESKD Modality Choice and Outcomes
Among 554 patients studied, 22.2% (123) participated in SDM to choose an ESKD treatment. Survival was significantly higher in the SDM group (p = 0.001).
Read the abstract » | (added 2024-08-16)
Tags: Renal Replacement Therapy, Shared Decision Making, Modality, Dialysis Therapy
Is There a Best Practice for PD Exit Site Care to Prevent Infection?
In a systematic review and meta-analysis, 2,092 studies were examined and 13 comprising 1,229 PD patients were selected for analysis (9 RCTs, 3 quasi-experimental, and one self-controlled trial). Five types of exit site care dressings were compared: named disinfection, antibacterial, non-antibacterial occlusive, sterile gauze, and no-particular dressings. No dressing was more effective than any other for preventing exit site infections or peritonitis.
Read the abstract » | (added 2024-08-16)
Tags: Systematic Review, Meta analysis, PD, Exit Site Infection. Peritonitis
Which is Safer: Urgent Start HD or Urgent Start PD?
Analysis of data from 9 studies (941 PD and 779 HD patients) revealed that the risk of all-cause mortality, dialysis-related infections, and mechanical complications were higher in patients who started HD urgently than in those who started PD urgently.
Read the abstract » | (added 2024-07-12)
Tags: PD, HD, All cause Mortality, Dialysis related Infections, Mechanical Complications, Urgent start
Startling Proportion of Patients Chose PD or Home HD After a Dialysis Start Unit
The University Health Network of Toronto examined the uptake of home dialysis between 2013 and 2021 among patients who started in a “Dialysis Start Unit” (equivalent to a transitional care unit in the U.S.). Of 122 patients, 68 (55.7%) chose either PD (57; 46.7%) or home HD (11; 9%).
Read the abstract » | (added 2024-07-12)
Tags: Home Hemodialysis, HHD, Peritoneal Dialysis, PD, Dialysis Start Unit
A U.S. Staff-assisted PD Program
Staff-assisted PD has been successful outside the U.S., but is it feasible in the framework of U.S. healthcare? A pilot program with 16 clinics from August, 2020 to October 2023 suggests that it can. Some indications for referral of patients (73 of 112 referred) who received staff assistance were physical function limitations, cognitive impairments, and/or psychosocial challenges. The duration of assistance was limited, with a median duration of 8 days, primarily for treatment set-up, observation, and direction.
Read the abstract » | (added 2024-07-12)
A Validated Measure to Predict PD Technique Failure
Data from 424 adult PD patients were analyzed to construct a nomogram based on the best model (created with LASSO Cox regression). Model variables included hypertension, peritonitis, serum creatinine, LDL, triglycerides, fibrinogen, thrombin time, prothrombin activity, anemia, and serum albumin.
Read the abstract » | (added 2024-07-12)
Tags: Peritoneal Dialysis, Prediction Model, Technique Failure
Home HD, Self-cannulation, and Survival
An observational study of all home HD patients at a single center from 2001 to 2020 examined treatment survival and mortality. Among 77 self-cannulating patients dialyzing for a median of 18 hours per week, there were 11 deaths, largely cardiovascular, and 19 technique failures after 100 months, largely due to vascular access issues.
Read the abstract » | (added 2024-06-14)
Tags: Home HD, Self Cannulation, Treatment Survival, Mortality, Cardiovascular, Technique Failure, Vascular Access
Personalized PD Prescriptions
Urea alone is not able to assess dialysis adequacy. Rather than a focus on removing a single toxin, a more holistic, person-centered approach is emerging to improve well-being and minimize treatment burden—based on clinical outcomes and patient experiences of care. This approach requires close collaboration between patients and care teams and eliciting patient goals, priorities, and preferences. This paper reviews the evidence for a patient-centered approach to PD.
Read the abstract » | (added 2024-06-14)
Tags: Urea, Dialysis Adequacy, Treatment Burden, Patient centered Care, PD