Journal Watch

  1. Why Seniors Choose HD vs. PD

    Older people may be equally suited for PD or HD, so what guides their choice? In an interview study, PD was selected by those wanted convenience and a normal life. HD, on the other hand, was chosen by those who were afraid and wanted security. EDITOR’S NOTE: Of course patients are afraid! We need to help ease their fears before we educate them about their options.

    Read the abstract » | (added 11/10/2016)

    Tags: Hemodialysis

  2. In the Netherlands, High-Dose HD Holds Up to Cost Scrutiny

    Is high-dose HD cost-effective?  A new Dutch study finds that while conventional home HD (three treatments per week) may be the most cost-effective, since high-dose HD is twice as much treatment, "from a payer’s perspective, high dose HD should be offered as a home therapy to obtain its clinical benefits in a cost-effective manner."

    Read the abstract » | (added 10/13/2016)

    Tags:

  3. US Home Dialysis Use by Racial and Ethnic Minorities

    Are African Americans about 50% less likely to do home therapies across the entire US—or are certain states less well-represented than others?  An analysis of 369,164 Medicare fee-for-service dialysis patients was analyzed by state. African American patients were the least likely to use PD in every US region except Massachusetts. Across the US, all minorities were less likely to use home HD than Caucasians, but Asians were more likely to use home HD in the Midwest.

    Read the abstract » | (added 10/13/2016)

    Tags:

  4. Patient Peritonitis Perspectives

    Australian researchers conducted interviews with 29 current or past PD patients to gain insights into the prevention of peritonitis. The four themes identified were the constant need for vigilance, invading harm from infection, incapacitating lifestyle interference, and exasperation with hospitalizations. The authors concluded that education about peritonitis and lifestyle impacts of PD may be helpful.

    Read the abstract » | (added 10/13/2016)

    Tags:

  5. Case Study Offers Hope for Successful EPS Treatment

    Working on the hypothesis that encapsulating peritonitis has TWO causes (a deteriorating peritoneum and inflammation), researchers tried a new treatment approach—and it worked. Combining sirolimus, a low-dose corticosteroid, and intradialytic parenteral nutrition helped a patient.

    Read the abstract » | (added 10/13/2016)

    Tags:

  6. PD Dose Needs Adjustment for Activity Level

    Is one PD Kt/Vurea level the same in a sedentary older person as it is in an active younger one?  NO, finds a new study that looked at energy expenditure in 148 PD patients. Adjusting Kt for resting energy use showed that women received less PD than men, younger people received less PD than older ones, and working people received less PD than unemployed ones—among other significant differences.

    Read the abstract » | (added 10/13/2016)

    Tags: Hemodialysis

  7. Personal Support Workers for Home HD

    Oh, Canada. The Canadians are out ahead of the US in virtually every dialysis parameter and they innovate constantly. Now, they have introduced a concept that CMS threw out with the bathwater in the 1980s—assisted home HD. A pilot project to dialyze six patients at home with personal support workers projected that costs would still be lower than for in-center HD. Phase 2 of the project includes 8 hospitals and 67 patients.

    Read the abstract » | (added 09/14/2016)

    Tags: Hemodialysis

  8. Considering Alternative Markers for Dialysis Dose

    A new review article looks at the impact of longer and/or more frequent, high-dose HD on dialysis adequacy—and inadequacy. Some uremic solutes come from nutrient intake and others don’t. For nutrient-based solutes, the authors suggest using inorganic phosphorus and protein-bound wastes as markers to develop new dose measures. For non-nutrient based middle molecules, they suggest beta-2-microglobulin measurement.

    Read the abstract » | (added 09/14/2016)

    Tags: Hemodialysis

  9. VIPs in Dialysis Modality Choice

    Whose opinion matters most to patients when it comes time to make a dialysis decision? In New Zealand, at least, it’s the nephrologist—even though respondents thought it would be predialysis nurses. In fact, a 1-point increase in nephrologist decisional power increased the rate of home therapies by 6.1%.

    Read the abstract » | (added 09/14/2016)

    Tags: Hemodialysis

  10. Risk Factors for Encapsulating Peritoneal Sclerosis (EPS)

    In a study of 703 PD patients between 1980 and 2015 at two centers, the 44 who developed EPS were more likely to have had a history of peritonitis, which rose with the duration of time on PD. The use of biocompatible PD fluid reduced the risk.

    Read the abstract » | (added 09/14/2016)

    Tags: