Journal Watch
The PD Surprise Question Predicts Transfer to HD
An observational study of 1,275 PD patients in 35 programs asking the RN and treating nephrologist, “Would you be surprised if this patient transferred to HD in the next 6 months?” identified 15% as high risk. After 6 months, the transfer to HD rate was nearly four times higher in the high risk group than the low risk group.
Read the abstract » | (added 2023-12-15)
Tags: PD, Home Dialysis, Peritoneal Dialysis, Surprise Question
How Sugar Harms the Peritoneum and Causes Fibrosis
HOW does sugar harm the peritoneum? An RNA sequencing study looked at peritoneal endothelial cell (EC) function in mice and human ESRD cells in the presence or absence of glucose. In mice, glucose increased EC proliferation, permeability, and inflammation. Blocking glucose caused a therapeutic benefit. Human cells reacted in a similar way.
Read the abstract » | (added 2023-12-15)
Tags: Sugar, Glucose, Peritoneum, RNA Sequencing, Endothelial Cell Function
High Ultrafiltration Volumes May Contribute to Pruritus
Could changes in skin perfusion and inflammation play a role in dialysis itching? An observational study of 392 patients looked at self-reports of pruritus severity and UF volumes. BMI and UF volume independently predicted pruritis severity.
Read the abstract » | (added 2023-12-15)
Tags: Ultrafiltration Volume, UF Volume, BMI, Pruritus, Skin Perfusion, Inflammation
Should We Drop PD “Adequacy” as a Measure?
New ISPD guidelines suggest that patient well-being should be the goal of the PD prescription, not target urea or creatinine clearances. Identification of solutes that cause uremic symptoms could help devise ways to limit their accumulation.
Read the abstract » | (added 2023-12-15)
Tags: ISPD Guidelines, Patient Well being, PD Prescription, Uremic Symptoms
Assisted PD in Europe
Not every PD patient can perform solo treatments—or has a care partner to help. Some European countries are offering assisted PD in the home, often temporarily, using a variety of PD prescriptions and care provided by private care agencies or nursing home staff. Tailoring the prescription to residual kidney function reduces PD burden and aids technique survival.
Read the abstract » | (added 2023-11-15)
Tags: Assisted PD
Hope, Quality of Life, and Psychoscial Distress in PD
Are people on PD hopeful? A study from China surveyed 134 people on PD, assessing their level of hope. Working patients with higher income using APD had higher hope scores, and hope correlated significantly with both age and social support. Higher hope scores were linked with better mental well-being and less severe depression.
Read the abstract » | (added 2023-11-15)
Tags: Hope, Quality Of Life, Psychoscial Distress In PD, Income, APD, Depression
Home Dialysis and Psychological Health
An interview study of 36 people on PD (n=13) or home HD (n=7) and care partners identified four themes and subthemes, including isolation and disconnection, importance of support systems, burden of distress, and seeking mental health support.
Read the abstract » | (added 2023-11-15)
Tags: Isolation, Support Systems, Distress, Mental Health Support
Steady Glucose Concentration in PD and Sodium Removal
In a small pilot study (n=8), two fast-average and six fast transporters used a standard 4-hour CAPD dwell as a control, and three 5-hour steady-concentration treatments using the Carry Life® UF device following an overnight icodextrin fill as the intervention. UF rates were significantly higher with the steady glucose concentration treatments, as were sodium removal and glucose UF efficiency.
Read the abstract » | (added 2023-11-15)
Tags: PD, Glucose Concentration, Sodium Removal
Surprising Impact of First Dialysis Modality on Survival in Patients with Diabetes
A retrospective cohort study of 739 patients from 2010 to 2018 (inclusive) used propensity score matching to compare mortality between standard HD and PD in China, matching 125 PD patients with HD patients. No significant differences were found—except in those with diabetes, who had significantly better survival with PD.
Read the abstract » | (added 2023-11-15)
Tags: Modality, Survival, Diabetes, Propensity Score Matching
How to Set Up New Home Dialysis Programs
More than half of U.S. dialysis clinics are either not licensed to train patients in PD or home HD, or are licensed but have no patients in their home programs. A new review article outlines the core domains needed to set up and run a home dialysis program in the U.S.
Read the abstract » | (added 2023-11-15)