Journal Watch
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Home Dialysis in Finland
Prevalence of home dialysis has dropped in the past decade in Finland, despite its better survival compared to in-center HD. Semi-structured surveys for nephrologists, nephrology nurses, and patient associations endeavored to understand why. Nursing shortages and patient comorbidities received wide agreement as barriers, and clinicians believed that starting in-center reduces the odds of switching to home treatments later. For patients, financial burdens and impact on care partners were critical, as was “bringing hospitals home” or living in small spaces.
Read the abstract » | (added 2025-03-13)
Tags: Home Dialysis, Survival, Modality, Barriers
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Reasons for Switching from PD to HD
A retrospective analysis of 15,974 French PD patients between 2002 and 2018 found 6,835 deaths, 5,108 transfers to HD, and 3,094 transplants. Nurse-assisted PD reduced the risk of transfer to HD due to infection in the first 18 months as well as adequacy after 6 months. Surprisingly, CAPD had a higher risk of transfers to HD for mechanical issues than APD in the first 6 months—but a lower risk of issues after 18 months. Suboptimal starts had more psychosocial issues.
Read the abstract » | (added 2025-02-14)
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Anxiety, Symptom Burden, and Quality of Life (QOL) on PD
Survey responses from 305 PD patients measured anxiety levels, symptom burden, and QOL. Participants had an average of 5.9 to 10.5 symptoms that negatively correlated with QOL. Anxiety explained 38.9% of the symptom number and 33.3% of the symptom-related distress.
Read the abstract » | (added 2025-02-14)
Tags: Anxiety Levels, Symptom Burden, QOL
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Home Sweet Home Dialysis
Home Sweet Home (HSH) is a new Canadian program where current home dialysis patients share their lived experiences with prospective patients in a home-like setting. Of 291 participants between 2015 and 2019, 92% were interested in a home modality, noting that they valued patients’ real-life perspective and felt less anxious. At follow-up, 25% were doing home dialysis, 24% had a transplant, and the remaining survivors were dialyzing in-center.
Read the abstract » | (added 2025-02-14)
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Use of Plastic Cannulae for Nocturnal HD Wins Award
In Singapore, nurses noted that 30% of in-center nocturnal HD patients dropped out due to fear and pain from steel needles—so they switched to plastic cannulae. This change resulted in 85% less anxiety and 63% less fear.
Read the abstract » | (added 2025-02-14)
Tags: In center Nocturnal HD, Fear, Pain, Anxiety, Steel Needles, Plastic Cannulae
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Psychosocial Concerns May Impact Minority Uptake of PD
Analysis of qualitative interview data from 113 patients in Bronx, NY who completed dialysis modality education found gaps in the areas of support for the emotional trauma of an ESKD diagnosis and lack of a program to reduce anxiety about PD responsibilities, along with failure to address structural barriers to PD.
Read the abstract » | (added 2025-02-14)
Tags: Qualitative Interview Data, Dialysis Modality Education, Patient Support, Emotional Trauma, ESKD
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Impact of Extended HD with a Liberalized Diet on Protein Energy Wasting
An 8-year longitudinal study assessed BMI and creatinine generation rate for 402 patients who started extended-hours HD (>18 hours/week). Over time, treatment sessions got longer (70% received >21 hours/week). Participants maintained their BMIs and % creatinine generation over time, and the 5-year survival rate was 85%.
Read the abstract » | (added 2025-02-14)
Tags: Extended hours Hemodialysis, Liberalized Diet, Longitudinal Study, Protein energy Wasting
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Peer Support + Nurse-led Modality Education Increases Patient Choice of PD
Of 238 patients from 500 outpatient clinics in 2018 to 2020, 112 received both nursing education (NE) and peer support to make an ESKD modality choice. The combination helped patients make informed choices that aligned with their values and preferences.
Read the abstract » | (added 2025-01-13)
Tags: Peer Support, Nursing Education, Modality Choice, Modality Education
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Predicting Sarcopenia on PD using Handgrip Strength and BMI
Identifying patients at risk of sarcopenia without costly assessment tools would allow for earlier treatment. Analysis of data from 699 PD patients in China found a sarcopenia prevalence of 13.92% and nomogram models identified handgrip strength and BMI as independent predictors.
Read the abstract » | (added 2025-01-13)
Tags: Body Mass Index, Handgrip Strength, Nomogram, Peritoneal Dialysis, Risk Factors, Sarcopenia
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Organizational Culture and Home Dialysis Uptake
An ethnographic study of dialysis clinic culture was conducted at four clinics in England with average or high rates of home dialysis and maximal geographic, ethnic, and socioeconomic diversity. Three themes identified were encouraging the patient voice and providing individualized support, ensuring home dialysis access (minimalizing eligibility assumptions), and achieving sustained change based on benefits for patients.
Read the abstract » | (added 2025-01-13)
Tags: Dialysis Clinic Culture, Home Dialysis Access, Patient Benefits