Journal Watch
Among Prediabetic Patients, PD Nearly Tripled the Risk of New Onset Diabetes vs. HS
A retrospective cohort study was done of 1426 non-diabetic end-stage renal disease (ESRD) patients who started PD or in-center HD. Over a 12 year period, 23% of the patients developed NODM. Among patients with prediabetes, those on PD had a 2.93 times higher risk of NODM than those on HD (p <0.001).
Read the abstract » | (added 2024-01-17)
Tags: ESRD, PD, In center HD, NODM, New Onset Diabetes Mellitus
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
PD Reduced Hospitalization 24% vs. In-center HD with a Catheter
In an 18-month retrospective study, 717 PD patients were matched 1:1 with in-center HD patients using central venous catheters. The matching also included cause of ESKD, race, diabetes status, and insurance. The hospitalization rate was 24% lower for those on PD, and mortality was 15% lower.
Read the abstract » | (added 2022-04-18)
Tags: PD, In center HD, Catheters, Cause Of ESKD, Race, Diabetes Status, Insurance, Hospitalization Rate, Mortality
Glycemic Variability and Survival in People with Diabetes on PD
A Swedish study divided 325 people with diabetes on PD into seven groups based on glycemic variability. Using the lowest variability group as a reference point, survival was significantly better with less variability in blood sugar.
Read the abstract » | (added 2022-02-14)
Tags: Diabetes, PD, Glycemic Variability, Survival, Blood Sugar
What We Don’t Know About Insulin Dosing for PD or HD Can Hurt Us
After 60 years of dialysis, we have a good sense of how to adjust insulin doses for PD and HD, right? Wrong. Even though diabetes is the leading cause of kidney failure, a systematic review of 11 articles found little information about insulin management.
Read the abstract » | (added 2022-02-14)
Tags: Insulin Dose, PD, HD, Insulin Management
Incremental PD with Residual Kidney Function: Safe and Effective
Compared to 42 people who started full-dose PD, 54 who began incremental PD between 2015 and 2019 tended to be female, not have diabetes, and have more residual kidney function. PD technique survival, peritonitis, and hospitalization were about the same for both groups.
Read the abstract » | (added 2022-01-14)
Tags: Incremental PD, Residual Kidney Function, Full dose PD, Technique Survival
Standard vs. Incremental PD Start: 12-year Retrospective Study
When people start PD with some residual function, is it beneficial not to begin with a full PD prescription? A study looked back at 12 years of people who started PD, 232 standard and 71 intermittent (iPD; 2-3 manual exchanges per day). Those who did iPD had higher residual kidney function than those on standard PD. For people with diabetes, iPD was linked with a survival advantage as well.
Read the abstract » | (added 2021-12-16)
Tags: PD, Residual Function, Intermittent PD, IPD, Diabetes
Better Technique Survival with Assisted PD
A study of 384 PD patients in China compared the outcomes of 274 who did self-care PD with 110 who had assisted PD. Older age, diabetes, low residual kidney function and low serum albumin predicted higher mortality, as did assisted PD, since this group had more comorbidities. Technique failure was also significantly lower in the assisted PD group.
Read the abstract » | (added 2021-04-16)
Prolonged PD Training Linked with Higher Peritonitis Risk
A single center retrospective analysis of all PD training sessions from 2001 to 2018 (135 patients) found that the 23% whose training lasted longer than 13 sessions had a significantly higher risk of peritonitis, though technique survival was not reduced. Factors associated with prolonged PD training included older age, diabetes, and unemployment.
Read the abstract » | (added 2020-12-10)
Universal AVF Back-up for PD Patients Reduces HD Catheter Use
Should an arteriovenous fistula always be placed as a PD back-up for new patients? A retrospective study of two hospitals examined this question. Hospital RAH (n=142) did universal AVF back-up at PD start. Hospital PAH (n=232) did selective AVF back-up for “high risk” patients only. Yet, the transfer-to-HD rate at RAH was about half that of RAH (23% vs. 43%)—as was the HD catheter usage rate (33% vs. 65%; p<0.001), despite a population at RAH that was more likely to be older, Caucasian, and have diabetes.
Read the abstract » | (added 2020-05-12)