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  • Meta-analysis of Urgent Start vs. Conventional Start PD

    Analysis of data from 27 studies found comparable post-procedure infections, peritonitis, and exit site infections, technique survival, and transfer to HD for urgent and conventional start PD. Urgent start PD had a signficantly higher risk of mechanical complications such as leaks, and significantly higher mortality rates.

    Read the abstract » | (added 2024-03-15)

    Tags: Chronic Kidney Disease, Meta analysis, Peritoneal Dialysis

  • Lessons from Almost 15,000 PD Catheter Placements

    Of the various PD catheter placement techniques, laparoscopy had higher 6-month mechanical complications, exit site infections, revision, and removal rates, while fluoroscopy had higher rates of sepsis and death. Open surgery had higher rates of catheter displacement.

    Read the abstract » | (added 2023-12-15)

    Tags: PD Catheter Placement Technique, Laparoscopy, Mechanical Complications, Exit Site Infections, Revision, Removal Rates, Fluoroscopy, Sepsis, Death

  • PD vs. Home HD for Severe Infections

    In a Finnish study of 536 patients using home dialysis, the risk of a severe infection (C-reactive protein of 100mg/L or higher) in year 1 of CAPD was 35%, APD was 25% and home HD was 11%. Over a 5-year period, compared to home HD, the hazard ratio of severe infection for APD was 2.2 and for CAPD, 2.8. PD peritonitis accounted for the difference.

    Read the abstract » | (added 2023-07-17)

    Tags: Home Dialysis, Severe Infection, C reactive Protein, CAPD, APD, HD, Home HD, PD Peritonitis

  • Can People do Urgent Start PD and Intermittent PD?

    Yes. Among 169 people starting PD urgently, 111 had fewer than four exchanges per day (intermittent) and 58 received full-dose PD. A year later, both groups had adequate PD and similar peritoneal transport, residual kidney function, blood pressure control, anemia management, and correction of bone minerals. Infections, complications, and technique survival were similar as well.

    Read the abstract » | (added 2022-04-18)

    Tags: Urgent Start PD, Incremental Peritoneal Dialysis, USPD, IPD

  • Pilot: Chlorhexidine-impregnated Sponge Dressings to Prevent Exit Site Infections

    In a single-center study, 50 incident PD patients were taught to use a weekly chlorhexidine dressing on their exit sites, and followed for a year. While 12% developed contact dermatitis, 73% found the dressings acceptable. Episodes per patient year of exit-site/tunnel infections and peritonitis were 0.09 and 0.07, respectively, while 1-year technique and patient survival rates were 86% and 96%, respectively.

    Read the abstract » | (added 2020-10-12)

    Tags: Chlorhexidine Dressing, Exit site Infection, Peritoneal Dialysis

  • Outcomes Between Urgent-start PD and HD

    Urgent-start PD (n=93) and urgent-start HD (n=91) patients similar in age, diabetes and other comorbidities, and lab values, were followed for 6 months to 2 years. Rates of mechanical complications, bacteremia, and survival were comparable. Exit site/access infections were significantly higher in the PD patients, but those on PD had significantly better residual kidney function and phosphorus control, and used significantly less erythropoietin and antihypertensives

    Read the abstract » | (added 2020-04-13)

    Tags: Haemodialysis, Renal Function Recovery, Peritoneal Dialysis, Urgent Start

  • Simultaneous Hernia Repair and PD Catheter Placement

    Taking care of two surgeries at once saves a procedure, recovery time, and costs. Among 123 patients who had catheters placed at a single center over a 4-year period, 23 (19%) had hernias. Across the 23, 27 procedures were done combining hernia repair with PD catheter placement. None of the hernias recurred, and there were no early surgical site infections. Five of the patients developed new hernias at other sites, but after a median of about 3 years, 96% of the catheters were still working.

    Read the abstract » | (added 2019-12-10)

    Tags: Hernia Repair, PD Catheter Placement, Outcome

  • A Post-op Surgical Girdle for Pain and Catheter Tunnel Infections in Urgent Start PD

    Urgent start PD can be associated with pain and tunnel infections. In a study of 85 consecutive PD catheter placements, a surgical girdle was used from days 1-3 while patients were supine. Among the 23 patients who completed pain surveys, the girdle helped significantly. Tunnel infections were reduced as well.

    Read the abstract » | (added 2019-11-16)

    Tags: Urgent Start PD, Pain, Tunnel Infection, PD Catheter, Surgical Girdle

  • PD and Swimming

    Australian nurses in 39 PD clinics conducted phone surveys. While only 77% of the clinics advocated swimming, nearly all had patients who did swim, mainly in sea water or a private pool. Covering the exit site and catheter with a waterproof dressing or ostomy bag was recommended, along with routine exit-site care. Several infections were linked with swimming.

    Read the abstract » | (added 2019-10-14)

    Tags: PD, Swimming, Exit Site, Waterproof, Infections

  • Moving the PD Exit Site to Combat Infection

    A 5-year retrospective cohort analysis looked at the impact of treating PD exit site and tunnel infections in 27 patients by removing the cuff and relocating the catheter under local anesthetic. After follow up ranging from 10.8 to 79.4 months, no leaks occurred, and the infections resolved in 74% of the patients. The rest had to have their catheters removed.

    Read the abstract » | (added 2019-06-13)

    Tags: Exit Site Relocation, Exit site Infection, Tunnel Infection, Peritoneal Dialysis Catheter, PD Catheter