Journal watch: PD

Chest ultrasound finds some lung congestion in asymptomatic PD patients

Italian researchers did chest ultrasounds on 88 PD patients. Just under half had moderate to severe lung congestion—even though 57% had no shortness of breath, and only 27% had foot swelling.

Are infections requiring hospitalization more common with PD or standard HD?

A study in Canada paired 910 people on PD with people on HD, matched by age, race, smoking, BMI, comorbid conditions, and lab data. After 2 years, researchers found that those on PD were more likely to be in the hospital for peritonitis—but less likely to have sepsis or pneumonia than those on standard HD.

A “self-locating” PD catheter

The Di Paolo self-locating PD catheter was tested in 20 patients in Italy. The researchers found no infections, and only 0.8% dislocated catheters—vs. 12% for Tenkhoff PD catheters.

How to do urgent-start PD

Researchers developed an urgent-start PD plan to address the needs of people who needed dialysis right away and had not chosen a treatment option. The outcomes of urgent-start PD patients were very similar to those of regular-start patients, though the urgent-start group had more minor leaks.

Mupirocin best for preventing PD exit site infections

A new double blind, controlled study of mupirocin antibiotic ointment vs. polysporin found that mupirocin came out on top. Twice as many patients who used polysporin had exit site redness and they were more likely to get fungal infections.

PD in older patients

This study from Ireland looked at 148 people over age 50 who started PD between 1998 and 2008. The mean age was 63; most were over 70. The researchers found no difference in survival or technique survival by age, though older people did need a longer hospital stay to get started on PD.

Arterial stiffness is equally high in PD and standard in-center HD

Arteries are supposed to be flexible. In a study of 35 people on PD and 26 doing standard HD, both groups had equally stiff arteries that were more rigid than those of the general public.

Antibiotic ointment reduces PD exit site infections, but not peritonitis

Researchers studied 1,270 people who used mupirocin ointment on their PD catheters, 502 used gentamycin, and 1,203 did not use an antibiotic ointment. While the ointments helped prevent exit site infections, they did not reduce the rate of peritonitis.

Coiled vs. straight PD catheters—is one better than the other?

Researchers in China randomly assigned 80 people doing PD to a straight or a coiled catheter and looked at results from an 493 more people on PD. No differences were found in migration of the catheter tips, catheter failure, infection, stopping PD, or death between the two types of catheters. In the larger analysis, coiled catheters had far more problems than straight ones.

HD offers better survival than PD for congestive heart failure

A study of 933 people with CHF on PD and 3468 on HD in the French dialysis registry found that for people with congestive heart failure, HD is a safer choice. The risk of death with PD was 48% higher.

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