Journal Watch

  1. Home Dialysis “Virtual Ward” Addresses Gaps in Care Transitions

    Following hospital discharge, a procedure, antibiotics, or completion of home training, 2 weeks of telephonic follow-up was provided to 193 PD or home HD patients as a “home dialysis virtual ward” (HDVW). The HDVW identified a median of 1 care gap per patient, with newer patients at higher risk of gaps. Patients were highly satisfied with the HDVW.

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

    Tags: Home Dialysis, Home Dialysis Virtual Ward, Hdvw, Care Gap

  2. Tablo HD Machine Safe and Effective at Home and In-center

    Safety and efficacy human trials of the easy-to-use Tablo were conducted with 28 participants who received 4 treatments per week in-center and then at home for a total of 21 weeks. Home adherence (99%) was slightly better than in-center (96%), with average prescribed—and delivered—treatments of 3.4 hours, and an average weekly standard Kt/Vurea of 2.8 in both settings. Adverse events were not related to the Tablo, and alarm resolution time was 8 seconds in-center and 5 seconds at home.

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

    Tags: Tablo, Home Hemodialysis, Hemodialysis System

  3. Is PD Unwise for Patients with Lupus Nephritis?

    A small study found 92.4% (1 year), 84.7% (3 year) and 67.6% (5 year) patient survival among 28 non-diabetic lupus patients doing PD—compared to 100% (1 year), 93.5% (3 year), and 82.9% (5 year) among 56 controls. While the lupus was not directly associated with mortality, it was a risk factor for PD technique failure, infection, and hospitalizations.

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

    Tags: Patient Survival, Lupus, Pd, Mortality, Technique Failure, Infection, Hospitalization

  4. Antibiotics Before Colonoscopy May Reduce Peritonitis Risk in PD Patients

    In a retrospective study of 236 CAPD patients who had colonoscopies, 9 developed peritonitis within a week of the procedure. No patient who received prophylactic antibiotics developed peritonitis. Randomized controlled trials are recommended.

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

    Tags: Capd, Colonoscopy, Peritonitis, Prophylactic Antibiotics, Polypectomy, Endoscopic Mucosal Resection

  5. Proton Pump Inhibitors Increase Peritonitis Risk in PD

    In a single-center, 36-month retrospective look at 230 Japanese PD patients, those who took PPIs were 72% more likely to develop peritonitis than those who did not.

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

    Tags: Pd, Pp Is, Peritonitis, Proton Pump Inhibitors

  6. 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 11/16/2019)

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

  7. PD vs. Standard In-center HD for Quality of Life

    A 24-month observational study compared 45 standard HD and 30 PD patients, and assessed their quality of life, cognitive function, and depression at study start and every 12 months. Over the 24 months, PD patients had significant improvement in physical and social well-being—while HD patients stayed the same. Cognitive function held steady in PD patients—but declined in HD patients. Depression increased among those on standard HD—but not those on PD.

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

    Tags: Peritoneal Dialysis, Hemodialysis, Cognitive Function, Emotional Distress, Quality Of Life

  8. Transplant Survival Better After PD Than Standard In-center HD

    Is there an advantage to PD over standard in-center HD for transplant graft survival? YES, suggests a 15-year retrospective study of 2,277 transplant recipients. Those who did PD prior to transplant were 34.5% more likely to survive, and had less frequent rejection. Living donor kidneys did best among patients who received transplants before starting dialysis—or did PD.

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

    Tags: Kidney Transplant, Modality, Pd, Hd, Hemodialysis, Peritoneal Dialysis

  9. Home Dialysis: Better Outcomes at Lower Costs

    Five years after starting dialysis, the population of Ontario, Canada over age 18 had mean 30-day PD costs 50% lower than in-center HD—and home HD costs 64% lower than in-center. After adjusting for covariates, home HD cost the least and had the highest survival (80%) vs. 52% on PD and 42% on in-center HD.

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

    Tags: Home Dialysis, Pd Cost, Hd Cost, Hd Survival

  10. The Role of Frailty in Home Dialysis

    Evaluation of frailty among 109 home dialysis patients revealed a greater than 2-fold increase in risk of a composite outcome that included technique failure and all-cause death. Weakness and weight loss were both linked with higher risk. “Assessing frailty as part of the clinical evaluation for home dialysis therapies may be useful for prognostication and clinical management,” report the authors.

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

    Tags: Frailty, Home Dialysis, All Cause Death