Journal Watch - Infection
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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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Stepwise PD Starts vs. Conventional PD Starts—Which is Better?
Stepwise Initiation of PD (SIPD) is an approach that uses a gradual introduction to PD (perhaps like incremental PD in the U.S.?). In a retrospective look at 39 SIPD patients vs. 78 conventional PD (CPD) starts during a 13-year period matched for age and sex, early complications and PD catheter survival were similar between groups. But, late complications were significantly lower in the SIPD group. The authors believe SIPD may aid tissue healing and reduce biofilms, which may reduce infections. As always, more studies are needed…
Read the abstract » | (added 2024-11-21)
Tags: Stepwise Initiation Of PD, Incremental PD, Late Complications, Infection, Tissue Healing, Biofilms
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Home HD Begins in Mainland China
Intrigued by observational studies suggesting better survival for home HD than in-center HD or PD—and reduced COVID exposure—a clinic in China established a training center and enrolled six patients. Patients were monitored by home visits, online, and by outpatient services. After an average of 16 months of training, three patients began independent dialysis at home, with no serious adverse events. Blood levels remained stable.
Read the abstract » | (added 2022-12-19)
Tags: Home HD, In center HD, PD, Infection, Mainland China
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Wound Vac Use Helpful for 7 Days After PD Catheter Placement
A new PD catheter is surrounded by an open wound. Among 30 people who had PD catheters placed, half were randomly assigned to receive negative pressure wound therapy (wound vac) for 7 days. The other half received conventional dressings. The exit site scores were significantly better in the wound vac group, and their exit sites remained significantly better for the next 6 months, though peritonitis rates were the same.
Read the abstract » | (added 2022-01-14)
Tags: PD Catheter, Catheter Exit site Care, Infection, Wound Vac