A Home First Policy Helps Drive Home Therapy Choice

In the multinational Peridialysis study, of 1,587 people starting dialysis, 32.5% were judged “unsuitable” for a home treatment due to contraindications—or a lack of assessment. Among the suitable 1,071, 65.4% chose PD and 3.6% chose home HD, and the remainder went in-center. Late referral, suboptimal dialysis initiation, acute illness—and no “home dialysis first” policy were factors linked to use of in-center HD.

Read the abstract » | (added 2021-09-14)

Tags: Lack Of Assessment, Glomerular Filtration Rate, Haemodialysis, Peritoneal Dialysis, Pre dialysis, Uraemia

Feel Low on PD? Could be Vitamin D

In a study of 50 people on PD, those with vitamin D deficiency (< 20ng/mL) did more poorly than those with adequate vitamin D levels on all subscales of the KDQOL-36 survey to measure health-related quality of life. High blood pressure was also a factor in higher kidney disease burden.

Read the abstract » | (added 2021-08-12)

Tags: Serum Vitamin D Levels, Health related Quality Of Life, Peritoneal Dialysis

Genes Help Predict Peritoneal Transport Rates

Among 2,850 people on PD who had complete genetic data, 5 single nucleotide variants at four loci had suggestive associations with the peritoneal solute transfer rate (PSTR), in particular rs28644184 at the KDM2B locus.

Read the abstract » | (added 2021-07-12)

Tags: Genetic Variants, Peritoneal Solute Transfer Rates, Kidney Failure, Peritoneal Dialysis

PD vs. Standard In-Center HD for Stroke Risk: A 14-year Study

Of 7,916 ESRD patients with atrial fibrillation between 2001 and 2013, data from 363 PD and 5,302 HD patients were analyzed. At 1 year, 3 years, and 5 years, the participants who used PD had significantly lower risks for outcomes including stroke, major bleeding, and intracranial hemorrhage than those using HD.

Read the abstract » | (added 2021-06-15)

Tags: ESRD, End Stage Renal Disease, Atrial Fibrillation, Peritoneal Dialysis, Hemodialysis, Patient Outcomes

Safety Study of the PD Automated Wearable Artificial Kidney

In the AWAK pilot study, 15 participants used up to nine sessions over 72 hours and were then followed for one month. There were no serious adverse events, but 60% of participants had abdominal pain and 47% reported bloating. Median body weights were not significantly different before and after the study. Device enhancements will address ultrafiltration and pain.

Read the abstract » | (added 2021-06-15)

Tags: Wearable Kidney, Artificial Kidney, Chronic Kidney Disease, Peritoneal Dialysis

U.S. nephrology fellows’ perceptions of their home dialysis training

To grow home therapies, we must have clinicians who are trained in PD and home HD. A survey of 110 nephrology trainees suggests that we are not there yet. Of the 76 respondents, most were moderately confident about PD principles—but not urgent start PD or catheter insertion. Confidence around home HD was low.

Read the abstract » | (added 2021-05-14)

Tags: Home Dialysis, Hd, Home Hemodialysis, Hdd, Peritoneal Dialysis, Pd

How the Ontario Renal Network (ORN) has been trying to grow home dialysis

ORN started efforts to increase home dialysis use in Ontario in 2012, using a new funding formula based on modality, mandatory informatics, home dialysis coordinator and assisted PD funding, support for urgent start PD, targets for home dialysis rates, a network of clinics committed to home therapies, and frequent leadership meetings. Did they succeed?

Read the abstract » | (added 2021-05-14)

Tags: Home Dialysis, Home Haemodialysis, Peritoneal Dialysis, Hd, Pd

Measure needed for life participation in PD

A literature review and metaanalysis of 301 studies identified 42 measures to assess life participation, but most were used in just one study or were not specific to PD. The authors conclude that a new measure is needed.

Read the abstract » | (added 2021-05-14)

Tags: Life Participation, Peritoneal Dialysis, Pd

Home Dialysis Care Experience instrument

A new patient-reported experience measure for PD and home HD has been developed, based on a structured literature review, focus groups, interviews, and then cognitive testing. The 26-item measure covers 16 domains in six areas: communication and patient education, care team concern and helpfulness, care team proficiency, patient-centered care, care coordination, and personalized care.

Read the abstract » | (added 2021-04-16)

Tags: Hemodialysis, Hd, Peritoneal Dialysis, Pd

Missed Opportunities to Help Patients to Home Dialysis

Even strong home dialysis programs do not always successfully get everyone who is interested in a home therapy to go home. In British Columbia, of the 1,845 patients who started dialysis between 2015 and 2017, 34% started on their preferred home therapy—while 8.9% did not, and 8.4% had remained undecided and started in-center. A significant factor was that those who chose and started a home treatment had more home therapy-specific (vs. “general modality orientation”) education

Read the abstract » | (added 2021-03-09)

Tags: Home Hemodialysis, Peritoneal Dialysis, Pd