Journal Watch - Mortality
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)
Impact of PD Exchange Volume/Day on Outcomes
A DOPPS cohort study in Japan divided patients into two groups by daily PD dialysate volume (<4L/day; n=98 or >4L/day; n=244). Despite demographic differences between the groups, there were no significant differences in transfers to HD, mortality, hospitalization, peritonitis, or patient-reported outcomes based on volume—thus less volume may be more cost effective.
Read the abstract » | (added 2024-12-11)
Tags: Dialysate Volume, Peritoneal Dialysis Outcomes, Mortality, Patient reported Outcomes
Management of PD Anemia in Japan
Should people who use PD have the same hemoglobin (hb) targets as those who do HD? Researchers analyzed registry data of 4,875 patients 18 or older who were doing PD at the end of 2012 and compared their hb levels with mortality for the 1,586 who died. In a U-shaped curve, hb levels < 9.0 and > 13.0 were significantly associated with death. In those who had a history of cardiovascular disease, hb levels > 12.0 were significantly associated with death.
Read the abstract » | (added 2024-06-14)
Home HD, Self-cannulation, and Survival
An observational study of all home HD patients at a single center from 2001 to 2020 examined treatment survival and mortality. Among 77 self-cannulating patients dialyzing for a median of 18 hours per week, there were 11 deaths, largely cardiovascular, and 19 technique failures after 100 months, largely due to vascular access issues.
Read the abstract » | (added 2024-06-14)
Tags: Home HD, Self Cannulation, Treatment Survival, Mortality, Cardiovascular, Technique Failure, Vascular Access
Early Survival Advantage for Incremental PD
From 2008 to 2017, 1,315 patients from one hospital who started PD were enrolled in a study that propensity matched them 1 (incremental; n=285):2 (full dose; n=502) for age, sex, residual kidney function and urine volume, hemoglobin, serum albumin, and other variables. For the first 6 years, intermittent PD had significantly better survival than full dose PD, with a 39% lower risk of all-cause mortality and 41% less cardiovascular mortality. This advantage disappeared with longer time on PD.
Read the abstract » | (added 2023-09-13)
Tags: Intermittent PD, Full Dose PD, Mortality
Meta-analysis of PD Remote Patient Monitoring
Analysis of data from 22 studies revealed that remote monitoring for PD reduced technique failure, hospitalization, and mortality vs. traditional PD monitoring.
Read the abstract » | (added 2023-04-19)
Tags: Remote Monitoring, PD, Technique Failure, Hospitalization, Mortality, Traditional PD Monitoring
Serum albumin at 1 Year Predicts Long-term CAPD Outcomes
Among 436 patients using CAPD and followed for at least a year (48.25 + 24.05 months), each 1 g/dL increase in serum albumin at 1 year after PD start reduced the risk of death by 8.7%.
Read the abstract » | (added 2022-12-19)
Tags: Peritoneal Dialysis , Serum Albumin, CAPD, Mortality
Better COVID Survival with PD and Home HD
Among 1,336 people whose kidneys failed between March, 2020 and January, 2021, 13.12% (n=178) contracted COVID-19. Of these, most (n=139) did standard in-center HD, and 33 (3.87%) died. On PD, 39 people developed COVID, and 1 (0.81%) died. On home HD, there were zero cases of COVID and no deaths. Five transplant patients developed COVID, with a mortality rate of 1.47%.
Read the abstract » | (added 2022-10-17)
Tags: Covid, Standard In center HD, PD, Mortality, Home HD, Home Hd And Covid, Transplant
Frequent HD Shortens Recovery Time—Even in Nursing Homes
In a study of 2,309 people receiving 14 hours of more frequent HD in skilled nursing facilities (SNFs), 92% reported recovery time of 2 hours or less. Those who received five treatments per week or had systolic blood pressure of 160-179 prior to treatment had greater odds of rapid recovery.
Read the abstract » | (added 2022-07-13)
Tags: ESRD, Home Hemodialysis, More Frequent Dialysis, Mortality, Nursing Home, Post dialysis Recovery Time
Fatigue at PD Start Linked with Higher Mortality
A PLOS One study compared 4,285 incident PD patients who completed a KDQOL-SF vitality scale from Brazil (1,388) and the U.S. (2,897) from 2004 to 2011. Lower vitality scores after 90 days of PD were linked with a higher risk of mortality in both countries
Read the abstract » | (added 2022-07-13)
Tags: Fatigue, Incident Peritoneal Dialysis, Vitality, Mortality