Journal Watch - Peritoneal Dialysis

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  • Exercise May Improve Residual Kidney Function in PD

    A post-hoc study of a 12-week randomized controlled trial of home exercise for PD patients eliminated those with anuria (n=18) and analyzed 13 patients in the usual care group and 16 in the exercise group. Two RKF markers, liver-type fatty acid-binding protein (L-FABP) and the microalbumin-to-creatinine ratio, were significantly lower in the exercise group.

    Read the abstract » | (added 2020-12-10)

    Tags: Microalbumin to creatinine Ratio, Peritoneal Dialysis

  • Use of CMS-reimbursed CKD Education Doubles the Likelihood of Home Dialysis

    While Medicare has paid for stage 4 CKD kidney disease education (KDE) since 2010, only a tiny fraction have used it—but KDE matters, finds an analysis of 369,968 patients who started dialysis between 2010 and 2014. Just 3,469 (0.9%) had received at least one KDE session, but compared to controls matched for age, gender, ESRD Network and year of dialysis start, they were twice as likely to have started a home dialysis treatment. Concerningly, African American and Hispanic patients were significantly less likely to have received KDE services.

    Read the abstract » | (added 2020-12-10)

    Tags: Home Dialysis, Kidney Disease Education, Peritoneal Dialysis

  • The Influence of Perceptions on PD Burnout

    A focus group study conducted with 81 PD patients and 45 care partners in Australia, Hong Kong, and the United States identified relentlessness and feeling overwhelmed by daily responsibilities as a factor in burnout. Building resilience and finding a new normal and meaning in other activities may be protective.

    Read the abstract » | (added 2020-12-10)

    Tags: Burnout; Dialysis, Peritoneal Dialysis

  • International Use of PD

    Worldwide PD use is approximately 11%, which varies across the globe, finds a new survey of stakeholders in 182 countries (with 313 respondents from 160 countries). Median PD use was 38.1 per million. Thirty countries, mainly low-income, did not offer PD, while in 69% of countries, PD was the first modality for <10% of incident patients. The range of PD costs passed on to patients was 1-25%, with higher co-pays in South Asia and low-income countries. Patient-reported PD outcomes were rarely measured.

    Read the abstract » | (added 2020-09-11)

    Tags: Epidemiology, Kidney Failure, Peritoneal Dialysis

  • SARS-CoV-2 in PD Effluent

    Analysis of bodily fluids from 3 SARS-CoV-2-infected PD patients found that, while viral load was quite high in nasopharyngeal swabs, none of the PD effluent tested positive, even after dialysate concentration. This suggests that the risk of virus transmission from used PD fluid may be low.

    Read the abstract » | (added 2020-09-11)

    Tags: COVID 19, SARS CoV 2, Peritoneal Dialysis

  • Starting with PD Better than Switching to it from HD

    A metaanalysis comparing patients who started with PD to those who began HD and then switched to PD after 3 months found significantly better overall and technique survival in the PD first group. There were no significant differences in the peritonitis rate.

    Read the abstract » | (added 2020-07-10)

    Tags: Hemodialysis, Peritoneal Dialysis, Renal Replacement Therapy

  • Are PD eHealth Initiatives Ready for Prime Time?

    A review of 15 studies (n=1,334) of use of telemedicine and eHealth to support PD self-management found bias and low-quality evidence that made a metaanalysis impossible. While no adverse effects of eHealth interventions were reported, effectiveness was mixed. Better quality evidence is needed.

    Read the abstract » | (added 2020-05-12)

    Tags: Digital Health, EHealth, Peritoneal Dialysis, Evidence

  • Outcomes Between Urgent-start PD and HD

    Urgent-start PD (n=93) and urgent-start HD (n=91) patients similar in age, diabetes and other comorbidities, and lab values, were followed for 6 months to 2 years. Rates of mechanical complications, bacteremia, and survival were comparable. Exit site/access infections were significantly higher in the PD patients, but those on PD had significantly better residual kidney function and phosphorus control, and used significantly less erythropoietin and antihypertensives

    Read the abstract » | (added 2020-04-13)

    Tags: Haemodialysis, Renal Function Recovery, Peritoneal Dialysis, Urgent Start