Journal Watch - Survival
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Home Dialysis in Finland
Prevalence of home dialysis has dropped in the past decade in Finland, despite its better survival compared to in-center HD. Semi-structured surveys for nephrologists, nephrology nurses, and patient associations endeavored to understand why. Nursing shortages and patient comorbidities received wide agreement as barriers, and clinicians believed that starting in-center reduces the odds of switching to home treatments later. For patients, financial burdens and impact on care partners were critical, as was “bringing hospitals home” or living in small spaces.
Read the abstract » | (added 2025-03-13)
Tags: Home Dialysis, Survival, Modality, Barriers
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Survival on HD vs. Immediate-start PD
After reviewing medical records from 911 incident dialysis patients from 2005 to 2023, 140 HD and 140 immediate start PD patients were selected for 1:1 propensity score matching. While long-term survival was comparable between the two modalities, non-diabetic patients had significantly higher survival on immediate start PD than HD.
Read the abstract » | (added 2025-01-13)
Tags: HD, Immediate start PD, Survival, Propensity Score
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Cycler vs. Manual PD for Survival
A systematic review and meta-analysis looked at 17 studies of more than 230,000 people for PD failure and all-cause mortality with cycler vs. manual PD. Both options had equivalent PD technique failure. But, there was a significant survival advantage for automated cycler PD.
Read the abstract » | (added 2022-12-19)
Tags: Peritoneal Dialysis, PD, Modality, Automated Peritoneal Dialysis, APD, Continuous Ambulatory Peritoneal Dialysis, CAPD, All cause Mortality, ACM, PD Failure, Survival
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The Predictive Value of Early, Non-infectious PD Complications
A prospective, multicenter cohort study of 1,596 people starting PD in New Zealand from 2014 to 2018 (inclusive) looked at survival and time on PD of those who had catheter-related exit site dialysate leaks or other leaks within 30 days of PD start. Peritonitis-free survival, first PD catheter survival, and tunnel infection free survival were secondary outcomes. Among the 102 with an early complication, overall mortality, the rate of stopping PD, and first catheter failure were all higher.
Read the abstract » | (added 2022-11-16)
Tags: PD, Survival, Peritonitis free Survival, First PD Catheter Survival, Tunnel Infection Free Survival, Early Catheter related Complication
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Urgent Start PD Takes on Urgent Start HD—Which One Wins?
A new meta-analysis examines survival vs. urgent start HD (which is experienced by an estimated 50%-60% of U.S. dialyzors). Pooled data from seven studies identified “a statistically significant reduced risk of all-cause mortality in patients undergoing urgent-start PD as compared to urgent-start HD.” While infectious complications did not differ, there was a significantly reduced risk of mechanical complications with PD.
Read the abstract » | (added 2022-05-12)
Tags: Urgent Start PD, Urgent Start HD, Survival, All cause Mortality, Mechanical Complications
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Glycemic Variability and Survival in People with Diabetes on PD
A Swedish study divided 325 people with diabetes on PD into seven groups based on glycemic variability. Using the lowest variability group as a reference point, survival was significantly better with less variability in blood sugar.
Read the abstract » | (added 2022-02-14)
Tags: Diabetes, PD, Glycemic Variability, Survival, Blood Sugar
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Urgent Start PD: Better Survival, Fewer Complications than Urgent Start HD
A metaanalysis pooling data from seven studies found that urgent start PD was linked with significantly better survival than urgent start HD, though infectious complications were comparable. Urgent start PD had significantly less risk of mechanical complications as well.
Read the abstract » | (added 2021-09-14)
Tags: Urgent start Peritoneal Dialysis, Survival, Urgent Start HD, Mechanical Complications, Infectious Complications
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Outcomes of Incremental PD
A retrospective cohort study looked at 175 PD patients followed for about 2 years. Starting PD with a lower vs. higher dose was associated with better survival.
Read the abstract » | (added 2021-08-12)
Tags: Peritoneal Dialysis , PD, End stage Kidney Disease, Dialysate Volume, Survival
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Higher HD Dose Linked with Better Survival
A national registry of 32,283 standard HD patients found that “a higher dose of dialysis was consistently associated with better survival.” Kt was most discriminating, with survival highest in the upper Kt quartile. Arteriovenous access, hemodiafiltration, scheduled dialysis initiation, and long weekly HD hours predicted higher Kt.
Read the abstract » | (added 2021-07-12)
Tags: Dialysis Frequency, Survival, Kt, Mortality