Journal Watch - PD
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Meta-analysis of Factors in PD Catheter-related Infections
Thirteen studies were included in a meta-analysis that found PD catheter-infection factors included diabetes, insecure catheter fixation, >2 years on dialysis, BMI >20 kg/m2, mechanical strain, lack of proper care, irregular caregivers, and a history of catheter pulling.
Read the abstract » | (added 2025-10-14)
Tags: PD, Catheter related Infections, Risk Factors, Meta analysis
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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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Early Icodextrin (ICO) Use Reduced PD-associated Peritonitis Risk
A group of 82 patients who did PD between 2011 and 2020 were divided into a group (n=21) who received ICO at PD initiation and a group (n=61) who received it later or not at all. Patients were followed until they stopped PD, died, or 3 years passed. PD-associated peritonitis and tunnel infection-free survival rates were significantly better with early ICO use.
Read the abstract » | (added 2024-12-11)
Tags: PD, ICO, Early Icodextrin, Peritonitis, Tunnel Infection free Survival Rates
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PD vs. HD for Women’s Sexual Function (But, Would Intensive HD be Better?)
Women (n=200) with non-dialysis CKD, HD, CAPD, and controls who completed the Female Sexual Function Index (FSFI) were analyzed by treatment group. The control group had the highest FSFI mean scores. The point means between PD and standard HD were nearly identical, except for sexual satisfaction, which favored CAPD (p<0.05). NOTE: Intensive HD was not compared in this study—but may prove to be helpful.
Read the abstract » | (added 2024-09-12)
Tags: PD, HD, Female Sexual Function Index, FSFI
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Fat Mass May Protect Bones and Muscles on PD
Among 359 PD patients, 25% had osteoporosis, 32% had sarcopenia, 15% had osteosarcopenia, with considerable overlap between these conditions. Using body composition monitoring, fat tissue index (FTI) and lean tissue index (LTI) were measured. Low FTI—but not normal or high FTI—was linked with all three conditions, even after adjusting for age and BMI.
Read the abstract » | (added 2024-09-12)
Tags: PD, Osteoporosis, Sarcopenia, Osteosarcopenia, Fat Mass, Fat Tissue Index, FTI, Lean Tissue Index, LTI
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Which is Safer: Urgent Start HD or Urgent Start PD?
Analysis of data from 9 studies (941 PD and 779 HD patients) revealed that the risk of all-cause mortality, dialysis-related infections, and mechanical complications were higher in patients who started HD urgently than in those who started PD urgently.
Read the abstract » | (added 2024-07-12)
Tags: PD, HD, All cause Mortality, Dialysis related Infections, Mechanical Complications, Urgent start
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Cardiovascular Outcomes Compared in PD vs. Home HD
Data from almost 69,000 patients in the USRDS who started PD or home HD to assess for rates of hospitalizations due to incident cardiovascular events (acute coronary syndrome, heart failure, stroke). While the unadjusted rate of cardiovascular events was higher in home HD than PD patients, the adjusted rates were lower for stroke and acute coronary syndrome. There was no difference in heart failure risk, but home HD was linked with a 22% lower adjusted risk of cardiovascular death.
Read the abstract » | (added 2024-02-07)
Tags: USRDS, PD, Home HD, Hospitalization Rate, Incident Cardiovascular Events
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The PD Surprise Question Predicts Transfer to HD
An observational study of 1,275 PD patients in 35 programs asking the RN and treating nephrologist, “Would you be surprised if this patient transferred to HD in the next 6 months?” identified 15% as high risk. After 6 months, the transfer to HD rate was nearly four times higher in the high risk group than the low risk group.
Read the abstract » | (added 2023-12-15)
Tags: PD, Home Dialysis, Peritoneal Dialysis, Surprise Question
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Steady Glucose Concentration in PD and Sodium Removal
In a small pilot study (n=8), two fast-average and six fast transporters used a standard 4-hour CAPD dwell as a control, and three 5-hour steady-concentration treatments using the Carry Life® UF device following an overnight icodextrin fill as the intervention. UF rates were significantly higher with the steady glucose concentration treatments, as were sodium removal and glucose UF efficiency.
Read the abstract » | (added 2023-11-15)
Tags: PD, Glucose Concentration, Sodium Removal
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Exercise and Quality of Life on PD
In a cross sectional study of 339 PD patients, 81.7% exercised a median of 5 hours per week, mainly slow walking. Those who exercised had better quality of life. Older age, female sex, higher BMI, and pain were independently associated with lower exercise capacity.
Read the abstract » | (added 2023-10-13)
Tags: PD, Exercise, Quality Of Life