Journal Watch - Peritoneal Dialysis
Is Endoscopy Safe in PD?
Peritonitis can occur after endoscopy. A retrospective 10-year review divided 570 PD patients who had 1,316 endoscopies into three groups. Group 1 did not have prophylactic antibiotics. Group 2 did have them. Group 3 had prior antibiotics. An analysis of the peritonitis rates within 7 days of the procedures found a 3% rate that was not affected by whether or not antibiotics were given.
Read the abstract » | (added 2021-07-12)
Tags: Endoscopy, Peritoneal Dialysis, Peritonitis
PDOPPS Findings of Factors Important to Peritonitis Outcomes
The Peritoneal Dialysis Outcomes and Practice Patterns Study analyzed factors in the outcomes variations among 1,631 peritonitis episodes in 1,190 patients in seven countries. About 2/3 of the bouts were successfully cured, which was more likely with Gram-positive organisms, automated PD, and use of icodextrin (facility level), aminoglycosides, and ciprofloxacin vs. ceftazidime for Gram-negative organisms.
Read the abstract » | (added 2021-06-15)
Tags: Peritoneal Dialysis, Peritonitis, Peritoneal Dialysis And Outcomes Practice Patterns Study
Glucose and Peritonitis
A prospective, longitudinal cohort study followed 105 PD patients for up to 5 years (mean of 23 months). Higher glucose exposure significantly predicted peritonitis, and patients with more residual kidney function also had a significantly longer time to first bout of peritonitis. Read the abstract. The authors suggest using the lowest concentration of glucose possible.
Read the abstract » | (added 2020-03-16)
PD Glucose Absorption and Lipid Profiles
Lipid status was assessed at baseline and 12 month in 143 CAPD patients, 2/3 of whom used a daytime icodextrin exchange. No associations were found between glucose absorption, lipid profiles, or changes in serum lipids.
Read the abstract » | (added 2020-02-19)
Tags: Peritoneal Dialysis, Cholesterol, Glucose, Triglycerides
Exercise in PD Patients and Residual Renal Function
After a 12-week home-based exercise program was completed, researchers analyzed residual renal function among 13 patients who received usual care and 16 who had been in the exercise intervention group. Urinary liver-type fatty acid-binding protein and microalbumin-to-creatinine ratios were significantly lower in the exercise group, suggesting a possible benefit.
Read the abstract » | (added 2020-02-19)
Tags: Exercise, Renal Outcome, Residual Renal Function, Peritoneal Dialysis
Comorbidities—but not Peritonitis—drove Mortality on PD
Among 242 Turkish PD patients followed for up to 9 years, age over 65, diabetes, cancer, and heart failure were independent risk factors for death, but surprisingly peritonitis was not.
Read the abstract » | (added 2020-02-19)
Tags: Peritoneal Dialysis, Mortality, Patient Survival, Peritonitis, Technique Survival
Higher Serum Phosphorus Predicts More Residual Function Loss—in Men Only
A retrospective analysis of 1,245 CAPD patients followed for up to 11 years divided participants into tertiles based on their baseline serum phosphorus levels. One third of patients lost residual renal function (RRF) during the study, and those with the highest baseline phosphorus levels had a 51% higher risk of RRF loss than those in tertiles 1 and 2 combined. The risk of RRF loss was significantly higher for men.
Read the abstract » | (added 2019-12-10)
Tags: Serum Phosphorus, Renal Function Loss, Gender, Peritoneal Dialysis
PD—Controlling Volume to Reach Normal Hydration Protects the Heart
Reanalysis of data from a multicenter, prospective, randomized controlled trial looked at fluid control in PD in 151 patients followed for a year. While most (120) reached normal hydration levels as measured by bioimpedance analysis, those who did not had significantly higher left atrial diameter—and a lower left ventricular ejection fraction at the end of the study.
Read the abstract » | (added 2019-12-10)
Tags: Fluid Management, Cardiovascular Risk, PD, Peritoneal Dialysis, Bioimpedance Spectroscopy
Transplant Survival Better After PD Than Standard In-center HD
Is there an advantage to PD over standard in-center HD for transplant graft survival? YES, suggests a 15-year retrospective study of 2,277 transplant recipients. Those who did PD prior to transplant were 34.5% more likely to survive, and had less frequent rejection. Living donor kidneys did best among patients who received transplants before starting dialysis—or did PD.
Read the abstract » | (added 2019-11-16)
Tags: Kidney Transplant, Modality, PD, HD, Hemodialysis, Peritoneal Dialysis
PD vs. Standard In-center HD for Quality of Life
A 24-month observational study compared 45 standard HD and 30 PD patients, and assessed their quality of life, cognitive function, and depression at study start and every 12 months. Over the 24 months, PD patients had significant improvement in physical and social well-being—while HD patients stayed the same. Cognitive function held steady in PD patients—but declined in HD patients. Depression increased among those on standard HD—but not those on PD.
Read the abstract » | (added 2019-11-16)
Tags: Peritoneal Dialysis, Hemodialysis, Cognitive Function, Emotional Distress, Quality Of Life