Journal Watch - Mortality

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  1. Is PD Unwise for Patients with Lupus Nephritis?

    A small study found 92.4% (1 year), 84.7% (3 year) and 67.6% (5 year) patient survival among 28 non-diabetic lupus patients doing PD—compared to 100% (1 year), 93.5% (3 year), and 82.9% (5 year) among 56 controls. While the lupus was not directly associated with mortality, it was a risk factor for PD technique failure, infection, and hospitalizations.

    Read the abstract » | (added 11/16/2019)

    Tags: Patient Survival, Lupus, Pd, Mortality, Technique Failure, Infection, Hospitalization

  2. Is PD a Good Option for Patients with Liver Cirrhosis?

    A study matched patients with cirrhosis who did PD, patients with cirrhosis who did HD, and non-cirrhosis patients on PD by age, sex, catheter placement date, and diabetes status. PD technique failure and all-cause mortality were similar between patients with and without cirrhosis.

    Read the abstract » | (added 10/14/2019)

    Tags: Pd, Cirrhosis

  3. PD Outcomes under the Medicare Expanded Dialysis Prospective Payment System

    A Medicare change in 2011 may have increased the likelihood that clinics would expand PD to a broader population. Did this affect outcomes? A prospective cohort study compared 10,585 patients who started PD before payment reform, 7,832 interim patients, and 18,742 during the reform period. With similar demographics, more patients were treated in clinics with less PD experience—and these clinics had higher PD discontinuation rates. But, PD discontinuation fell overall, and mortality risk was stable.

    Read the abstract » | (added 10/14/2019)

    Tags: Medicar, Expanded Dialysis Prospective Payment System, Pd

  4. Glycated Albumin vs. HbA1c Predicts Mortality in PD Patients with Diabetes

    In patients on hemodialysis, glycated albumin (GA) reflects glycemic control and predicts all-cause mortality. A new retrospective, longitudinal observational study looked at GA in PD. Among 44 PD patients with diabetes matched to 88 HD patients with diabetes followed for 3 years, GA was a more precise way to measure glycemic control than hemoglobin A1c.

    Read the abstract » | (added 09/11/2019)

    Tags: Peritoneal Dialysis, All Cause Mortality, Glycaemic Control, Glycated Albumin, Glycated Haemoglobin

  5. Payment Policy is Driving Increases in U.S. Home Dialysis

    Follow the money. Analysis of 523,526 patients starting dialysis in the U.S. between 2005 and 2013 found increases in home dialysis use in all groups, and a decline in racial/ethnic differences in home dialysis. However, over time, white patients had an increase in mortality compared to minority patients, while transplant rates remained lower in minority patients.

    Read the abstract » | (added 08/14/2019)

    Tags: Home Dialysis Outcomes, Racial, Ethnic, Mortality, Transplant Rates

  6. BMI and Survival on PD

    A large study from Korea (N=80,674 PD patients) found that those in the highest group for BMI: just 25.71, had significantly higher all cause mortality.

    Read the abstract » | (added 06/13/2019)

    Tags: Body Mass Index, Survival, Diabetes Mellitus, Peritoneal Dialysis, Mortality

  7. Wanted: A Paradigm Shift from Urea to Sodium Removal

    When nephrology icon Zyblut Twardowski talks, we listen! When dialyzors in Seattle in the 1960s got 30 hours a week of dialysis, the mortality rate was 10%. Since then, short treatments—justified by the flawed NCDS study—were driven by the equally flawed notion of Kt/V urea.

    Read the abstract » | (added 12/14/2018)

    Tags: Kt/V Urea, Mortality Rate, Sodium Removal, Dialysis Quality, Ncds, Rct

  8. Protein Clearance Predicts Mortality on PD

    Protein clearance on PD may be a marker of peritoneal inflammation. Among 711 PD patients followed for at least one year, each 10mL/day rise in protein clearance was linked with a 10.4% increase in the risk of all-cause mortality (p=0.008). Protein clearance was linked with serum albumin and C-reactive protein levels.

    Read the abstract » | (added 12/14/2018)

    Tags: Protein Clearance, Peritoneal Dialysis, Mortality

  9. Peritonitis Symptoms in Older vs. Younger People

    A single center study compared the time to first episode of peritonitis treated successfully with antibiotics in PD patients >65 (n=79)compared to those who were younger (n=168). Of 377 peritonitis episodes, 126 were in the older group and 251 in the younger group. Older patients were less likely to have fever or cloudy dialysate as symptoms than younger patients, but rates of transfer to hemodialysis, relapse, hospitalization, and mortality were similar. Read the abstract.

    Read the abstract » | (added 10/12/2018)

    Tags: Peritonitis, Outcomes Of Peritonitis, Elderly Pd, Patient Pd

  10. Home HD After PD Failure May Lead to More Transplants, Lower Mortality

    Since PD failure can lead to hospitalization and death in those who switch to standard in-center HD (ICHD), would outcomes improve with home HD? A new analysis found 521 patients in the USRDS data who made the change. Compared to matched ICHD patients, the chance of transplant was nearly double (21% vs. 10.6%), while survival of home HD patients was 89.1% at 1 year and 80.5% at 2 years.

    Read the abstract » | (added 08/13/2018)

    Tags: Pd Technique Failure, Ichd, Transplant, Home Hd, Lower Mortality