Journal Watch
Higher Serum Albumin May Protect Residual Kidney Function in PD
In a prospective study of 104 new PD patients, having low serum albumin levels was independently associated with complete RKF loss (<100 mL/day of urine).
Read the abstract » | (added 2019-06-13)
Tags: Serum Albumin, Residual Kidney Function, Urine Volume, Peritoneal Dialysis, PD
Cognitive Impairment Predicts PD Peritonitis
A prospective cohort study assigned 458 PD patients to a cognitively impaired (CI) or non-CI group based on results of mental state testing. The groups were not otherwise significantly different. Over 31.4 (median) months, 94 patients had first-time peritonitis, and short-term memory losses were independently linked with a higher risk.
Read the abstract » | (added 2019-04-11)
Lower Dementia Risk with PD than Standard In-Center HD: Metaanalysis
An analysis of 15 studies concludes that PD is associated with a lower risk of cognitive decline and dementia than HD--but calls for well-conducted prospective studies.
Read the abstract » | (added 2019-02-14)
Tags: Dementia, PD, In center HD, Cognitive Functions
Low-volume Tidal PD for Urgent Starts
A randomized, prospective trial was done to see if tidal PD (TPD) would improve outcomes among 27 urgent start PD patients, vs. 22 who did low-volume intermittent PD. After follow up for up to 2 years, the TPD group did have significantly fewer catheter complications. Both options had about the same technique survival.
Read the abstract » | (added 2019-01-11)
Tags: Automated Peritoneal Dialysis, Tidal Peritoneal Dialysis, Intermittent Peritoneal Dialysis, Complications
Medicare Reimbursement Has Driven More PD
Changes to the Medicare Prospective Payment System (PPS) in 2011 to create financial incentives for PD have worked, finds a new analysis of 6,433 dialysis clinics before and after the change. Since 2011, 6% more clinics offered PD, and program size increased from an average of 5.7 patients to 6.9. Non-urban, chain, and larger clinics were significantly more likely to have changed their PD practices in response to the PPS change.
Read the abstract » | (added 2018-12-14)
Tags: Medicare, Prospective Payment System, Peritoneal Dialysis, Quality Of Life
What Makes Home HD Patients Reach for On-Call Support?
A 4-month prospective observational study analyzed the reasons why 58 home HD patients called the on-call nurse or technician. Most calls to nurses were made for clinical issues or machine set-up or alarm questions, some of which required a technician. Most of the technician calls were for machine malfunction, set-up and alarms, or water treatment. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Home Hemodialysis, Independent Hemodialysis, Nocturnal Hemodialysis, Short Daily Hemodialysis
Metaanalysis of Nocturnal HD and Sleep Quality
Nine studies of 286 patients found significantly less sleep apnea and better O2 saturation—but less total sleep time—after switching from conventional to nocturnal HD. Prospective pre-post studies found improved sleep quality, but randomized trials did not. Read the abstract.
Read the abstract » | (added 2018-10-12)
Tags: Sleep Apnea, CHD, NHD, O2 Saturation, Nocturnal HD, Conventional HD, Sleep Quality
Blood Flow Rates and Clinically Meaningful Solute Removal
A prospective study of 17 patients looked at BFRs of 300, 350, and 450 and Kt/V urea, beta-2 microglobulin, and phosphorus when low dialysate flow rates were used. While Kt/V did increase, the impact on B2M and phosphorus were minimal.
Read the abstract » | (added 2018-08-13)
Tags: Daily Hemodialysis, Home Hemodialysis, Kt/V, Blood Flow
Urgent-start PD in Brazil
In a prospective study, 51 patients who needed dialysis urgently began peritoneal dialysis instead of hemodialysis. Even with high-volume dialysate used less than 72 hours after catheter placement (on alternate days in the dialysis clinic), the option was feasible and safe. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Acute Peritoneal Dialysis, Unplanned Peritoneal Dialysis, Urgent start Dialysis, Urgent start Peritoneal Dialysis
More CMS Incentives Needed to Boost Home Dialysis
More CMS Incentives Needed to Boost Home Dialysis Have changes in the ESRD Prospective Payment System (“bundle”) designed to increase the use of home dialysis been successful? A new analysis of USRDS data from 2006 to 2013 found that bundling injectable medications and paying for home training did move the needle a bit—but not enough. Compared to patients with other insurance who had a 4.1% increase in home dialysis during this period, Medicare beneficiaries had a non-significant 5.8% rise.
Read the abstract » | (added 2017-10-13)
Tags: Education Issues: For Patients And Professionals, Choosing The Right Path Through ‘The System’