Journal Watch
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
PD Reduced Hospitalization 24% vs. In-center HD with a Catheter
In an 18-month retrospective study, 717 PD patients were matched 1:1 with in-center HD patients using central venous catheters. The matching also included cause of ESKD, race, diabetes status, and insurance. The hospitalization rate was 24% lower for those on PD, and mortality was 15% lower.
Read the abstract » | (added 2022-04-18)
Tags: PD, In center HD, Catheters, Cause Of ESKD, Race, Diabetes Status, Insurance, Hospitalization Rate, Mortality
Poorer Survival for Those Who Switch from Home to In-center HD
Among 19,306 people who started HD in the ANZDATA registry from 2005 to 2015 and were treated for more than 90 days, those who started home HD and then went to in-center HD had significantly higher mortality than those who stayed at home. The reasons for this are not yet known.
Read the abstract » | (added 2021-08-12)
Tags: HD, Home HD, In center HD, Mortality, Home Hemodialysis Treatment Failure
The impact of low magnesium levels on heart disease deaths on PD
Hypomagnesemia is linked with all-cause mortality in HD—but, what about PD? A study classed 1,004 blood tests from PD patients measuring magnesium into one of three groups: <0.7 mmol/L, 0.7-1.2 mmol/L, and >1.2 mmol/L. Those in the lowest magnesium group did have a higher risk of death from both heart and non-heart causes.
Read the abstract » | (added 2021-05-14)
Better Technique Survival with Assisted PD
A study of 384 PD patients in China compared the outcomes of 274 who did self-care PD with 110 who had assisted PD. Older age, diabetes, low residual kidney function and low serum albumin predicted higher mortality, as did assisted PD, since this group had more comorbidities. Technique failure was also significantly lower in the assisted PD group.
Read the abstract » | (added 2021-04-16)
Outcomes and Costs of Assisted PD
As many as half of those who could use PD need assistance to do so, and many countries outside the U.S. offer this. A narrative review found no differences in quality of life, hospitalization, or mortality between PD and in-center HD patients after adjusting for age and frailty. Nurse assistance may result in better technique survival than family assistance. Assisted PD was still significantly less costly than in-center HD in Canada and Western Europe.
Read the abstract » | (added 2021-03-09)
Tags: Assisted Peritoneal Dialysis, Barriers, Cost, Hemodialysis, Peritoneal Dialysis, Pd
Functional Iron Deficiency and Survival on PD
A 10-year retrospective look at survival examined records from 1,173 PD patients who had normal iron levels, absolute iron deficiency, functional iron deficiency (FID), or high iron levels. Among the group, 77.5% had iron deficiency, and FID, in particular, was linked with an increased risk of all-cause—but not cardiovascular—mortality.
Read the abstract » | (added 2021-03-09)
Tags: Mortality, Peritoneal Dialysis, PD
Complications in Planned vs. Unplanned Peritoneal Dialysis Starts
A metaanalysis of 14 papers totalling 2,401 PD patients looked at the outcomes and safety of unplanned PD starts within 7 days of catheter placement vs. 7-14 days. Early-start PD was linked with more leaks, omental wrap, and—for CAPD—catheter malposition. There were no significant differences in infectious complications, but the risk of transition to HD and mortality were higher. More studies are needed.
Read the abstract » | (added 2020-11-12)
Survival Benefit of More HD Hours is Not Sustained After a Switch Back to Standard
In the ACTIVE Dialysis trial, 200 standard HD patients were randomized to receive usual care (median of 12 hours of HD/week) or extended hours (median of 24 hours of HD/week) for 12 months, with follow up through 60 months. After the 12 months, intervention group participants were switched back to usual care. At 5 years, there was no difference between the groups in all-cause mortality.
Read the abstract » | (added 2020-10-12)
Tags: Dialysis, End stage Kidney Disease
Aspergillus Peritonitis Review
Compared to other fungal peritonitis, colonization with aspergillus is more dangerous, and identification is still a challenge. Among 55 cases reported in the literature between 1968 and 2019, the mortality rate was 38.3%, 85.5% had to have their PD catheter removed, and 81.8% of patients had to switch to HD.
Read the abstract » | (added 2020-09-11)
Tags: Aspergillus, Mortality, Peritoneal Dialysis, Peritonitis