Journal Watch

  • Physician Reimbursement Increases Did Not Drive PD in Canada

    Among a cohort of 4,262 patients in Alberta, Canada followed between 2001 and 2014, an increase in PD physician pay from $0 to $135 (over a 9-year period) revealed no statistical evidence of a difference in PD use or trends—and the role of the physician in modality selection was unclear.

    Read the abstract » | (added 2020-03-16)

  • Peritonitis with Diarrhea Could be C-diff

    Cloudy PD dialysate can signal infectious peritonitis from a variety of causes—including C-diff. But, use of cephalosporins could worsen a C-diff infection. A new article presents two case histories of C-diff peritonitis and suggests reexamining the traditional empiric treatment of peritonitis when diarrhea is present.

    Read the abstract » | (added 2020-03-16)

  • Patient and Clinic Factors Driving Home Dialysis in Australia/New Zealand

    Among 54,773 patients in 76 centers in the ANZDATA registry, an overall 45% (0-87%) were using some form of home dialysis. Males, people of color, and patients who were older, had comorbidities, experienced late nephrology referral, lived remotely, or were obese had lower uptake of home therapies. Smaller centers, those with shorter hours, and clinics who had fewer patients with permanent access had lower uptake as well.

    Read the abstract » | (added 2020-02-19)

  • The Q-Cohort Study: More Dialysis, Less Risk of Cancer

    Uremic toxins increase cancer risk. In a study of 3,450 HD patients followed for 4 years, patients were divided into quartiles based on their baseline Kt/V. Four-year survival dropped linearly along with Kt/V. Every 0.1 increase in Kt/V reduced the risk of cancer death by 8%.

    Read the abstract » | (added 2020-02-19)

  • 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)

  • Green Nephrology: Reducing the Environmental Impact of Dialysis

    Climate change and extreme weather events both increase the incidence of kidney disease and destabilize care. But, healthcare in general—and dialysis in particular—contribute substantially to greenhouse gases. Monitoring resources and reducing waste in HD can be done through reuse of RO reject water, renewable energy sources, better waste management, and slower dialysate flow rates. For PD, point-of-care dialysate will reduce the environmental impact.

    Read the abstract » | (added 2020-02-19)

  • 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)

  • 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)

  • Survival with PD vs. Home HD and When to Go Home

    Using a national cohort of 1,993 patients transitioning to home HD and 16,514 to PD between 2007 to 2011, 1,195 home HD were matched to 1,195 using propensity scores and adjusting for demographics, comorbidities, dialysis duration, and BMI. Those on home HD had significantly better survival (9.6 vs. 12.9 deaths per 100 patient-years; p<0.001). However, when patients switched to PD within the first 12 months of starting dialysis, survival was comparable between PD and home HD: patients who transitioned after 12 months had an 83% higher risk of death.

    Read the abstract » | (added 2020-02-19)

  • Diabetes and the Risk of Peritonitis on PD

    In contrast to earlier reports, a single-center study of PD patients between 1980 and 2012 (by era: 1980-’93, 1994-’04, 2005-12) found that while PD-associated peritonitis was higher among patients with diabetes in the earlier two eras, there were no differences in recent years.

    Read the abstract » | (added 2020-01-09)