Journal Watch
Remote PD Monitoring Reduced Hospitalizations
A study of people starting automated PD matched patients who did and did not receive remote patient monitoring (RPM), with 63 patients in each group. Those who received RPM had significantly fewer hospital stays and days.
Read the abstract » | (added 2019-08-14)
Tags: Automated PD, Remote Patient Monitoring, Hospitalization
PD: Better Quality of Life than In-Center HD for 2 Years
Among 989 patients starting PD or in-center HD, health-related quality of life (HRQOL) was measured at 3, 12, and 24 months after dialysis start. PD patients scored higher all along on several key dimensions than HD patients—and this effect lasted up to 2 years. Both PD and HD patients had about the same amount of decline in HRQOL over 2 years.
Read the abstract » | (added 2019-08-14)
Tags: HRQOL, PD, In center HD, Quality Of Life
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 2019-08-14)
Tags: Home Dialysis Outcomes, Racial, Ethnic, Mortality, Transplant Rates
Home Dialysis Barriers Examined (Again)
Since the NKF-KDOQI is a latecomer to the home dialysis party (at least for home HD), they started at the beginning with a conference identifying barriers to starting and keeping patients at home. Not surprisingly, cursory education, and lack of exposure to home options or support for care partners were implicated.
Read the abstract » | (added 2019-01-11)
Tags: Home Dialysis, KDOQI, Barriers, Patient Support
New Ideas for Incremental PD
Starting incremental PD without the exclusive focus on residual plus peritoneal clearances may ease transitions of new patients onto dialysis—and reduce our “obsession” with small moleule kinetics.
Read the abstract » | (added 2018-06-12)
Emergent Start PD Yet Again
Learn about the rationale and feasibility of using PD as a first dialysis option for emergent start patients instead of inserting a central venous catheter and starting HD. .
Read the abstract » | (added 2018-04-12)
Tags: End stage Renal Disease, Haemodialysis, Peritoneal Dialysis, Unplanned Start, Urgent Start
Starting PD with One Daily Exchange of Icodextrin
Incremental PD can be less restrictive for patients initiating therapy. Is one daily exchange with icodextrin enough? A physiological study used a 3-pore kinetic model to assess fluid and solute removal among patients with residual function that ranged from 0 to 15 mL/min/1.73m2. All but very large patients (total body water >60L) were predicted to achieve adequate dialysis with this approach.
Read the abstract » | (added 2018-02-15)
Survival in Those Eligible for BOTH PD or Standard In-center HD
Yes, this is yet another survival comparison. A study of almost a decade of people (N=2,032) starting dialysis at seven Ontario clinics looked at mortality only among those who were judged to be suitable for either PD or standard in-center HD by a multidisciplinary team. Both options offered similar survival.
Read the abstract » | (added 2017-12-14)
Heart Disease? PD is a Good Option
In a single clinic study, 112 new patients starting PD with or without heart disease were followed for 5 years. More people with heart disease had diabetes (53.3% vs. 31.7%), and they tended to be older. But, there were no differences between groups in hospital admissions, peritonitis, or PD technique failure.
Read the abstract » | (added 2017-02-08)
Tags: Peritoneal dialysis
For HD Survival, Home Beats In-Center
An observational study looked back at 41 incident patients starting home HD and matched them to patients starting in-center HD by sex, age, comorbidity, and start date. Mean survival on home HD was 17.3 years, vs. 13 years in-center. Home HD patients also had significantly lower phosphate levels and did not require blood pressure medications.
Read the abstract » | (added 2016-07-12)
Tags: Hemodialysis