Journal Watch

  • Home HD: Hospitalizations and Technique Survival

    In a Swedish registry study, patients initiating PD (n=456), home HD (n=152), and in-center HD (IHD; n=608) were matched by age, sex, comorbidity, and start date. Patients using home HD had significantly lower hospital admissions and days than those doing PD or IHD (1.7, 12 days vs. 2.8, 20 days and 2.2, 14 days respectively). Home HD patients also had significantly fewer admissions for cardiovascular diagnoses or infectious disease, as well as significantly longer technique survival.

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

  • First European Patients Using Nocturnal Home HD with Low-flow Dialysate

    A retrospective analysis looked at 21 patients using low-flow dialysate for nocturnal home HD and followed for a minimum of 12 months. Participants had a mean dialysis duration of 28 hours per week; most used alternate nights and 50-60 L of dialysate per session. Use of phosphate binders and blood pressure medications was significantly reduced, and no patient safety events were reported.

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

  • Impact of a Nurse-led Protocol on PD Fluid Overload

    Among PD patients divided into a group symptomatic of fluid overload (>2L; n=53) and a group that was not (n=50), a 12-week nurse-led education and motivation intervention—with hypertonic cycles for short-term relief of fluid overload—significantly reduced overhydration. Knowledge and adherence were both significantly improved as well.

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

  • PD vs. In-center HD for Sudden Cardiac Death

    A Korean registry study of 132,083 PD and in-center HD patients followed between 1985 and 2017 analyzed 34,532 deaths. Sudden cardiac death (SCD) was responsible for 19.6% of deaths on PD and 22.2% of deaths on in-center HD. Even after adjusting for age and comorbidities, the risk of SCD was higher with HD.

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

  • Factors Associated with Fatigue in PD Patients

    Analysis of fatigue scale data from 108 PD patients in China revealed that 78.7% suffered from fatigue, a number significantly higher than in the community population. Associated factors included sleep quality, normalized protein nitrogen appearance, transferrin, alkaline phosphatase, and total cholesterol levels.

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

  • A Novel Surgical Technique for Urgent Start PD

    Placing a PD catheter with a double purse-string around the inner cuff was safe and feasible for urgent start PD, finds a study of 135 catheter insertions between 2011 and 2018. Double-cuffed straight Tenckhoff catheters were implanted surgically or semi-surgically using the double purse-string technique, and the incidence of leakages, dislocations, peritonitis, and exit-site infection were low. There were no bleeding events, bowel perforations, or hernia formations.

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

  • Low-dose IV Iron Sucrose for Treatment of Anemia in PD

    A small study (n=18) of IV iron sucrose (200mg loading dose followed by 100mg monthly for 5 consecutive months) found reductions in ESA dosing for 5 patients and discontinuation in one, with no reported side effects.

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

  • PD—Controlling Volume to Reach Normal Hydration Protects the Heart

    Reanalysis of data from a multicenter, prospective, randomized controlled trial looked at fluid control in PD in 151 patients followed for a year. While most (120) reached normal hydration levels as measured by bioimpedance analysis, those who did not had significantly higher left atrial diameter—and a lower left ventricular ejection fraction at the end of the study.

    Read the abstract » | (added 2019-12-10)

  • Higher Serum Phosphorus Predicts More Residual Function Loss—in Men Only

    A retrospective analysis of 1,245 CAPD patients followed for up to 11 years divided participants into tertiles based on their baseline serum phosphorus levels. One third of patients lost residual renal function (RRF) during the study, and those with the highest baseline phosphorus levels had a 51% higher risk of RRF loss than those in tertiles 1 and 2 combined. The risk of RRF loss was significantly higher for men.

    Read the abstract » | (added 2019-12-10)

  • In-center Nocturnal HD: Fewer Complications than PD in Patients with PKD

    An analysis that matched PDK patients who did conventional HD (26) or PD (26) to in-center nocturnal HD (NHD; 13) found no significant difference in mortality—but after a median follow up of 5.5 years, NHD had significantly fewer complications than PD—and higher serum albumin levels as well.

    Read the abstract » | (added 2019-12-10)