Journal Watch
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)
Tags: Polycystic Kidney Disease, Conventional Dialysis, In center Nocturnal HD, Nocturnal Hemodialysis, Mortality
European Patients Live Longer with Extended HD Treatments
Compared to standard in-center HD, patients from eight European countries who dialyzed for 6+ hours thrice weekly lived longer. Of 142,460 patients, 1,338 did extended HD. Compared to in-center HD (13.5/100 person-years), crude mortality for extended HD (6.0/100 person-years) was significantly better. Overall, those treated with extended treatments were 73% more likely to have survived.
Read the abstract » | (added 2019-12-10)
Tags: Survival, Extended hours Hemodialysis, Haemodialysis, ERA EDTA Registry
Is PD Unwise for Patients with Lupus Nephritis?
A small study found 92.4% (1 year), 84.7% (3 year) and 67.6% (5 year) patient survival among 28 non-diabetic lupus patients doing PD—compared to 100% (1 year), 93.5% (3 year), and 82.9% (5 year) among 56 controls. While the lupus was not directly associated with mortality, it was a risk factor for PD technique failure, infection, and hospitalizations.
Read the abstract » | (added 2019-11-16)
Tags: Patient Survival, Lupus, PD, Mortality, Technique Failure, Infection, Hospitalization
Is PD a Good Option for Patients with Liver Cirrhosis?
A study matched patients with cirrhosis who did PD, patients with cirrhosis who did HD, and non-cirrhosis patients on PD by age, sex, catheter placement date, and diabetes status. PD technique failure and all-cause mortality were similar between patients with and without cirrhosis.
Read the abstract » | (added 2019-10-14)
PD Outcomes under the Medicare Expanded Dialysis Prospective Payment System
A Medicare change in 2011 may have increased the likelihood that clinics would expand PD to a broader population. Did this affect outcomes? A prospective cohort study compared 10,585 patients who started PD before payment reform, 7,832 interim patients, and 18,742 during the reform period. With similar demographics, more patients were treated in clinics with less PD experience—and these clinics had higher PD discontinuation rates. But, PD discontinuation fell overall, and mortality risk was stable.
Read the abstract » | (added 2019-10-14)
Tags: Expanded Dialysis Prospective Payment System, PD, Medicare
Glycated Albumin vs. HbA1c Predicts Mortality in PD Patients with Diabetes
In patients on hemodialysis, glycated albumin (GA) reflects glycemic control and predicts all-cause mortality. A new retrospective, longitudinal observational study looked at GA in PD. Among 44 PD patients with diabetes matched to 88 HD patients with diabetes followed for 3 years, GA was a more precise way to measure glycemic control than hemoglobin A1c.
Read the abstract » | (added 2019-09-11)
Tags: Peritoneal Dialysis, All cause Mortality, Glycaemic Control, Glycated Albumin, Glycated Haemoglobin
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
BMI and Survival on PD
A large study from Korea (N=80,674 PD patients) found that those in the highest group for BMI: just 25.71, had significantly higher all cause mortality.
Read the abstract » | (added 2019-06-13)
Tags: Body Mass Index, Survival, Diabetes Mellitus, Peritoneal Dialysis, Mortality
Wanted: A Paradigm Shift from Urea to Sodium Removal
When nephrology icon Zyblut Twardowski talks, we listen! When dialyzors in Seattle in the 1960s got 30 hours a week of dialysis, the mortality rate was 10%. Since then, short treatments—justified by the flawed NCDS study—were driven by the equally flawed notion of Kt/V urea.
Read the abstract » | (added 2018-12-14)
Tags: Kt/V Urea, Mortality Rate, Sodium Removal, Dialysis Quality, NCDS, RCT
Protein Clearance Predicts Mortality on PD
Protein clearance on PD may be a marker of peritoneal inflammation. Among 711 PD patients followed for at least one year, each 10mL/day rise in protein clearance was linked with a 10.4% increase in the risk of all-cause mortality (p=0.008). Protein clearance was linked with serum albumin and C-reactive protein levels.
Read the abstract » | (added 2018-12-14)