Journal Watch

  • How to Prevent and Manage COVID-19 in PD Patients

    A comprehensive set of recommendations from China suggest reinforcing hygiene education, avoiding fear, and encourage patients to stay home—deferring clinic visits or using virtual ones when possible.  When clinic or hospital visits are necessary, safety steps are described in detail.  Covid-19 positive patients must be quarantined.  Download the article

    Read the abstract » | (added 2020-05-12)

  • Universal AVF Back-up for PD Patients Reduces HD Catheter Use

    Should an arteriovenous fistula always be placed as a PD back-up for new patients? A retrospective study of two hospitals examined this question. Hospital RAH (n=142) did universal AVF back-up at PD start. Hospital PAH (n=232) did selective AVF back-up for “high risk” patients only. Yet, the transfer-to-HD rate at RAH was about half that of RAH (23% vs. 43%)—as was the HD catheter usage rate (33% vs. 65%; p<0.001), despite a population at RAH that was more likely to be older, Caucasian, and have diabetes.

    Read the abstract » | (added 2020-05-12)

  • PD Catheter Placement Outcomes: Urgent- vs. Elective-start

    After analyzing 13 years of data comparing urgent-start (n=29) and elective-start (n=211) PD, the only significant difference between the mostly-comparable groups was a higher incidence of catheter leaks. Complication and catheter removal rates at 3 and 12 months were similar, as were days to first complication and 12-month patient survival. Catheter placement technique did not affect the outcomes.

    Read the abstract » | (added 2020-05-12)

  • Bioimpedance-measured Fluid Overload and Short Daily HD Survival

    In 297 patients switched from thrice-weekly to 5-6 sessions per week of in-center short daily HD (SDHD), predialysis hydration was measured at initiation of SDHD and 6 and 18 months later using bioimpedance. Compared to patients whose predialysis fluid overload (FO) was <15% of extracellular volume (ECV), those whose FO was >15% of ECV had no survival difference by 6 months. However, at 18 months, those with an FO <15% had 91% survival, while those whose FO was >15% had just 72% survival (p = 0.0006), and remained significant after adjustment for demographic, clinical, and laboratory variables.

    Read the abstract » | (added 2020-05-12)

  • Are PD eHealth Initiatives Ready for Prime Time?

    A review of 15 studies (n=1,334) of use of telemedicine and eHealth to support PD self-management found bias and low-quality evidence that made a metaanalysis impossible. While no adverse effects of eHealth interventions were reported, effectiveness was mixed. Better quality evidence is needed.

    Read the abstract » | (added 2020-05-12)

  • Cardiovascular Benefits of Benefits

    A review considers the impact of nocturnal HD on cardiac remodeling, myocardial stunning, hypertension, heart rate variability, sleep apnea, coronary calcification, and endothelial dysfunction.

    Read the abstract » | (added 2020-04-13)

  • Effect of a Nurse-led Program on PD Nutritional Status

    In a controlled trial, 203 PD patients were randomly assigned to a study or control group. The study group received health education, treatments, case management, and nurse-led surveillance based on the Omaha system. The control group received usual care. After intervention, the study group had significantly more well-nourished patients (6.19% to 29.9%), and several other parameters were significantly improved as well. Hemoglobin, albumin, and pre-albumin were also significantly higher in the study group.

    Read the abstract » | (added 2020-04-13)

  • Outcomes Between Urgent-start PD and HD

    Urgent-start PD (n=93) and urgent-start HD (n=91) patients similar in age, diabetes and other comorbidities, and lab values, were followed for 6 months to 2 years. Rates of mechanical complications, bacteremia, and survival were comparable. Exit site/access infections were significantly higher in the PD patients, but those on PD had significantly better residual kidney function and phosphorus control, and used significantly less erythropoietin and antihypertensives

    Read the abstract » | (added 2020-04-13)

  • Impact of Assisted PD

    A retrospective look at 1,576 incident patients at one clinic between 2002 and 2017 examined the effects of offering assisted PD on the rates and cumulative incidence of PD starts. Those who used assisted PD tended to be older. Use of the program significantly increased the rate of PD initiation, but there was a fall in usage over time.

    Read the abstract » | (added 2020-04-13)

  • Double Purse String Suture for Urgent Start PD Catheters

    An Italian article reports that use of a double purse-string technique allowed immediate CAPD starts within 24 hours of catheter placement, with no difference in complications (mechanical or infectious) or catheter survival between surgical or trocar placement.

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