Journal Watch
Who Matters Most for Modality Choice: Clinicians or Patients?
New Zealand has one of the highest rates of home dialysis use in the world—and they still believe there is room for improvement. An online study of all NZ dialysis clinics coupled with a measure of “decisional power” aimed to see who had the most influence on modality choice. While respondents believed that predialysis nurses were most influential, nephrologists still held the most decisional power—and a one point increase in nephrologist decisional power drove a 6.1% rise in home dialysis use.
Read the abstract » | (added 2017-12-14)
Tags: New Zealand, Home Dialysis, Modality Choice, Patients
In-hospital Patient Education Helps “Crash” Dialysis Starts to Consider PD
As many as half of people who start dialysis in the U.S. each year “crash” into a need for treatment with an urgent, unplanned start—and most receive HD with a catheter. The same is true in Germany, but a new structured education program changed the pattern. Compared to patients who started dialysis urgently before the program, those who were educated were significantly more likely to choose PD.
Read the abstract » | (added 2017-12-14)
Tags: Dialysis, Choose PD, PD Education
Mycophenolate Mofetil (MMF) and Residual Kidney Function in PD
A small randomized controlled trial of people on PD (N=60) looked at whether the immune-suppressing drug mycophenolate mofetil could help protect residual kidney function. After a year, those who received MMF had significantly higher urine volume and urine Kt/V than controls, with no serious complications.
Read the abstract » | (added 2017-12-14)
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)
New UK PD Guidelines
Download a free, full-length PDF if you want to learn how PD equipment, training, dose, infection control, and management of complications are done in the UK.
Read the abstract » | (added 2017-12-14)
Tags: PD Equipment, PD Training, Infection Control, PD Dose, PD Complications Management, UK
Olive Oil Polyphenols and Peritoneal Fibrosis
It’s not just for cooking any more. Researchers have studied the ability of components of extra virgin olive oil to prevent or treat fibrosis and thickening of the peritoneal membrane, both in vivo and in vitro. The polyphenols were not able to reverse fibrosis, but did help to prevent it, and the authors suggest further research.
Read the abstract » | (added 2017-12-14)
Tags: Extra Virgin Olive Oil, Fibrosis, Peritoneal Membrane, Polyphenols
Remote Monitoring in PD May Catch Problems Early and Reduce Costs
A simulation study using 12 patient profiles has determined that the ability to obtain clinical treatment information from PD could avoid the use of home and ER visits and hospital stays by identifying problems early, saving an estimated $7,088 to $23,364 across Italy, Germany, and the U.S. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Chronic Kidney Disease, Economics, End stage Renal Disease, Peritoneal Dialysis, Remote Therapy Management, Telemedicine
Barriers to Intensive HD in Pediatrics
Why don’t more people choose intensive hemodialysis? Responses to a survey by 134 of the 221 pediatric dialysis centers in the International Pediatric Dialysis Network found that more than 2/3 were aware of evidence supporting the benefits of intensive HD and half believed it produced the best outcomes (just 2% favored conventional HD). Key barriers included lack of funding and staff, with lack of expertise and motivation as minor factors. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Children, Financial Barriers, Home Dialysis, Intensified Hemodialysis, Nocturnal Hemodialysis
Risk Factors for Encapsulating Peritoneal Sclerosis
EPS is a rare but devastating complication of PD. Among a series of 703 PD patients in Japan between 1980 and 2015, 6.3% developed EPS. Identified risk factors included a history of longer-duration peritonitis and longer time on PD, while use of biocompatible PD fluid reduced the risk. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Biocompatible Peritoneal Dialysis Fluid, Dialysate To Plasma Creatinine (D/P Cr) Ratio By Peritoneal Equilibration (PET), Peritoneal Dialysis, Peritoneal Dialysis Duration, Peritonitis
Iron-based Binder Safe and Effective in PD
A study conducted with 84 PD patients compared sucroferric oxyhydroxide (n=56) to sevelamer (n=28). After a year, both groups had serum phosphate levels within the target range. The iron-based binder required fewer pills per day and resulted in fewer adverse events. Read the abstract.
Read the abstract » | (added 2017-11-13)
Tags: Chronic Kidney Disease, Hemodialysis, Peritoneal Dialysis; Phosphate Binder, Sevelamer Carbonate, Sucroferric Oxyhydroxide