Journal Watch
Color of Used PD Dialysate Gives Diagnostic Clues
A review article proposes a differential diagnosis of various conditions based on a change in the color of PD effluent from clear to red, orange, cloudy, milky white, green, yellow, purple or black.
Read the abstract » | (added 2018-08-13)
Tags: Bloody Effluent, Chyloperitoneum, Peritoneal Dialysis, Peritonitis, Rhabdomyolysis
Home HD After PD Failure May Lead to More Transplants, Lower Mortality
Since PD failure can lead to hospitalization and death in those who switch to standard in-center HD (ICHD), would outcomes improve with home HD? A new analysis found 521 patients in the USRDS data who made the change. Compared to matched ICHD patients, the chance of transplant was nearly double (21% vs. 10.6%), while survival of home HD patients was 89.1% at 1 year and 80.5% at 2 years.
Read the abstract » | (added 2018-08-13)
Tags: PD Technique Failure, ICHD, Transplant, Home HD, Lower Mortality
Regional Variation in PD Infection Prevention
A PDOPPS analysis of surveys from medical directors caring for more than 11,000 patients from 170 clinics in seven countries (Australia, New Zealand, Canada, Thailand, Japan, the UK, and the US) found variation from 63% to 100% in use of antibiotic prophylaxis for PD exit sites, with mupirocin used most often.
Read the abstract » | (added 2018-08-13)
Tags: Peritoneal Dialysis related Infections, Peritoneal Dialysis, Infections, Peritoneal Dialysis Outcomes
The Secrets to Boosting Home Therapy Choice in Sweden
What factors make a choice PD or home HD more likely? A survey of Swedish patients found that receiving high quality, comprehensive predialysis information from three or more sources made a difference. Younger patients and men living with a spouse were also more likely to choose home, while those who lived close to a clinic were less likely. Once in-center, patients believed social interaction at the clinic influenced their choice.
Read the abstract » | (added 2018-08-13)
Tags: Dialysis Modality
New Model Could Help Screen PD Patients for CeVD Risk
A new risk score could predict how likely new PD patients are to develop cerebrovascular disease down the road. The strongest predictors of CeVD were blood pressure, total cholesterol, and serum phosphate and sodium levels.
Read the abstract » | (added 2018-08-13)
Tags: Cerebrovascular Diseases, Mortality, Peritoneal Dialysis, Risk Prediction
Blood Flow Rates and Clinically Meaningful Solute Removal
A prospective study of 17 patients looked at BFRs of 300, 350, and 450 and Kt/V urea, beta-2 microglobulin, and phosphorus when low dialysate flow rates were used. While Kt/V did increase, the impact on B2M and phosphorus were minimal.
Read the abstract » | (added 2018-08-13)
Tags: Daily Hemodialysis, Home Hemodialysis, Kt/V, Blood Flow
Driving Home Dialysis Takes More Than Money
Are financial incentives enough to change nephrologist practice to favor home therapies? Only a little, finds a comprehensive literature review and an international workshop. Other levers, such as the framework of funding for clinics, nephrologist belief in home treatments, and direct costs to patients (e.g., utilities) may play a role as well.
Read the abstract » | (added 2018-08-13)
Tags: Home Dialysis, Financial Incentives, Nephrologist Practice
Lower B2M levels linked with WORSE survival on PD
Unlike HD, a new study of 725 incident PD patients divided into three beta-2 microglobulin tertiles found that the lowest third of B2m levels was associated with a higher risk of death. The increased risk was especially seen in females; older patients; and those with comorbidities, low BMI, low serum albumin, and less residual kidney function. Read the abstract.
Read the abstract » | (added 2018-07-13)
Tags: PD, B2m, Morbidity Rate
Nephrologists’ attitudes toward intensified HD
Among German nephrologists, 44% believe there is not enough evidence in favor of intensified HD, whether or not they offer it. Respondents cited a need for more funding and more staff to support the therapy. Among the 44% who did offer the option, most reserved it for patients who were not receiving adequate treatment with conventional HD, and just 19% offered it routinely. Read the abstract.
Read the abstract » | (added 2018-07-13)
Tags: Intensified HD
Does RRF affect quality of life in CAPD?
The SF-36 was given to 120 adult patients on CAPD for at least 3 months, divided into a group with and without residual renal function. There were no correlations between RRF and total SF-36 scores. However, SF-36 scores did correlate with measures of inflammation, fluid overload, and malnutrition. Read the abstract.
Read the abstract » | (added 2018-07-13)