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  • 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)

    Tags: Peritoneal Dialysis, Dialysis, Chronic Kidney Disease, Nursing, Nutritional Status, Omaha System

  • 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)

    Tags: Haemodialysis, Renal Function Recovery, Peritoneal Dialysis, Urgent Start

  • Nocturnal HD in Children

    There are very few studies of the impact of intensified hemodialysis regimens (days/hours) on children. This review addresses implementation challenges.

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

    Tags: Intensified Hemodialysis, Children, Implementation Challenges

  • Peritonitis with Diarrhea Could be C-diff

    Cloudy PD dialysate can signal infectious peritonitis from a variety of causes—including C-diff. But, use of cephalosporins could worsen a C-diff infection. A new article presents two case histories of C-diff peritonitis and suggests reexamining the traditional empiric treatment of peritonitis when diarrhea is present.

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

    Tags: PD Dialysate, Infectious Peritonitis, C diff, Cephalosporins, Empiric Treatment, Diarrhea

  • Physician Reimbursement Increases Did Not Drive PD in Canada

    Among a cohort of 4,262 patients in Alberta, Canada followed between 2001 and 2014, an increase in PD physician pay from $0 to $135 (over a 9-year period) revealed no statistical evidence of a difference in PD use or trends—and the role of the physician in modality selection was unclear.

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

    Tags: PD Physician Pay, PD Use Trend

  • Glucose Degradation Product (GDP) Disrupts Peritoneal Membrane Function

    Growth of new, immature blood vessels on the peritoneal membrane is linked with ultrafiltration failure. Exposure to the GDP methylgyoxal (MGO) up-regulated both vascular endothelial growth factor (VEGF) and suppressed platelet-derived growth factor (PDGF) in vitro, potentially disrupting the balance of angiogenesis.

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

    Tags: Peritoneal Membrane, Ultrafiltration Failure, Methylgyoxal, Angiogenesis

  • 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)

    Tags: Double Purse string, CAPD Starts, Catheter Placement, Catheter Survival

  • Why Early Survival on PD Matters

    If survival between PD and standard in-center HD “evens out in the end,” does it matter? Yes, argues Mark Marshall, MD, from New Zealand. The early survival benefit increases patient life years—and persists even when accounting for use of central venous HD catheters. To support shared decision-making, patients have the right to know about survival on PD vs. standard HD.

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

    Tags: Survival, PD, In center HD, Early Survival, HD Catheter

  • Glucose and Peritonitis

    A prospective, longitudinal cohort study followed 105 PD patients for up to 5 years (mean of 23 months). Higher glucose exposure significantly predicted peritonitis, and patients with more residual kidney function also had a significantly longer time to first bout of peritonitis. Read the abstract. The authors suggest using the lowest concentration of glucose possible.

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

    Tags: Glucose Exposure, Peritoneal Dialysis, Peritonitis

  • Patient and Clinic Factors Driving Home Dialysis in Australia/New Zealand

    Among 54,773 patients in 76 centers in the ANZDATA registry, an overall 45% (0-87%) were using some form of home dialysis. Males, people of color, and patients who were older, had comorbidities, experienced late nephrology referral, lived remotely, or were obese had lower uptake of home therapies. Smaller centers, those with shorter hours, and clinics who had fewer patients with permanent access had lower uptake as well.

    Read the abstract » | (added 2020-02-19)

    Tags: Uptake Of Home Dialysis, Dialysis Centers