Journal Watch
Italians Improve on Daily Home HD
As in the U.S., the Italian Ministry of Health has home dialysis as a primary objective. In a 2-year study of seven people switched to six times per week daily home HD, significant improvements began to appear almost immediately. After 3-6 months, bone mineral balance and blood pressure were better, PTH levels and use of phosphate binders dropped, and the participants needed less rhEPO.
Read the abstract » | (added 2021-11-12)
Tags: Home Dialysis, Daily Home HD, RhEPO, Mineral Balance, Blood Pressure, PTH Levels
New Clinical Practice Guidelines for Exercise on PD
The International Society for Peritoneal Dialysis and the Global Renal Exercise Network have teamed up to grade and review the literature and clinical experience to help people on PD stay physically active safely. With sparse quality evidence available, the new guidelines are largely opinion based, and cover timing of exercise relative to PD (i.e., empty or full); impact of exercise on mental health, weight, frailty, etc.; exercise nutrition, and potential adverse PD outcomes.
Read the abstract » | (added 2021-11-12)
Tags: Peritoneal Dialysis, Exercise, Physical Activity, PD Outcomes
Lower salt diet and residual kidney function on PD
Sixty-two people on PD were divided into three groups by salt intake (<6 grams/day, 6-8 grams/day, and>8 grams/day). One year later, those with the highest salt intake had the fastest decline in residual kidney function.
Read the abstract » | (added 2021-10-13)
Tags: PD, Salt Intake, Residual Kidney Function
PD and home HD patients less stressed by COVID-19
Does the social isolation of PD or home HD contribute to a negative psychosical impact from COVID? Apparently not. Forty patients (85% on home HD) responded to a COVID impact survey sent to 98 home HD and 43 PD patients in Toronto. About 80% rated their dialysis satisfaction at 8/10 or higher, had infrequent anxiety or depression, felt dialysis had minimal impact on their lives, and were almost always happy with their family interactions. Just 9% were often worried about caregiver burden. The authors suggest that home is “the optimal form of dialysis.”
Read the abstract » | (added 2021-10-13)
Tags: Home HD, COVID 19, Coronavirus
Low serum vitamin D levels, anemia, and inflammation on PD
When 62 people on PD were compared to 56 healthy volunteers, the PD group had significantly lower vitamin D levels—and significantly higher inflammatory markers (HS-CRP, IL-6, and TNF-α). The researchers concluded that low vitamin D levels contribute to anemia, oxidative stress, and microinflammation.
Read the abstract » | (added 2021-10-13)
Tags: PD, Vitamin D, Inflammatory Markers, Anemia, Oxidative Stress, Microinflammation
Home HD Core Curriculum, 2021
COVID-19 and policy changes have revived interest in home HD, so nephrologists need to better understand the therapy. This article focuses on factors in successful training and retention, including benefits, pitfalls, challenges, new equipment, prescriptions, and more.
Read the abstract » | (added 2021-10-13)
Lessons from Europe: How to Grow PD
Analysis of 575 survey responses to a hypothetical case study of an unplanned dialysis start found that about 1/3 would recommend emergent start PD. About another 1/3 would start unplanned HD—and plan to educate about PD later. Predialysis education about PD, dedicated PD catheter placement teams, and other initiatives were most helpful.
Read the abstract » | (added 2021-09-14)
Tags: Peritoneal Dialysis, Emergent Start PD, Unplanned HD, PD Incidence, PD Prevalence
Learn About PD on YouTube
People cannot choose PD if they do not know it exists. A study assessing 295 YouTube PD videos found that those targeted to professionals had higher information quality than those aimed at consumers. More easy-to-understand PD videos that describe benefits are needed, and could help to raise awareness of this option.
Read the abstract » | (added 2021-09-14)
Tags: PD Awareness, PD Videos, PD Benefits
A Home First Policy Helps Drive Home Therapy Choice
In the multinational Peridialysis study, of 1,587 people starting dialysis, 32.5% were judged “unsuitable” for a home treatment due to contraindications—or a lack of assessment. Among the suitable 1,071, 65.4% chose PD and 3.6% chose home HD, and the remainder went in-center. Late referral, suboptimal dialysis initiation, acute illness—and no “home dialysis first” policy were factors linked to use of in-center HD.
Read the abstract » | (added 2021-09-14)
Tags: Lack Of Assessment, Glomerular Filtration Rate, Haemodialysis, Peritoneal Dialysis, Pre dialysis, Uraemia
Urgent Start PD: Better Survival, Fewer Complications than Urgent Start HD
A metaanalysis pooling data from seven studies found that urgent start PD was linked with significantly better survival than urgent start HD, though infectious complications were comparable. Urgent start PD had significantly less risk of mechanical complications as well.
Read the abstract » | (added 2021-09-14)
Tags: Urgent start Peritoneal Dialysis, Survival, Urgent Start HD, Mechanical Complications, Infectious Complications