Journal Watch

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  • Nephrologist-owned Dialysis Clinics and Home Therapies

    A study of the USRDS data set looked at ownership of adult dialysis clinics in 2017 caring for 251,651 patients. Those in nephrologist-owned clinics had a 2.4% higher probably of home dialysis, a 2.2% lower probability of receiving an ESA, and no significant difference in anemia treatment.

    Read the abstract » | (added 2022-11-16)

    Tags: Nephrologist owned Clinics, Clinical Outcomes

  • Urine Output on PD Predicts Solute Removal

    In an observational study of 93 people on CAPD (n=34) or APD (n=59) who still made urine, 24-hour urine collection correlated positively with removal of wastes + residual clearance. There was no significant difference between CAPD and APD.

    Read the abstract » | (added 2022-11-16)

    Tags: CAPD, APD, Urine

  • Extended HD and Nutrition

    An attempt to do a metaanalysis of the literature on the impact of daily and nocturnal HD (15+ hours per week) on nutritional status failed due to lack of sufficient high quality papers. In five studies of nocturnal and/or daily HD—three in-center and two at home—lean body mass improved significantly and one study found deficiency in water-soluble vitamins.

    Read the abstract » | (added 2022-11-16)

    Tags: Extended Hemodialysis, Nutrition, Lean Body Mass

  • The Varied Uses of Assisted PD in Spain

    In a retrospective look from 1997 through 2020, a Spanish clinic identified four groups who used assisted PD at some point. Group 1 was totally dependent at PD start, group 2 was self-care and then became totally dependent, group 3 needed short-term PD help, and group 4, the controls, remained on self-care. Of those who required assistance, 73% did so during follow up, not initially. Up to 44% of autonomous patients became dependent for various reasons over time, including loss of a care partner. Assisted PD—even when paying care partners—was less costly than switching to standard HD.

    Read the abstract » | (added 2022-10-17)

    Tags: Assisted PD, Dependency

  • PD: Sweat it Out to Reduce Fluid Overload

    In a small study, 4 people on PD used a portable sauna bath daily for 10 days, at 30 minutes a day and a temperature of 45°C. Most (51) of the 54 sauna sessions were well-tolerated; two people reported dizziness and one person with advanced diabetic neuropathy received a second degree skin burn. Body water loss and blood pressure improved significantly from the control period. Larger studies are needed.

    Read the abstract » | (added 2022-10-17)

    Tags: Diaphoresis, Fluid Overload, Sauna Bath, Sweat

  • Better COVID Survival with PD and Home HD

    Among 1,336 people whose kidneys failed between March, 2020 and January, 2021, 13.12% (n=178) contracted COVID-19. Of these, most (n=139) did standard in-center HD, and 33 (3.87%) died. On PD, 39 people developed COVID, and 1 (0.81%) died. On home HD, there were zero cases of COVID and no deaths. Five transplant patients developed COVID, with a mortality rate of 1.47%.

    Read the abstract » | (added 2022-10-17)

    Tags: Covid, Standard In center HD, PD, Mortality, Home HD, Home Hd And Covid, Transplant

  • Remote vs. In-person PD Training: Which is Better?

    It’s a tie, finds a small, retrospective Italian study comparing 21 in-home, in-person PD trainings from 2014 through 2016 to 25 video-based training from 2016 through 2018. After a home visit, PD training done by telemedicine. Actually, there were 5 episodes of peritonitis in the home training group—and 0 in the telemedicine group. And, 2-year technique survival with in-person training was 56.3%—while for telemedicine training, it was 76.9%.

    Read the abstract » | (added 2022-10-17)

    Tags: Remote Training, PD Training, Telemedicine

  • Savings from Incremental PD

    In a stud of 147 people who did incremental PD from 2009 through 2021, 11.9% transitioned to full-dose PD. Peritoneal glucose exposure was reduced by multiple kilos per year, and costs, plastic waste, and water use were also lower, as was time to manage PD.

    Read the abstract » | (added 2022-10-17)

    Tags: Healthcare Cost, Cost Analysis, Incremental PD, Full dose PD, Peritoneal Glucose Exposure

  • Safety of Exercise for Those Who Do PD

    A review of 25 studies of exercise in PD found only minor adverse events, mainly short-term muscle or joint pain or fatigue. There were no serious adverse events or signs of harm.

    Read the abstract » | (added 2022-09-13)

    Tags: PD, Peritoneal Dialysis, Exercise, Benefits, Adverse Events

  • Replacing Dextrose in PD Fluid—with Steviol Glycosides?

    Using glucose to remove water will scar the peritoneum over time—making PD a short-term option for most. Icodextrin (Extraneal®) is a glucose-free alternative. Now, researchers are looking at another one: steviol glycosides (SG), the compounds that make stevia taste sweet. Using artificial membranes and mice, dialysate with 1.5%, 1%, and even 0.75% SG had similar results as glucose-based fluids—with better biocompatibility.

    Read the abstract » | (added 2022-09-13)

    Tags: Dextrose, PD Fluid, Steviol Glycosides, Icodextrin