Journal Watch
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Incremental PD may preserve residual kidney function longer
A single-center observational study in Korea followed 347 patients; half started full-dose PD and half started incremental PD. While patient, technique, and peritonitis-free survival were similar between groups, the incremental PD group had a significantly lower risk of losing all of their kidney function (anuria).
Read the abstract » | (added 07/15/2019)
Tags: Full Dose Pd, Incremental Pd, Residual Kidney Function
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10-year retrospective study of urgent-start PD
Among urgent-start 2,059 PD patients followed for a decade, older patients were less likely to have PD catheter failure than younger ones, while men and people with diabetes had higher catheter failure rates. Lower hemoglobin levels predicted more abdominal wall complications. Overall, urgent-start PD was safe and effective, and a well-trained team and comprehensive follow up were recommended.
Read the abstract » | (added 07/15/2019)
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Half of PD patients may develop a new glucose disorder
A metaanalysis of nine studies with a total of 13,879 PD patients found that 8% had new-onset diabetes, 15% developed impaired glucose tolerance, and 32% had newly abnormal fasting blood sugar levels. No differences were found by ethnicity. The authors concluded that PD patients should receive glucose tolerance tests.
Read the abstract » | (added 07/15/2019)
Tags: Pd, Diabetes, Glucose Tolerance, Blood Sugar Levels, Glucose Tolerance Test
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Bioimpedance Assessment of Conventional vs. Daily HD
In a small physiological study, 12 patients were switched from conventional (3x/week) to daily (6x/week) HD treatments. Baseline and monthly blood pressure, BMI, and bioimpedance measurements were gathered on participants. Among the 9 patients who completed the data collection, body composition was not altered--but fluid overload was reduced and fewer antihypertensive medications were needed.
Read the abstract » | (added 06/13/2019)
Tags: Conventional Hd, Daily Hd, Blood Pressure, Bmi, Bioimpedance, Fluid Overload, Antihypertensive Medications
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Frequency vs. Time in HD Survival
Which matters more for HD--the number of treatments per week, or the length of each treatment? A retrospective registry study from the ANZDATA database looked at survival among 16,944 non-indigenous adult patients in Australia and New Zealand from 2001 to 2015. After controlling for frequency, patients with 5+ hour long treatments had significantly better survival than those whose treatments <5 hours. However, controlling for duration, increasing frequency did not boost survival.
Read the abstract » | (added 06/13/2019)
Tags: Anzdata, Session Frequency, Session Duration, Survival, End Stage Kidney Disease
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Low vs. Very Low Site PD Catheter Placement to Prevent Migration
A retrospective 5-year series of 76 patients whose PD catheter tips migrated had received either a traditional low-site insertion (N=39) or a very-low-site insertion (N=37). After 2 years of follow up, the very-low-site group had significantly better catheter and patient survival, with fewer catheter complications—and no tip migration.
Read the abstract » | (added 06/13/2019)
Tags: Catheter Dysfunction, Catheter Migration, Pd Catheter, Peritoneal Dialysis Catheter, Patient Survival
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BMI and Survival on PD
A large study from Korea (N=80,674 PD patients) found that those in the highest group for BMI: just 25.71, had significantly higher all cause mortality.
Read the abstract » | (added 06/13/2019)
Tags: Body Mass Index, Survival, Diabetes Mellitus, Peritoneal Dialysis, Mortality
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Will Zinc Supplements One Day Help Prevent Peritoneal Sclerosis?
Ironically, PD saves lives, but high-glucose PD fluid damages the peritoneum, leading to fibrosis that can make PD impossible. By activating a complex metabolic pathway, a study in rats found that supplementing with zinc helped prevent fibrosis.
Read the abstract » | (added 06/13/2019)
Tags: High Glucose Pd Fluid, Peritoneum, Fibrosis, Zinc
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Moving the PD Exit Site to Combat Infection
A 5-year retrospective cohort analysis looked at the impact of treating PD exit site and tunnel infections in 27 patients by removing the cuff and relocating the catheter under local anesthetic. After follow up ranging from 10.8 to 79.4 months, no leaks occurred, and the infections resolved in 74% of the patients. The rest had to have their catheters removed.
Read the abstract » | (added 06/13/2019)
Tags: Exit Site Relocation, Exit Site Infection, Tunnel Infection, Peritoneal Dialysis Catheter, Pd Catheter
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Higher Serum Albumin May Protect Residual Kidney Function in PD
In a prospective study of 104 new PD patients, having low serum albumin levels was independently associated with complete RKF loss (<100 mL/day of urine).
Read the abstract » | (added 06/13/2019)
Tags: Serum Albumin, Residual Kidney Function, Urine Volume, Peritoneal Dialysis, Pd