Mechanism of AGE Damage to Peritoneal Membranes

Advanced glycation end-products (AGEs) are a well-known reason for peritoneal inflammation, though we didn’t know why. Researchers developed a way to study the Maillard reaction in collagen at near-physiological temperatures and found markedly increased permeability to small and medium-sized molecules as well as reduced proliferation of adherent mesothelial cells.

Read the abstract » | (added 2025-05-20)

Tags: Advanced Glycation End products, AGEs, Peritoneal Inflammation, Maillard Reaction

Glucose Exposure: Incremental vs. Full-dose PD

A 2-year retrospective study of 117 patients (46 incremental; 71 full-dose) with a 12 or more months of PD and 24-hour urine volume > 500 mL analyzed Q6-month cardiometabolic parameter trends: dry weight, BMI, HbA1c, cholesterol, serum glucose. HbA1c—lower in incremental PD users—was the only significant baseline difference between groups. The incremental group had significantly less estimated cumulative glucose exposure.

Read the abstract » | (added 2025-05-20)

Tags: Glucose Exposure, Incremental, Full dose PD, Cardiometabolic Parameter Trends

Guidelines Drive European Home Dialysis Practice

A consensus meeting held in Copenhagen, Denmark in 2023 investigated ways to improve home dialysis uptake, which was at a 10.5% prevalence and 13.3% incidence across Europe. Interestingly, national guidelines for advanced kidney care patient education drove uptake: home dialysis prevalence was significantly higher in countries with guidelines.

Read the abstract » | (added 2025-04-23)

Tags: National Guidelines, Advanced Kidney Care Patient Education, Home Dialysis Prevalence, Home Dialysis Uptake, Europe

Seniors, PD, and Inappropriate Prescriptions

No study has previously assessed what percent of people over age 65 on PD are receiving the correct doses of prescribed drugs. Unfortunately, this study finds that a large minority may not be.

Read the abstract » | (added 2025-04-23)

Tags: Seniors, PD, Inappropriate Prescriptions, Correct Dose

Promising Ways to Increase Use of Home Dialysis

A scoping review of 43 studies categorized interventions to increase home dialysis uptake into three categories: education, service provision, and payment modifications. What worked best? Education aimed to enhance dialysis options knowledge and promote shared decision-making among patients, families, and clinicians and providing services like assisted PD. Payment intervention effectiveness depended on context.

Read the abstract » | (added 2025-04-23)

Tags: Home Dialysis, Home Modality, Patient Education, Provision, Home Dialysis Uptake, Shared Decision making

Impact of Hurricane Helene on the PD Supply Chain

Hurricane damage to Baxter’s North Cove plant—which produces 60% of U.S. IV solutions—significantly disrupted patients’ ability to start or even continue PD. This analysis highlights healthcare vulnerabilities due to climate change.

Read the abstract » | (added 2025-04-23)

Tags: Hurricane, Emergency Planning, PD Supply

The Impact of Rural Outreach in West Virginia on Home Dialysis

Of 22,408 WV patients who started dialysis between 1965 and 2020, 13% overall started with a home modality—but this figure was 18% in counties that had a rural outreach kidney care clinic.

Read the abstract » | (added 2025-03-13)

Tags: Dialysis, Home Modality, Rural Outreach

Laparoscopic vs. Open PD Catheter Placement

Analysis of 11,731 PD catheter insertions from 2013 to 2018 examined the association between type of placement, complications, length of hospital stay, and mortality. During the 5-year period there was a significant increase in laparoscopic PD insertions. Complications were similar between groups, with slightly longer hospital stays for open placements.

Read the abstract » | (added 2025-03-13)

Tags: PD Catheter, Complications, Laparoscopic PD Insertions

Progress in PD Fluid

While glucose-based PD fluids are inexpensive, non-physiological PD fluid can, ironically, damage the peritoneum and cause devastating complications including peritoneal fibrosis and encapsulating peritoneal sclerosis (EPS). Neutral pH and solutions low in glucose degredation products (GDPs) help preserve peritoneal integrity and residual renal function, while using other osmotic agents such as icodextrin can improve ultrafiltration. Alternative buffers are also helpful.

Read the abstract » | (added 2025-03-13)

Tags: PD Fluid, Glucose Degredation Products, Icodextrin, Peritoneal Fibrosis, Encapsulating Peritoneal Sclerosis

Can PD Patients Safely Exercise?

A systematic review and meta-analysis founc nine randomized controlled trials of 398 patients, of whom 199 were randomized to a physical activity group. After 3-6 months of follow up, the exercise group had significant improvements in such diverse measures as social support, social interaction, pain, sitting and standing, and insulin-resistance. However, C-reactive protein levels increased significantly.

Read the abstract » | (added 2025-03-13)

Tags: Physical Activity, Exercise, C reactive Protein Levels