Journal Watch
U.S Nephrologists on When to Start Dialysis
While clinical practice guidelines recommend starting dialysis mainly on signs and symptoms, almost half of 255 nephrologists surveyed relied solely on eGFR. For them, a level of 8.4 meant dialysis—even in the absence of symptoms.
Read the abstract » | (added 2022-12-19)
Incremental PD (IPD) and Preservation of Residual Kidney Function
A single-center, retrospective study of IPD vs. standard PD (SPD) examined data from 87 patients, about 2/3 on IPD, with a median follow up of 23 months. IPD was associated with longer technique survival and significantly higher GFRs at 6 months and after 24 months.
Read the abstract » | (added 2022-12-19)
Tags: Incremental PD, IPD, Residual Kidney Function, Technique Survival
Cycler vs. Manual PD for Survival
A systematic review and meta-analysis looked at 17 studies of more than 230,000 people for PD failure and all-cause mortality with cycler vs. manual PD. Both options had equivalent PD technique failure. But, there was a significant survival advantage for automated cycler PD.
Read the abstract » | (added 2022-12-19)
Tags: Peritoneal Dialysis, PD, Modality, Automated Peritoneal Dialysis, APD, Continuous Ambulatory Peritoneal Dialysis, CAPD, All cause Mortality, ACM, PD Failure, Survival
Next Gen Sorbent Dialysis: Oral Sorbents with Carbon Block Columns?
Innovator Steven Ash is reimagining sorbent, as regenerating dialysate is complex. He is testing an oral sorbent to bind potassium, sodium, hydrogen, and ammonium, in animals. Carbon block columns can then bind organic and middle molecule toxins, and Ash believes the two technologies could simplify dialysis.
Read the abstract » | (added 2022-12-19)
Tags: Oral Sorbent, Uremic Toxins, Carbon Block
Serum albumin at 1 Year Predicts Long-term CAPD Outcomes
Among 436 patients using CAPD and followed for at least a year (48.25 + 24.05 months), each 1 g/dL increase in serum albumin at 1 year after PD start reduced the risk of death by 8.7%.
Read the abstract » | (added 2022-12-19)
Tags: Peritoneal Dialysis , Serum Albumin, CAPD, Mortality
Home HD Begins in Mainland China
Intrigued by observational studies suggesting better survival for home HD than in-center HD or PD—and reduced COVID exposure—a clinic in China established a training center and enrolled six patients. Patients were monitored by home visits, online, and by outpatient services. After an average of 16 months of training, three patients began independent dialysis at home, with no serious adverse events. Blood levels remained stable.
Read the abstract » | (added 2022-12-19)
Tags: Home HD, In center HD, PD, Infection, Mainland China
Impact of a 1-hour Discussion on Choice of a Home Dialysis Option
Of 620 incident dialysis patients in Japan from 2013 to 2021, 128 received a 1-hour discussion of treatment options. The discussion group had a tendency for fewer urgent hospitalizations—and had a significantly higher chance of choosing PD (30.7% vs. 9.4%).
Read the abstract » | (added 2022-11-16)
Tags: Patient Education, Dialysis Modality, Treatment Options
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)
A New PET Resource
How and why are peritoneal equilibrium tests (PETs) done? What are the various iterations? What can be learned from the results? Find out in this new review.
Read the abstract » | (added 2022-11-16)
Tags: Peritoneal Equilibrium Tests, PETs
Which Modality is Better Between Transplants: PD or HD?
Among 776 people in a registry who received a second kidney transplant, 656 did standard in-center hemodialysis (HD) between transplants, 72 did PD, and 48 went immediately to a second transplant. Those who did PD or went directly to a second transplant had better adjusted survival than those on HD.
Read the abstract » | (added 2022-11-16)