Journal Watch
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Biocompatible PD Solutions Maintain Membranes Longer
Independently of inflammation, biocompatible PD solutions helped 71 patients keep a steady level of solute transport over 7.5 years, compared to 295 patients who used standard solutions. Read the abstract.
Read the abstract » | (added 09/10/2018)
Tags: Dialysis Solutions, Glucans, Glucose, Il6 Protein, Human, Inflammation, Interleukin 6, Peritoneal Fibrosis, Peritoneum, Peritonitis, Creatinine, Hospitalization, Icodextrin, Peritoneal Dialysis, Peritoneal Membrane
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PD Catheter Outcomes in Low vs. High-Volume Centers
Not surprisingly, patients whose PD catheters were placed at high-volume centers (in Japan) had fewer adverse events, needed feer blood transfusions, and had shorter hospital stays than those from low-volume centers. Read the abstract.
Read the abstract » | (added 09/10/2018)
Tags: Pd, Catheter, Hospital Volume
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Gender and Malnutrition in PD
Do hypoalbumineumia, overhydration, inflammation, and cardiovascular risk affect men and women on PD differently? A small study (N=26 men and 28 women) with comparable BMI found more fluid overload, inflammation, and heart risk in women with low serum albumin than in men. Read the abstract.
Read the abstract » | (added 09/10/2018)
Tags: Gender, Malnutrition, Cardiovascular Risk, Hypoalbuminemia, Inflammation, Overhydration, Peritoneal Dialysis
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5-year study: Predialysis PD Education Saves Lives on PD
Among 398 patients who started PD from 2007-2016, 169 had received predialysis education. After 5 years, this group had a significantly lower rate of peritonitis, a longer median time to a first peritonitis episode, and less risk of death from peritonitis than patients who did not get CKD education. Read the abstract.
Read the abstract » | (added 09/10/2018)
Tags: Pd, Predialysis, Peritonitis, Mortality, Ckd Education
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Blood Flow Rates and Clinically Meaningful Solute Removal
A prospective study of 17 patients looked at BFRs of 300, 350, and 450 and Kt/V urea, beta-2 microglobulin, and phosphorus when low dialysate flow rates were used. While Kt/V did increase, the impact on B2M and phosphorus were minimal.
Read the abstract » | (added 08/13/2018)
Tags: Daily Hemodialysis, Home Hemodialysis, Kt/V, Blood Flow
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Driving Home Dialysis Takes More Than Money
Are financial incentives enough to change nephrologist practice to favor home therapies? Only a little, finds a comprehensive literature review and an international workshop. Other levers, such as the framework of funding for clinics, nephrologist belief in home treatments, and direct costs to patients (e.g., utilities) may play a role as well.
Read the abstract » | (added 08/13/2018)
Tags: Home Dialysis, Financial Incentives, Nephrologist Practice
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Home HD After PD Failure May Lead to More Transplants, Lower Mortality
Since PD failure can lead to hospitalization and death in those who switch to standard in-center HD (ICHD), would outcomes improve with home HD? A new analysis found 521 patients in the USRDS data who made the change. Compared to matched ICHD patients, the chance of transplant was nearly double (21% vs. 10.6%), while survival of home HD patients was 89.1% at 1 year and 80.5% at 2 years.
Read the abstract » | (added 08/13/2018)
Tags: Pd Technique Failure, Ichd, Transplant, Home Hd, Lower Mortality
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Regional Variation in PD Infection Prevention
A PDOPPS analysis of surveys from medical directors caring for more than 11,000 patients from 170 clinics in seven countries (Australia, New Zealand, Canada, Thailand, Japan, the UK, and the US) found variation from 63% to 100% in use of antibiotic prophylaxis for PD exit sites, with mupirocin used most often.
Read the abstract » | (added 08/13/2018)
Tags: Peritoneal Dialysis Related Infections, Peritoneal Dialysis, Infections, Peritoneal Dialysis Outcomes
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The Secrets to Boosting Home Therapy Choice in Sweden
What factors make a choice PD or home HD more likely? A survey of Swedish patients found that receiving high quality, comprehensive predialysis information from three or more sources made a difference. Younger patients and men living with a spouse were also more likely to choose home, while those who lived close to a clinic were less likely. Once in-center, patients believed social interaction at the clinic influenced their choice.
Read the abstract » | (added 08/13/2018)
Tags: Dialysis Modality
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PD vs. In-Center HD for Stroke Risk
A systematic review of 15 cohort studies totaling nearly 1.3M ESRD patients concludes that PD had a significantly lower (16%) risk of hemorrhagic stroke, though the risks of other types of strokes were comparable.
Read the abstract » | (added 08/13/2018)
Tags: Dialysis, Hemodialysis, Meta Analysis, Peritoneal Dialysis, Stroke