Journal Watch

  • Higher HD Dose Linked with Better Survival

    A national registry of 32,283 standard HD patients found that “a higher dose of dialysis was consistently associated with better survival.” Kt was most discriminating, with survival highest in the upper Kt quartile. Arteriovenous access, hemodiafiltration, scheduled dialysis initiation, and long weekly HD hours predicted higher Kt.

    Read the abstract » | (added 2021-07-12)

    Tags: Dialysis Frequency, Survival, Kt, Mortality

  • Is Endoscopy Safe in PD?

    Peritonitis can occur after endoscopy. A retrospective 10-year review divided 570 PD patients who had 1,316 endoscopies into three groups. Group 1 did not have prophylactic antibiotics. Group 2 did have them. Group 3 had prior antibiotics. An analysis of the peritonitis rates within 7 days of the procedures found a 3% rate that was not affected by whether or not antibiotics were given.

    Read the abstract » | (added 2021-07-12)

    Tags: Endoscopy, Peritoneal Dialysis, Peritonitis

  • Safety Study of the PD Automated Wearable Artificial Kidney

    In the AWAK pilot study, 15 participants used up to nine sessions over 72 hours and were then followed for one month. There were no serious adverse events, but 60% of participants had abdominal pain and 47% reported bloating. Median body weights were not significantly different before and after the study. Device enhancements will address ultrafiltration and pain.

    Read the abstract » | (added 2021-06-15)

    Tags: Wearable Kidney, Artificial Kidney, Chronic Kidney Disease, Peritoneal Dialysis

  • PDOPPS Findings of Factors Important to Peritonitis Outcomes

    The Peritoneal Dialysis Outcomes and Practice Patterns Study analyzed factors in the outcomes variations among 1,631 peritonitis episodes in 1,190 patients in seven countries. About 2/3 of the bouts were successfully cured, which was more likely with Gram-positive organisms, automated PD, and use of icodextrin (facility level), aminoglycosides, and ciprofloxacin vs. ceftazidime for Gram-negative organisms.

    Read the abstract » | (added 2021-06-15)

    Tags: Peritoneal Dialysis, Peritonitis, Peritoneal Dialysis And Outcomes Practice Patterns Study

  • PD vs. Standard In-Center HD for Stroke Risk: A 14-year Study

    Of 7,916 ESRD patients with atrial fibrillation between 2001 and 2013, data from 363 PD and 5,302 HD patients were analyzed. At 1 year, 3 years, and 5 years, the participants who used PD had significantly lower risks for outcomes including stroke, major bleeding, and intracranial hemorrhage than those using HD.

    Read the abstract » | (added 2021-06-15)

    Tags: ESRD, End Stage Renal Disease, Atrial Fibrillation, Peritoneal Dialysis, Hemodialysis, Patient Outcomes

  • Funding U.S. Dialysis Innovation: The Role of TPNIES

    CMS is expanding reimbursement to encourage use of home treatments under the transitional add-on payment for new and innovative equipment and supplies (TPNIES). An up to 26% reimbursement to clinics requires machines to be eligible under the substantial clinical improvement (SCI) criteria—but these have not been adapted for home dialysis and may not be suitable.

    Read the abstract » | (added 2021-06-15)

    Tags: Home Dialysis, Transitional Add on Payment For New And Innovative Equipment And Supplies, TPNIES

  • In-center Nocturnal HD Improves Quality of Life vs. Standard In-center HD

    A small prospective cohort study of standard in-center HD patients (n=36) who switched to in-center nocturnal HD compared baseline health-related quality of life to levels 12 months later. Among the 24 who completed the study and permitted follow up, the mental component score increased by 7.1 points, and improvements were seen in several domains.

    Read the abstract » | (added 2021-06-15)

    Tags: In center Nocturnal Hemodialysis, Health related Quality Of Life, End stage Renal Disease, KDQOL 36

  • Home vs. In-center HD Outcomes from a Matched Cohort

    After adjusting for BMI, smoking, race, and comorbidities, home HD came out ahead of in-center HD when 181 home HD patients were matched to 413 using in-center HD. With home HD, the risk of death was significantly less, and phosphate levels were significantly lower. There were no major differences in transplant rates, graft survival, hemoglobin, calcium, or PTH levels.

    Read the abstract » | (added 2021-06-15)

    Tags: Dialysis Modality; End stage Kidney Disease; Haemodialysis, Hemodialysis, Home Haemodialysis, Home Hemodialysis, Mortality

  • The impact of low magnesium levels on heart disease deaths on PD

    Hypomagnesemia is linked with all-cause mortality in HD—but, what about PD? A study classed 1,004 blood tests from PD patients measuring magnesium into one of three groups: <0.7 mmol/L, 0.7-1.2 mmol/L, and >1.2 mmol/L. Those in the lowest magnesium group did have a higher risk of death from both heart and non-heart causes.

    Read the abstract » | (added 2021-05-14)

    Tags: Noncardiovascular Disease, Peritoneal Dialysis, PD

  • PD vs. standard HD for health-related quality of life, and employment

    A DOPPS study analyzed data from 7,771 standard in-center HD and PD patients in six countries. Those from Japan had the highest physical functioning and employment rates—with PD better than HD. The U.S. had the highest mental functioning and lowest employment rates. During one year, physical and mental function did not change much.

    Read the abstract » | (added 2021-05-14)

    Tags: Kidney Disease, Employment, DOPPS