Journal Watch

  • Mobile Health Readiness of Home vs. In-Center Dialysis Patients

    Smartphones and other mobile devices can be used to deliver health messages. In a survey of 949 patients from 14 home and 21 in-center dialysis clinics, 81% had mobile devices to get online, and 72% used the Internet, some (18%) despite concerns about data privacy and security. Younger, non-Hispanic, and more educated patients were more likely to use mobile health, and working patients had the highest rates of proficiency. After adjustment, in-center and home patients were equally proficient with mobile health.

    Read the abstract » | (added 2021-01-12)

    Tags: Kidney Disease, Hemodialysis, Telehealth, Telemedicine

  • Are In-center Hemodialysis Patients Interested in Self-Care?

    In-center self-care can be a bridge to home hemodialysis. A survey of 91 patients and 31 nurses revealed higher interest among the patients than the nurses (2.43+0.93 vs. 2.19+0.77). Patients also considered themselves to be capable of performing self-care tasks. Greater interest and perceived capability were linked with years of education, patient activation, disease severity, and age.

    Read the abstract » | (added 2020-12-10)

    Tags: Renal Dialysis, Self‐care, Self‐management

  • Nephrology Fellows Not Ready for Home Dialysis

    Even nephrology fellows attending home dialysis conferences did not feel prepared to care for PD or home HD patients, finds a small study. Of 110 attendees, 76 (66%) completed a survey about their confidence with regard to management of home dialysis. Most were “moderately” confident about PD principles—though just 11% had seen a PD catheter insertion, and only 3% had initiated a patient on urgent start PD. Most had “low” confidence in their ability to manage home hemodialysis.

    Read the abstract » | (added 2020-12-10)

    Tags: Education, Home Dialysis, Nephrology Fellowship

  • Use of CMS-reimbursed CKD Education Doubles the Likelihood of Home Dialysis

    While Medicare has paid for stage 4 CKD kidney disease education (KDE) since 2010, only a tiny fraction have used it—but KDE matters, finds an analysis of 369,968 patients who started dialysis between 2010 and 2014. Just 3,469 (0.9%) had received at least one KDE session, but compared to controls matched for age, gender, ESRD Network and year of dialysis start, they were twice as likely to have started a home dialysis treatment. Concerningly, African American and Hispanic patients were significantly less likely to have received KDE services.

    Read the abstract » | (added 2020-12-10)

    Tags: Home Dialysis, Kidney Disease Education, Peritoneal Dialysis

  • Prolonged PD Training Linked with Higher Peritonitis Risk

    A single center retrospective analysis of all PD training sessions from 2001 to 2018 (135 patients) found that the 23% whose training lasted longer than 13 sessions had a significantly higher risk of peritonitis, though technique survival was not reduced. Factors associated with prolonged PD training included older age, diabetes, and unemployment.

    Read the abstract » | (added 2020-12-10)

    Tags: Peritoneal Dialysis, Peritoneal Dialysis Learning

  • The Influence of Perceptions on PD Burnout

    A focus group study conducted with 81 PD patients and 45 care partners in Australia, Hong Kong, and the United States identified relentlessness and feeling overwhelmed by daily responsibilities as a factor in burnout. Building resilience and finding a new normal and meaning in other activities may be protective.

    Read the abstract » | (added 2020-12-10)

    Tags: Burnout; Dialysis, Peritoneal Dialysis

  • Benefits of Remote PD Monitoring

    Compared to 38 standard care PD patients, 35 who received remote monitoring (RM) for 6 months had better outcomes despite higher Charlson Comorbidity scores. The RM group lived further from the clinic or had mobility issues, but were more satisfied with their care, and they had fewer emergency room visits and nephrology-related hospitalizations.

    Read the abstract » | (added 2020-12-10)

    Tags: Quality Of Life, Remote Monitoring

  • Exercise May Improve Residual Kidney Function in PD

    A post-hoc study of a 12-week randomized controlled trial of home exercise for PD patients eliminated those with anuria (n=18) and analyzed 13 patients in the usual care group and 16 in the exercise group. Two RKF markers, liver-type fatty acid-binding protein (L-FABP) and the microalbumin-to-creatinine ratio, were significantly lower in the exercise group.

    Read the abstract » | (added 2020-12-10)

    Tags: Microalbumin to creatinine Ratio, Peritoneal Dialysis

  • Which Form of PD Has a Higher Risk of Peritonitis?

    If you guessed CAPD because there are more exchanges to perform, you are correct, finds a study that matched 106 APD to 106 CAPD patients and followed them for 3 years. During the study period, there were 64 cases of peritonitis, and the risk was 30% higher among those who did CAPD.

    Read the abstract » | (added 2020-11-12)

    Tags: PD, Peritoneal Dialysis, CAPD

  • Complications in Planned vs. Unplanned Peritoneal Dialysis Starts

    A metaanalysis of 14 papers totalling 2,401 PD patients looked at the outcomes and safety of unplanned PD starts within 7 days of catheter placement vs. 7-14 days. Early-start PD was linked with more leaks, omental wrap, and—for CAPD—catheter malposition. There were no significant differences in infectious complications, but the risk of transition to HD and mortality were higher. More studies are needed.

    Read the abstract » | (added 2020-11-12)

    Tags: End Stage Kidney Disease, Peritoneal Dialysis, PD