The Impact of Abdominal Adhesions on PD

A total of 758 people getting laparoscopic PD catheter placement in Canada; 27% with adhesions, were enrolled in a study of PD catheter complications. Among the adhesion group, 17% had catheter complications such as abdominal pain or flow restriction, vs. 10% in the group without adhesions. Yet, the majority did not have complications, even with adhesions.

Read the abstract » | (added 2024-01-17)

Tags: Intra abdominal Adhesions, Peritoneal Dialysis, Catheter Complications, Laparoscopic PD Catheter Placement

Urgent-start PD vs. Urgent-start HD: Meta-analysis

Analysis of data from nine studies looking at all-cause mortality found a rate of 0.173 for urgent-start PD vs. .214 for urgent-start HD. Those who started PD urgently had lower risks of infection-related death, bacteremia, and other complications, though rates of cardiovascular and cancer mortality were similar.

Read the abstract » | (added 2024-01-17)

Tags: All cause Mortality, Urgent start PD, Urgent start HD, Infection related Death, Bacteremia

Is Wearable HD Moving Forward?

A review article contends that wearable kidney replacement will “radically reshape the landscape of kidney replacement therapies and have the potential to dramatically improve the lives of individuals living with kidney failure.” Great, but when?

Read the abstract » | (added 2024-01-17)

Tags: Wearable Kidney Replacement, Kidney Replacement Therapies, Quality Of Life

A Home Dialysis Primer for Internists

Since PD and home HD are increasing in use due to their clinical and practical advantages, clinicians need to understand these treatments. A new primer in the Annual Review of Medicine will help them do just that.

Read the abstract » | (added 2023-12-15)

Tags: Home Dialysis, HD, PD, Home Dialysis Primer

High Ultrafiltration Volumes May Contribute to Pruritus

Could changes in skin perfusion and inflammation play a role in dialysis itching? An observational study of 392 patients looked at self-reports of pruritus severity and UF volumes. BMI and UF volume independently predicted pruritis severity.

Read the abstract » | (added 2023-12-15)

Tags: Ultrafiltration Volume, UF Volume, BMI, Pruritus, Skin Perfusion, Inflammation

Dietary Protein Intake and Survival on PD

Among 668 stable PD patients followed for up to 13 years, quarterly 3-day dietary records were collected for 2 ½ years. Dietary protein intake greater than 0.8 g/Kg/day improved long-term survival.

Read the abstract » | (added 2023-12-15)

Tags: Dietary Protein, Survival, PD

Perhaps Prophylactic Omentectomy Should be Standard in Pediatric PD Patients

A meta-analysis of nine studies and 775 patients found significant reductions in catheter obstruction in children who had an omentectomy at the time of PD catheter placement. There was a trend toward reduced rates of PD catheter removal or reinsertion as well.

Read the abstract » | (added 2023-12-15)

Tags: Prophylactic Omentectomy, Pediatric PD, Catheter Obstruction

The PD Surprise Question Predicts Transfer to HD

An observational study of 1,275 PD patients in 35 programs asking the RN and treating nephrologist, “Would you be surprised if this patient transferred to HD in the next 6 months?” identified 15% as high risk. After 6 months, the transfer to HD rate was nearly four times higher in the high risk group than the low risk group.

Read the abstract » | (added 2023-12-15)

Tags: PD, Home Dialysis, Peritoneal Dialysis, Surprise Question

How Sugar Harms the Peritoneum and Causes Fibrosis

HOW does sugar harm the peritoneum? An RNA sequencing study looked at peritoneal endothelial cell (EC) function in mice and human ESRD cells in the presence or absence of glucose. In mice, glucose increased EC proliferation, permeability, and inflammation. Blocking glucose caused a therapeutic benefit. Human cells reacted in a similar way.

Read the abstract » | (added 2023-12-15)

Tags: Sugar, Glucose, Peritoneum, RNA Sequencing, Endothelial Cell Function

Lessons from Almost 15,000 PD Catheter Placements

Of the various PD catheter placement techniques, laparoscopy had higher 6-month mechanical complications, exit site infections, revision, and removal rates, while fluoroscopy had higher rates of sepsis and death. Open surgery had higher rates of catheter displacement.

Read the abstract » | (added 2023-12-15)

Tags: PD Catheter Placement Technique, Laparoscopy, Mechanical Complications, Exit Site Infections, Revision, Removal Rates, Fluoroscopy, Sepsis, Death