Journal Watch

  • Is There a Best Practice for PD Exit Site Care to Prevent Infection?

    In a systematic review and meta-analysis, 2,092 studies were examined and 13 comprising 1,229 PD patients were selected for analysis (9 RCTs, 3 quasi-experimental, and one self-controlled trial). Five types of exit site care dressings were compared: named disinfection, antibacterial, non-antibacterial occlusive, sterile gauze, and no-particular dressings. No dressing was more effective than any other for preventing exit site infections or peritonitis.

    Read the abstract » | (added 2024-08-16)

    Tags: Systematic Review, Meta analysis, PD, Exit Site Infection. Peritonitis

  • Best Practices in Interventional Radiology for Peritoneal Dialysis

    The Italian Society of Nephrology has endorsed a practical core curriculum for interventional nephrology in PD and has made it available on the Society website. The core curriculum addresses abdominal wall hernias, catheter placement with open surgical technique, video laparoscopy, cuff-shaving and more.

    Read the abstract » | (added 2024-08-16)

    Tags: Peritoneal Dialysis, Interventional Nephrology, Catheter Placement, Hernia

  • Virtual Reality (VR) Training for PD

    Does all PD training have to be done face-to-face by a nurse, or is there a role for technology? VR-based training (stay•safe MyTraining) by Fresenius with a headset and hand controls was investigated in an interview study of seven nurses using the system with 2-5 patients each. The system was efficient, well-accepted, and improved the learning experience for patients, though it did not replace the need to handle PD materials and did not provide emotional or motivational support.

    Read the abstract » | (added 2024-08-16)

    Tags: PD Training, VR Training, Learning Experience, Patient Education

  • Risk Factors for Cognitive Impairment in Peritoneal Dialysis

    A retrospective analysis of 268 CAPD patients from January 2020 to September 2023. categorized participants into a cognitively impaired (CI; 58.2%) and a cognitively normal (CN) group. Logistic regression analysis identified male gender, older age, lower educational attainment, hypercholesterolemia, and elevated high-sensitivity C-reactive protein levels as independent risk factors for CI in CAPD patients (P < .05), while dialysis duration and residual renal function were protective against CI (P < .05).

    Read the abstract » | (added 2024-08-16)

    Tags: CAPD, Cognitive Impairment, Logistic Regression Analysis, Risk Factors

  • A Validated Measure to Predict PD Technique Failure

    Data from 424 adult PD patients were analyzed to construct a nomogram based on the best model (created with LASSO Cox regression). Model variables included hypertension, peritonitis, serum creatinine, LDL, triglycerides, fibrinogen, thrombin time, prothrombin activity, anemia, and serum albumin.

    Read the abstract » | (added 2024-07-12)

    Tags: Peritoneal Dialysis, Prediction Model, Technique Failure

  • A U.S. Staff-assisted PD Program

    Staff-assisted PD has been successful outside the U.S., but is it feasible in the framework of U.S. healthcare? A pilot program with 16 clinics from August, 2020 to October 2023 suggests that it can. Some indications for referral of patients (73 of 112 referred) who received staff assistance were physical function limitations, cognitive impairments, and/or psychosocial challenges. The duration of assistance was limited, with a median duration of 8 days, primarily for treatment set-up, observation, and direction.

    Read the abstract » | (added 2024-07-12)

    Tags: Staff assisted PD, Indications For Referral

  • Startling Proportion of Patients Chose PD or Home HD After a Dialysis Start Unit

    The University Health Network of Toronto examined the uptake of home dialysis between 2013 and 2021 among patients who started in a “Dialysis Start Unit” (equivalent to a transitional care unit in the U.S.). Of 122 patients, 68 (55.7%) chose either PD (57; 46.7%) or home HD (11; 9%).

    Read the abstract » | (added 2024-07-12)

    Tags: Home Hemodialysis, HHD, Peritoneal Dialysis, PD, Dialysis Start Unit

  • Which is Safer: Urgent Start HD or Urgent Start PD?

    Analysis of data from 9 studies (941 PD and 779 HD patients) revealed that the risk of all-cause mortality, dialysis-related infections, and mechanical complications were higher in patients who started HD urgently than in those who started PD urgently.

    Read the abstract » | (added 2024-07-12)

    Tags: PD, HD, All cause Mortality, Dialysis related Infections, Mechanical Complications, Urgent start

  • Management of PD Anemia in Japan

    Should people who use PD have the same hemoglobin (hb) targets as those who do HD? Researchers analyzed registry data of 4,875 patients 18 or older who were doing PD at the end of 2012 and compared their hb levels with mortality for the 1,586 who died. In a U-shaped curve, hb levels < 9.0 and > 13.0 were significantly associated with death. In those who had a history of cardiovascular disease, hb levels > 12.0 were significantly associated with death.

    Read the abstract » | (added 2024-06-14)

    Tags: Hemoglobin Targets, Mortality, Cardiovascular Disease

  • Personalized PD Prescriptions

    Urea alone is not able to assess dialysis adequacy. Rather than a focus on removing a single toxin, a more holistic, person-centered approach is emerging to improve well-being and minimize treatment burden—based on clinical outcomes and patient experiences of care. This approach requires close collaboration between patients and care teams and eliciting patient goals, priorities, and preferences. This paper reviews the evidence for a patient-centered approach to PD.

    Read the abstract » | (added 2024-06-14)

    Tags: Urea, Dialysis Adequacy, Treatment Burden, Patient centered Care, PD