Journal Watch

  • Healthcare System Factors in Home Modality Choice

    A Midwest interview study was conducted with 40 people, half doing standard in-center HD. Access to and engagement in healthcare prior to nephrology care and after dialysis start had an impact on patients’ awareness of their CKD, its progression, and dialysis options—and most had been passive during decision-making. Level of fatigue, treatment schedule, and access problems affected satisfaction.

    Read the abstract » | (added 2022-08-11)

    Tags: Standard In center HD, CKD Progression, Dialysis Options, Shared Decision making

  • Frequent HD Shortens Recovery Time—Even in Nursing Homes

    In a study of 2,309 people receiving 14 hours of more frequent HD in skilled nursing facilities (SNFs), 92% reported recovery time of 2 hours or less. Those who received five treatments per week or had systolic blood pressure of 160-179 prior to treatment had greater odds of rapid recovery.

    Read the abstract » | (added 2022-07-13)

    Tags: ESRD, Home Hemodialysis, More Frequent Dialysis, Mortality, Nursing Home, Post dialysis Recovery Time

  • Home Dialysis Associated with Higher Patient Activation

    Increased patient activation is linked with better health outcomes. Among 182 people starting dialysis who took the Patient Activation Measure (PAM) survey at month 1 and month 4, those who did home dialysis tended to have higher PAM scores than those who did in-center treatments.

    Read the abstract » | (added 2022-07-13)

    Tags: Patient Activation, Health Outcomes, Dialysis, Patient Activation Measure, PAM, Home Dialysis

  • Fatigue at PD Start Linked with Higher Mortality

    A PLOS One study compared 4,285 incident PD patients who completed a KDQOL-SF vitality scale from Brazil (1,388) and the U.S. (2,897) from 2004 to 2011. Lower vitality scores after 90 days of PD were linked with a higher risk of mortality in both countries

    Read the abstract » | (added 2022-07-13)

    Tags: Fatigue, Incident Peritoneal Dialysis, Vitality, Mortality

  • Safety and Efficacy of Wearable PD

    The automated wearable artificial kidney (AWAK) uses sorbent technology. In a pilot study done in Singapore, patients used the AWAK for 72 hours and were followed up for a month. Among the 15 patients who took part, the AWAK had to be altered to fix blocked flows, but no serious adverse events occurred. Abdominal pain (60%) and bloating (47%) were reported.

    Read the abstract » | (added 2022-07-13)

    Tags: Peritoneal Dialysis, Automated Wearable Artificial Kidney, AWAK, Sorbent Technology

  • Spiritual Well-being and PD Outcomes

    The Peritoneal Dialysis Outcomes and Practice Patterns (PDOPPS) study has looked at whether spiritual well-being (SWB) affects PD outcomes, using a survey of SWB and SF-12 results. Among 529 people on PD who completed the surveys, 70% had moderate or higher SWB scores, which were positively correlated with higher physical and mental functioning and burden of kidney disease scores, and linked with less likelihood of depression.

    Read the abstract » | (added 2022-07-13)

    Tags: Peritoneal Dialysis Outcomes, PDOPPS, Spiritual Well being, SWB

  • Structured CKD Education More Than Tripled Uptake of Home Therapies

    In a matched retrospective cohort study, 2,398 CKD patients who attended a single 90-minute education program were pair-matched with others who did not. Compared to controls, those who attended the session were significantly more likely to be doing home dialysis (38.5% vs. 12.6%) and to be using a permanent access (57.9% vs. 33.8%). Hospitalization rates were 38% lower as well, and education-attendees had lower first-year mortality.

    Read the abstract » | (added 2022-07-13)

    Tags: CKD, Education Program, Home Dialysis, Permanent Access, Hospitalization Rates, First year Mortality

  • Rapid Differentiation of PD Peritonitis Causes

    Eosinophilic vs. microbial peritonitis requires different treatment, but cultures take days—and still may not find the cause. A center used effluent microscopy—slides of gram-stained PD fluid under a microscope—to determine if microbes were present and if so, which types. Among 250 people between 2007 and 2017, there were 155 at-risk cases of peritonitis, hemacolor staining was key to differentiating the cause and guiding treatment.

    Read the abstract » | (added 2022-07-13)

    Tags: Eosinophilic, Microbial, Peritonitis, Effluent Microscopy, Hemacolor Staining

  • Prospective Cohort Study of Urgent-start APD

    Can automated PD be used for urgent-start dialysis? A study from China enrolled 68 people who needed to start treatment urgently and did either APD (52.9%) or HD. After following for an average of 20.1 months, the APD group had “significantly fewer short-term dialysis-related complications,” and lower hospital costs. Both groups had similar technique survival, infection rates, and patient survival.

    Read the abstract » | (added 2022-07-13)

    Tags: Automated Peritoneal Dialysis, Cost effectiveness, End stage Renal Disease, Esrd, Urgent start

  • In Which Countries Do People Stay on PD Longer?

    The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) analyzed time on PD among 218 randomly chosen clinics and 7,121 patients in seven countries including the U.S. Median time on PD ranged from 1.7 years in the UK to 3.2 years in Japan and Thailand. PD mortality risk was higher in Thailand and the U.S., and infection was the leading cause of transfers to HD.

    Read the abstract » | (added 2022-06-10)

    Tags: Peritoneal Dialysis Outcomes And Practice Patterns Study, PDOPPS, PD, Mortality, Hemodialysis Transfer, Kidney Transplantation