Journal Watch
Video-based vs. Traditional PD Training: Which is Better
PD could be expanded more quickly if training did not have to be done one-on-one in person. In Italy, Videodialysis has been used since 2016 for remote patient and care partner training, after an initial home visit. In a small series (46 trainings; 21 at home and 25 by video), the video technique was found to be as effective as traditional training with fewer home visits.
Read the abstract » | (added 2023-01-10)
Tags: PD Training, Videodialysis, Home Visits, Telemedicine
New PD Prescription Core Curriculum Update for 2023
Individualizing PD to align with patient lifestyle preferences should take precedence over small solute clearance targets, say global PD experts.
Read the abstract » | (added 2023-01-10)
Tags: Individualized PD, Patient Lifestyle, Solute Clearance, PD Prescription
A Safety Framework to Address Risk Factors for Home HD Dropout
In an effort to pre-emptively identify and reduce drop out risks from a new home HD program, a clinic in Singapore undertook failure mode and effects analysis (FMEA). They listed each key process and sub-process, scored them for failure mode, and designed solutions. The transition from in-center to home HD was found to have the highest failure risk, in 59 areas, so two teams with different clinical experience developed a safety framework.
Read the abstract » | (added 2023-01-10)
Tags: Home HD, Risk Factors, Drop Out Risk, Failure Mode And Effects Analysis, Safety Framework
Cycler vs. Manual PD for Survival
A systematic review and meta-analysis looked at 17 studies of more than 230,000 people for PD failure and all-cause mortality with cycler vs. manual PD. Both options had equivalent PD technique failure. But, there was a significant survival advantage for automated cycler PD.
Read the abstract » | (added 2022-12-19)
Tags: Peritoneal Dialysis, PD, Modality, Automated Peritoneal Dialysis, APD, Continuous Ambulatory Peritoneal Dialysis, CAPD, All cause Mortality, ACM, PD Failure, Survival
Next Gen Sorbent Dialysis: Oral Sorbents with Carbon Block Columns?
Innovator Steven Ash is reimagining sorbent, as regenerating dialysate is complex. He is testing an oral sorbent to bind potassium, sodium, hydrogen, and ammonium, in animals. Carbon block columns can then bind organic and middle molecule toxins, and Ash believes the two technologies could simplify dialysis.
Read the abstract » | (added 2022-12-19)
Tags: Oral Sorbent, Uremic Toxins, Carbon Block
Incremental PD (IPD) and Preservation of Residual Kidney Function
A single-center, retrospective study of IPD vs. standard PD (SPD) examined data from 87 patients, about 2/3 on IPD, with a median follow up of 23 months. IPD was associated with longer technique survival and significantly higher GFRs at 6 months and after 24 months.
Read the abstract » | (added 2022-12-19)
Tags: Incremental PD, IPD, Residual Kidney Function, Technique Survival
Home HD Begins in Mainland China
Intrigued by observational studies suggesting better survival for home HD than in-center HD or PD—and reduced COVID exposure—a clinic in China established a training center and enrolled six patients. Patients were monitored by home visits, online, and by outpatient services. After an average of 16 months of training, three patients began independent dialysis at home, with no serious adverse events. Blood levels remained stable.
Read the abstract » | (added 2022-12-19)
Tags: Home HD, In center HD, PD, Infection, Mainland China
U.S Nephrologists on When to Start Dialysis
While clinical practice guidelines recommend starting dialysis mainly on signs and symptoms, almost half of 255 nephrologists surveyed relied solely on eGFR. For them, a level of 8.4 meant dialysis—even in the absence of symptoms.
Read the abstract » | (added 2022-12-19)
Serum albumin at 1 Year Predicts Long-term CAPD Outcomes
Among 436 patients using CAPD and followed for at least a year (48.25 + 24.05 months), each 1 g/dL increase in serum albumin at 1 year after PD start reduced the risk of death by 8.7%.
Read the abstract » | (added 2022-12-19)
Tags: Peritoneal Dialysis , Serum Albumin, CAPD, Mortality
Urine Output on PD Predicts Solute Removal
In an observational study of 93 people on CAPD (n=34) or APD (n=59) who still made urine, 24-hour urine collection correlated positively with removal of wastes + residual clearance. There was no significant difference between CAPD and APD.
Read the abstract » | (added 2022-11-16)