Journal Watch

  • What We Don’t Know About Insulin Dosing for PD or HD Can Hurt Us

    After 60 years of dialysis, we have a good sense of how to adjust insulin doses for PD and HD, right? Wrong. Even though diabetes is the leading cause of kidney failure, a systematic review of 11 articles found little information about insulin management.

    Read the abstract » | (added 2022-02-14)

    Tags: Insulin Dose, PD, HD, Insulin Management

  • Can Urgent PD Starts Use Incremental PD?

    In a retrospective study of 169 people who began PD, 111 started with incremental PD, while the remaining 58 began full-dose PD. Both groups were similar at the start. After 1 year, the full-dose group was on a higher PD prescription and had significantly higher PD adequacy numbers. Residual kidney function, blood pressure, anemia, and bone mineral correction were similar in both groups.

    Read the abstract » | (added 2022-01-14)

    Tags: Incremental PD, Full dose PD, PD Prescription, PD Adequacy, Urgent start Peritoneal Dialysis, Residual Kidney Function

  • PD and Home HD in the U.S. vs. Canada

    PD and home HD offer well-documented advantages and lower total costs in high-income countries. Both have seen growth in the US during the last decade, driven by payment changes and COVID-19—but US numbers still lag behind Canada and other countries.

    Read the abstract » | (added 2022-01-14)

    Tags: Peritoneal Dialysis, PD, Home Haemodialysis, HHD

  • Wound Vac Use Helpful for 7 Days After PD Catheter Placement

    A new PD catheter is surrounded by an open wound. Among 30 people who had PD catheters placed, half were randomly assigned to receive negative pressure wound therapy (wound vac) for 7 days. The other half received conventional dressings. The exit site scores were significantly better in the wound vac group, and their exit sites remained significantly better for the next 6 months, though peritonitis rates were the same.

    Read the abstract » | (added 2022-01-14)

    Tags: PD Catheter, Catheter Exit site Care, Infection, Wound Vac

  • Incremental PD with Residual Kidney Function: Safe and Effective

    Compared to 42 people who started full-dose PD, 54 who began incremental PD between 2015 and 2019 tended to be female, not have diabetes, and have more residual kidney function. PD technique survival, peritonitis, and hospitalization were about the same for both groups.

    Read the abstract » | (added 2022-01-14)

    Tags: Incremental PD, Residual Kidney Function, Full dose PD, Technique Survival

  • Cost of the Quanta SC+ in the UK

    In the United Kingdom, in-center hemodialysis costs more than £36,350 per year, which includes patient transport. Annual costs for use of the SC+ were estimated to be less: £26,642 for thrice weekly HD as home self-care, £30,235 for standard in-center HD; and £29,866 for 5x/weekly HD as home self-care.

    Read the abstract » | (added 2022-01-14)

    Tags: Quanta SC+, Hemodialysis Costs

  • Plastic vs. Metal Hemodialysis Needles: An International Nurse Survey

    Plastic HD needles help prevent infiltration and hematomas, especially in elbow-located, new, or fragile fistulae—yet most countries continue to use cheaper metal needles. A nurse survey found strong resistance to plastic cannulae among respondents. Reduction in adverse access events may reduce costs, staff time, and patient distress.

    Read the abstract » | (added 2022-01-14)

    Tags: Plastic HD Needles, Plastic Cannulae, Infiltration, Hematomas

  • Platelet-to-Albumin Ratio Predicts PD Technique Success and Survival

    Dividing patients’ absolute platelet counts by their serum albumin levels creates a protein-to-albumin ratio (PAR) that predicts PD outcomes, finds a new study of 405 people over a median of 2 years. Patients with lower PAR levels had higher rates of PD success and better survival.

    Read the abstract » | (added 2021-12-16)

    Tags: Platelet to albumin Ratio, Technique Failure, Mortality, Peritoneal Dialysis

  • Standard vs. Incremental PD Start: 12-year Retrospective Study

    When people start PD with some residual function, is it beneficial not to begin with a full PD prescription? A study looked back at 12 years of people who started PD, 232 standard and 71 intermittent (iPD; 2-3 manual exchanges per day). Those who did iPD had higher residual kidney function than those on standard PD. For people with diabetes, iPD was linked with a survival advantage as well.

    Read the abstract » | (added 2021-12-16)

    Tags: PD, Residual Function, Intermittent PD, IPD, Diabetes

  • Oral Hygiene and Nutritional Status on PD

    Clean teeth mattered for nutritional status and hand grip strength in a small study (n=41) of people on PD. Inflamed gums can cause tooth loss and limit what people can eat. Those with dirty to very dirty teeth had poorer nutrition than those with clean or slightly dirty teeth, and their hand grips were weaker. Those with dirty teeth also had more GI symptoms and a higher risk of malnutrition.

    Read the abstract » | (added 2021-12-16)

    Tags: PD, Tooth Loss, Malnutrition, Gingivitis, Periodontitis