Journal Watch
Fat Mass May Protect Bones and Muscles on PD
Among 359 PD patients, 25% had osteoporosis, 32% had sarcopenia, 15% had osteosarcopenia, with considerable overlap between these conditions. Using body composition monitoring, fat tissue index (FTI) and lean tissue index (LTI) were measured. Low FTI—but not normal or high FTI—was linked with all three conditions, even after adjusting for age and BMI.
Read the abstract » | (added 2024-09-12)
Tags: PD, Osteoporosis, Sarcopenia, Osteosarcopenia, Fat Mass, Fat Tissue Index, FTI, Lean Tissue Index, LTI
Value of Remote Monitoring of PD
A cluster-randomized trial assigned 21 hospitals with automated PD (APD) programs to either do remote monitored (RM-APD; 10 hospitals) or conventional APD (11 hospitals) for 398 adult patients initiating PD. In the conventional APD group, all-cause mortality, cardiovascular deaths, and hospitalizations were significantly higher, as were PD dropouts and adverse events and hospitalizations related to cardiovascular disease, fluid overload, or poor PD adequacy.
Read the abstract » | (added 2024-09-12)
Tags: Automated PD, APD, All cause Mortality, Cardiovascular Deaths, Hospitalizations, Cardiovascular Disease, Fluid Overload, PD Adequacy
Frailty and Transfers from PD to HD
In an 11-year, single-center, retrospective study, incident PD patients (n=182) were assessed with the clinical frailty scale from 1 (very fit) to 7 (severely frail). In 379 patient years at risk, there were 42 deaths and 69 transfers from PD to HD. The rates of death and transfer to HD were twice as high among patients whose frailty score was >4.
Read the abstract » | (added 2024-09-12)
Self-efficacy Support for Home Dialysis Patients
Data were extracted from 15 primarily quantitative studies of home dialysis training programs promoting self efficacy. Researchers identified that self-efficacy builds over time, with two themes that included gaining skills and building and maintaining knowledge. Multifaceted strategies and support from nurses, families, and peers helped patients develop self-efficacy around home dialysis.
Read the abstract » | (added 2024-09-12)
Potential Benefits for Tidal (TPD) vs. Intermittent PD (IPD)
A study randomized 85 patients to TPD (n=43) or IPD (n=42) and followed them for up to 2 years. Of the total, 19 patients died and 25 stopped PD. There were no differences in overall survival or technique survival among the remaining patients, but those who did TPD had significantly higher urine volume (p=0.001) as well as lower BUN (p=0.002) and phosphorus (p=0.004) and fewer cycler alarms (p<0.001). The TPD group had a higher chance of reporting abdominal fullness (p=0.001).
Read the abstract » | (added 2024-09-12)
Tags: Tidal PD, TPD, Intermittent PD, IPD
PD vs. HD for Women’s Sexual Function (But, Would Intensive HD be Better?)
Women (n=200) with non-dialysis CKD, HD, CAPD, and controls who completed the Female Sexual Function Index (FSFI) were analyzed by treatment group. The control group had the highest FSFI mean scores. The point means between PD and standard HD were nearly identical, except for sexual satisfaction, which favored CAPD (p<0.05). NOTE: Intensive HD was not compared in this study—but may prove to be helpful.
Read the abstract » | (added 2024-09-12)
Tags: PD, HD, Female Sexual Function Index, FSFI
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