Journal Watch

  • 44 Years of Home HD Technique Survival in Valencia, Spain

    In Valencia, 13.4% of patients on dialysis were using home HD in 2018. Researchers compared home HD data from two eras: “ancient” (1976-2000) and “modern” (2001-2020). Interestingly, 1- and 2-year patient survival were superior in the modern era (87.3% vs. 83.7% for 1-year; 83% vs. 77.4% for 2-year)—but 5-year survival was better in the ancient era (61% vs. 47.8%), as patients aged. Technique survival was better at every point in the modern era.

    Read the abstract » | (added 2023-02-13)

    Tags: Home HD, Patient Survival, Technique Survival

  • 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

  • Frequency of Sexual Dysfunction on PD

    A study enrolled 201 people who did CAPD for 3+ months (49 females and 65 males), with slightly more than half (n=114) under age 65). Gender-appropriate surveys administered in person, along with the SF-36 and Beck Depression Inventory (BDI) revealed that almost 90% of women and almost 88% of men reported sexual dysfunction. Depression was highly prevalent as well. The authors concluded that not discussing and treating sexual dysfunction could adversely affect quality of life.

    Read the abstract » | (added 2023-01-10)

    Tags: CAPD, Depression, Sexual Dysfunction, Quality Of Life

  • Do Pets Boost the Risk of Peritonitis on PD? A DOPPS Study

    Surprisingly, the answer was no. Among 3,655 PD patients from eight country followed for a median of 14 months (55,475 patient months), the peritonitis rate was 0.29 episodes per year, with no increased risk for pet ownership—except in households with both cats and dogs, where the risk was 45% higher.

    Read the abstract » | (added 2023-01-10)

    Tags: Pets, Peritonitis, PD, DOPPS

  • 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

  • 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)

    Tags: Medical Management, Dialysis Initiation, EGFR

  • 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

  • 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