Cardiovascular Outcomes Compared in PD vs. Home HD

Data from almost 69,000 patients in the USRDS who started PD or home HD to assess for rates of hospitalizations due to incident cardiovascular events (acute coronary syndrome, heart failure, stroke). While the unadjusted rate of cardiovascular events was higher in home HD than PD patients, the adjusted rates were lower for stroke and acute coronary syndrome. There was no difference in heart failure risk, but home HD was linked with a 22% lower adjusted risk of cardiovascular death.

Read the abstract » | (added 2024-02-07)

Tags: USRDS, PD, Home HD, Hospitalization Rate, Incident Cardiovascular Events

Short Daily HD, Muscle Strength, and Bone Health

A cross-sectional study compared a variety of parameters between 86 conventional HD patients and 92 short daily HD patients. The short daily HD patients had significantly higher serum albumin levels, Kt/V, and bone mineral density, required significantly fewer ESAs, and had lower phosphorus, inflammation, and PTH levels than conventional HD patients. Short daily HD patients also had significantly higher scores on the 6-minute walking test, stronger hand grips, lower fasting blood sugars, and higher hemoglobin levels.

Read the abstract » | (added 2024-02-07)

Tags: Bone Mineral Density, Conventional Haemodialysis, End stage Kidney Disease, Inflammation, Muscle Function, Short daily Haemodialysis

Finally: A Patient Reported Experience Measure for Home Dialysis

The Home Dialysis Care Experience survey is a new 26-item experience measure with one composite scale and two global rating scores, derived from 1,372 patients who use PD or home HD at 30 U.S. clinics. The measure was tested for floor and ceiling effects and test-retest reliability. Of the group, 495 patients completed at least one survey.

Read the abstract » | (added 2024-02-07)

Tags: Home Dialysis Care Experience Survey, Patient Reported Experience Measure

Non-mechanical Complications of PD

Learn from a review of non-mechanical PD complications, including oddly-colored PD effluent, encapsulating peritoneal sclerosis, and metabolic changes.

Read the abstract » | (added 2024-01-17)

Tags: Non mechanical PD Complications, Oddly colored PD Effluent, Encapsulating Peritoneal Sclerosis, Metabolic Changes

The Impact of Abdominal Adhesions on PD

A total of 758 people getting laparoscopic PD catheter placement in Canada; 27% with adhesions, were enrolled in a study of PD catheter complications. Among the adhesion group, 17% had catheter complications such as abdominal pain or flow restriction, vs. 10% in the group without adhesions. Yet, the majority did not have complications, even with adhesions.

Read the abstract » | (added 2024-01-17)

Tags: Intra abdominal Adhesions, Peritoneal Dialysis, Catheter Complications, Laparoscopic PD Catheter Placement

Mechanical Complications of PD

Learn from a review of mechanical PD complications, including leaks, hernias, dialysate flow issues, pain, and changes in breathing. Most of these happen early, due to catheter placement or dialysate filling, though late complications can also occur.

Read the abstract » | (added 2024-01-17)

Tags: Mechanical PD Complications, Catheter Placement, Dialysate Filling

Patient Training and Safety with Home HD

Despite the paramount importance of safety with home HD, there is “a surprising lack of literature” about it and no consensus on optimal training techniques or schedules, contend the authors of a new study.

Read the abstract » | (added 2024-01-17)

Tags: Home HD, Training Techniques, Home HD Training Schedules

Among Prediabetic Patients, PD Nearly Tripled the Risk of New Onset Diabetes vs. HS

A retrospective cohort study was done of 1426 non-diabetic end-stage renal disease (ESRD) patients who started PD or in-center HD. Over a 12 year period, 23% of the patients developed NODM. Among patients with prediabetes, those on PD had a 2.93 times higher risk of NODM than those on HD (p <0.001).

Read the abstract » | (added 2024-01-17)

Tags: ESRD, PD, In center HD, NODM, New Onset Diabetes Mellitus

Progression of Brain Atrophy in PD vs. HD

A follow-up study of brain atrophy progression followed 73 PD and 34 HD patients who had brain MRIs, including 42 PD and 25 HD patients who had a second brain MRI. Brain grey matter volume measurement demonstrated faster progression of brain atrophy in PD than in HD, independent of potential confounders.

Read the abstract » | (added 2024-01-17)

Tags: Brain Atrophy, PD, HD

Urgent-start PD vs. Urgent-start HD: Meta-analysis

Analysis of data from nine studies looking at all-cause mortality found a rate of 0.173 for urgent-start PD vs. .214 for urgent-start HD. Those who started PD urgently had lower risks of infection-related death, bacteremia, and other complications, though rates of cardiovascular and cancer mortality were similar.

Read the abstract » | (added 2024-01-17)

Tags: All cause Mortality, Urgent start PD, Urgent start HD, Infection related Death, Bacteremia