Journal Watch

  • Survival Benefit of More HD Hours is Not Sustained After a Switch Back to Standard

    In the ACTIVE Dialysis trial, 200 standard HD patients were randomized to receive usual care (median of 12 hours of HD/week) or extended hours (median of 24 hours of HD/week) for 12 months, with follow up through 60 months. After the 12 months, intervention group participants were switched back to usual care. At 5 years, there was no difference between the groups in all-cause mortality.

    Read the abstract » | (added 2020-10-12)

    Tags: Dialysis, End stage Kidney Disease

  • 24-hour Dietary Recall Less Accurate for Protein Intake Assessment in PD

    Among 50 PD patients, use of protein nitrogen appearance (PNA) revealed levels of protein that ranged from 48.27-67.74 grams per day; median 55.75—while 24-hour dietary estimated the levels at 45.28-87.40; median 61.43 g/day. The authors suggest that proportionality bias may have influenced the results.

    Read the abstract » | (added 2020-10-12)

    Tags: Dialysis Initiation, Dialysate, Peritoneal Dialysis, PD

  • Pilot: Chlorhexidine-impregnated Sponge Dressings to Prevent Exit Site Infections

    In a single-center study, 50 incident PD patients were taught to use a weekly chlorhexidine dressing on their exit sites, and followed for a year. While 12% developed contact dermatitis, 73% found the dressings acceptable. Episodes per patient year of exit-site/tunnel infections and peritonitis were 0.09 and 0.07, respectively, while 1-year technique and patient survival rates were 86% and 96%, respectively.

    Read the abstract » | (added 2020-10-12)

    Tags: Chlorhexidine Dressing, Exit site Infection, Peritoneal Dialysis

  • Physical Activity May Reduce Bone Density in PD

    In a paradoxical finding, 13 women and 21 men on PD who were sedentary had higher BMD than those who were moderately or vigorously physically active. Other aspects of body composition and biochemistry, such as creatinine clearance and triglyceride levels were linked with higher levels of physical activity.

    Read the abstract » | (added 2020-10-12)

    Tags: Body Composition, Bone Density, Muscle Strength

  • Benefits of PD Remote Monitoring

    A retrospective study compared two groups of APD patients, one that received remote monitoring (n=38) and one that received routine care (n=35). PD dropout and fluid status were similar between the two groups. But, the remote monitoring group had fewer ER and hospital visits related to kidney disease, especially among those with more comorbidities. Patients also preferred remote monitoring, and were more satisified with their care.

    Read the abstract » | (added 2020-09-11)

    Tags: Clinical Outcomes, Quality Of Life, Remote Monitoring, Telemedicine

  • Impact of Depression on PD Patient and Technique Survival

    Among 275 patients who had done CAPD for at least 3 months, 31.3% tested as having depressive symptoms. Long-term patient and technique survival were significantly poorer in this group, even adjusting for cofounders.

    Read the abstract » | (added 2020-09-11)

    Tags: Depressive Symptoms, Mortality, Peritoneal Dialysis

  • Aspergillus Peritonitis Review

    Compared to other fungal peritonitis, colonization with aspergillus is more dangerous, and identification is still a challenge. Among 55 cases reported in the literature between 1968 and 2019, the mortality rate was 38.3%, 85.5% had to have their PD catheter removed, and 81.8% of patients had to switch to HD.

    Read the abstract » | (added 2020-09-11)

    Tags: Aspergillus, Mortality, Peritoneal Dialysis, Peritonitis

  • PD vs. Standard HD for Cognitive Function

    A metaanalysis of papers including 195,774 patients looked at whether PD or standard in-center HD better supported cognitive function. The authors found significantly less risk of cognitive impairment among those who did PD.

    Read the abstract » | (added 2020-09-11)

    Tags: Cognitive, Renal Failure

  • Advantages of PD in Primary Glomerulonephritis (PGN)

    A prospective observational study followed all incident PD patients (n=2,243) who had PGN in the Levante registry from 1995 to 2014. Compared to other diagnoses, those with PGN had a significantly lower rate of peritonitis and better mean survival. The authors conclude that “PD has several advantages as a first dialytic treatment, and our results suggest that it is an excellent technique to manage patients with PGN while they await a kidney transplant.”

    Read the abstract » | (added 2020-09-11)

    Tags: Patient Survival, Peritoneal Dialysis, Primary Glomerulonephritis

  • International Use of HD—Including Home HD

    A new survey of stakeholders in 182 countries (with respondents from 160 countries) found a use rate for HD of 298.4 per million. Among incident dialysis patients, the HD rate was 98.0. Standard in-center HD was available among 27% of low-income countries (and these patients paid more of the costs); home HD was available in 36% of high-income countries. Monitoring of patient-reported outcomes was done in 61% of countries, while 60% monitored bone minerals and patient survival, and 51% monitored technique survival. Just 5% of countries initiated patients on HD with arteriovenous access.

    Read the abstract » | (added 2020-09-11)

    Tags: Hemodialysis, Homedialysis, HD