Journal Watch
Home Dialysis and Psychological Health
An interview study of 36 people on PD (n=13) or home HD (n=7) and care partners identified four themes and subthemes, including isolation and disconnection, importance of support systems, burden of distress, and seeking mental health support.
Read the abstract » | (added 2023-11-15)
Tags: Isolation, Support Systems, Distress, Mental Health Support
Steady Glucose Concentration in PD and Sodium Removal
In a small pilot study (n=8), two fast-average and six fast transporters used a standard 4-hour CAPD dwell as a control, and three 5-hour steady-concentration treatments using the Carry Life® UF device following an overnight icodextrin fill as the intervention. UF rates were significantly higher with the steady glucose concentration treatments, as were sodium removal and glucose UF efficiency.
Read the abstract » | (added 2023-11-15)
Tags: PD, Glucose Concentration, Sodium Removal
Surprising Impact of First Dialysis Modality on Survival in Patients with Diabetes
A retrospective cohort study of 739 patients from 2010 to 2018 (inclusive) used propensity score matching to compare mortality between standard HD and PD in China, matching 125 PD patients with HD patients. No significant differences were found—except in those with diabetes, who had significantly better survival with PD.
Read the abstract » | (added 2023-11-15)
Tags: Modality, Survival, Diabetes, Propensity Score Matching
How to Set Up New Home Dialysis Programs
More than half of U.S. dialysis clinics are either not licensed to train patients in PD or home HD, or are licensed but have no patients in their home programs. A new review article outlines the core domains needed to set up and run a home dialysis program in the U.S.
Read the abstract » | (added 2023-11-15)
Rate of Residual Kidney Function Decline and Mortality in PD
When 497 PD patients were divided into two groups based on RRF decline value, those in the fast-decline group had significantly higher rates of all-cause and cardiovascular mortality. In fact, each 0.1mL/min/1.73m2 per month drop in RRF in the first year of PD predicted a 19% higher risk of all-cause mortality and a 20% higher risk of cardiovascular mortality.
Read the abstract » | (added 2023-11-15)
Tags: Rate Of Residual Kidney Function Decline, All cause Mortality, Cardiovascular Mortality
Home HD Dose and Frequency Prescriptions
Current Kt/V formulas don’t guide nephrologists to prescribe home HD with low-flow machines. A study of 38 home HD patients resulted in 231 clinical data sets for urea modeling, which were analyzed using the Solute Solver software recommended by the KDOQI guidelines. The researchers chose 7 of the 62 potential combinations, assuming Monday blood draws, and found the new formula for stdKtV to be reliable and helpful for guiding clinicians.
Read the abstract » | (added 2023-10-13)
Tags: Home HD, Kt/V, Urea Modeling, StdKt/V
PD Patient Training to Enhance Independence and Prevent Complications
The ISPD recommends that PD clinics around the world develop training programs that will improve self-care. A new scoping review included 22 articles that recommend training for 5-8 days in the clinic or at home for a total of 15+ hours, using a 1:1 nurse-to-patient ratio and 1-3 hour sessions. Experienced nurses who use adult learning strategies were found to be effective.
Read the abstract » | (added 2023-10-13)
Tags: Patient Training, Training Programs, Self care, Adult Learning Strategies
Magnesium Inhibits the Peritoneal Calcification of Late-stage EPS in Mice
Encapsulating peritoneal sclerosis (EPS) is a devastating and potentially lethal complication of PD. The reasons for EPS are not clear, but phosphate loading seems to contribute to the condition. This study successfully induced peritoneal calcification in mice—and found that administering magnesium into the peritoneum suppressed fibrosis and calcification.
Read the abstract » | (added 2023-10-13)
Tags: Encapsulating Peritoneal Sclerosis, Magnesium, Peritoneal Calcification, EPS
Exercise and Quality of Life on PD
In a cross sectional study of 339 PD patients, 81.7% exercised a median of 5 hours per week, mainly slow walking. Those who exercised had better quality of life. Older age, female sex, higher BMI, and pain were independently associated with lower exercise capacity.
Read the abstract » | (added 2023-10-13)
Tags: PD, Exercise, Quality Of Life
Melatonin Shows Promise for Preventing Peritoneal Fibrosis
Glucose in peritoneal dialysate drives inflammation and angiogenesis, which lead to fibrosis that can cause loss of use of the membrane. A new study from China proposes that melatonin may break this cycle.
Read the abstract » | (added 2023-10-13)
Tags: Melatonin, Peritoneal Fibrosis, Glucose, GSDME, Pyroptosis