Journal Watch

  • Safety of Bedside PD Catheter Placement During COVID-19

    Urgent-start PD is being used to address acute kidney injury due to COVID-19. A New York hospital successfully placed 14 PD catheters bedside to minimize use of critical hospital resources. The catheter did not work in one patient, who required HD. Another had bleeding stopped with compression and withholding of anticoagulants. The remaining 12 worked at follow up (3-18 days), with long-term follow-up suggested.

    Read the abstract » | (added 2020-06-10)

    Tags: Acute Kidney Injury, Requiring Renal Replacement

  • Soy Isoflavones Reduce Heart Disease Risk Factors in PD

    A trial randomly assigned 40 PD patients to a soy isoflavone or placebo group, and took several measures of inflammation at baseline and 8 weeks. At the end of the study, those in the soy group had significant decreases in serum VCAM-1 and serum ICAM-1, two cardiovascular disease risk factors in PD patients

    Read the abstract » | (added 2020-06-10)

    Tags: Systemic Inflammation, Heart Disease, Soy Isoflavones

  • 10-year PD Survival

    In a group of 533 incident PD patients (mean starting age of 48 +16 years) followed from 2006 until 2018, survival at 1 year was 93%, at 3 years 81%, at 5 years 64%, and at 10 years 36%. Encapsulating peritoneal sclerosis (EPS) occurred in 1.3%.

    Read the abstract » | (added 2020-06-10)

    Tags: Peritoneal Dialysis, Mortality, Long Term Outcome

  • Are PD eHealth Initiatives Ready for Prime Time?

    A review of 15 studies (n=1,334) of use of telemedicine and eHealth to support PD self-management found bias and low-quality evidence that made a metaanalysis impossible. While no adverse effects of eHealth interventions were reported, effectiveness was mixed. Better quality evidence is needed.

    Read the abstract » | (added 2020-05-12)

    Tags: Digital Health, EHealth, Peritoneal Dialysis, Evidence

  • Universal AVF Back-up for PD Patients Reduces HD Catheter Use

    Should an arteriovenous fistula always be placed as a PD back-up for new patients? A retrospective study of two hospitals examined this question. Hospital RAH (n=142) did universal AVF back-up at PD start. Hospital PAH (n=232) did selective AVF back-up for “high risk” patients only. Yet, the transfer-to-HD rate at RAH was about half that of RAH (23% vs. 43%)—as was the HD catheter usage rate (33% vs. 65%; p<0.001), despite a population at RAH that was more likely to be older, Caucasian, and have diabetes.

    Read the abstract » | (added 2020-05-12)

    Tags: Https://www.ncbi.nlm.nih.gov/pubmed/32358909

  • Bioimpedance-measured Fluid Overload and Short Daily HD Survival

    In 297 patients switched from thrice-weekly to 5-6 sessions per week of in-center short daily HD (SDHD), predialysis hydration was measured at initiation of SDHD and 6 and 18 months later using bioimpedance. Compared to patients whose predialysis fluid overload (FO) was <15% of extracellular volume (ECV), those whose FO was >15% of ECV had no survival difference by 6 months. However, at 18 months, those with an FO <15% had 91% survival, while those whose FO was >15% had just 72% survival (p = 0.0006), and remained significant after adjustment for demographic, clinical, and laboratory variables.

    Read the abstract » | (added 2020-05-12)

    Tags: Bioimpedance; Dialysis; Fluid Overload, Hd, Demographic

  • Physical Activity and Survival in PD

    Among 79 PD patients, fat and muscle mass, strength, and physical performance were not different between patients who were alive 2 years later and those who were not. However, the odds of death were 7.4 times higher in those whose level of physical activity was below the group’s median.

    Read the abstract » | (added 2020-05-12)

    Tags: Muscle Mass, Group’s Median, Physical Activity

  • How to Prevent and Manage COVID-19 in PD Patients

    A comprehensive set of recommendations from China suggest reinforcing hygiene education, avoiding fear, and encourage patients to stay home—deferring clinic visits or using virtual ones when possible.  When clinic or hospital visits are necessary, safety steps are described in detail.  Covid-19 positive patients must be quarantined.  Download the article

    Read the abstract » | (added 2020-05-12)

    Tags: Https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198185/pdf/main.pdf

  • PD Catheter Placement Outcomes: Urgent- vs. Elective-start

    After analyzing 13 years of data comparing urgent-start (n=29) and elective-start (n=211) PD, the only significant difference between the mostly-comparable groups was a higher incidence of catheter leaks. Complication and catheter removal rates at 3 and 12 months were similar, as were days to first complication and 12-month patient survival. Catheter placement technique did not affect the outcomes.

    Read the abstract » | (added 2020-05-12)

    Tags: Https://www.ncbi.nlm.nih.gov/pubmed/32373364

  • Outcomes Between Urgent-start PD and HD

    Urgent-start PD (n=93) and urgent-start HD (n=91) patients similar in age, diabetes and other comorbidities, and lab values, were followed for 6 months to 2 years. Rates of mechanical complications, bacteremia, and survival were comparable. Exit site/access infections were significantly higher in the PD patients, but those on PD had significantly better residual kidney function and phosphorus control, and used significantly less erythropoietin and antihypertensives

    Read the abstract » | (added 2020-04-13)

    Tags: Haemodialysis, Renal Function Recovery, Peritoneal Dialysis, Urgent Start