Journal Watch

  • Low vs. Very Low Site PD Catheter Placement to Prevent Migration

    A retrospective 5-year series of 76 patients whose PD catheter tips migrated had received either a traditional low-site insertion (N=39) or a very-low-site insertion (N=37). After 2 years of follow up, the very-low-site group had significantly better catheter and patient survival, with fewer catheter complications—and no tip migration.

    Read the abstract » | (added 2019-06-13)

  • Higher Serum Albumin May Protect Residual Kidney Function in PD

    In a prospective study of 104 new PD patients, having low serum albumin levels was independently associated with complete RKF loss (<100 mL/day of urine).

    Read the abstract » | (added 2019-06-13)

  • BMI and Survival on PD

    A large study from Korea (N=80,674 PD patients) found that those in the highest group for BMI: just 25.71, had significantly higher all cause mortality.

    Read the abstract » | (added 2019-06-13)

  • Frequency vs. Time in HD Survival

    Which matters more for HD--the number of treatments per week, or the length of each treatment? A retrospective registry study from the ANZDATA database looked at survival among 16,944 non-indigenous adult patients in Australia and New Zealand from 2001 to 2015. After controlling for frequency, patients with 5+ hour long treatments had significantly better survival than those whose treatments <5 hours. However, controlling for duration, increasing frequency did not boost survival.

    Read the abstract » | (added 2019-06-13)

  • Moving the PD Exit Site to Combat Infection

    A 5-year retrospective cohort analysis looked at the impact of treating PD exit site and tunnel infections in 27 patients by removing the cuff and relocating the catheter under local anesthetic. After follow up ranging from 10.8 to 79.4 months, no leaks occurred, and the infections resolved in 74% of the patients. The rest had to have their catheters removed.

    Read the abstract » | (added 2019-06-13)

  • NxStage HD and Removal of Beta-2 Microglobulin

    Which works best to remove B2M, High-flux standard HD, post-dilution hemodiafiltration (HDF), NxStage short daily HD, or automated PD? In a small study (N=43), HDF and NxStage HD done 6 days per week removed the most B2M. Standard HD was next, with automated PD removing the least.

    Read the abstract » | (added 2019-05-15)

  • KDIGO Controversies: Dialysis Start and Modality Choice

    A January 2018 Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference addressed significant variations between countries in dialysis start, patient preparation, and modality mix. Happily, attendees supported individualized care that incorporates patient goals and preferences (within quality and safety parameters), and the need to avoid a one-size-fits-all approach.

    Read the abstract » | (added 2019-05-15)

  • To Reinsert a PD Catheter or Not to Reinsert: That is the Question

    Among 470 PD patients in Singapore, 92 required PD catheter removal. Of these, 39% had a second PD catheter placed, while the rest switched to HD. Patients who could not continue PD were excluded from the analysis. Survival was about the same in both groups. Surprisingly, those who required catheter removal due to infection were more likely to be able to continue PD than those who required it due to catheter malfunction.

    Read the abstract » | (added 2019-05-15)

  • A Swan Song for Kt/V (It’s About Time!)

    A new review of the flaws of Kt/V—including a lack of proof of concept—“leaves little room for any conclusion other than that Kt/V, as an indicator of dialysis adequacy, is obsolete.” [Editor’s Note: Now, if the authors would take on the concept of “adequate” vs. optimal therapy…]

    Read the abstract » | (added 2019-05-15)

  • PD Fluid Overload Linked with Peritonitis from Gut Pathogens

    PD patients with extra fluid in their bodies are at a significantly higher risk for peritonitis due to gut bacteria, finds a study of 138 patients. Patients in the highest third for intra-and extracellular water were at the highest risk.

    Read the abstract » | (added 2019-05-15)