Journal Watch

  • Platelet-to-Albumin Ratio Predicts PD Technique Success and Survival

    Dividing patients’ absolute platelet counts by their serum albumin levels creates a protein-to-albumin ratio (PAR) that predicts PD outcomes, finds a new study of 405 people over a median of 2 years. Patients with lower PAR levels had higher rates of PD success and better survival.

    Read the abstract » | (added 2021-12-16)

    Tags: Platelet to albumin Ratio, Technique Failure, Mortality, Peritoneal Dialysis

  • Simplified Half Percutaneous PD Catheter Placement Technique

    Use of a simple modified metal trocar was safe and effective in a series of 280 consecutive PD patients followed for 3 years. Taking an average of less than 30 minutes, the new technique was technically successful 99.3% of the time initially, with mechanical complications occurring in 10% during the follow-up period; most commonly catheter malfunction, and 32 episodes of peritonitis (10.4%). By the end of the study, 83.9% lived and still had their initial catheters.

    Read the abstract » | (added 2021-12-16)

    Tags: PD, Peritoneal Dialysis, Catheter, Half percutaneous Technique

  • Home HD Core Curriculum 2021

    AJKD has released a new edition of this manual, which covers benefits, pitfalls and challenges of starting and growing a home HD program, home HD equipment, prescriptions, and medical management.

    Read the abstract » | (added 2021-12-16)

    Tags: Home Hemodialysis, HHD, Home HD Program, Patient Choice

  • Clinically-focused Shared Decision-making Does NOT Improve Home Dialysis Uptake

    A qualitative interview study with 95 people in Wales found that generic, clinically-focused shared decision-making was not able to overcome denial, lack of symptoms, and health systems issues to increase use of home dialysis. Unmet and unrecognized family needs and untranslated medical knowledge were additional challenges. The “simplest” option seemed to be standard hemodialysis.

    Read the abstract » | (added 2021-12-16)

    Tags: Clinically focused Shared Decision making, Home Dialysis Uptake, Pre dialysis

  • Standard vs. Incremental PD Start: 12-year Retrospective Study

    When people start PD with some residual function, is it beneficial not to begin with a full PD prescription? A study looked back at 12 years of people who started PD, 232 standard and 71 intermittent (iPD; 2-3 manual exchanges per day). Those who did iPD had higher residual kidney function than those on standard PD. For people with diabetes, iPD was linked with a survival advantage as well.

    Read the abstract » | (added 2021-12-16)

    Tags: PD, Residual Function, Intermittent PD, IPD, Diabetes

  • Oral Hygiene and Nutritional Status on PD

    Clean teeth mattered for nutritional status and hand grip strength in a small study (n=41) of people on PD. Inflamed gums can cause tooth loss and limit what people can eat. Those with dirty to very dirty teeth had poorer nutrition than those with clean or slightly dirty teeth, and their hand grips were weaker. Those with dirty teeth also had more GI symptoms and a higher risk of malnutrition.

    Read the abstract » | (added 2021-12-16)

    Tags: PD, Tooth Loss, Malnutrition, Gingivitis, Periodontitis

  • Minority of UK Dialyzors Would Choose Standard HD Schedule

    Given the choice of 12 different scheduling options, just 38% of 183 people doing standard in-center HD would always choose to keep doing what they were doing. Of the remainder, after being informed of the survival and quality of life benefits of more dialysis, 27.1% would choose longer treatments thrice weekly, and 34.4% would choose four 4-hour treatments per week.

    Read the abstract » | (added 2021-11-12)

    Tags: In center HD, More Frequent Hemodialysis, Longer Treatments

  • Italians Improve on Daily Home HD

    As in the U.S., the Italian Ministry of Health has home dialysis as a primary objective. In a 2-year study of seven people switched to six times per week daily home HD, significant improvements began to appear almost immediately. After 3-6 months, bone mineral balance and blood pressure were better, PTH levels and use of phosphate binders dropped, and the participants needed less rhEPO.

    Read the abstract » | (added 2021-11-12)

    Tags: Home Dialysis, Daily Home HD, RhEPO, Mineral Balance, Blood Pressure, PTH Levels

  • Local Anesthetic for PD Catheter Placement

    A study of 27 people tested the feasibility of using mepivacaine 1% (which lasts longer than lidocaine) plus sedation with Remifentanil for PD catheter placement. None of the 27 needed to convert to general anesthesia, and all of the catheters worked with no leakage.

    Read the abstract » | (added 2021-11-12)

    Tags: PD Catheter, Mepivacaine, Remifentanil

  • Some Antihypertensive Meds Reduce GI Bleeds in PD

    GI bleeding is more likely in people with CKD. A study of 734 people on PD were followed to see if use of an ACE-inhitor or angiotensin receptor blocker (ARB) would reduce the incidence. After an 8-year follow-up, those who were taking these meds had a significantly lower rate of GI bleeding.

    Read the abstract » | (added 2021-11-12)

    Tags: GI Bleeding, CKD, PD, ACE inhitor, Angiotensin Receptor Blocker