Journal Watch
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
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
Assisted PD in Europe
Not every PD patient can perform solo treatments—or has a care partner to help. Some European countries are offering assisted PD in the home, often temporarily, using a variety of PD prescriptions and care provided by private care agencies or nursing home staff. Tailoring the prescription to residual kidney function reduces PD burden and aids technique survival.
Read the abstract » | (added 2023-11-15)
Tags: Assisted PD
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
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)
Hope, Quality of Life, and Psychoscial Distress in PD
Are people on PD hopeful? A study from China surveyed 134 people on PD, assessing their level of hope. Working patients with higher income using APD had higher hope scores, and hope correlated significantly with both age and social support. Higher hope scores were linked with better mental well-being and less severe depression.
Read the abstract » | (added 2023-11-15)
Tags: Hope, Quality Of Life, Psychoscial Distress In PD, Income, APD, Depression
Longer Survival with Extended Home HD
A study in Turkey compared 348 patients doing extended home HD (418 minutes) matched with 1,047 doing standard in-center HD (242 minutes) and followed both groups for about 55 months. The extended home HD patients had an all-cause mortality rate of 3.76 per 100 patient years—vs. 6.27 for the in-center HD patients; a significant 40% reduction.
Read the abstract » | (added 2023-10-13)
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
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
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