Journal Watch

  • Complications in Planned vs. Unplanned Peritoneal Dialysis Starts

    A metaanalysis of 14 papers totalling 2,401 PD patients looked at the outcomes and safety of unplanned PD starts within 7 days of catheter placement vs. 7-14 days. Early-start PD was linked with more leaks, omental wrap, and—for CAPD—catheter malposition. There were no significant differences in infectious complications, but the risk of transition to HD and mortality were higher. More studies are needed.

    Read the abstract » | (added 2020-11-12)

    Tags: End Stage Kidney Disease, Peritoneal Dialysis, PD

  • Which Form of PD Has a Higher Risk of Peritonitis?

    If you guessed CAPD because there are more exchanges to perform, you are correct, finds a study that matched 106 APD to 106 CAPD patients and followed them for 3 years. During the study period, there were 64 cases of peritonitis, and the risk was 30% higher among those who did CAPD.

    Read the abstract » | (added 2020-11-12)

    Tags: PD, Peritoneal Dialysis, CAPD

  • PD vs. HD for Quality of Life

    Eleven studies from 2000 to 2019 (N=3,711) comparing PD with in-center HD (ICHD), PD vs. home HD, ICHD vs. self-care ICHD, ICHD vs. home HD, and various home HD modalities with each other were analyzed to determine the impact of modality on quality of life. PD was favored in some domains, while ICHD was favored in others. Home HD was rated significantly higher than ICHD for some domains.

    Read the abstract » | (added 2020-11-12)

    Tags: Dialysis, Dialysis Choice, PD, HD

  • Warming PD Fluid to Body Temperature Does Not Improve Clearance

    There may not be a clear benefit to warming PD fluid to body temperature, suggests a small (N=18) single blind randomized controlled trial. Participants were assigned to have a peritoneal equilibrium test with fluid at 37°C or warmed with conventional methods. The two groups had similar outcomes for peritoneal clearance, abdominal discomfort, body temperature, blood pressure, and other parameters.

    Read the abstract » | (added 2020-11-12)

    Tags: Peritoneal Clearance, Peritoneal Dialysis, PD

  • Pilot: Chlorhexidine-impregnated Sponge Dressings to Prevent Exit Site Infections

    In a single-center study, 50 incident PD patients were taught to use a weekly chlorhexidine dressing on their exit sites, and followed for a year. While 12% developed contact dermatitis, 73% found the dressings acceptable. Episodes per patient year of exit-site/tunnel infections and peritonitis were 0.09 and 0.07, respectively, while 1-year technique and patient survival rates were 86% and 96%, respectively.

    Read the abstract » | (added 2020-10-12)

    Tags: Chlorhexidine Dressing, Exit site Infection, Peritoneal Dialysis

  • Physical Activity May Reduce Bone Density in PD

    In a paradoxical finding, 13 women and 21 men on PD who were sedentary had higher BMD than those who were moderately or vigorously physically active. Other aspects of body composition and biochemistry, such as creatinine clearance and triglyceride levels were linked with higher levels of physical activity.

    Read the abstract » | (added 2020-10-12)

    Tags: Body Composition, Bone Density, Muscle Strength

  • 24-hour Dietary Recall Less Accurate for Protein Intake Assessment in PD

    Among 50 PD patients, use of protein nitrogen appearance (PNA) revealed levels of protein that ranged from 48.27-67.74 grams per day; median 55.75—while 24-hour dietary estimated the levels at 45.28-87.40; median 61.43 g/day. The authors suggest that proportionality bias may have influenced the results.

    Read the abstract » | (added 2020-10-12)

    Tags: Dialysis Initiation, Dialysate, Peritoneal Dialysis, PD

  • Survival Benefit of More HD Hours is Not Sustained After a Switch Back to Standard

    In the ACTIVE Dialysis trial, 200 standard HD patients were randomized to receive usual care (median of 12 hours of HD/week) or extended hours (median of 24 hours of HD/week) for 12 months, with follow up through 60 months. After the 12 months, intervention group participants were switched back to usual care. At 5 years, there was no difference between the groups in all-cause mortality.

    Read the abstract » | (added 2020-10-12)

    Tags: Dialysis, End stage Kidney Disease

  • Impact of Depression on PD Patient and Technique Survival

    Among 275 patients who had done CAPD for at least 3 months, 31.3% tested as having depressive symptoms. Long-term patient and technique survival were significantly poorer in this group, even adjusting for cofounders.

    Read the abstract » | (added 2020-09-11)

    Tags: Depressive Symptoms, Mortality, Peritoneal Dialysis

  • Benefits of PD Remote Monitoring

    A retrospective study compared two groups of APD patients, one that received remote monitoring (n=38) and one that received routine care (n=35). PD dropout and fluid status were similar between the two groups. But, the remote monitoring group had fewer ER and hospital visits related to kidney disease, especially among those with more comorbidities. Patients also preferred remote monitoring, and were more satisified with their care.

    Read the abstract » | (added 2020-09-11)

    Tags: Clinical Outcomes, Quality Of Life, Remote Monitoring, Telemedicine