Journal Watch - Australia
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 06/13/2019)
Daily HD Practices in France and Australia/New Zealand
Registry data from both regions compared all incident patients who dialyzed 5-6 sessions per week—both daytime and nocturnal—with one-to-one matching of French to Australia/New Zealand patients based on age, sex, and dialysis start year. While survival and transplant access were comparable, other intriguing differences appeared.
Read the abstract » | (added 05/15/2019)
PD Technique Survival by Equipment Manufacturer
An Australia/New Zealand study of all 16,575 new PD patients between 1995 and 2014 compared PD cyclers made by Baxter, Fresenius, or Gambro. Gambro users had the fewest days to technique failure among the 72% who had it, followed by Fresenius, and then Baxter.
Read the abstract » | (added 01/11/2019)
Regional Variation in PD Infection Prevention
A PDOPPS analysis of surveys from medical directors caring for more than 11,000 patients from 170 clinics in seven countries (Australia, New Zealand, Canada, Thailand, Japan, the UK, and the US) found variation from 63% to 100% in use of antibiotic prophylaxis for PD exit sites, with mupirocin used most often.
Read the abstract » | (added 08/13/2018)
When to start PD after catheter placement
A new randomized controlled trial included 122 new PD starts at two Queensland, Australia hospitals for 5 years. Participants were randomized to three groups, who started PD at either 1 week, 2 weeks, or 4 weeks after PD catheter placement. Leaks were higher in the 1-week group, while PD technique failure was higher in the 4-week group.
Read the abstract » | (added 05/09/2017)
PD Patient Education in Australia
Clinical PD outcomes in Australia were as much as 10-fold different from one site to another. An effort to standardize PD teaching has begun to improve PD outcomes. Of the 54 PD clinics, 70% completed an online survey about their PD teaching practices—which varied widely in the number of hours and presence of competency assessments.
Read the abstract » | (added 01/09/2017)
Patient Peritonitis Perspectives
Australian researchers conducted interviews with 29 current or past PD patients to gain insights into the prevention of peritonitis. The four themes identified were the constant need for vigilance, invading harm from infection, incapacitating lifestyle interference, and exasperation with hospitalizations. The authors concluded that education about peritonitis and lifestyle impacts of PD may be helpful.
Read the abstract » | (added 10/13/2016)
What Predicts Transfer to Home HD After PD Failure?
In Australia and New Zealand, an analysis of all 10,710 patients treated with PD between 2000 and 2012 found that 2,915 transferred to HD—but just 156 started home HD. Among those who switched to home HD, more were male, obese, and had done PD longer. Older patients, those who stopped PD due to infection, who were underweight, whose ESRD was due to hypertension or diabetes, and those who were Aboriginal were less likely to go home.
Read the abstract » | (added 11/11/2015)
Outcomes of “integrated home dialysis” (PD then home HD)
What happens to people after PD fails—and why not plan to get them home on HD? Researchers in Australia and New Zealand looked at this model using ANZDATA registry data. Those treated with PD only (n=168) had the highest risk of technique failure and death, while those who did only home HD or who transitioned from PD to home HD fared much better.
Read the abstract » | (added 07/08/2015)
Tags: Home Dialysis
ACTIVE trial of extended dialysis described
A Clinical Trial of IntensiVE (ACTIVE) Dialysis is a randomized trial of extended (24+ hours) or standard (12-18 hours) of weekly HD for 12 months, looking at quality of life, left ventricular mass, and safety. The study has 200 participants from Australia, China, Canada, and New Zealand, meeting the planned recruitment target. The trial is registered at clinicaltrials.gov (NCT00649298).
Read the abstract » | (added 04/10/2015)