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)
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)
Cardiovascular Benefits of Benefits
A review considers the impact of nocturnal HD on cardiac remodeling, myocardial stunning, hypertension, heart rate variability, sleep apnea, coronary calcification, and endothelial dysfunction.
Read the abstract » | (added 2020-04-13)
Impact of Assisted PD
A retrospective look at 1,576 incident patients at one clinic between 2002 and 2017 examined the effects of offering assisted PD on the rates and cumulative incidence of PD starts. Those who used assisted PD tended to be older. Use of the program significantly increased the rate of PD initiation, but there was a fall in usage over time.
Read the abstract » | (added 2020-04-13)
Nocturnal HD in Children
There are very few studies of the impact of intensified hemodialysis regimens (days/hours) on children. This review addresses implementation challenges.
Read the abstract » | (added 2020-03-16)
Green Nephrology: Reducing the Environmental Impact of Dialysis
Climate change and extreme weather events both increase the incidence of kidney disease and destabilize care. But, healthcare in general—and dialysis in particular—contribute substantially to greenhouse gases. Monitoring resources and reducing waste in HD can be done through reuse of RO reject water, renewable energy sources, better waste management, and slower dialysate flow rates. For PD, point-of-care dialysate will reduce the environmental impact.
Read the abstract » | (added 2020-02-19)
Impact of a Nurse-led Protocol on PD Fluid Overload
Among PD patients divided into a group symptomatic of fluid overload (>2L; n=53) and a group that was not (n=50), a 12-week nurse-led education and motivation intervention—with hypertonic cycles for short-term relief of fluid overload—significantly reduced overhydration. Knowledge and adherence were both significantly improved as well.
Read the abstract » | (added 2020-01-09)
Impact of daily low-flow HD on potassium and lactate levels
In the NxStage FREEDOM study, 345 patients switched from standard in-center HD to daily, low-flow HD. Blood levels of potassium and lactate were analyzed during the last 3 months of standard HD and the first 3 months of daily HD. On daily HD, predialysis serum potassium decreased significantly at a dialysate potassium level of 1 mEq/L, with no change at 2 mEq/L. Predialysis serum bicarbonate level decreased significantly with dialysate lactate concentration of 40 mEq/L—but increased significanty at 45 mEq/L. Choosing the correct dialysate for the patient is important.
Read the abstract » | (added 2019-07-15)
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)
Impact of High Protein Diets on Residual Kidney Function in PD
Does a high-protein diet cause a faster loss of residual kidney function for PD patients? An observational study of 336 patients for at least 6 months suggests that it may.
Read the abstract » | (added 2019-01-11)