The Impact of Patient Empowerment on PD Self-management
A controlled trial investigated use of a problem-based learning (PBL) model to empower people on PD to self-manage. Among 94 participants, 47 patients were randomized to PBL learning, while the control group got usual care. PBL participants were divided into five study groups that each had six lessons. After 9-11.5 months, the PBL group had significantly more basic PD knowledge, higher self-management scores, better quality of life, increased satisfaction, and less depression and anxiety.
Read the abstract » | (added 2023-04-19)
Extended HD and Nutrition
An attempt to do a metaanalysis of the literature on the impact of daily and nocturnal HD (15+ hours per week) on nutritional status failed due to lack of sufficient high quality papers. In five studies of nocturnal and/or daily HD—three in-center and two at home—lean body mass improved significantly and one study found deficiency in water-soluble vitamins.
Read the abstract » | (added 2022-11-16)
Impact of a 1-hour Discussion on Choice of a Home Dialysis Option
Of 620 incident dialysis patients in Japan from 2013 to 2021, 128 received a 1-hour discussion of treatment options. The discussion group had a tendency for fewer urgent hospitalizations—and had a significantly higher chance of choosing PD (30.7% vs. 9.4%).
Read the abstract » | (added 2022-11-16)
Impact of Telemedicine on PD Technique Survival
Can telemedicine (TM) help people stay on PD longer? A prospective study conducted in 27 hospitals in China since 2016 enrolled 7,539 patients. Compared to matched patients in the non-TM group (60.9%), those in the TM group (39.1%) had significantly lower risks of severe fluid overload, inadequate solute clearance, non-infectious catheter complications, transfer to HD, and death.
Read the abstract » | (added 2022-09-13)
Healthcare System Factors in Home Modality Choice
A Midwest interview study was conducted with 40 people, half doing standard in-center HD. Access to and engagement in healthcare prior to nephrology care and after dialysis start had an impact on patients’ awareness of their CKD, its progression, and dialysis options—and most had been passive during decision-making. Level of fatigue, treatment schedule, and access problems affected satisfaction.
Read the abstract » | (added 2022-08-11)
Surprise Supplement Reduced Risk of Peritonitis on PD
Does correction of hypokalemia with potassium supplementation impact peritonitis rates? Yes, finds a new randomized controlled trial of 167 PD patients with hypokalemia from six clinics. Compared to conventional potassium management, use of a protocol aimed at maintaining potassium levels at 4-5mEq/L significantly extended time to first peritonitis.
Read the abstract » | (added 2022-06-10)
The Impact of Vitamin D Levels on Quality of Life in PD
Fifty people on PD were divided into a normal vitamin D (>20 ng/mL) and a deficient vitamin D group (<20 ng/mL), and both groups took the KDQOL-36 quality of life questionnaire. All subscales of the KDQOL-36 were significantly lower in the vitamin D deficient group.
Read the abstract » | (added 2022-04-18)
COVID Anxiety Less of a Problem for Home Dialyzors
A single center survey of 98 home HD and 43 PD patients in Toronto found high rates of satisfaction with dialysis, little depression or anxiety or fears of caregiver burden, and few signs of burden. There was “no indication of a negative psychosocial impact from the pandemic, despite the increased social isolation,” reported the authors.
Read the abstract » | (added 2022-02-14)
New Clinical Practice Guidelines for Exercise on PD
The International Society for Peritoneal Dialysis and the Global Renal Exercise Network have teamed up to grade and review the literature and clinical experience to help people on PD stay physically active safely. With sparse quality evidence available, the new guidelines are largely opinion based, and cover timing of exercise relative to PD (i.e., empty or full); impact of exercise on mental health, weight, frailty, etc.; exercise nutrition, and potential adverse PD outcomes.
Read the abstract » | (added 2021-11-12)
PD and home HD patients less stressed by COVID-19
Does the social isolation of PD or home HD contribute to a negative psychosical impact from COVID? Apparently not. Forty patients (85% on home HD) responded to a COVID impact survey sent to 98 home HD and 43 PD patients in Toronto. About 80% rated their dialysis satisfaction at 8/10 or higher, had infrequent anxiety or depression, felt dialysis had minimal impact on their lives, and were almost always happy with their family interactions. Just 9% were often worried about caregiver burden. The authors suggest that home is “the optimal form of dialysis.”
Read the abstract » | (added 2021-10-13)